Learning to Walk Again

I have a number of drugs in my arsenal that don't seem to be doing their magic anymore, so I've been struggling with insomnia. It's nothing new; I've struggled with insomnia to varying degrees for my whole life, or at least as long as I can remember. In a bout of insomnia a while ago, I started reading through this blog, and I was really happy I took the time to write out all that I did. It inspired me to try to start writing again. If for nothing else, for me. Writing has always been my outlet, something cathartic for me, but lately it has just seemed like such a chore. So many things that used to give me pleasure just seem like such a chore. I've mentioned that since my surgery, I've just felt so... blah. I need to bust out of that. I think I'm finally ready. So here we go.

Fortunately, I actually have something to write about that's relevant to this blog. I (FINALLY!) had my first PT session on Friday. Dr. Terminator told me that he wanted my first PT session to be with one of his own PTs; however, his assistant (an athletic trainer) hinted to me that she didn't think it was necessary, especially since I live a few hours away. So I ignored Dr. Terminator and set up an appointment with a physical therapist in town my husband had seen for his knee and highly recommended. 

I LOVED him! I think he is going to be a godsend in terms of my recovery. He was extremely thorough and knowledgeable, and spent the entire appointment with me. No aides, no assistants, unlike the last time I did hip PT and spent most of my time with girls straight out of college who know a lot less about physiology than I do. (Though, to be fair, the PT in that case was so mediocre that I actually enjoyed the aides and assistants more than him.) Anyway, I feel confident that Jerry will be able to make up for whatever shortcomings Dr. Terminator may have, and help me get through this rehab. I really, really, really needed this boost right now, and cannot tell you how happy I feel after this appointment. When I finally got a date for my surgeries, I wrote this post, about how I was revved up to kick some ass. I feel so disappointed in myself that I've been sooooo... blaaaaah... during this recovery, and that I've squandered two months of my life doing pretty much nothing. But that's water under the bridge, and it's better late than never, I guess. I really am revved up to kick some ass now. 

I told Jerry my #1 priority right now is walking. I'm so embarrassed that I cannot walk at all without at least one crutch, not even a few steps. I told him I'm not sure if it's that I CAN'T or that I'm too afraid to. My hip feels like this weird body part that isn't mine, that I don't trust. It's totally weird. It's not that it hurts, it's just weird. I was prepared for pain, but not the weirdness. Fortunately, Jerry completely understood what I was talking about and said that walking is a very complex movement involving hundreds of muscles. That's why it takes babies so long to figure it out. Because of the amount of changes that took place during the surgery, I will essentially have to learn how to walk again. And that's no simple task. It is not just a question of regaining strength in my muscles and getting them all to fire at the appropriate time, it's also that the trauma of the surgery has changed the connections between my brain and my muscles, so my proprioception is off, and my brain needs to be retrained. The fact that I don't feel like I can take even one step without crutches could be as much about lack of balance as lack of strength. Of course, I do have significant weakness as well. Jerry told me that it takes twice as long to regain muscle mass as it does to lose it. Also, because even before surgery, I wasn't walking normally, it's even harder. It's not just like getting back up on a bike and riding again; it's like learning to ride a bike and then a unicycle. That made me feel better.

I did a little bit of walking for him, with crutches, and told him that I think my surgeon has a philosophy of two crutches or no crutches; he doesn't like the one crutch thing. (He's never actually told me this, but someone else from my PAO Facebook group informed me of this.) Jerry said he could understand this, as walking with one crutch usually makes you lean toward the crutch side, and can lead to bad habits. However, realistically, there are times when it's just more practical to use one crutch so you can carry things around. I told him my concern was that with two crutches, I was putting less weight on my right side than I actually COULD (enter the literal and metaphorical crutch). He showed me a different way to walk with crutches, where you don't bring both crutches forward at once, but alternate one crutch at a time - so when your right leg goes forward, only the left crutch goes with it, and when your left leg goes forward, only the right crutch goes with it. This helps balance your gait and allows you to put a little more pressure on your weak side without the potential complications of using a single crutch too much. He emphasized that I didn't have to use one technique all the time; I should use a combination of all of them as needed. 

Other highlights, in no particular order:

• He asked what type of exercises, if any, I was doing at home. I told him I hadn't been able to do much because of my restrictions, but that I had started to ride the stationary bike about a week ago, and that I was constantly wiggling my feet around and flexing my leg muscles because I'm naturally fidgety and I can't help it. Even Dr. Terminator and Christian made a note of this when I was still in the hospital, saying it was a good thing. Jerry encouraged me to continue riding the bike with little to no resistance for 20-30 minutes a day, and suggested that I try riding backwards as well, just to use slightly different muscles. He also gave me more specific exercises involving isometric contractions of not just my leg muscles, but also my glutes and my abdominal muscles, to strengthen my core.
• He asked about my pain levels, and I told him that I was happy with them; I'm not in a lot of pain. I do have some pain, but it feels like it is from the incisions and muscles and not from the joint itself. (On a side note, this seemed like Dr. Terminator's top priority - that regardless of all else, the pain from within my joint should be gone, which it is. Which is amazing.) However, I also mentioned that I think I have a fairly high pain tolerance, which has led me to have problems in the past. I told him I've made a conscious effort to exaggerate my pain levels when asked to rate my pain on a pain scale, but sometimes I'm not really sure about my own perceptions. He said he would definitely make a note about that, but that this clinic was definitely NOT a 'no pain, no gain,' clinic; that pain is a message that should be taken very seriously. He said that in the past, pain was viewed only as a sign of damage, but research now shows that there can be pain with no damage, or damage with no pain. The current view of pain is that it can not only be a sign of damage, but also the body's warning signal of impending danger. Either way, he said it was a good thing I have little pain, because many of the people he works with are limited by pain, and that won't be a major issue with me. At the same time, we need to be wary of my higher pain tolerance.
• I told him that one of my biggest sources of pain is on the lateral side of my thigh, where my nerve got messed up. As the feeling comes back, I get weird pains. Christian told me that this was normal, and would likely last for a while, because nerves regenerate at a rate of 1 mm per day from the spinal cord. Jerry said that contrary to what might seem logical, damaged nerves are actually hypersensitive, because as they repair themselves, they are seeking input. So the more I can touch the areas that hurt from nerve pain, the better it will be in the long run in terms of helping to calm down the neurons. They just want attention. The same goes for my itchy scars. I should not hesitate to scratch them, as they are seeking input, and the more 'attention' I can give them in their healing phases, the more they will chill out later. He said it was thanks to a bunch of studies done on rats that we know this. Unfortunately, one of my scars is on my butt, so he agreed I'd have to set time aside for a private scratching session of that one, LOL. He was very excited that I teach biology and he could geek talk with me, and I was very excited that he was knowledgeable enough to geek talk with me.
• We talked about managing what pain I do have and whether or not I should be icing or heating. I never know, and as far as I can tell, there is no strong evidence one way or another. He concurred, and said I should do whatever feels the best. He said current research suggests that no matter what - ice or heat - blood flow to the area will increase after 20 minutes, so you should do what feels best. He said that our own bodies are smarter than any research that is out there. :) 
• I also let him know that my left side is also bad, and that we will need to protect it while rehabbing my right side. I said my left side was not as severe as my right side, and had been asymptomatic until PT messed it up. I told him I would be getting the left side fixed soon, and that I wanted to make it as functional and pain-free as possible. 

So, I left feeling energized. I've been riding the stationary bike as much as I can and practicing walking the different ways we talked about. I have been mostly using just one crutch because freeing up one hand to carry things is amazing. However, I have been very conscious about not leaning into the crutch and mostly just using it for balance. As much as I can, I practice walking in front of the full length mirror so I can be confident in my posture. In just the past 24 hours, I'm amazed at the progress I've been able to make, and am feeling far less anxiety about returning to work in just over a week.

Second Post-Op Visit

Yesterday I had my highly anticipated, been-keeping-me-awake-at-night, follow-up appointment with my surgeon. It has been 7.5 (very long) weeks since my labral repair and microfracture, and 6.5 (very long) weeks since my PAO. You can bet that I've been counting the days and knew that the day of the solar eclipse was officially six weeks post-surgery #1, and that Christian had told me that I could start putting some weight on my right side at six weeks. So I started that week, even though technically I wasn't cleared to do so, because jeez. Patience is not my greatest virtue; in fact, it's probably one of my biggest weaknesses, and OMGTHEREISONLYSOMUCHOFTHISICANTAKE. And anyway, I didn't try full weight bearing. I just started standing with both legs down, which I know from my previous hip PT is considered 50% weight bearing. Also, instead of crutching around holding my leg up, I started actually walking with crutches, to at least get my leg used to the motion again and retrain my brain. (Seeeeeee, I know a little bit about physiology.)

I felt pretty good about jumping the gun slightly because I figured I'd be in pain if I were doing too much, and I actually feel very little pain. Still, I was nervous that if things didn't look good, Dr. Terminator might chew me out for messing up his work. LOL. When he came in, the first thing he asked about was the eclipse, haha. Then he got right down to business and told me everything looked fine. The healing is going well, or well enough at least, and I now am officially cleared to start weight bearing as tolerated. Of course, this came with a lecture about how 'cleared to do' does not mean 'can actually do' or even 'should do.' (Did I look like I was ready to ditch the crutches and sprint out of there?!) I have to use the crutches until I can walk without a limp, which I currently can't do at all, even for one or two steps, so it could still be another month or more before my crutch burning party. (Oh wait, they're metal. And I still have to do my left side. Never mind.)

I had a few specific concerns, the first being that I have lost a ton of range of motion (ROM) in my hip. I still cannot touch my foot, and I'm still using my old lady contraption to put my socks on and wearing my slip-on clogs everywhere, which is frustrating. I mean, I realize I will no longer be able to wrap my legs around my head, but I would like to at least be able to put my shoes and socks on! I was worried Dr. Terminator had actually over corrected me. Yes, that's a real thing. And I know from one of Dr. Terminator's patients that it actually happened to her, so it wasn't pure paranoia. Dr. Terminator assured me that my ROM will come back eventually; I just need to be patient. (There's that damn concept again. I hate it.) He said that he tested my ROM during the surgery, and it is there, it's just that my body doesn't want to bend like that right now.

The second concern I had was that I still can't really flex my thigh. So when I'm getting into bed or even into the car, I have to use my arms to lift my leg up. I can lift it enough to move my foot from the gas to the brake when I'm driving, which by the way, I started to do on August 22nd. (I only remember the exact date because it's my son's birthday, and I was so excited that I wanted to post about it on Facebook, only I had to wait, because posting about me driving before posting pictures of my son's birthday party would make me a bad mom.) But even just the little bit of lifting from driving is tiring, which limits me to short trips around town. I still needed my husband to take me to this appointment two hours away.

I had a feeling this wasn't really normal because when I inquired about it to my PAO group on Facebook, no one really responded. I understand some loss of function is normal because of the muscles that got detached and reattached during surgery, and even the ones that didn't get detached got traumatized, and this is a major surgery and blah blah blah. But apparently it's NOT normal that I can barely lift my leg at all. Basically my loss of function is the worst Dr. Terminator has seen. I believe his exact words were, Some weakness is normal, but I've never seen it THIS bad before. Um, lucky me. With so much of what I've experienced, I've been assured that it's all normal, it will get better, I just need to be patient. So when I demonstrated to Dr. Terminator just how much I cannot lift my leg, and he twisted his mouth into a frustrated little scowl of shock and awe, I knew it wasn't normal.

The only good news is that there doesn't appear to be any major damage to the muscles - like a torn muscle, or a muscle that accidentally didn't get reattached. The fact that I can pull my leg up when I'm lying down means that the muscle function is there, it's just that the muscles are insanely weak, too weak to overcome the force of gravity. This explains why the function diminishes the more upright I get. Dr. Terminator came to the conclusion that because of the extent of the correction he had to make to my hip joint, there is a lot of irritation to my hip flexors while the bone heals, and they are just super pissed off right now. I will need to work extra hard on this during rehab. And be patient. So there we go again.

In other news, Dr. Terminator felt confident I would be able to ski by December, and told me not to cancel my ski pass. We bought them way back when, because they are cheaper if buy them early, but you can bet we splurged on the insurance, so I could get a refund if necessary. I asked him about screw removal, and he told me he didn't want me to worry about that right now. He said he normally takes the screws out six months post-PAO, which would put it in December. However, he said it didn't have to be then; we could wait until the end of ski season, if I wanted. But even if he did it in December, I'd be able to ski within a week because he can pull the screws out through a very tiny hole, and the gaps fill in with blood and are stable. So that is something to look forward to/work toward. In the end, Dr. Terminator counseled me to stay in the present and focus on the task at hand, which is getting my muscles to work again and being able to walk. Baby steps. And patience.

All in all, I'm feeling hopeful and nervous at the same time. I have to go back to work the week after next, which adds a whole new dimension of stress that merits an entry of its own. However, I started physical therapy today - which also merits an entry of its own - and I will work hard to make as much progress as I can in the next 10 days. I'll try to take Dr. Terminator's advice and focus on each immediate task at hand. And be patient.

First Post-Op Visit and Return to Normalcy

I just took half of an oxycodone for pain, yet today has been The Best Day Ever in post-PAO territory. I feel... happy? Energized? Or maybe just... normal? That's it. I FEEL NORMAL! Aside from the whole I can't walk thing, I FEEL NORMAL.

I had my first post-op appointment yesterday, and it went well, which put me in good spirits. I was bracing for bad news. About 10 days ago, I had a near-catastrophic mishap due to me being an idiot. The fact that I didn't write about it when it happened just goes to show you how lazy I've been even about writing. I've been making a concerted effort to stay well hydrated, so I filled up my water jug to take to bed, and because I'm tired of everyone having to do everything for me and because everyone is tired of having to do everything for me, I decided to carry it myself. Unfortunately, some water dripped out, my crutch hit the water and slid, and subsequently, my right leg (operated side) slid. Fortunately, it rammed into the couch, otherwise I would have gone into the splits. And I mean really, I would have gone into the splits. As it is, I went down pretty far, and it hurt. A lot. I screamed my head off, causing my husband, who was upstairs putting the kids to bed, to come running down the stairs. I held onto the couch, hyperventilating and freaking out, then once I calmed down, my husband helped me to bed. I immediately took two oxycodones and a Valium, and went to sleep.

When I woke up, I was in pain, but I couldn't tell if it was bad or not. The pain was similar to the pain I'd already had, only more intense. I debated whether I should even contact my surgeon about it, and I eventually texted Christian, explaining what happened. At first he told me not to worry, but then later texted back and asked if I thought it was bad enough that I needed an X-ray. (I suspect he may have consulted with Dr. Terminator.) After a few days, I decided there was no point in getting an X-ray when I was going to get one soon anyway. Nonetheless, that left me pretty nervous for my appointment. However, much to everyone's relief, everything was still in place! Dr. Terminator's first words to me were, 'Everything is fine - you didn't mess up my work!' LOL. I think it's funny surgeons think of patients as their own personal works of art.

Other highlights:

#1: They* removed the stitches from my arthroscopy a month ago. A MONTH AGO! I was pretty worried about this, with good reason. When I had my first arthroscopy, I remember my surgeon had a hard time getting my stitches out two weeks post-op, because my skin had already grown around them. I understand that technically this was a 'two week' post-op appointment, BUT it was actually a two week post PAO post-op, AND it was not two weeks post-op, but two weeks from the (estimated) time that I would leave the hospital (since I would see the surgeon and/or his PA every day in the hospital). So in reality, it was over four weeks post arthroscopy and three weeks post PAO.

So when I say they* removed my stitches, it's because Christian started, but couldn't get them out, so went and got Dr. Terminator. Then, they had a conversation that went something like this.

Dr. Terminator to Christian: I really need a curved scalpel. Can you go get one for me?
Christian leaves and comes back a few minutes later.
Christian: They don't have those here.
Dr. Terminator: Okay, well then go get me something sharp - whatever.
OMG are you f-ing kidding me?! 
So I looked at Dr. Terminator and joked: You mean like a steak knife?
Then Dr. Terminator looked at me and gave me a cute little smile, like, Haha, you're kind of funny. I might like you after all. And suddenly I liked him a lot more than I have in the past. It was one of those hard to describe bonding moments.

And after much pain, the stitches came out.

#2: I asked when I could drive, and Dr. Terminator said, 'Now.'

!!!!!

Like... I seriously can't imagine driving right now, but the fact that I *could* if I wanted or had to is comforting and helps me feel like my life is getting back to normal.

Also, since the first surgery, I've been limited to flexing my hip no more than 90 degrees, and that restriction is now gone. Not that I actually CAN flex past 90 degrees, but at least I can try! And I don't have to stress if I need to bend over and scratch my foot!

#3: I inquired about this whole non weight bearing thing because that is hands down the hardest part of this. Technically, in a week, it will be six weeks since the arthroscopy and microfracture procedure, which is the reason for six weeks of non weight bearing. However, my next appointment isn't until about eight weeks post-arthroscopy. And when you're working on my timeline, those two weeks make a huge difference - because I have to go back to work, and I want to be at least partially weight bearing when I do. I don't want to start bearing weight until I'm technically cleared to do so, but at the same time, I don't want to wait an extra two weeks just because that's when my appointment is. So we agreed to move my next appointment up to the end of August, rather than mid-September. It will require a longer drive - because Dr. Terminator and his team are only at University Hospital twice a month - but I felt happy that they were on board with accelerating my rehab period rather than not.

#4: I really, really, REALLY like Christian. The jury is still out on Dr. Terminator, lol, but I decided that I really like Christian. Honestly, I don't see a lot of Dr. Terminator, which doesn't fit with what other people have said about him, but I'm okay with it. Christian spends a lot of time with me, answers all my texts promptly, and we generally just click. Maybe that's why I don't see a lot of Dr. Terminator.

When I was waiting for my appointment, I sat down in the nearest chair, which happened to be right under the TV, which was super loud. Eventually it started to bug me, enough to motivate me to get up and try to move across the waiting area. Right as I managed to stand up, Christian walked by with Dr. No Name, who I remembered from my first appointment.

'Hi!' he said very cheerfully. Followed by, 'Wow! You look really good!' It was very genuine, and I was impressed he knew who I was out of context, in the waiting room. And he seemed genuinely happy that I apparently looked 'really good.' Then he asked how I felt, and of course after all that, I couldn't say anything other than 'I feel good!' (which, angst about my upcoming X-rays aside, was true). Then he repeated, 'Well you look like it,' before saying he would see me in a few minutes and disappearing back into the exam area. That just about made my day.

Then, back in the exam room, he mentioned that classes must be starting soon and asked when. August 21st, I told him.

'Ah!' he said, 'The day of the eclipse.'

Soooooo.... my husband has been talking about the total eclipse for, like, years and years. Seeing a total eclipse is very high on his (very long) bucket list. And on August 21st, we will be within a few hours of the band of totality of a total solar eclipse. For the past few years, my husband has been planning a trip to see the eclipse, and has tried to convince me that I can miss the first day of classes for this once in a lifetime event, while I have patiently explained that no, no I cannot.

So the mere fact that Christian recognized August 21st as Eclipse Day led to instant love. And a lot of conversation. Of course my husband tried to convince Christian that he should take the day off, to which he replied, 'We have two PAOs on that day.' However, that didn't stop him from bringing it up with Dr. Terminator - only semi-jokingly.

Ironically, because of this surgery, I am off work until September 11th, so I'll be able to see the eclipse after all. At the end of my appointment, Christian told me, 'I'll see you after the eclipse.' Dr. Terminator's last words to me were, 'DO NOT FALL!'

* * * * *

All in all, I felt really good after I left - about my hip, about my care team, about everything. Even the flat tire we discovered once back in the car couldn't break my good mood.

And I've been in a good mood ever since. Yesterday evening, I hosted book club, which is always good for my soul. A bunch of my friends came over with food and wine, and we talked and laughed until late into the night. I'll admit that trying to get from the front porch to bed was a bit of a challenge, especially with Dr. Terminator's DO NOT FALL! words ringing in my head. But it was so worth it. :)

Today, I had two back-to-back meetings, both work related. People graciously agreed to come by my house, but still. After a late night last night, I got up this morning, showered, worked, ordered lunch for our lunch meeting, met with colleagues, then had another meeting, and OMG I AM EXHAUSTED! And sort of in pain - hence the oxycodone at the beginning of this post, even though I've mostly been getting by with ibuprofen. BUT. It was a normal day, and I did normal people stuff in normal people clothes, and despite being on crutches, I led a meeting and provided lunch and was a mentor/leader and it just felt so. damn. good.

I feel like I've turned a major corner, and I can't tell you what a great feeling that is. Considering it's been an entire month since my first surgery, I guess it's about time. Nonetheless, it's an amazing feeling, and even if this is just a typical experience in terms of recovery timeline, I'm still reveling in my happiness. Like I said at the beginning of this post, I feel NORMAL. And that's AMAZING.

Even in your normal isn't perfect, embrace it, or at least don't take it for granted. That's my (maybe crappy) advice, anyway. :)

Four Weeks Post-Arthroscopy, Three Weeks Post-PAO

So wow, it has been four weeks since my hip arthroscopy and three weeks since my PAO. It just goes to show that time doesn't only fly when you're having fun. It also flies when you're miserable and bored out of your frickin mind. I feel like I've lost an entire month of my life to doing absolutely nothing. This has hands down been the dullest, most uneventful rehab in the history of all rehabs/bedrests I've gone through, which is not a ton, but also not a trivial number, either. I'm not motivated to do anything, really. I've done minimal TV-watching, minimal reading, pretty much zero of all of the things you'd think one might do when one is largely couch bound (e.g., knitting, coloring, writing, Tetris-playing, etc.), to the extent that I'm like WHAT IN THE HELL AM I DOING ALL DAY LONG?! And the answer is: nothing. I pretty much do nothing all day long. Maybe I'm depressed or something? Is that possible? I'm not a person who usually does nothing. And my sixth-grade teacher taught us that you should never be bored. If you are bored, it is your own fault for not having an inquisitive and imaginative enough mind. So there you go. Mea culpa, mea culpa.

I'm not even inspired to write this entry, I just feel like I should because of the whole four week/three week mark and all. And I'm not doing anything else. LOL. But really, what is there to write about? Nothing. In the past, I've been determined to get all the details down, but now I just feel like one big giant blob of blaaaaaaah. I think part of me still doesn't believe this is actually happening.

Okay, so in fairness to myself, it's not as bad as I'm making it sound. I have done some stuff whilst laid up, it just doesn't feel noteworthy at all like it has in the past. Plus, in my normal life, there are a lot of things I'd love to do that I just don't have time for anymore that I could be doing now. I'm disappointed in myself that I haven't cherished this time and worked on some of these things. Instead, I just sit around and complain that I'm bored. I just HATE this feeling! HATE it!

But, maybe I need to be easier on myself? Like Christian said. Then again, maybe the reason I'm such a LOSER UNDERACHIEVER is because I spend too much time being easy on myself.

So alright, it has been four weeks/three weeks, so I'll use this entry to officially end my period of doing nothing and going easy on myself. Time to kick some ass. :)

The Anesthesiologist's Daughter

In an earlier post, I wrote about how my anesthesiologist was a super weirdo the morning of my surgery. Like, weird enough that he actually freaked me out. Granted, I was in easy freak-out mode, but still. I usually try to give medical folks the benefit of the doubt, but man.

Anyhow, I went into full freak-out mode when he was putting the epidural in me while I was fully conscious. He ran his finger up and down my backbone, commenting, 'I see you have scoliosis.' Why yes, yes I do. He asked if I had ever had surgery for it. I told him I had not, meanwhile freaking out thinking OMG, is it so bad that it looks like I should have had surgery for it?! My scoliosis was discovered in a routine, elementary-school screening, but I was always told it was not severe. Then again, I was also told I had 'mild' hip dysplasia by an actual hip doctor who really should have known better. So while the anesthesiologist appeared to be fumbling around, walking his fingers up and down my vertebrae, trying to figure out where to put the epidural in, I of course started crying. I know I write a lot of entries the involve me crying, but something you should know about me is that I rarely cry. On the surface, I am - or at least, I've been told that I am - very stoic and unemotional. So if I'm crying, I'm in a really bad place mentally.

It was about that time that he barked at the nurse to give me some Versed, also known as 'happy juice,' and I honestly don't remember much after that.

So on Tuesday, when he came strolling into my hospital room, I honestly had no idea who he was. First of all, all these surgeons look the same to me in their surgeon outfits with their head covered. Second of all, I'm, like, blind as a bat without my contacts in (20/900, in case you don't believe me), and I obviously did not have them in pre-surgery. I do have glasses, but they aren't the greatest, just because I'm so very dependent on contacts, and have been since I was 10 years old.

'Hi!' he said very cheerfully.

'Um, hi?' I responded, thinking it was some surgeon in the wrong room or something. Or maybe it was Christian, the PA, who is also a very generic looking white dude?

'Do you remember me?' he asked.

'Yes,' I lied. (WTF, why did I lie? What if it really had been a surgeon in the wrong room? LOL.)
Fortunately, right about the time I was lying, he was re-introducing himself as Dr. S, the anesthesiologist. He was very pleasant, not weird at all. He said he was there to check on my epidural and see how my pain levels were. I told him my pain levels were creeping up, but that I was anxious to get the epidural out so that I could have the catheter removed, because it was VERY uncomfortable. (Honestly, I don't think it was put in properly.) Also, the epidural made both legs numb, which basically made me unable to move, which was uncomfortable once the drugs started to wear off and I became more alert mentally. Christian, the surgeon's PA, had made it very clear that the epidural had to come out before the catheter, and had made both me and my husband repeat E comes before F; EF - meaning, epidural first, then (Foley) catheter. I guess in the past, the reverse has happened, leaving the patient with no way to pee, and he wanted to be sure it didn't happen to me - so, you know, I could advocate for myself if anyone tried to take out my catheter too soon.

Dr. S understood my desire to get the epidural out, and cut back the amount of meds coming through the epidural and said that he could take it out the next day, at which point I could transition to oral pain meds.

Then he commented, 'You look like you're in a lot of pain.'

I couldn't deny it.

'I've heard this is one of the most painful surgeries there is,' he added.

I couldn't deny that, either. Not that I've had every surgery that exists, but I did tell him I could certainly believe it.

He lingered a little longer, sitting down on the edge of the bed, or on a chair, or something. Making himself comfortable. Different from everyone else who is constantly on the go, go, go. It was evening, my husband had gone back home to tend to our kiddos that morning, so the company was welcome. Then he explained, 'I guess I'm interested in your experience because my daughter has hip dysplasia, and I'm not sure what to do.' He went on to say that she had been diagnosed as a baby, and spent a year in a cast, which is what they do to babies with hip dysplasia. (Google 'cast for hip dysplasia' if you need a visual. It's not pretty.) The goal is to force the head of the femur into the acetabulum at a different angle to cause the acetabulum to develop deeper. It helps, but it's not always enough. Lots of the people who end up having PAOs in their teens and 20s were treated as babies with a cast or a brace. I didn't need to tell Dr. S this. Obviously he knew already. I told him that must have been very difficult to deal with, and he admitted that it was. Then I asked how old his daughter was now, and he said she was 12. I asked if her hips ever bothered her, and he replied, 'No, but...' and trailed off.

No, but...

But they will. It's coming. It's very likely coming. He didn't have to say this. He knows. I know.  I also understood his concern for me was more because he was imagining his daughter in my place, trying to wrap his mind around going through this with his daughter. Honestly, I can't imagine. As much of wreck as I was, I would have been infinitely worse if it had been my daughter instead of me. And honestly, after educating myself about hip dysplasia, I am very worried my own daughter may have it as well, and that one day soon, her hips will start hurting, and I'll find myself in the same place as Dr. S, knowing what will happen if you don't treat it, but also wondering if it's something you want your teenage daughter to have to go through.

Throughout my hospital stay, the nurses commented on how tough I was, even when I was screaming and howling and not feeling tough at all. More than one of them mentioned that most of people they see who are having this particular surgery are teenage girls, 'and they have no coping mechanisms.' LOL. But in all seriousness, I can't imagine going through this surgery as a teenager, nor can I imagine going through it with my daughter when she's a teenager. Obviously Dr. S couldn't imagine it either.

We chatted some more, about how it was incredible I was never diagnosed earlier, and that my hips never bothered me a whole lot, and how it was probably better that I wasn't diagnosed as a baby because I'm not sure my parents could have handled it. It was actually a fairly intense conversation, a heart-to-heart from a parent to another parent, over a shared experience - both of us struggling with choices, worrying about the same thing, trying to do the right thing.

After a good 5-10 minutes, Dr. S said, 'Well, I should go. I'll see you tomorrow,' and sauntered out.

Later, one of the nurses told me that she was pretty sure he had never done this before, not for this type of surgery. So this was his first experience with PAO, a surgery he knew in the back of his mind his daughter might need someday. That must have been a tough experience for him. And it was a good reminder that we're all just... human. Flailing our way through this weird experience we call life, by putting one foot in front of the other. That is, if we're lucky enough to have the luxury of two working legs.

Take it Easy

I mentioned that I've joined a couple of online 'support' groups for people with hip dysplasia, many of whom have had a periacetabular osteotomy, and some of whom have had a PAO with my surgeon, Dr. Terminator. I believe I mentioned that I've put my full faith into this guy because in all of my vetting, no one has had anything bad to say about him. His patients not only LOVE him, but also think he is BRILLIANT, and many would trust him with their lives! So obviously that makes me feel good, and as an educator who is subject to wrath of students on sites such as RateMyProfessors, it's pretty amazing he doesn't even have a few disgruntled ex-patients going out of their way to badmouth him.

That said, I don't get it. I mean, Dr. Terminator is... fine. And like I said, I don't think bedside manner is the most important thing when it comes to surgery, and especially not a big one like a PAO. I'm far more concerned with whether the surgeon knows what the hell he's doing than if he has a compatible personality and takes the time to make awesome small talk with me. Been there, done that. I'm over it. I mean, it never hurts for a surgeon to be caring and compassionate, but those aren't my top priorities. So don't get me wrong, I'm not complaining. But I'm just not seeing that side of Dr. Terminator that pretty much makes my local PAO Facebook Group a Dr. Terminator fan club. I dunno, maybe I'm just picky, or bitchy, or overly high maintenance, and maybe he just doesn't like me, but there's seriously nothing lovable about the man that I've noticed. In fact, aside from the two pre-op appointments I've had with him, during which he was fine, but certainly not AMAZING, I've hardly seen the man.

Before surgery #1, he came in briefly, as surgeons usually do, and gave us about 30 seconds of his time, during which he said something to the effect of You'll be fine. LOL. After the surgery, he came in and asked me how I was feeling, and I said sleepy, and he said, Good, go back to sleep. Granted, he apparently spent more time debriefing with my husband, explaining how everything had gone, what he had done, and so forth, but still. It's not exactly a lovefest here! For surgery #2, he didn't bother to come in beforehand. When he came by afterward, it was, like, 8:00 PM, and he looked tired. Obviously the man works crazy hard, so I resisted the urge to make some snide comment like, Whoa, so you are real after all! And, of course, I was crazy drugged up so it's not like we were going to have some deep conversation or anything. In fact, I have no idea what we talked about. I do think maybe he told me he was happy with the outcome, the coverage he was able to give me, and the placement of the screws. Something like that. Or maybe that was the next day; it's hard to say.

Fortunately, Dr. Terminator seems to have assembled a very competent and effective team of people around him. So the whole package is good. It's not that I don't feel well cared for, I'm just not feeling the love that everyone else seems to feel, and I'm starting to wonder if it's me. Ha. I don't feel like I'm a particularly problematic patient, but maybe I am. If I had to describe Dr. Terminator's style, I'd say it's tough love, minus the love. LOL. His PA, Christian, seems to have taken over a lot of the hand-holding duties with me that Dr. Terminator apparently takes on with other patients. But Christian, too, is an interesting fellow. Mostly in a good way, but sometimes he gives off this vibe that makes me feel like he's silently judging me, thinking, Wow woman, you are a fruitcake, and I can't wait to get away from you! I mean, I know I'm a crazy fruitcake, but I don't think I actually act like one most of the time. It's as if I'm some lunatic trapped in the vessel of a totally normal person, so when I feel like people can see through to the crazy me, it creeps me out a little.

One of the hardest days after the surgery, either the second or third day, Christian was in my hospital room, and I just LOST IT. I don't even remember why, but it was surely some combination of self-pity, self-loathing, loneliness, frustration, drugs, and all-time high pain levels converging to some undignified moment where a grown woman finds herself sobbing inexplicably and inconsolably. The type of moment where you just need a hug, some human contact, someone to tell you it's going to be okay, even if it isn't. Christian did nothing; he stood there quietly, saying nothing, looking at me. And I could not. stop. crying. And since he was just standing there, staring at me, I finally said in between heaves, I'm sorry, because I didn't know what else to say and I guess I somehow wanted to give him permission to leave if he wasn't going to do anything but stare at me like I just sprouted a second head. And I was sorry, sorry for myself that I was having this total meltdown in front of some guy I barely know, sorry that I was clearly making him uncomfortable and wishing he could leave, sorry that I was letting someone else see me in one of my worst moments, which I usually hold inside my head where only I can experience them, and occasionally try to write about them. Finally, he very bluntly and unapologetically told me, Don't be sorry, while I continued to cry and hyperventilate like a three-year-old having a tantrum. Then he said, You just had your hip bone cut into pieces, and a bunch of muscles detatched and reattached. It's a lot to go through. You need to be easier on yourself.

You need to be easier on yourself. 

What exactly does that even mean? Nonetheless, in that moment, I found some solace in it, the closest thing to a lifeline that I could grab onto; Christian's best offering. He's giving me permission to cry like a blathering idiot and not feel bad about it. Or he's giving me permission to feel sorry for myself, to fully accept I'm on this lonely journey that no one understands nor really cares to understand. Or he's giving me permission to hate myself, for being emotionally weak, for living in this ridiculously horrible deteriorating body. Or he's giving me permission to cry because this hurts so. damn. bad. He's giving me permission to show my worst, most pathetic side. Whatever the case, he and the nurse briefly colluded, and I ended up getting some combination of drugs that knocked my pain level down significantly, but more importantly, knocked me out cold. When I woke up, it was the middle of the night, and the lights were out, and I was calm, and Christian was long gone. He gave me permission to cry myself to sleep, and himself permission to leave after a long day of work, and go home. It's only fair. If I have permission to cry and yell and rant and lose it, then certainly the people who care for me have permission to not be able to help every person they see who is crying and yelling and ranting and losing it. We all get to go easier on ourselves.

I'm trying, I'm really trying. To be easier on not just myself, but also others.

Well I did it, I got screwed.

Isn't it kind funny how for, like, a year I've had nothing of real substance to say, yet I came here to wax philosophical and yada yada yada, and now... I have real shit to say, and a lot of it, and I can't bring myself to be here. At first it was because I didn't want to think about it. Like, really, I was filled with so much dread I couldn't think about it. I mean dudes, YOU ARE SAWING MY HIP INTO THREE PIECES! Who wants to think about that?! So... I didn't. I mean, weirdly enough, I did a bunch of prep work, I rearranged the house so it was handicap accessible, I bought all the shit that comes with these types of surgeries, but I did it without actually THINKING about the surgeries themselves. I went to Florida, I took my daughter on a special trip to New England and New York City, and I barely thought about it at all.

And then, July 10th came, and part of me was like, holy shit, I guess this is really happening, despite the fact that I have successfully avoided thinking about it for months now. But guess what? I went into the hospital, had the damn surgery, and it was still like it wasn't happening. I came home, spent a week pretending it was business as usual, minus the walking and all that, and then July 17th came, and I was like, holy shit, I guess this is really happening! And the morning of July 17th, the morning of the PAO, was when I pretty much started to fall apart. Like, first of all, my arrival time was 5:45 AM at the hospital, and it seemed like Monday morning chaos, which I get, but doesn't exactly lend itself to you having a great feeling about having your hip sawed into three pieces and screwed back together. Then the anesthesiologist came in and I swear he was high, or hung over, or something, and he was so weird it was kind of freaking me out. I thought it was just me, but after he left the room, my husband joked, 'Wow, I think he's had a few.' But no worries. This is the just the guy who is going to KEEP ME ALIVE during surgery! Totally not a big deal. LOL. Eventually my surgeon's PA came in and gave his usual (not very convincing) You're going to be fine, you have one of the best surgeons in the world pep talk. Then the anesthesiologist came back to put in an epidural (did you know those aren't just for child birth?) and by that time I was so worked up, I was crying or sobbing or doing something that made the anesthesiologist bark at the nurse to give me some Versed through my IV. Then he told me, 'It will make you happier. And if you're happier, the rest of us will be happier, too.'

And that's pretty much all I remember. And then I woke up. So I lived to tell about it, which is why I can joke about Dr. Crackhead. (He actually ended up being one of my favorites; more on that later, perhaps.)

The End.

Not really, of course. That's more like The Beginning. You know, the first 24 hours were really not bad. The epidural was still in, so I had pretty much zero pain. And I was fairly drugged up, so I slept a lot. On Day 2, I started to get uncomfortable, and the drugs started wearing off, and the catheter started to get uncomfortable, only I couldn't really move AT ALL, so I started to get antsy. AND, I got diarrhea and horrible stomach cramps, which is RIDICULOUS, because all those drugs they give you are supposed to give you constipation. And I did get horrible constipation with surgery #1, so I think I overdid my anti-constipation actions for surgery #2, and I'm not sure which one is worse, to be honest. Gross topic, I know, so let me just say that the diarrhea was HORRIBLE. Diarrhea and GI distress is not welcome under any circumstance, but diarrhea and GI distress when you are bedridden and any movement causes excruciating pain is probably among the most unpleasant and undignified experiences I've eeeeeeeever had. I'll leave it at that, because I'm not trying to make you throw up or anything.

I remember from my DIEP surgery that the second and third days afterward were the worst. The catheter comes out, so you have to get up and move around to at least go to the bathroom, yet you're also being weaned off your pain meds, so there's a lot of pain. It was about the same with this surgery. Days 2 and 3, I spent a lot of time crying and feeling sorry for myself. And there were times when my pain levels were just absolutely through the roof, times when I actually screamed and scared the nursing aides out of the room. But for the most part, I think I've blocked it out. As bad as I was expecting this surgery to be, those days were even worse than I expected. But, it got better pretty quickly, more quickly than I had imagined. My surgeon had told me that the first few weeks post-op were going to be very, very rough, so I was prepared for that. And don't get me wrong, it's been rough. But, once my pain was under control about 72 hours post-op, and I could start moving about a bit, it wasn't as bad as I was expecting. The extreme misery was pretty short-lived. By Friday, I had started the hospital's occupational/physical therapy program in preparation to go home, and I left on Saturday morning. It was good to get home. The hospital was in a city two hours away from my home, so I spent a lot of time alone during my stay, which was pretty hard at times.

And now... here I am. I think I'm still sort of in a weird state of denial, even though I'm fully in the thick of things. I just have no desire to try to recall or mull over the details, which isn't normal for me. I just feel so... detached? It is hard to say. I promise to write more later, now that I've broken out of my non-writing funk. It felt good to at least get that much down. Peace and love. :)