2 weeks post hip arthroscopy (again)
The best perk of being a PT you ask? Most definitely... having PT friends. After a long day in clinic, Jackie (ahem... Dr. Piccone) worked some PT magic and finally got my muscles to chill the F out. Combo ultrasound + e-stim for the win! It provided a similar effect that dry needling would have (although not quite as specific or focused) and seriously helped get my spasms in check.
I always tell my patients that surgery is "elective trauma." And although those procedures are necessary to fix an underlying structural deficiency/injury, it always leaves you with collateral damage. In fact, you are often left MORE broken leaving the OR than you were when you went in. I am forever thankful for the skillful hands of Dr. Mei-Dan, but I know that it would all be for nothing without all the fabulous PT's in my life who have helped put me back together again (and again... and again... and again... and again... and again) after surgery. Both physically and mentally. So THANK YOU. I love you all and am so grateful to have had you by my side through all of this <3
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10 days post hip arthroscopy (again)
When I think about all of MY patients that I've treated following hip surgery and the goals/expectations I have for them 10 days post-operatively, it completely baffles me that I find it so incredibly difficult to allow myself the same patience. The following day was Friday and I was completely worn out. A lot of my friends were going out to celebrate the end of the work week and I found myself almost numb as I sunk into the couch. I didn't want to eat or read or watch TV. I didn't want to do any of my own rehab (which I hadn't done in 2 days because I was so tired and sore.) I just sat there until I fell asleep... sitting up. When I woke up I still felt so heavy and numb and I knew I needed to snap out of it. I needed to actually do something to make myself feel better. So, around 10 pm, I went to the gym and got on the stationary bike. Almost as soon as I made my first revolution, I broke out into tears. And instead of trying to stop them and put on a tough act like I always do, I just let them fall. I was in and out of tears nearly the entire time I was on the bike but, when I finished, I felt like this giant weight had been lifted off my shoulders and I could breathe again. These moments- the ones that break you down and test your resolve- are the moments that pave the way for true growth and change. They are not a sign of weakness, but rather, a signal of readiness to completely surrender to and accept the journey that you are on. So in other words my friends... let yourself have a good cry and then go kick some ass :) In addition to kicking some ass this next week, I plan to practice a bit more self love and patience- a life long skill that I think we all need to nurture more often than we probably do.
3 days post hip arthroscopy (again)
0 days post hip arthroscopy (again)
Day of Surgery
Once inside, Dr. Mei-Dan found an area of cartilage damage with underlying subchondral bone defect. He performed small micro fracture to promote cartilage healing and smoothed out the cartilage in the area. This defect was not picked up by any of my imaging studies and the only reason he found it was because he was "searching" for it based on my clinical presentation and a slight artifact on CT. He believes this defect is most likely the root cause behind all of my symptoms. However, just to be safe, he fixed all other structural abnormalities while he was in there since I have tended to be a bit of an enigma throughout all of this. Interestingly enough, he found that a portion of bone on the acetabulum (socket portion of joint) had actually grown under and around one of the previous anchors, leading to a protrusion of bone and labrum. This protrusion may have been acting like a pincer-type irritation of the surrounding tissues- but especially the labrum, as there was evidence of peripheral tearing/fraying. As such, the anchor was surgically removed from this site, the extra bone growth was shaved down and the labrum repaired. I also had a bursectomy of the iliopsoas bursa due to chronic inflammation and, to finish, he closed the anterior hip capsule and tightened this closure to make up for my inherent collagen laxity and to prevent me from over-stretching it (I was a dancer and figure skater... I can't help it!). All in all, he seemed quite pleased with how things went! So fingers crossed this is the last time this hip finds herself up on an operating table :)
Rehabilitation
2 Months I transitioned from non weight-bearing to full weight bearing and began working on increasing ROM now that precautions had been lifted. Strengthening exercises were also progressing well. I was beginning to feel much better... and even managed to get out of the house a bit more! 3 Months I had a significant flare up after walking around Boulder for a CU football game. My hip was incredibly sore and all hip flexion strength and ROM gains I had made were now diminished due to inflammation. With this flare up, my pelvic floor symptoms returned. It took 1-2 weeks to recover from this incident. During this time, I returned to some of my earlier exercises to take it easy and used a lot of ice to manage inflammation. I also found that exercising in the pool was a great way to continue rehab without pissing my hip off too much. 4 Months Rehab was going well! I was making excellent gains in strength and balance with minimal flare ups :) I was however, beginning to experience some vague knee pain. My surgeon cleared me to begin skiing greens, so long as my physical therapist gave me the green light as well. I was on cloud nine! FINALLY I was back on the mountain! 5 Months Return to running had begun with a very slow progression. Although strength and stability/proprioception had returned to near 90% of the uninvolved side, I was having a lot of pain with this. It was a mild-moderate vague pain around the outside of my hip that radiated to the knee. Most of the pain was localized to the knee, though, so I didn't think much of it. I just figured that I was experiencing patellofemoral pain due to an increase in activity after being sedentary for so long. 6 Months
I was unable to progress past running for 1 minute at a time without significant pain. Run progression was put on hold and we decreased my weight bearing exercise to try and return my pain to baseline. However, my pain persisted and it was present in my every day life--such as walking through the grocery store or rolling over in bed. The pain was always worse at night, regardless of the activity done during the day. 6 Month Post-Op Appointment At what I thought would be my last follow up appointment with Dr. Mei-Dan, I found out that I would need another surgery to address my symptoms. Even though everything had healed perfectly from the hip scope, I was experiencing pain due to my underlying hip dysplasia. I have a more mild form of the condition called "borderline hip dysplasia", which leads to micro-instability of the joint. This micro-instability over the past 26 years has slowly compromised the integrity and health of the joint, causing early signs and symptoms of osteoarthritis. The surgery recommended to me was a Periacetabular Osteotomy (PAO) as a means to preserve my own hip joint, and prevent the need for a total hip replacement. August 13th, 2014Nearly 1.5 years after initial "injury" and 6 months after diagnosis, I was finally getting my hip fixed! Surgery was delayed for so long because my curriculum in PT school required a lot of manual skills in lab... which wasn't exactly suited for crutch life... and I was not about ready to let anything prevent me from continuing on in the program. It sucked. A lot. School was a constant battle because I was unable to sit for more than 20 minutes without experiencing extreme discomfort and pain. On top of that, I was unable to continue my active lifestyle- which proved to be the hardest thing of all. But finally the day had come and I was able to begin the road to a healthy hip. Dr. Mei-Dan performed my surgery at Children's North Surgical Center. He anticipated my surgery lasting only 2-3 hours, but once in surgery, he found extensive damage that he had not anticipated. I had stage 5 labral pathology in which my labrum had completely ossified from 10 to 3 o'clock around the acetabulum. I also had a grade III tear of ligamentum teres and extensive synovitis that required debridement. After 6 hours, I left the OR with a reconstructed labrum from cadaver IT band graft and a smoother femoral neck from CAM osteotomy. In spite of all this, surgery went extremely well and he was able to fix everything. I had a really hard time with pain management for the first 2 weeks. I was on a pretty consistent schedule of: 1. Sleep for 4 hours 2. Wake up 3. Eat some crackers 4. Take meds 5. Repeat Although I was prescribed Zofran for nausea, I found that I didn't need to use it hardly at all. In pre-op, I was given a nausea patch behind my ear that stayed on for 3 days (usually how long it takes anesthesia to clear your body). I would highly recommend requesting this! As I found out during my second surgery... having this patch makes a HUGE difference! post-op challenges
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