A quick update. I rode the bike for about 8 minutes last night and another 15 tonite. Getting on the bike proved to be much harder than actually riding it. I had to sort of mount it from behind so as not to put any weight on my right foot and I couldn't lift my leg too high or I would get that horrid stabbing groin pain compliments of the labrum in its newly anchored state. Because I've never had any kind of orthopedic surgery before I wouldn't know this but I can't believe how weak I felt afterwards and how hard it is just to pedal on no resistance for 15 minutes. I mean I know they tell you your muscles are going to be weak but I just couldn't really conceive how weak. I practically had to fall back on the couch with my ice pack afterwards. Its particularly strange when I look at the two tiny incision sites where they stuck the probes and camera in and I can't believe how sore I am. I know "gimp" isn't the most politically correct term but laying in a a machine for 6 hours a day and showering on one leg kind of diminishes my aspirations for political correctness.
In related news, I have been to PT two days in a row and Bob was very pleased with my ROM (range of motion) and told me I was much better off than others a week out of surgery. I can already tell this journey is going to be about finding small victories in every day experiences. Since I won't actually be able to exercise for fitness (as opposed to rehab) for probably close to another month, and even then its going to be very limited, being diligent about The Protocol will be the best possible means for preserving some semblance of sanity.
Tuesday, January 27, 2009
Monday, January 26, 2009
Post -Op Day 4
Surgery was on Thursday, January 22, 2009. I have been too hopped up on painkillers and too sleepy to make a very worthy blog entry since arriving home from the hospital on Thursday evening. Now that I'm slowly kicking the painkillers, I noticed that I have some time to kill to put it mildly.
The days leading up to surgery were stressful and way busier than I had hoped but I really don't know who I was kidding thinking otherwise. We had a house to re-arrange, groceries to buy, clothes to wash, cars to clean, etc. on top of trying to get ready to be out of the office for 3 weeks. It reminded me of the days before the bar exam in 2003 -- I had hoped to be all zen and calm and relaxed but instead I was up till the wee hours the night before getting things ready and racing around the house making my hip sore (I got 2 hours of sleep the night before the CO bar exam and still passed...I got a little more than that for this surgery but I'm not sure it made much of a difference in terms of results). The morning of surgery the girl from the ortho equipment company came to show me how to use the ice and CPM machines...the dogs were barking and chasing eachother around the house, Brian was upstairs vaccuming and I was still dripping from the shower...it was the usual pandemonium. Not suprisingly, I didn't really remember what I was supposed to do with the machines when I got home 12 hours later in a narcotic haze.
Surgery was scheduled for 12pm but they were running behind so it was really a little before 1 when they finally wheeled me into the OR. Brian was a trooper and hung out with me in the pre- surgery room for more than two hours. Surgery prep involved all the usual things -- blood pressure, lots of questions about what allergies and medications, an IV, etc. and then they also rinsed my hip with iodine and stuffed me into some compression stockings to help prevent blod clots. I felt like some kind of creepy hospital clown with white thigh-high leggings, a faux-bronzed ass and a blue shower cap on my head. Dr. Seng came in twice and chatted with us and went over the procedure again. He told us the labral repair and osteoplasty were the easy parts -- it was making a determination about the cartilage damage that would be tougher. If it was "all cobblestone-y" he would probably have to debride some of it because it wouldn't be worth salvaging. Unfortunately, as we found out later, there was some of that cobblestone shit in there. I told him I was lucky to have gotten out once last week on tele skis and he said not to worry it probably wouldn't be that great of a season anyhow. Right.
The anesthesiologist came in about 10 minutes before surgery and explained that I had two options -- a spinal or general. Given the length of the procedure and the fact that a spinal can be a longer recovery in terms of getting cleared to leave the hospital, I opted of course for general. I peppered him with my nerdy questions about whether he uses a brain monitor to make sure his patients don't wake up and he shut me up with a lot of smart statistics about how the brain monitors aren't very reliable anyhow. He said he had never had a patient wake up in 15 years. That sounded like a pretty reliable statistic to me. I listened to my meditation CD as they rolled me into the OR and even though the anesthesiologist said I wouldn't remember the time in the OR beforehand I actually remember virtually all of it. It was freezing and really loud in there -- they were playing some really bad music like Dave Matthews or something and they moved me on a couple of different beds while they got the machines started. Dr. Seng was there wearing his surgical cap and gumb boots on his feet of all things. A nurse said she was just giving me some oxygen when she dangled the gas in front of my face but I had heard that line before....and the next thing I knew I was waking up in the recovery room nearly 3 hours later. I was in recovery for a good hour or so before they wheeled me out to Brian and my Dad and Sam. I was pretty out of it but I knew when Brian didn't immediatley say anything that they must have found some pretty bad damage in the joint. He said the surgery had gone well but that Seng had confirmed that there was a fair amount of damage. I felt pretty bummed about that and couldn't think of much else for the rest of the day but I knew going into it that there was a pretty strong chance of that happenning. I never got a chance to talk to Dr. Seng because he left for the weekend while I was still out of it so I will have to wait until this week to hear the rest of the war story. Maybe in some ways that's good because I'm fairly sure that these painkillers are making me emotional too and I don't know how much more mediocre news I can take at the moment.
I've been recovering ok over the last four days and am trying to spend the recommended 4-6 hours per day in this passive motion machine (CPM) as directed. I was so sleepy the first few days that Brian would just stick me in it and I'd pass out with my leg slowly raising and lowering 5 times per minute. Sitting on the toilet turned out to be the worst of all the basic tasks that I had to try and accomplish in my gimp state. Needless to say, I think Brian and I crossed some relationship boundaries much earlier than we had anticipated...maybe as much as 30 years early! My Dad has been super helpful - taking our dogs for walks, running errands and cleaning the house so that Brian can spend the day at work and not worrying about me fumbling around the house on crutches. Our friends have been great and have brought us food so that we don't have to spend alot of time digging around for dinner, though I have to say I haven't had much of an appetite especially considering that my stomach has felt like cement since I got home from the hospital. Nothing like being sent home with a bottle of stool softeners to make you look forward to the pile of pills you'll be ingesting over the course of the week.
The hip is still pretty painful -- if I twist the wrong way or lean down too far I feel that familiar stab of pain in my groin or buttocks. When I finally took off the bandage today I was shocked by how small the incision sites actually were considering how many tools they crammed in there during the 3 hour surgery. Oh, and the 4 pages of pictures (arthro-porn) that he sent me home with are pretty unbelievable too. This is coming from someone who can barely thread a needle so the idea that someone else was able to stitch up a piece of flapping cartilage in the deepest joint in the body using a hole smaller than my pinky nail sort of blows you away.
Tonite, I'm supposed to get on the bike and start pedaling with no resistance just to work on ROM and keep the scar tissue from building up. Crutches to a stationary bike is sort of a funny prospect but we'll see how it goes.
The days leading up to surgery were stressful and way busier than I had hoped but I really don't know who I was kidding thinking otherwise. We had a house to re-arrange, groceries to buy, clothes to wash, cars to clean, etc. on top of trying to get ready to be out of the office for 3 weeks. It reminded me of the days before the bar exam in 2003 -- I had hoped to be all zen and calm and relaxed but instead I was up till the wee hours the night before getting things ready and racing around the house making my hip sore (I got 2 hours of sleep the night before the CO bar exam and still passed...I got a little more than that for this surgery but I'm not sure it made much of a difference in terms of results). The morning of surgery the girl from the ortho equipment company came to show me how to use the ice and CPM machines...the dogs were barking and chasing eachother around the house, Brian was upstairs vaccuming and I was still dripping from the shower...it was the usual pandemonium. Not suprisingly, I didn't really remember what I was supposed to do with the machines when I got home 12 hours later in a narcotic haze.
Surgery was scheduled for 12pm but they were running behind so it was really a little before 1 when they finally wheeled me into the OR. Brian was a trooper and hung out with me in the pre- surgery room for more than two hours. Surgery prep involved all the usual things -- blood pressure, lots of questions about what allergies and medications, an IV, etc. and then they also rinsed my hip with iodine and stuffed me into some compression stockings to help prevent blod clots. I felt like some kind of creepy hospital clown with white thigh-high leggings, a faux-bronzed ass and a blue shower cap on my head. Dr. Seng came in twice and chatted with us and went over the procedure again. He told us the labral repair and osteoplasty were the easy parts -- it was making a determination about the cartilage damage that would be tougher. If it was "all cobblestone-y" he would probably have to debride some of it because it wouldn't be worth salvaging. Unfortunately, as we found out later, there was some of that cobblestone shit in there. I told him I was lucky to have gotten out once last week on tele skis and he said not to worry it probably wouldn't be that great of a season anyhow. Right.
The anesthesiologist came in about 10 minutes before surgery and explained that I had two options -- a spinal or general. Given the length of the procedure and the fact that a spinal can be a longer recovery in terms of getting cleared to leave the hospital, I opted of course for general. I peppered him with my nerdy questions about whether he uses a brain monitor to make sure his patients don't wake up and he shut me up with a lot of smart statistics about how the brain monitors aren't very reliable anyhow. He said he had never had a patient wake up in 15 years. That sounded like a pretty reliable statistic to me. I listened to my meditation CD as they rolled me into the OR and even though the anesthesiologist said I wouldn't remember the time in the OR beforehand I actually remember virtually all of it. It was freezing and really loud in there -- they were playing some really bad music like Dave Matthews or something and they moved me on a couple of different beds while they got the machines started. Dr. Seng was there wearing his surgical cap and gumb boots on his feet of all things. A nurse said she was just giving me some oxygen when she dangled the gas in front of my face but I had heard that line before....and the next thing I knew I was waking up in the recovery room nearly 3 hours later. I was in recovery for a good hour or so before they wheeled me out to Brian and my Dad and Sam. I was pretty out of it but I knew when Brian didn't immediatley say anything that they must have found some pretty bad damage in the joint. He said the surgery had gone well but that Seng had confirmed that there was a fair amount of damage. I felt pretty bummed about that and couldn't think of much else for the rest of the day but I knew going into it that there was a pretty strong chance of that happenning. I never got a chance to talk to Dr. Seng because he left for the weekend while I was still out of it so I will have to wait until this week to hear the rest of the war story. Maybe in some ways that's good because I'm fairly sure that these painkillers are making me emotional too and I don't know how much more mediocre news I can take at the moment.
I've been recovering ok over the last four days and am trying to spend the recommended 4-6 hours per day in this passive motion machine (CPM) as directed. I was so sleepy the first few days that Brian would just stick me in it and I'd pass out with my leg slowly raising and lowering 5 times per minute. Sitting on the toilet turned out to be the worst of all the basic tasks that I had to try and accomplish in my gimp state. Needless to say, I think Brian and I crossed some relationship boundaries much earlier than we had anticipated...maybe as much as 30 years early! My Dad has been super helpful - taking our dogs for walks, running errands and cleaning the house so that Brian can spend the day at work and not worrying about me fumbling around the house on crutches. Our friends have been great and have brought us food so that we don't have to spend alot of time digging around for dinner, though I have to say I haven't had much of an appetite especially considering that my stomach has felt like cement since I got home from the hospital. Nothing like being sent home with a bottle of stool softeners to make you look forward to the pile of pills you'll be ingesting over the course of the week.
The hip is still pretty painful -- if I twist the wrong way or lean down too far I feel that familiar stab of pain in my groin or buttocks. When I finally took off the bandage today I was shocked by how small the incision sites actually were considering how many tools they crammed in there during the 3 hour surgery. Oh, and the 4 pages of pictures (arthro-porn) that he sent me home with are pretty unbelievable too. This is coming from someone who can barely thread a needle so the idea that someone else was able to stitch up a piece of flapping cartilage in the deepest joint in the body using a hole smaller than my pinky nail sort of blows you away.
Tonite, I'm supposed to get on the bike and start pedaling with no resistance just to work on ROM and keep the scar tissue from building up. Crutches to a stationary bike is sort of a funny prospect but we'll see how it goes.
Sunday, January 4, 2009
The Countdown
Now that my surgery date is less than three weeks away, I've realized that I actually feel good about my hip for the first time in about eight months. Not that it doesn't hurt every day, not that I don't think about it hurting every day but knowing that I'm moving forward instead of stuck in this awful purgatory of not having a diagnosis has meant the proverbial cloud has lifted for a while. I've got a plan of action and although it doesn't mean there won't be problems down the road, at least there is a plan. I don't have to feel desperate searching for yet another opinion from a skeptical orthopedic surgeon or an over-confident chiropractor. Its going to get alot worse before it gets even remotely better but at least I know I'm on the right track. Six months, or eight months, or even a year isn't all that much time in the grand scheme of things when you have a path forward. When you don't, its interminable.
Oddly enough, I've found that I can skate ski and nordic ski without too much pain. I was actually able to go for close to two hours today at Eldora skating up and down little hills on my rented skinny skis. It doesn't make alot of sense unless you have some understanding of how a labral tear manifests itself. Since it isn't a pulled muscle or ligament sprain, its mostly about finding those activities which don't produce that catching pain of the labrum flapping over the bump on the femur (unpleasant thought, I know). Kicking my leg forward on an uphill slope with a heavy ski boot and tele ski attached is pretty brutal but kicking and gliding in a skate motion somehow stays in the right plane of movement. Just getting to be outside in the sunshine under a bluebird sky was so refreshing after the tedium of the last eight months droning back and forth in the pool or on the trainer bike. If I'm a little sore tomorrow - or even alot -- it was worth it as I actually felt good out there this afternoon.
That's another thing about having a plan. I'm not so worried when my hip is stiff and achy the next day because I know I'm not really making anything worse as far as the tear goes -- its just a question of my own pain tolerance and what I can put up with for three more weeks. Its not going to get better on its own so I don't have to feel guilty and depressed every time I wake up with a crappy hip after doing too much the day before. Three more weeks. I can handle three more weeks. That means only about 15,000 more yards in the pool and maybe another 4 or 5 hours on the bike. My PT is adamant that I continue to exercise my hip and stay in shape both mentally and physically as it will make my recovery go that much smoother and faster. My health insurance finally gave in and coughed up the dough for the $400 per box of super-potent anti-inflammatory patches I paste onto my groin every 12 hours (they're super sexy too). And thankfully, I've got four more weekend days in which to get outside and take in the beauty of winter in Colorado before its four walls, my laptop and a bunch of painkillers for the rest of ski season.
Oddly enough, I've found that I can skate ski and nordic ski without too much pain. I was actually able to go for close to two hours today at Eldora skating up and down little hills on my rented skinny skis. It doesn't make alot of sense unless you have some understanding of how a labral tear manifests itself. Since it isn't a pulled muscle or ligament sprain, its mostly about finding those activities which don't produce that catching pain of the labrum flapping over the bump on the femur (unpleasant thought, I know). Kicking my leg forward on an uphill slope with a heavy ski boot and tele ski attached is pretty brutal but kicking and gliding in a skate motion somehow stays in the right plane of movement. Just getting to be outside in the sunshine under a bluebird sky was so refreshing after the tedium of the last eight months droning back and forth in the pool or on the trainer bike. If I'm a little sore tomorrow - or even alot -- it was worth it as I actually felt good out there this afternoon.
That's another thing about having a plan. I'm not so worried when my hip is stiff and achy the next day because I know I'm not really making anything worse as far as the tear goes -- its just a question of my own pain tolerance and what I can put up with for three more weeks. Its not going to get better on its own so I don't have to feel guilty and depressed every time I wake up with a crappy hip after doing too much the day before. Three more weeks. I can handle three more weeks. That means only about 15,000 more yards in the pool and maybe another 4 or 5 hours on the bike. My PT is adamant that I continue to exercise my hip and stay in shape both mentally and physically as it will make my recovery go that much smoother and faster. My health insurance finally gave in and coughed up the dough for the $400 per box of super-potent anti-inflammatory patches I paste onto my groin every 12 hours (they're super sexy too). And thankfully, I've got four more weekend days in which to get outside and take in the beauty of winter in Colorado before its four walls, my laptop and a bunch of painkillers for the rest of ski season.
Thursday, January 1, 2009
On Running
I've been a fairly dedicated runner since I was about 18. I got hooked back in 1995 when I was living in Boulder for the summer after my sophmore year in college. Thousands of miles and a few hunder pairs of ninety-dollar running shoes later, I still love my hour-long jaunts through the trails behind my house and, like many, I've come to depend on running for mental clarity, stress relief, mood regulation and a little bit of self-inflicted solitude. Perhaps most importantly, trail running has also provided me with that ever-essential connection to the natural world which is so lacking in most of our daily lives of endless email, 8 hour-a-day desk jobs, cell phones and all the other things that inhibit meaningful communication with other humans and our environment. I've never really cared about distance or times or mileage or any other means of measuring myself against others. I just like getting outside, seeing different places and watching the seasons change around my favorite loops through aspen meadows in the Colorado high country and the pinon and juniper forests nearer to my home.
I've run in some pretty wild places -- switchbacking up steep passes above treeline in the San Juans during the summer solstice, sub-zero mornings along the dirt roads of rural Vermont biting back tears and frozen fingers from the cold, the foggy beaches of central Chile, the coastal trail in Anchorage on a sunny summer evening with the alder trees sparkling against the bay, the Atacama desert with the snow-capped Andes at the horizon, hazy afternoons aside the Mississippi River in New Orleans dodging skinny stray dogs and broken glass, perfectly quiet mornings after a new snow along the Mesa Trail in Boulder. I've run in probably 20 other countries -- many where people just looked at me like they couldn't figure out what I was running from. I've run in Central Park, in the French Quarter, downtown Auckland and through the dense pine forest parks of Portland, Oregon. I've seen little moments of life in other places and right around the corner that I might never have experienced - the families of quiltros, or stray dogs, roaming the pre-dawn streets of Valparaiso, Chile looking for scraps in abandoned alleys, the smell of fresh bread rising in ovens along the cobblestone streets of Sienna, Italy, a small black bear startled by our approach one June morning a few years ago, the mist rising off Avalanche Creek near Carbondale in early fall, a family of foxes looking at me with wide eyes as they step gingerly across the street and hurry off to the safety of the tall grasses in the fields near our home. I've run with my headlamp the whole hour before the sun appears to the east and in the dim twilight of a summer evening. I've run with numerous friends, ex boyfriends, co-workers, my dog Phoebe and lots of other dogs and much of the time just by myself. I've run on most Christmases and Thanksgivings and almost always on my birthday on July 3rd. I've run through 2 years of college finals, 3 years of law school, 2 bar exams (one failed) and seven years of ups and mostly downs as an attorney. I've run through four break-ups (gladly at this point) and alot of New Orleans-style hangovers. I've had two bouts with a bad left IT band at the knee, some achy shins, a crick in my shoulder and an awful case of plantar fasciitis in my right foot that hurt so bad I felt sick to my stomach in the mornings from the pain getting out of bed.
Now I've got a much more serious injury and its going to be a long, long time before I run again. I didn't get to run on the morning of my wedding and it just about killed me. I had always pictured myself stepping out on my wedding day for a early-morning jog through wildflower meadows in whatever mountaintop setting we would ultimately choose for the exchange of our vows, clearing my head and wondering in amazement how I ever got there. But, as it has been said, life is what happens when you're busy making other plans. And so I'll have to be content with my memories for a while and try to conjure up images of myself jogging for one-minute intervals along the South Shanahan Trail this July. Its going to be a long road back.
I've run in some pretty wild places -- switchbacking up steep passes above treeline in the San Juans during the summer solstice, sub-zero mornings along the dirt roads of rural Vermont biting back tears and frozen fingers from the cold, the foggy beaches of central Chile, the coastal trail in Anchorage on a sunny summer evening with the alder trees sparkling against the bay, the Atacama desert with the snow-capped Andes at the horizon, hazy afternoons aside the Mississippi River in New Orleans dodging skinny stray dogs and broken glass, perfectly quiet mornings after a new snow along the Mesa Trail in Boulder. I've run in probably 20 other countries -- many where people just looked at me like they couldn't figure out what I was running from. I've run in Central Park, in the French Quarter, downtown Auckland and through the dense pine forest parks of Portland, Oregon. I've seen little moments of life in other places and right around the corner that I might never have experienced - the families of quiltros, or stray dogs, roaming the pre-dawn streets of Valparaiso, Chile looking for scraps in abandoned alleys, the smell of fresh bread rising in ovens along the cobblestone streets of Sienna, Italy, a small black bear startled by our approach one June morning a few years ago, the mist rising off Avalanche Creek near Carbondale in early fall, a family of foxes looking at me with wide eyes as they step gingerly across the street and hurry off to the safety of the tall grasses in the fields near our home. I've run with my headlamp the whole hour before the sun appears to the east and in the dim twilight of a summer evening. I've run with numerous friends, ex boyfriends, co-workers, my dog Phoebe and lots of other dogs and much of the time just by myself. I've run on most Christmases and Thanksgivings and almost always on my birthday on July 3rd. I've run through 2 years of college finals, 3 years of law school, 2 bar exams (one failed) and seven years of ups and mostly downs as an attorney. I've run through four break-ups (gladly at this point) and alot of New Orleans-style hangovers. I've had two bouts with a bad left IT band at the knee, some achy shins, a crick in my shoulder and an awful case of plantar fasciitis in my right foot that hurt so bad I felt sick to my stomach in the mornings from the pain getting out of bed.
Now I've got a much more serious injury and its going to be a long, long time before I run again. I didn't get to run on the morning of my wedding and it just about killed me. I had always pictured myself stepping out on my wedding day for a early-morning jog through wildflower meadows in whatever mountaintop setting we would ultimately choose for the exchange of our vows, clearing my head and wondering in amazement how I ever got there. But, as it has been said, life is what happens when you're busy making other plans. And so I'll have to be content with my memories for a while and try to conjure up images of myself jogging for one-minute intervals along the South Shanahan Trail this July. Its going to be a long road back.
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