Three Months Post-PAO

Alright, I've been slacking. I've been spending a lot of time - probably too much time - with my Facebook PAO group, which fulfills a lot of the same purpose as writing here. I'm sharing all my challenges, frustrations, and [small] victories there. I've also been busy working, coaching, and getting back to my normal life. Wait... did I say getting back to my normal life? Whoa. OMG, is that really true?! It's hard to believe, but it is really true. It is mostly good, and I've slipped back into my normal life with little fanfare or celebration; it just kind of happened. And it's great. Unfortunately, I find myself at the end of most days with little left in the tank, and I just drop into bed, exhausted to the bone. I guess the upside of this is that until I contracted a horrid cough about 10 days ago, I was managing to go to bed with no prescription drugs, which might sound small, but is something I haven't really been able to do for several years.

Anyway, when I say 'my normal life,' that's somewhat of an exaggeration. Also, keep in mind that I don't even know what 'normal' is anymore. I'm still trying to find that 'new normal.' BUT. I'm back at work, trekking across campus with just one forearm crutch (so it's really more like a cane, only not a cane, which is one of things I just can't do), coaching diving at nights, and generally feeling about as good as I did before these hip surgeries. I'm not going to lie, it has been one hell of a recovery, but I do feel like I'm starting to finally turn some metaphorical corner.

Over a week ago, I went up to see my surgeon for my three-month follow-up. I was going through a rough patch at the time, as I was frustrated by my inability to completely ditch the crutches. Apparently both my surgeon and my PT (though to a lesser extent) are in the 'two crutches or no crutches' camp, as they believe using just one crutch makes you walk weird. I do walk some at PT with a cane, or 'gait enhancement device,' as my PT calls it, because even that little extra tap of the cane on the ground is enough to ease my brain's panic and even out my gait. But - and call me vain if you must - I just can't do the cane in public. So one forearm crutch is my compromise. I'm not sure if this is medically acceptable, but I figure no one needs to know. lol. Around the house, I'm pretty much not using anything these days. I do have a slight limp, and I know I'm not supposed to be walking with a limp, but geez, after over three months on crutches, you just get to a point where enough is enough. Seriously, y'all, my shoulders are killing me after so long on crutches.

So anyway, I was nervous for my appointment, because Dr. Terminator makes me nervous, and I felt like I wasn't as far along as they were expecting I would be. I even texted Christian ahead of time to let him know I was nervous, so at least he knew I was going to be super needy, haha. It didn't help that I was super duper sick at the appointment, too. I mentioned earlier that I got a terrible cough that I just couldn't get rid of, then I coughed myself into a terrible case of laryngitis that caused me to have to cancel class the day before (which was only my second canceled class in over eight years). Despite heavy meds, I hadn't been able to get more than a few hours of sleep per night. Add into that a horrid two-hour drive through insane traffic up to see Dr. Terminator, and I was in a pretty pissy mood by the time I arrived.

Then, the appointment started off the wrong way with one of his new fellows, who was wearing a low-cut lingerie type of tank top, short skirt, and cowboy boots. I mean... really? Then she asked me to describe what activities I had been doing lately, and that just rubbed me the wrong way. Activities? Like... did she really think I'd rattle of a list of activities? Oh yes, I just ran a marathon, getting ready for my first Ironman! I mean, what the what? So I gynosplained to her that I'd been spending most of my rehab time doing damage control on other parts of my body, and I really wasn't doing any 'activities' other than just surviving my daily life. Then she looked over my X-rays with me, and told me they looked great, even though to me they looked exactly the same as they did six weeks ago. Then Dr. Terminator came in and upon seeing me and hearing how awful I sounded sat across the room from me giving me the stink eye. Okay so maybe he wasn't REALLY giving me the stink eye, and I totally understand and respect that he didn't want to get sick from me, but it just didn't add any warm fuzzies to the situation.

Fortunately, Christian was also there and was my hero. I think our brief text exchange had prepared him for what a fragile state I was in. When he came in the room, he smiled and said, 'Hi sweetie!' and put his hand on my shoulder and immediately started to reassure me that everything looked good, and this recovery is a long process, and I'm exactly where I need to be. It's just that I'm older than a lot of patients, and am going to recover more slowly, and I'm also peri-menopausal, 'so there's a lot going on down there.' I'm not sure exactly what he meant by that, except maybe I'm feeling overly emotional? I don't know.

Dr. Terminator also thought my X-rays looked good - in fact, 'perfect' - but was concerned about my continuing inability to flex my thigh. I'm still having to use my arms to lift my leg into the car, into bed, etc. Jerry and I have only begun to address this issue in PT just because I've had so much pain in other parts of my body - namely my left hip and my back. I've been telling people it's as if I have a fixed amount of pain in my body that just keeps moving around. I need an exorcist or something. LOL. Dr. Terminator seemed slightly baffled that I still have this 'profound weakness of the iliopsoas' (how he described it in the post-visit write-up), and suggested that my physical therapist might not be the best, which sort of rubbed me the wrong way. Jerry has been an absolute godsend throughout this, and it was as if Dr. Terminator had no clue what hell I've been through with this rehab. He also seemed somewhat dismissive of the pain in my left hip, which sort of irked me seeing as how he knows that hip is bad, too; in fact, he's the one who told me I need to have this same series of surgeries on that hip ASAP. Ultimately, he concluded that the damage to my hip flexors must be the result of the epidural - apparently that's a thing - since such a major loss of function is rare. (Lucky me.) He gave me some exercises to do, regardless of what I'm doing at PT, and told me to be religious about doing them, as I'm going to have to put in some extra effort to get that function back. However, he assured me the function would come back, as the nerves and muscles are intact, which he determined by the fact that I can slide my leg up to about 90 degrees when I'm lying on my back - the same as during my first post-op appointment.

I'm not sure why, but the brief interaction just made me feel sort of crappy, like I was doing everything wrong, not working hard enough at PT, etc. I really don't think Dr. Terminator meant to make me feel bad or anything, he just did. I think Christian could tell I was feeling really down, and stayed with me for a long time after Dr. Terminator left. I really appreciated that, even though everything he said to try to make me feel better actually made me feel worse. Like, he told me that my pain wasn't real, it was just that my body was interpreting my weakness as pain. I know he was trying to reassure me that once I get stronger, I'll feel better, but of course I interpreted it as not only am I weak, but the pain is all just a figment of my imagination. I know he didn't mean it that way; in fact, Jerry has explained pain to me in a similar way, it just didn't make me feel shitty like when Christian said it.

Ironically, when Christian gave me a suggestion, and I responded, 'I'll try,' he replied, 'Do or do not. There is no try.' LOL. I did get the Star Wars reference, but I was so worked up I don't think I acknowledged it, then Christian clumsily tried to explain it, and I think he felt like a jerk. The final straw was when he noted that I was still limping (apparently the medical term is 'antalgic gait') and said he wanted me to continue using crutches indefinitely until I don't limp at all. He also said that's why my left hip and back were hurting, which isn't true, because they started to hurt long before I was even close to getting off the crutches. This also upset me because I really felt like I was walking well, and was proud I had managed to get up to the appointment from the parking lot without crutches, only to be told this wasn't the right thing to do. Argh. I was on the verge of tears the whole time, then after I left the appointment I DID cry, and basically couldn't stop crying the whole rest of the day. Maybe it is just peri-menopausal emotions running high, but I felt so defeated. And tired. Tired physically, emotionally, and whatever other -ally types of tired exist.

So, it was not the greatest visit, but as I write this over a week later, I'm already past it. It's water under the bridge. Aside from the fact that I'm STILL SICK - seriously, my body just doesn't have enough energy to grow bone, fight cancer, and take care of a stupid cough - I'm feeling pretty optimistic. Around the house, I'm pretty much crutch free, and I get around well with my crutch-cane for most other activities. The one exception is that I'm still using two crutches to get to diving practice, as I have to trek a very long way from the car to the pool. My pain is now well-managed with PT exercises, heat/ice, ibuprofen, dry-needling, and regular massages. Besides some stiffness and soreness, I feel good, and no worse than I did before these surgeries.

I was disappointed not to get to talk about when I can get my screws out or when I can schedule the next round of surgeries for my left side, but I do understand and respect Dr. Terminator and Christian's desire to just focus on one thing at a time, and realize I should probably do the same. This process is definitely testing my patience, but I feel like I'm finally in a good place, in that I'm at peace with where I am in terms of my progress. While I'd like to be completely crutch-free, my disability isn't affecting my ability to live my life and do all of my normal, everyday activities, and that's actually an amazing feeling.

In Search of Gratitude Lost

In case you didn't catch it, the title of this post is a play on the title À la recherche du temps perdu, or In Search of Lost Time, a book that I had the great fortune (not; that's sarcasm) of reading in college. In French. It's not actually the most accurate title for this post, but I just couldn't resist.

Anyhoo, one of my friends posted an article on Facebook yesterday that ended up being a game-changer for me. I'm pretty picky about about the articles I read from my Facebook feed, but I'm a sucker for certain types of articles, especially the ones that tell you how you can be happier and lead a better life, and blah freaking blah. This particular article promised happiness based on actual science, which has double appeal for me. Yeah, dudes, I'm sooooo all over that! A SCIENTIFIC FORMULA FOR HAPPINESS? What's not to love about that?

But the interesting thing about the article is that it suggests four things that I pretty much already do:

1. Be thankful. Or at least TRY to come up with reasons to be thankful. Even just LOOKING for reasons to be thankful has the same effect on your neurotransmitters as ACTUALLY being thankful. 
2. Label your negative emotions. Apparently if you can describe your awful feelings in words, your brain doesn't care about them as much. 
3. Make a decision. It doesn't have to be THE BEST DECISION EVER, just 'good enough.' Just do it. 
4. Hug people. Touching other people is good. If you can't don't hug, get a massage.

Upon reading it, it struck me that I'm actually pretty happy. I've written before how much I enjoy my 40s. But looking back, there are a lot of things about my 40s that have sucked. I welcomed in my 40s recovering from hip surgery and DVT. At about 40.5 years old, I was diagnosed with breast cancer. I dealt with that for over a year, and then I had more hip surgeries. So basically my 40s have been lots of bad medical news and lots of surgeries. Yet... I'm pretty happy. I mean, dude, WTF? 

But ya know, I think I have the first three points here covered. Weirdly enough, all the medical crises have given me a lot for which to be grateful. Before my medical crises, I don't feel like I was ungrateful, but I do think maybe I was complacent. When everything is copacetic, you don't necessarily make time to be thankful, express gratitude. You take your blessings for granted. But when you're faced with Big Things, you start thinking things like, I'm so glad I found this doctor; thank goodness my physical therapist noticed my swollen leg; I'm thankful I caught this early; I'm grateful this nurse advocated for me; I'm so happy to be out of hospital; I'm so glad that's over. And apparently, your brain doesn't know the difference between Thank God that lesion on my rib isn't cancer and Thank God I'm a billionaire and I'm gorgeous and famous and have a huge house! It's all the same to your brain. I also think when you're faced with Big Things, you start looking for silver linings, any positive news you can cling to. And apparently even just LOOKING for positive things has the same effect as Thank God I'm a billionaire and I'm gorgeous and famous and have a huge house! 

With regards to the second point - putting your negative emotions into words - I think that's why I write here. I always knew that writing had a therapeutic effect for me, and this makes perfect sense. Putting my thoughts into words puts my mind at ease. 

Likewise for third point - making decisions. I'm a high stress person, and even decisions about stupid, trivial things stress me out. But once I make a decision, I don't look back. I'm so relieved the decision has been made, I don't have the energy to look back, nor reflect on whether the decision I made was the best. What's done is done. I used to see this as a weakness, not having enough energy to revisit my decisions. But then again, maybe my brain just understands that making a decision, even if it's not THE BEST decision, is better than making no decision at all, as long as that decision is 'good enough.' 

As for the fourth point, I don't do the hugging thing. Never have, and probably never will. But, I love massages! Ha ha. Interestingly, I woke up on Friday of last week in a world of pain. Something I did on Thursday afternoon just destroyed my back, and even walking with crutches was causing me a lot of grief. This was particularly upsetting because I'm right at the three month mark and feel like the crutches need to go, but my back and my left hip are giving me just as much trouble as my right hip, which is making it super hard to progress in PT. Fortunately, Friday morning was also when I read the article about being happy. It made me think to myself, Now there's a good idea - I should go get a massage! I called two different massage therapists - one Jerry recommended to me who works part-time out of their PT office, and another I saw when I was recovering from breast reconstruction (which also destroyed my back). The one I'd seen before didn't have any openings for a week (!!!), so apparently I'm not the only one who loves massages. LOL. However, the woman that Jerry recommended could get me in at 2:30 on Friday.

Best. Decision. Ever. Normally I'd hem and haw over spending that much money, but I was inspired by the happiness article and my pain level was pretty out of control. So see, I killed two birds with one stone! Sharon was AMAZING. During the massage, I didn't feel like she was pushing hard enough, but as Jerry explained, the latest research shows that if you push too hard (e.g., elbow in the back, like I usually prefer), it will actually make the muscle feel threatened, and it will push back and actually tighten up. He felt that Sharon applies just the right amount of pressure, and wow, he was right. I got up to leave, and oh my gosh, I felt so damn good, I could have walked out of there with no limp and no crutches (except that I had to, you know, get the crutches out of there, and I felt stupid carrying them). Considering I had dragged myself into the appointment in massive pain even with crutches, that was a pretty amazing turnaround.

Then when I got out to the car, I checked my voice mail, and apparently massage therapist #2 had a cancellation, and said he could see me on Saturday. So I called him back and took that appointment, too! Just because. Because of the article. LOL. I felt amazing for the rest of the weekend, and thought maybe this week would be my coming off crutches week, but I decided not to push it. And it's a good thing that I didn't, because today at work my back started acting up again. Grrrrrr, it's so frustrating! Fortunately, I have another appointment on Thursday with Sharon. In a way, it feels sort of extravagant, but at the same time, it's practically a medical necessity. Plus, you know, it makes me happier. There's actual science here, people.

People will often tell you that happiness is a state of mind and yada yada yada, and it's hard to accept that when you're in the throes of a crisis. But happiness explained in these terms makes more sense to me. It also makes me feel like I'm not delusional or in a state of deep denial to have remained relatively happy throughout all of this crap. Sometimes when I explain my medical history to people, they look at me with pity - hell, even some doctors do, and you know they see a lot of shit - but I really don't feel that sorry for myself. I'm grateful for so much. And although this recovery seems to be going on forever and ever and freaking ever, I'm grateful that I'm recovering (even if slowly), that I have a good support system in place (family, friends, Internet groups), that I have good insurance and good medical care (trustworthy surgeon, responsive PA, fantastic PT), and that I have the financial means to splurge every once in a while on something that makes me feel better (occasional retail therapy, massages).

Going forward, I vow to make a note every day of my blessings. I hope you feel them, too. Thank you for being here with me.