Wallows and Sorrows

I had a day yesterday. A DAY. 

I’m just going to warn you that this post is full of whining and wallowing in sorrows and I HATE being that way. While I’m feeling way better now and far more like my optimistic and enthusiastic self…yesterday I had a bad, bad day. And while I’d rather just erase this day from my memory and move on with my life, this blog is a place to document the good, the bad, and the way ugly.

To start, that morning I had to drive an hour away to a field site where I had to spend most of my day. Because my prescribed Valium makes me feel like an astronaut floating through space, I thought it best to not take this pill and then drive a bazillion miles south down a 3-4 lane highway. I felt fine all day, much to my surprise. It felt a little, teeny bit tight, but mostly fine.

I had my Physical Therapy appointment scheduled at the hospital for yesterday afternoon. This was with the therapist associated with my surgeon’s office. I had intended to take my Valium when I changed to go to the appointment. THAT plan got foiled because we ran late in the field and I had to run around like ninny just to make it to the hospital in time for my 2:45 appointment. (Which I then had to sit and wait around for another half hour for them to be ready to take me…but I digress.)

Val, the very nice lady who looks very much like Sophia Bush, took me in and asked me 7 million questions and wrote notes all over my form. They all looked like chicken scratch but they apparently meant something to her. Then the fun stuff began.

She took all sorts of measurements of hip angles and ranges of motion. She took some lying on my back and my belly, an even on each side. She took measurements of both hips for comparison. There was lots of stretching and pushing and pulling. Then she started showing me “light” stretches to focus on the psoas/hip flexors. At that point, I could feel things getting a little angry in there. Just liiiiiittle bit angry.

She asked me how I thought the spasms might be triggered, so I told her that every time they’ve happened so far, it has been directly after sitting down. The folding of my torso and the contracting the muscle together seems to be what’s causing it (in my non-medically-trained brain). So she seemed intrigued but not surprised. Innocently she said “Okay, so just do me a favor, stand up and then bring your leg up into a marching motion.” And….BAM! Muscle SPASM OF DOOM! I immediately panicked because I knew I was a half hour from home, I had to drive my car, and I immediately couldn’t even walk or move. The therapist and I instantly tried working on it to get it to calm down.

We heated it, she did direct pressure and even massage, we stretched it…nothing helped. It was a freaking scene in the clinic because she had to help me with everything I did. She had to help assist me to the chair because I couldn’t move the leg, she had to get the heat for me. She had to help to and up onto the massage table while I writhed in pain. It was so embarrassing. And of course everyone watched in horror (probably not…but it sure felt that way). I was there for forty-five minutes with her trying to get it to calm down so I could at least leave. Finally we decided that I HAD to take the Valium, so she got my bag and some water for me. Luckily I had it with me.

After taking the pill it was like a twisted race against time. I needed the valium so that my leg could feel well enough to walk to my car and drive, but my Valium makes me pretty out of it and I didn’t feel comfortable driving while on it. What a mess.

When the spasms lightened a little, I was then able to at least move my leg a little bit so that I could walk if I crouched over and took tiny steps. I decided to leave at that point…there was nothing left they could do for me and as long as I could get myself into the car and comfortable, I was confident at that point that I would be okay to drive. As I was leaving, I bumped into my surgeon’s assistant, Hilda (aka nicest lady ever). She was so worried about me because I obviously looked like a hot mess. She didn’t know if I should drive like that. She lives in the town next to me and she wanted to drive me to a meeting place where Matt could then pick me up. I wanted to take her up on it, but the problem was that I was not leaving my car in the middle Providence overnight. I might as well leave a big sign on it saying “Please steal me!”

Hilda walked me all the way to my car, during which time she told me she really wants me to get a permanent handicapped placard. She told me to fill the papers out today and to send her the paperwork. She also said she was going to tell Dr. Schiller about the whole thing (I felt like it was when my mom used to say “Wait until I tell your father about this!”)

It took a few minutes to get into my car because of course I parked my car right next to a giant column and I couldn’t open my door very far. That made an already difficult situation even more difficult. Seems so silly to read that, I’m sure, but I was so stressed out from the mess of a scene at PT, then seeing Hilda and having her dote all over me and telling me she’s going to talk to Dr. S, and the tension from the spasm, this stupid column next to my car was like a monumental issue at the time.

I finally got myself into my car and found a position where I was actually pretty okay. I wasn’t irritating the spasm, and I could move my foot back in fourth to the pedals with minimal pain. It was obvious the valium was working and I could drive home. I just took it slow.

As I drove home, all of the everything that had happened over the last couple hours really just hit me all at once. I was overwhelmed and embarrassed. I was annoyed, aggravated, and most of all, severely discouraged. I kept having these awful “These spasms will never go away!” thoughts and the “I’m going to have to take Valium for the rest of my life!” thoughts. So dramatic, but I honestly couldn’t help it. I am not ever like that, ever. I pride myself on trying to always be thankful for what I do have, and grateful for an overall very healthy and happy life. But last night man, it all just kind of piled on.

And then it all just got worse. Because I am a Daddy’s Girl, through and through…right down to my core. I am the definition of a Daddy’s Girl. And my whenever anything got me discouraged, or down…or upset, I would always talk to my dad about it. He was the wisest man I’ve ever met; extremely intelligent, and insightful, and thoughtful. And besides all that, he was the most supportive person in my life. Always. He and I were two peas in a pod. So, for me, going through this has been difficult all along. But last night, after all I had been through that day, and the horrible pain that I was still having in my leg even three or four hours later, all I wanted was my Daddy.

I just wanted my Daddy. And he’s not here. So there it is. A girl sometimes just needs her dad…and I can’t have him. So while driving home, all of these awful emotions just hit me all at once and I had a “woe is me” sobbing-crying-pity-party all the way home and for about another hour after that.

Then I ate a brownie.

What can I say? Sometimes a girl just needs her Dad. BUT, I picked my head up, wiped the tears, realized I was being dramatic and have since just done my best to pick my sorry self up and move on. That’s what I do. I move on and adjust the sails.

Friday I see Sophia Bush (Val) again, and we are going to do more gentle stretches, no exercises. We may try some ultrasound, depending on how I’m doing. From this point forward I will not do any strenuous anything, I can’t even LOOK at strenuous exercises. No more of the exercises Dr. Schiller gave me. I just have a couple stretches that Val gave me and I have to do those three times a day every day.

Today, I am looking forward, and not backward. I’m realizing that even when I can’t hug my dad, he’s still hugging me. He’s here, and he’s supporting me, even if I sometimes can’t see that. Today, I move forward, and not backwards. This psoas is a roadblock, but I’ll find a detour to keep the course.

I'm Such a Spaz(m).

Hello friends,

Quick update on what’s what.

I spoke with my surgeon yesterday because Wednesday was obviously really crappy and I KEEP having these spasm episodes. He said that he wants me to get this psoas situation in check so that I can continue with PT and finally loosen it up and strengthen it so we stop having these issues. Because I’ve been continuing to have these episodes, he prescribed Valium as a muscle relaxer to treat my muscle spasms. I have to take a 5 mg pill every 8 hours for at least the next two weeks.

I picked up the prescription last night on my way home from work, and planned on taking one right after dinner. I was dreading it a bit because I don’t like taking pills at all and I had really felt okay all day.

I wanted to just sit in the living room and watch some of the Red Sox game before taking my pill so I went and sat down in my favorite chair and BAM. As soon as I sat down, it started to spasm immediately. I tried to stretch it out and calm it down before it got too bad but it was too late. At this point I was frustrated and disappointed so I just sucked it up and took the Valium. I also put a heating pad on it and tried to gently massage it. I hurt for another hour and a half or so, but it slowly got better as the Valium kicked it. Even though I hate to admit it, it definitely helped. The spasm was completely gone by 8:30 pm…lasting about an hour and half but being progressively better after a half hour of being on the Valium. The Valium made it tolerable, which is really the best I can ask for until we get this situation taken care of.

So, I’ve just taken the Valium again this morning, as ordered by my surgeon, and I’m hoping that it now starts to be preventative. I won’t lie; it makes me a little loopy. Kind of like when you take a dose of Nyquil. It’s not terrible, though…which is good.

I’ll keep you posted on how I make out.

Talk soon,

D

Adjust Your Sails

Well, it happened again this morning.

I got up around 5 and went downstairs to have a cup of coffee and watch the news. I was just sitting in my big, wonderful over-sized comfy chair when BAM! Psoas locked up in what shall, from this point forward, be dubbed as a MEGA-SPASM OF DOOM. I don’t remember moving or shifting in any particular way, really. I just remember all of a sudden I had an aching pain like I was tugging hard on my psoas. So I tried to shift, thinking I was just sitting funny (which was hard for me to believe, I wasn’t leaning to either side or putting weight on either hip, I was sitting straight forward on my bum). At this point the pain was getting worse and when I tried to move my leg the muscle spasm just got worse. So I tried to get up out of the chair and, like the last time, I couldn’t really stand up straight. With the help of my hubby, I managed to get myself upstairs and in the shower…hoping the hot water and warmth would help loosen it up. As time went on over the morning, it started to feel a little better. About 30-45 minutes later, I sat down and bent over to put on my socks, and when I sat back up and stood up it was almost completely better…like someone had flipped a switch. I don’t know if the pushing the muscle onto itself made it loosen up or what, but I was thankful!

I am fairly certain it’s a psoas muscle spasm, but I guess I’m not totally certain. The psoas runs up and down the front of the joint, and the pain I’m feeling is more across the front, like this:

 It’s an aching pain, almost like a pulling? Or...pushing maybe? No…not pushing…it’s pulling. Contracting even. Like it’s so contracted and tight that any time I try to use the muscle or stretch it to stand up it screams. It hurts mostly when I try to move the leg forward to take a step or pick it up for something (like to step up or over something, lift it to put socks/shoes/pants on, etc.). When I do these things it yells very loudly. If I’m not using it at all and just standing a little crouched over-like so that I don’t stretch it the pain is mostly an aching pain.

Anyway, I think it’s a bit appropriate that it happened this morning. I came across a quote yesterday while on Pinterest doing Pinterest-y things.

It said: “We can’t direct the wind, but we can adjust the sails.”

I felt like it was so appropriate for, not only my RPAO recovery, but also my life as a whole these past few years. Those who know me know this has been a difficult few years for me, and some of my most treasured loved ones.

I don’t want to tell a sob story, but I feel like I need to write these feelings down and document them not just for my readers, but for me as well. While I am so glad that this blog has been helpful for many, it also serves as a place to reflect. So I want to put down some things I’ve had in my head since reading that thought-provoking quote.

In the fall of 2009, my father, who was the light of my life and my best friend, was diagnosed with cancer. The cancer was serious, and it was aggressive. My family and I tried to rally together to support the man who was the constant rock for all five of us kids and my mother for our whole lives.  To say that coping with my fathers’ grim illness was an extremely difficult part of my life is an understatement. “Adjusting the sails” during this journey was an ever constant thing. The disease took its toll on my father, and our whole family and in August of 2010, the cancer won the battle.

Losing my father was, without a doubt, the most devastating thing I’ve ever had to deal with. And while I tried my best to cope, and to heal, just 5 weeks later my then fiancé/now husband and I lost one our best friends in a tragic accident. Our 29 year old friend, Sean, died of cardiac arrest after finishing a road race. He was an all-around outstanding human being, and an even better friend. One of the best people I’ve ever met. I could go on all day about Sean. Matt and Sean were best of friends. It broke my heart not only to know that Sean was gone forever, but to see Matt hurt in such a way. This was so much for both of us to bear. Again, “adjusting the sails” became a common thing for us, and those around us coping with the loss. I miss them both every day; it’s still so hard to believe we’ll have to always be without them.

2011 and 2012 held many ups and downs along the way, including this RPAO surgery which was another hurdle for us to jump. This has been difficult, but the past months have been so much easier than the months just after the surgery.

So, I guess in reading that quote last night it really hit me: you cannot plan life. Life is unexpected, and unpredictable. It’s whimsical and wonderful, but it can be disappointing and tragic. You can have dreams and set goals and most certainly do your best to achieve all of them, but you absolutely never know what life will throw at you. If there’s a most important thing to learn it’s that you need to know how to handle the shifting winds. 

That quote is so appropriate for many aspects of my life, but I can certainly relate to how it represents my PAO recovery. Many times throughout recovery I felt as though I was on a good path and headed in the right direction, when something would throw me off course. I’m sure we’ve all felt that way, either physically or emotionally. We know that this surgery takes such a toll on not only our bodies, but also our minds, too. We’re all re-learning ourselves; our capabilities and our limitations. We’re having moments of great achievement, and also of great frustration. We’re on cloud 9, and then at our wits end…maybe even in the same day. We are growing, we’re changing, and we’re trying to take every obstacle as it comes. The most important thing is to let us all remember: Keep our heads up, keep moving forward, and no matter what life throws as us, always remember to adjust your sails.

Just a "Pinch" of Pain

Hello again, all!

I had my appointment with Dr. S. on Monday. I wanted to take a few days to digest it all and think about how to write this post before I went about my business, so here goes nothing.

Here’s what we discussed in the appointment:

1. “Excess” Bone Growth
2. Psoas pain
3. Deep groin catching/pulling pain
4. Non-union
5. Heterotopic Ossification
6. Left hip pain

Here’s what Dr. S. said about each of these things:

1. The bone growth that I can feel on my iliac crest is completely normal and to be expected. Dr. S doesn’t think it has anything to do with my psoas pain or any of my other soreness since the growth is high and above my attachment point. He asked me if the screws that I can feel are uncomfortable and if I want them out, I said no. They are slightly uncomfortable, but I don’t want him anywhere near me with that scalpel anytime soon.
2. Dr. S. told me that my psoas and some of the surrounding muscles are really tight, but that my hip-flexor and quad strength is actually pretty good. He didn’t seem overly concerned about it, but does want me to try and get those muscles looser and in less pain. We are trying for 6 more weeks of physical therapy (on my own time) to see if that helps the pain I’m having. If it doesn’t, we’ll take it from there. 
3. Dr. S. was a little concerned about the deep groin/catching pain I described in my earlier post. He doesn’t like the idea of having pain that won’t allow me to stand up straight or walk (obviously). He’s hoping that it’s a continuation of the psoas tightness and pain and that it will resolve itself with physical therapy as well. If it doesn’t, he’s thinking some deep tissues could be catching on my screw head (see photo below). If PT doesn’t help, we may have to consider taking my screws out. That would not be ideal, since some of my screws are pretty deep. He’d have to re-open my incision and do a lot of moving around to get to the screws. It’s not as cut and dry (tee-hee) of a procedure that I was thinking it might be. He did mention that he’d really like to avoid putting me through that if he doesn’t have to. We will see at the end of the 6 weeks. 
   
4.  The non-union is a non-issue. He said that it’s not a weight bearing bone and it’s not going to have any impact on me. He also said that while it appears that it’s not closing, it more than likely is still growing bone and will close on its own eventually. 
5.  Dr. Schiller did confirm that I do actually have heterotopic ossification (HO) in the areas that I had suspected by looking at the x-rays. He said that's no big deal and it's mostly in the deep muscles tissues and I'll probably never even know I have it.
6. This is the part where I sigh loudly and with general unrest. As I’ve mentioned in past posts, I’ve been having “start-up” pain in my left hip. This isn’t a new thing, it’s been happening for years. Lately, though, it’s a little more common and a little more startling. I had attributed it to the RPAO and that my left hip has had to work overtime for years. Even before my RPAO, my poor left hip got the brunt of it as I compensated for my right hip pain. So I explained everything to Dr. Schiller. He showed me my x-rays and told me that in terms of coverage, I’ve got pretty good coverage on the left side. He wouldn’t consider LPAO at all. However, he did say that I do have impingement on my left side, and that that is what is more than likely causing all of my left hip pain. He said that if he had to guess, that he’d say my left hip is probably a little degraded due to both the impingement and the overtime work it’s had to put in and that that’s why I’m feeling the pain.

I did a little research on my own so that I could better explain and show you what’s going on (and better understand it for myself). What I’ve got in my left hip is called Femoroacetabular Impingement (FAI). There are a couple different kinds and they are outlined in the website I’ve provided below.

http://orthoinfo.aaos.org/topic.cfm?topic=A00571

I have what’s called Pincer FAI. I’ve attached a couple of my x-rays, one pre-RPAO and one post-RPAO to point out where my FAI is.

Pre-RPAO

Post-RPAO

So, what now? Well, Dr. S. said that there are some surgeons who would have fixed it as soon as they saw it, regardless of if it was really bothering me or not. He doesn’t really operate that way (pardon the pun). He would prefer to leave well enough alone until it starts to bother me to a point of needing fixing. Over time, it will probably continue to wear at my labrum and joint space, and eventually I will need to have it addressed. It would more than likely be a scope surgery like what I had last March on my right hip. Probably not a big deal. We’ll have to take a day at a time and see how it goes. For now, he wants me to do what I’m doing on my right side for PT to my left side as well. That way we can see if PT will be help to me for the FAI.

That’s that, in terms of what I spoke about with Dr. S. I will say that I’m disappointed to hear that I’ll more than likely eventually need another surgery on my other side. Going through degrading pain on the other side now is not something that I’m looking forward to, I can tell you that much. I guess that we’ll just have to see what happens. Maybe it WON’T get worse after all. Time will tell.

I have to keep doing the PT on both sides for 6 weeks. At the end of six weeks I have to call Dr. Schiller’s office and let them know how I’m feeling and make an additional appointment if PT doesn’t seem to help either side.

I’ll post later about what I’m doing on both sides (RPAO-ed and left FAI) for physical therapy exercises.

Thanks for listening, and we’ll talk soon,

D

Sitting Pretty.

Hello again! Updating on the painful hip issues.

A couple weeks ago I decided to call and make an appointment with Dr. S. to see what's going on with this silly little hip. It hasn't gotten better, and what's more is that it's more painful than it was. I've had a couple pretty concerning episodes with serious pain. One where I actually couldn't even stand up straight or walk at all, I had to have my husband get my crutches so I could get around for a few minutes while my hip worked itself out. The pain eventually went away, but it was scary for a few minutes.
It's doesn't seem like bone pain, though. It seems like it's psoas, or something muscular/tendon deep in there that is pulling. It's a pulling and aching feeling, and it only happens when I use the muscles. It doesn't seem to hurt when the leg is moved without my muscles (like if I move it physically with my hands). Almost every episode has happened after I've been sitting for a while. I am continuing to have a hard time with sitting. Even as I write this, I can feel everything stiffening up. Generally speaking, I can get along just fine with the sitting/stiffness issue. It's only painful to stand up straight, and for a few seconds walking when I get up, but after I move around to get things going again it's not really painful at all. It's just the "start-up" that hurts. I think I need some WD-40.

So, now I just wait until I can see Dr. S. I meet with him in another couple weeks on the 31st of March. It can't come soon enough. I want to chat about my right hip, and I also want to bring up my left hip, which is also stiff and painful when I first get up as well. The left isn't overly worrisome, but I want to bring it to his attention in case he wants to see what's up.

I know it could be any number of things. I could just be that I really need to get back to the gym and work and stretch these bad boys out. It could be that these are the kinds of things I should expect from a PAO-ed hip. It could be that there really is something going on. Who knows, we will hopefully start figuring it out over the next few weeks.

I'll let you know how my appointment with Dr. S. goes.
-D