It's the Little Things

It's  true that expression is way overused. But it can be so true. On the one hand, I have a very BIG excitement as with every day I have less pain in my hip, and more facility of movement. Sometimes it wells up inside me with such a powerful force, I feel as if I could explode with the joy of it all. The poignant side is to realize each day with more clarity how really tied down I was, how impinged the movement of my legs was. 

Rooftop terrace Sayulita, Mexico.

This photo was taken in February of this year, on our Mexican holiday. We were lucky to have this terrace over our beach apartment, where we practiced yoga every morning. When doing Warrior 2 before arthritis started showing up in my hips, my feet were wide enough to bring my thigh parallel to the ground. It is strange and uncomfortable, to feel your muscles get tighter, no matter how soft you visualize them, or how often you stretch them. It feels so big and wonderful to be on the other side. To feel my hip joints releasing and opening. 

It's the small details that are somehow the most profound, the most telling. Here's a list of little things that give me so much joy these days:

1. I can sit cross-legged again.
For as long as I can remember, I have been a floor sitter. I eschew chairs, and sit cross legged on the carpet. But as my right (the first to go) hip got more and more and more painful, I had to sit with my left leg tucked under, and right extended. It was a big deal to arrive again at sitting cross legged after the first surgery, but it quickly retreated as the left hip descended into pain. Now I can sit up straight, legs crossed!! I'm still a little stiff in the left hip, but it's getting better all the time. In fact, this morning I crossed my right leg over into half lotus. It's like finding a piece of myself that was lost. 

2. I can walk in the woods.
With losing the range of motion in my legs, and pain in every step, walking in the woods with my dog(s) became a chore. I began to stick to the flat, as it's tough to step over logs with tight inner thigh muscles restricting the movement of the legs. The fear of pain makes it tough to jump down off rocks or slide down a hill. I feel so much more at ease now, walking deer trails and hilly terrain, hugging huge trees. I am still cautious of falling, and weak in my legs. Even so walking is such a rediscovered joy! 

3. I can ride my bike.
First my right, then my left hip, would pinch at the front when I rode my bicycle. Raising my seat helped a little, but gave me less pedalling power. My right knee used to turn outward, and the heel inward to bang against the frame of the bike. Now I can ride pain free, though just like for hiking, my legs are weak. But they keep getting stronger. 

4. I can skip!
I'm not sure if it was the pain, or the lack of cartilage in my hip(s) or both, but I've been grounded for years. With hip pain, you can't run for a bus, and you can't 'Skip to My Lou.' I was trying to show my step-daughter the can can a few months ago, and couldn't bounce. But the other day, I was in a group of dancers and without thinking, I started skipping...and laughed out loud! So joyous to be able to do that simple movement.

5. I can shake my booty!!
I was in the kitchen cooking the other day, and started dancing. Maybe it was the pelvis circles I'd done with my yoga class the day before, or maybe my hips were just ready to move, but I started to boogy like I haven't for some time. The hip pain prevented me from shifting my hips side to side. I did my best to take the opportunity to be more expressive with my arms, torso and head, but it sure is awesome to be able to shake it again.

6. I can (almost) Cartwheel!!!
I haven't tried yet. But soon. Once my hip doesn't hurt. Once my muscles are longer and stronger, I'm going to work up to a Cartwheel. That will be the true sign that I am back on my...hands?


Today's Quote: “Dance, when you're broken open. Dance, if you've torn the bandage off. Dance in the middle of the fighting. Dance in your blood. Dance when you're perfectly free.” ― Rumi

The Last Physio Visit

I was just about at the three month mark when I went to see the physio. He invited me into the big room with the mirror and watched me walk up and down a bunch. He said my gait had improved 'dramatically'. It seems that like my yoga practice, and the physio exercises I've been incorporating have paid off. The exercises I've been doing are:

1. Little Bridge
Lie on your back, arms at your sides. Slide your feet on the floor towards your head until they are under your knees, hip width apart. Squeeze your  glutes to raise the hips, stopping when there is a straight line from knees to shoulders. Hold for 20 - 30 seconds, then lower slowly. Try to bring the two hips to the floor at the same time. This works Hamstrings, Glutes and Core.

2. One Legged Bridge
Go up into the bridge, then lift one foot a few inches off the floor. Hold for a few seconds, then put it down and lift the other. It helps to put the hands on the hipbones, so you can feel if they are level.
An excellent exercise for Core Stability.

3. Leg Extension.
Lying on my back with my thigh over a bolster or block, I extend the leg to straighten the knee, hold it for a few seconds, then lower my foot. This strengthens the quads.

4. Clamshell
Lie on your back, knees bent, then roll onto the unoperated side. Feet should be in line with hips, knees bent at 90 degrees, head supported by the arm. Put the other hand on your upper hip as a reference. Without moving your hips, lift the top knee away from the bottom one. Eventually you can wrap do the same exercise with a Dynaband. This works the Gluteus Medius and Maximus.

I've also been doing my best to walk with my feet parallel, and my pelvis tucked under. Sounds like it's working...but maybe too well.


The "Bad" News
John says that I've changed my movement patterns so drastically, that I can't stretch yet. He advised me to let the muscles, bones, and fascia settle into their new places before moving on to lengthening my hamstrings, and softening my tight hip muscles. Sigh.

On the Other Hand...
On the good side, he said that by August 1st, no one will be able to tell by looking at me what I've been through. John gave me my walking papers. He says there's nothing else he can do for me.

Moving Forward
Already I am getting comments on how well I walk. What I really care about, is that the pain is dissipating. I can lie on my operated side. In fact I can sleep in any position I like these days, which is so exciting! 

I so appreciate being able to move more freely. I am mostly keeping my restrictions, but not too strictly. Pun intended. I have been told more than once by friends that I walk very differently than I did. I really didn't know how much I limped, how ungainly my walking pattern looked to others. I only really see it, see myself moving in my mind's eye, now that it's over. I am so blessed. 


Today's Quote: “You have to participate relentlessly in the manifestation of your own blessings.” ~ Elizabeth Gilbert

Dislocation???

I am almost at the three month mark, and have been getting a bit concerned about my hip. I don't remember this much pain, and it seems that there is more swelling that there should be at this point. At least that's how I was feeling a week ago. I had started to wonder about dislocation.

I called the surgeon's office yesterday to make an appointment for my next check up. After I saw him at six weeks, he'd asked to see me again in 2 months, rather than in another 6 weeks. So, I spoke to the orthopaedic nurse to ask about whether I can start moving again, as my 3 months of restrictions will be up before I see him.

She said I can lift some restrictions, not all. That I can ditch the tall toilet seat and the cushion. I didn't tell her that I haven't been using either for a couple of weeks. My physio said it's 'torsion' that I need to avoid, to keep the hip healing well. I think that's the painful feeling in my hip that comes from pushing up with my left foot after sitting on a low seat. I always only push up to standing with my right, and keep my left leg extended on the way down and up.

It's partly due to that bit of disobedience, and partly because of the pain and swelling in my hip, that I have been wondering about dislocation. I was worrying that it could be gradual, that my greater trochanter was slowly moving out of my hip socket, causing the swelling and pain. A bit scary, as the surgeon has been pretty dire about dislocation, its attendant pain, and going back under the knife.

So I looked up dislocation after THR on the net. The information I found was very reassuring. What a wonderful resource we have at our fingertips! Turns out that's not what happens. If my hip were dislocated I'd be in excruciating pain and not be able to walk. Phew!

The nurse said I can expect some swelling and pain, along with various pops and snaps, for up to a year. She said I can start stretching, but gently. Hurray!


Today's quote: If you don't like something, change it. If you can't change it, change your attitude. ~ Maya Angelou  (RIP Ms. Angelou...)

Notes from 10 weeks Past Surgery

I have nothing really new to report. Still walking with my pelvis tucked, feet parallel and hips swaying. Or trying to. Still practicing patience in waiting out my three months of restrictions. Even so, here are some reflections from this place on the path.

1. My hip hurts. A lot. 
I just went back to read last year's blog. I don't remember it being this sore. The outside is tender to the touch, so I still can't lie on my left side. It also hurts to engage the external rotators. I've gone back to taking Tylenol. 

2. Both of my legs are weak. 
Six months of recovery in the last two years equals a lot of inactivity and muscle wasting. My hamstrings, quads and glutes are shadows of their former selves. My body feels dificult to lift. Perhaps because I am about 20 lbs heavier than my usual weight. It's hard to practice what I believe, to accept the roll at my belly, the extra flesh on my back, with love and compassion, when I miss my usual athletic self. I'm aching for dance class, acroyoga and bike rides on the Galloping Goose. 

Inspiring women like me to love their bodies as they are, here's Taryn Brumfitt. Taryn Brumfitt video


3. Zack cut my toenails
The second time around, I took care to cut the toenails on my left foot before I went in for surgery. Even so, they were appallingly long by the end of month two. Especially the baby toenail. I was in danger of slashing an ankle with it. Probably my own. Anyway, my partner Zack cut my left toenails for me. Thanks, Zack.

4. Inside to outside
A couple of weeks ago, I noticed a little black bump at the bottom end of my (I thought) completely healed incision. Over the course of a week, it wiggled its way out until it was a 3mm piece of thread sticking straight out, like a long, thick black hair. A bit alarming, as the little hole it sticks out of goes straight into the centre of my recent surgery. The perfect little tunnel for bacteria from our hot tub to invade my healing capsule. I was planning a trip to the clinic, and hopped in the shower. Then, as I ran my hand over the thread, it detached. Problem solved. I put a little Polysporin around the tiny hole, just to be safe.

5. Back on the Chain Gang
I'm able to carry my massage table again, and therefore back in business. Hurray! I love my work. You can book a Clearheart Bodywork treatment with me at 250-208-0300 or email peaceinpresence(at)gmail.com. I have also resumed setting up Personalized Restorative Yoga Programs for one, two or three people. I'll be teaching yoga at Ahimsa again in June. 

Come take advantage of the inspiration I've been soaking up while recuperating up here on Ming Mountain. I'll be so very pleased to share it with you.


Today's Quote: Healing takes courage, and we all have courage, even if we have to dig a little to find it. ~ Tori Amos

Physio Visit

I went to see my favourite physiotherapist, John Manley, the other day. He asked me how I was doing, I responded that my hip's feeling good, but I'm getting impatient. He said I've been impatient as long as he's known me. Maybe it's just the changes I've been going through in that time...

Put a Pebble in my Shoe
I told John about the one leg longer thing, and he seemed unsurprised, and furthermore, unfazed. He left the room for a minute, and came back with a chunk of insole and some scissors. He asked me to cut it to fit in my shoe, and feather the straight bit close to the instep. He said to try not to make a mess. John has rather a dry sense of humour. 

So I cut it to fit, put it in my shoe, and we went out into the big room with the mirrors to test out my walking. I've been focussing on keeping my gait even and my feet mostly parallel. I've been encouraging my hips to swing side to side a bit, but they're not very willing - yet. Turns out I've been missing an important detail. 

Debutante Slouch

John says my pelvis still has an anterior tilt of about 30 degrees more than it should. It's how my body has learned to move to avoid the pain in my hips. He asked me to walk and tilt my pelvis. Then to tilt it more. It felt like I was tilting A LOT! As if I were Steve Martin doing the pelvis forward walk for his character in Two Wild and Crazy Guys on Saturday Night Live in the 70's. https://www.youtube.com/watch?v=dpFNC7puU2M  

As I walked forward and backwards up and down the room, tilting my pelvis and relaxing my shoulders, I could feel a subtle response in my lower back. John said this will open up the fascia at the front of my hips, and bringing the vertebrae into alignment at the L4, L5/S1 juncture. This will in turn bring my thoracic and cervical curves into line. Once I'm past my restrictions, he'll give me some exercises.

Range of Motion, Clamshell and Mini Bridge
After that, I lay on my back on his massage table, and he checked my range of motion. He says it's exactly as it should be at the moment. He checked the activity of my external rotators by having me lie on my side with my knees bent, and open the top knee. He suggested I do this exercise, gently, to strengthen them. I remember he had given me that exercise before, but I'd forgotten to do it. Damn! 

John also asked me to lie on my back and lift my pelvis, coming up to a small bridge. He invited me to lift my right foot a little off the table, which was hard to do. Then I did the same with my left. Not quite so difficult, but still challenging. In fact, after a few reps of each side, my left hamstring started to cramp up. I have been noticing when I walk uphill that my hamstrings and glutes are weak from my long recovery period, and they need work. After I walked up the long set of steps from the beach the other day, leading with right foot, the top of my right hamstring was sore for about a week.

On Patience
As for the impatience - yes! I am very impatient, and for good reason. Almost 4 years ago I moved back to BC from Montreal. A few months later, I met my now partner, Zack, along with his kids, Noah and Piper, then 12 and 9. At first, we were a very active family, hiking, biking, swimming, diving, boarding, skiing, etc. etc. But it was soon after I met them, that I was diagnosed with osteoarthritis. Over time, my pain grew, and the list of fun activities I could do, shrank. No more running, jumping on the trampoline, and playing Survival in the forest for me.

Also, with one hip surgery last year, and the second this year, that makes 6 months, or half a year of movement restriction. Last year, as I was rejoicing in the new movement potential of my right hip, my left hip started to give me trouble. Just as i started to rev up my movement potential, it slowed back down again. Compared to my old life in Montreal, where I rode my bike everywhere, taught three yoga classes each day, danced contact improv and attended regular contemporary dance classes, I live the life of a slug. 

So, of course it will be SO AMAZING when this last month is over. Which is still a long way from the end of the healing journey. John says it takes 18 months all told to heal up after THR. But, to be able to move for the rest of my life, or until old age slows me down, the wait period is short. On the other hand, it's been so long, and most of my time with my family I've been hampered by arthritis. To be able to stretch and bend, run and jump, turn cartwheels and stick handstands. To be able to teach, to dance, to ski, surf and bike with my stepkids -  I can't wait to have my life back!!!


Today's quote: "Life isn't about waiting for the storm to pass; it's about learning to dance in the rain."  ~ Vivian Greene

Last Post Post-Script

After writing my last blog post, finishing up with the surgeon saying my left leg is now a bit longer than my right, I went out to the village. I was wandering around in a gift shop, looking at cool stuff, when I realized my left leg felt significantly longer than the right. More than I had ever noticed before. It was disturbing, having just been thinking about living with different leg lengths, and not being so pleased about it.

Then I looked down at my feet, and saw that I was wearing two different shoes. I must have slipped them on without looking. They clogs feel similar enough that I hadn't noticed while, but the red one has a slightly thicker sole. No wonder that leg felt longer! I felt rather silly, yet relieved at the same time. I continued with my errands, telling the part of me that was concerned about embarrassment with the reassurance that people mostly just look at faces, not at feet.


Today's Quote: "They say 'put your best foot forward' but which one??" ~ Rolf Harris

Six Week Surgeon Visit

I went to see the surgeon last week for my six week visit. I parked, walked in then realized I'd forgotten my cane. They recommend you keep using walking aids, to allow the muscles to heal evenly, and avoid creating bad movement habits. I can walk easily without my cane, though I usually take it with me for longer walks, as my hip starts to get sore. My walker has become and extra seat for visitors, and a rack for drying towels. The crutches I borrowed from the Sooke Loan Cupboard languish against the wall beside the door. I haven't used them once!

I spoke with the nurse, Colleen, for a long time while waiting for the surgeon. She checked my incision and said it was healing well. She wasn't thrilled I cane-free, but watched me walk, and said it looked good. I feel like a bit of a rebel, but I have been doing my physio, yoga, and taking care to walk evenly. I'm working on getting my pelvis in line and my hips swinging. Hoping to join a Zumba class for fun, fitness and mobility.

Getting Moving
I asked her about impact, once I've finished my three months of restrictions and am onto getting moving again. Turns out she's an ex-pro skier, maybe a bit older than me. She said it's the impact that creates the damage, and that her knees were starting to go from too much 'mogul-munching'. She likened my new hip to a Ferrari. If I 'drive' it carefully, I'll get a lot more miles out of it than if I grind through the gears and race it on bumpy roads. Makes sense. I'm still hoping to get some jumping in on the dance floor, but I won't be running any marathons. I'm fine with that. 

I've been itching to get moving, and thinking of taking my bike for a ride on the Galloping Goose. The Goose is a former railway bed, now a nice, relatively flat and wide path through the woods. The nurse said it would be okay to ride it, the only danger being falling off my bike, tearing my healing muscles. We agreed the wise choice is to wait until my three months are up. Sigh. 

Heredity vs Lifestyle
We also talked about heredity as the cause of arthritis. She felt it was a large factor, but that a lifestyle including lots of impact was also a contributor. My younger sister, who has not had such an active life, has recently developed hip pain. We're hoping it's a result of a fender bender, not the first step on the path to hip replacement. Only time will tell. 

Colleen asked how my hip felt. I replied that my left leg feels a little longer than my right, but my physio had said it was probably a result of the healing in the joint. It does feel rather full and stiff in there. She said it might feel like that for up to six months, and that it takes at least a year for the various clicks and pops to fade away. 

Revision Surgery
I asked her about revision surgery. She told me that it involves chipping the prosthetic out of the femur. She brought me a demo prosthetic to show me the small holes that the bone grows into, one of the reasons for the restrictions in the first three months. I have heard of cemented versus non-cemented prosthetics. The cemented version could have more risk of dislocation, but be easier to remove for revision. The nurse, Colleen, said that hopefully by the time I need revision, in 20 or 30 years, they'll have some fancy new technology that will make it easier. 

Surgeon Says!
The surgeon arrived, he said my x-rays look perfect. He checked out my gait and pronounced it good. He re-iterated the three month precautions, and chatted a bit.Then just before he left, he dropped the bomb. He said my left leg is 1/2 an inch longer than my left! That if it stays like that, I can just wear a lift in my shoe. Not the best news for someone who spends a lot of time barefoot. He talks so fast, and I was so surprised, that I didn't manage to ask him anything more about it. I will when I see him again, in about 2 months. 


Today's quote, to celebrate Shakespeare's 400th birthday: How poor are they that have not patience! What wound did ever heal but by degrees?  ~ William Shakespeare

Unexpected Drawbacks

Just passed the six week mark, and all is going well. I'm walking in the house a lot without cane or walker. Doing my best to stay slow and symmetrical. 

Though the pain is still there, I'm taking Tylenol less and less. Mostly just when I bump my activity level ahead too much all at once. When that happens, I do some lying around the next day. I have some tension in the upper left quad, a result of new or overworked muscles...or both. Yoga always helps!

I'm looking forward to my visit with the surgeon on Thursday, although I have a feeling it's going to be short and sweet. I'll let you know how it goes.

In the meantime, here's a list of some unexpected drawbacks of THR recovery. 

1. Say goodbye to the foot on your operated leg
Since you can't bend more than 90 degrees for 3 months, you can't get up close and personal with the foot on your operated leg. So, cut your toenails before you head into the hospital, or give yourself a last pedicure.

2. One wet shin
For the same reason, you can't dry all the way down your operated leg after the shower. I just wave it around a bit before I put my pants back on.

3. Limited cat petting or lifting
It's  not easy to reach down to cat level standing on one leg with the other behind you, though it's possible. What's really a challenge is picking up the cat, as usually I use two hands, and that requires expert balancing skills.

4. Bye bye fancy boots (sniff...)
I have a new pair of boots I adore, but the left is inexplicably tight, and they zip up on the side. I have worn them a few times with my loving partner's help, but I usually clop about in clogs. If I have to take my boots off when I'm out, at the physio for example, I'm forced to ask for help to get that left one back on.

5. Looking like a disabled person
It is interesting to be out in the world using a cane or crutches. People look at me sidelong, or ignore me. I know this state is temporary - but they don't. It gives me a little window into how it feels to use walking aids every day, for the rest of your life. My three month flirtation with sticks and wheels and small steps is really nothing to complain about. 

6. Getting nowhere fast
Do you remember the old man character Tim Conway used to do on the Carol Burnett Show? If you don't, he has this slow shuffle of small steps. Tim Conway Wheelchair Sketch It feels a bit like that when I walk. Walking down the hill after the bike race the other day, I kept having to step aside to let people pass. I guiltily remember striding ahead of my ex in the snow, leaving him and his aching knees struggling along in my footsteps. I am humbled.


Today's Quote: “There is nothing noble in being superior to your fellow man; true nobility is being superior to your former self.” ~  Ernest Hemingway

Four Weeks Down, Eight to Go!

Saw my favourite physio this week, John Manley out here in Sooke. I can go at no charge to the Adanac Clinic at the 'Jube' (aka Jubilee Hospital), but it's a long drive, and they didn't do much for me last time. John was happy with my progress. He ask me to let my hips swing side to side with my walk, which hurt a bit in the outside of my right thigh. He also suggested a slight pelvic tilt, as my pelvis is tipped quite a bit forward, to avoid the pain.

Don't overuse your arms
John also encouraged me to just 'tap' my cane, and to rest my hands lightly on my walker. I was rejoicing in my upper body strength early on in my healing. It makes it easier to get around, the fact that I can propel myself with my arms, connecting to my back when i need to, without any ache in my shoulders. Turns out at this point, though, the idea is to let the legs do the work, keeping my steps small, my gait slow and steady. Sigh.

It is getting a bit old, all this walking slowly. Though I am doing better, walking more often and smoothly without my walker, I still ain't goin nowhere fast. Though I can use my golfer's reach to lean forward, it's pretty awkward getting down to the floor. When I washed the windows the other day, I did all the top half, then laboriously got down to the floor to do the lower windows on my knees.

It's very one-sided
When I do yoga, I have to roll from my back to front, or vice versa, via the right side, pushing off the left foot before the knee comes too low.  As for sleeping, only on my back, or my right side, often with an icepack. At least this time, it's easier to get in and out of bed, as my operated side is the left side. Much easier than when my right hip was sore.

I asked the physio if I should try lying on my left side, even though it hurts. He says it could bother the incision, and it would be best not to.

Torsion
 I asked if was okay how I've been leaning forward, keeping my hip at less than 90 degrees by tilting my pelvis. John replied that we're trying to avoid torsion, which I understand as moving too much at the hip socket. There's a longer definition here: http://www.hss.edu/excessive-torsion-hip-pain-center.asp#.U0G4F61dUmc, along with plenty of other useful info about various types of hip pain. So I need to be more cautious about my angles. It feels from the inside that part of the problem is pushing off with the operated leg to stand up.

Book!
I am going to write a book about all this. Collect about 10 stories, meld them together with useful information, and e-publish it. There is a lack of information out there, and, though the system here in BC is efficient and helpful, I know I would've loved to read some other people's stories of hip surgery, before I went through it myself.

Today's Quote: "Walk as if you are kissing the earth with your feet." ~ Thich Nhat Hanh

Choices

Three weeks plus, and the pain is abating. Less Tylenol. I started the week with walking up a flight of stairs on Monday, followed by a very small series of even smaller standing poses on Tuesday. Wednesday it felt like a very large fist in a steel glove had pounded my left hip. Did some more lying around, watched The Moulin Rouge. I'm feeling better.

I keep meeting, or hearing about, people for who THR has been recommended, who are putting off the surgery. For some, it comes from a doctor's recommendation. There was an ex-dancer I spoke with in Montreal who was told by his doc to wait as long as he could, and could barely walk by the time of his operation, 8 years later. He wished he hadn't waited so long. There are others who choose to live with the pain, than go through the operation and recovery.

It took me awhile to get used to the idea of having surgery. I remember the phone call when my doc told me I needed a hip replacement. I cried. A lot. Somehow I thought there would be a less drastic solution to the growing pain I'd been living with.  I think it was a good 18 months, maybe two years before I was ready to go on the list for hip replacement surgery. When I finally did, I wished I had done it sooner. I was lucky to be able to go on the cancelation list, and both times jump to the front of the line through someone else's misfortune. Though going in for surgery with only a week to get used to the idea is a bit intense.

For sure it's an intense surgery. The recovery period is long. But it could be worse. Brain surgery, for example. Chemotherapy. Some kind of 'ectomy where you have something removed that you'd rather not. It's true that this surgery is elective. You can choose to live with severe arthritis. Many people do, by choice, or by necessity. Just pop pain meds all the time. Don't depend on being able to run for a bus, or get down on the floor to play with the kids. For a physical person, getting the procedure done seems to me a no brainer.

I was told I'd have a 6 to 12 month wait, and I've heard of longer. It can take time to find just the right surgeon. I'm so lucky here in Victoria. We have a pool of excellent surgeons grouped in a new 'Rebalance' centre. The Joint Replacement Clinic guides you through the pre- and post-op process. And it's all covered by our health insurance - unless you get ceramic hips, which I did. Worth every penny, though, for longevity.

Against the 80 or so (if we're lucky) years of a lifetime, 3 months, or even the full recovery period of a year to 18 months is tiny. It feels long from here, but short on the other side, I remember. Right now, the little steps of improvement are exciting, but underwhelming. Each week passes slowly. I still have two months to go, as of tomorrow, and it seems interminable.

My memories comfort me. Last time, once the three month mark was over, it was so liberating to slowly stretch out my tight muscles. The only thing holding me back was the degeneration in my left hip. The endless recovery became short as it receded into memory. This time, I'll be able to pull out all the stops. It's going to be so good!!

 I am so blessed that I can go in to surgery with a week's notice. That I don't have to go back to work, and sit in a desk all day with an aching hip, or use my crutches to clump around a sales floor. When I broke my elbow twenty years ago, and had to register for college wearing a soft cast, my left arm in a sling. Every little thing was so difficult. A day that was already intense, with endless forms to fill out, line-ups to navigate, and decisions to make brought me more than once to tears. I was in pain, and one hand short for things like carrying books and opening doors. It was hell.

Today Zack drove me up to the platform on the hill to meditate. We sat in a patch of sunlight, looking out of the Sooke Basin, and were serenaded by spring birds. This afternoon, I might repot some plants on the deck. If I get tired, I'll chill on the couch and read 'Tiny, Beautiful Things' by Cheryl Strayed. (You can find her here: http://therumpus.net/sections/blogs/dear-sugar/) I am truly blessed with a supportive and loving family. I am so grateful also to you for coming with me on this journey. Namaste.

Today's Quote is from the very inspiring Cheryl Strayed: "Your life is here and now. And the moment has arrived at which you’re finally ready to change. I know it. The thousands of people reading these words right now know it. And you know it too.. We have the power to heal what needs to be healed. We get to give ourselves that." 

Two Weeks!

Today is the two weeks since my surgery, and I can't quite believe how well I'm feeling.   I can stand, and hobble a bit without my walker, and am having lots of fun scooting about on it. Then I wave admonishing finger at myself, mentally. Slow down, Anthea. 

When I look back on my the two week mark on this blog (It's a Rollercoaster!), I remember the frustration. It's a long haul, that's for sure. As before, I ran out of Dilaudid, and went back to Celebrex topped up with Tylenol. The pain is always there in the background, even with painkillers. Without them - too much!

This time around, I had a two week follow-up call from Colleen at the Joint Replacement Clinic. It was very useful in answering a few questions I had.

Off with the bandage!
I mentioned to a nurse in the hospital that I'd only changed my dressing once last time. She said that people often mess around with their dressings too much. So this time I haven't even pulled it up to take a peek. Colleen said I could peel it off, and take a shower without it. 

Some people get staples, but my surgeon used steristrips, which will eventually fall off. The drugs make me sweaty and stinky, so showers feel extra wonderful. The only slight drawback is that if I don't have help, my left leg has to airdry.

Restrictions
Last time I was waiting for my 6 week surgeon visit, hoping that he'd lift my restrictions. That was before my physio explained the reasons for them. Besides the outside incision, the inner joint capsule is also cut. It needs to grow thick scar tissue to keep my new, ceramic femoral head in place. 

My restrictions, if you remember are:
1. don't bend at the hip past 90 degrees
2. don't twist at the hip
3. don't cross the operated hip over the midline of the body

I have to keep these restrictions for three months, so everything heals up tight and strong. During the operation, the surgeon dislocates the hip, so he can get at the acetabulum (hip socket) and femoral head (the top of the thigh bone). With too much range of motion, the new hip is in danger of re-dislocating, again and again. We wouldn't want that!

As with most things, it's easier the second time around. It works for me to keep the alignment between my pelvis and my thigh bone from going past 90 degrees. So if I turn, I turn with my whole body. If I bend forward, I keep my pelvis upright, rather than tipping it forward. I feel like I live in a pelvic tilt. 

I remembered another reason I don't use my reacher much. I don't need it for getting dressed. When I put on my pants, I hold them as low as I can without tipping my pelvis forward, and lift my operated foot up as high as I can without going outside of my restrictions. This allows me to (just barely) hook my foot into the top of my pant leg, then squirm it up to the top of my thigh. Then I put my other leg in, pull my pants up, and... Voila!

Today's quote: 'Slow and steady wins the race.' the Tortoise and the Hare

Walkers and Reachers

Well, I've been home a week. I'm told I'm more chipper this time, and have been spending more time on my feet and less in bed. It might be that things feel a little easier as I know what to expect this time around. 

I love my four wheeled walker! Last time I had the two wheeled version, as the 4 wheeler is deemed too unstable for hip replacement patients. The problem with the 2 wheeler was, as I got more mobile, I kept leaving it behind, and hobbling around. Not so good for the the 'symmetry, symmetry, symmetry' my favourite physio recommends. As before, I can walk a bit now, and in the kitchen I loco-mote leaning on counters to move in small spaces. The walker does get a bit in the way, especially when all four of us are in our tiny kitchen.

The 4 wheeled one moves so smoothly, with a swirly, gliding quality that makes me want to create a dance piece with it as partner. The wheels make a sound like distant thunder that makes the cats nervous, and I have my own comfy seat. It also has handy side zipper pockets, and a huge compartment under the seat that carries books and pens. I love it!

As last time, it's a challenge to walk slowly, though I try. I've heard more than once 'walking consciously is the best physio you can do', so I keep my steps small, my weight evenly on both feet, and press on the walker as little as possible, keeping my shoulders relaxed. I find it ironic that, though my job is healing, I often find myself rushing around the house, for no reason at all.

I told the nurse at the hospital that I hardly used the reacher last time, and she raised her eyebrows. The reacher has a handle on one end, and pinchers at the other, so you can pick things up. I realize now I'm back at it that I use the 'Golfer's Reach' instead. With my left the operated hip, I stand on my right, and reach my left leg behind me. If I were older, or less fit, I'd be using the Reacher more often. For me, it seems a bit finicky.

It's interesting to have this blog, so I can check in on how things went last year and compare. I didn't have the soreness in my upper back this time, but I think that came from spending more time in bed.  

It's seems I got back on the mat with Restorative Yoga a little sooner, which is feeling wonderful. It's easier to know how to move, as I spent three months staying within the same restrictions a year ago. I just have to transpose my body memory to the other leg. 

Today's quote: 'Smile, breathe and go slowly.' ~ Thich Naht Hanh

One Week Later

There! Surgery done on both hips, no third hip hanging around to require me to get this done again.

It was easier this time, knowing what was coming. I was much calmer the night before, and going through the pre-op steps. Maybe too calm. Last time I cried as I was being given my spinal on the operating table, and woke up just as it all finished. I think the tears earned me stronger sedation. This time, I was awake, though drifting. The spinal deadens any sensation from the waist down, and I was shielded from seeing by a blanket tent. There was a plastic covering over me, like a thin air mattress, with a vacuum cleaner hose constantly blowing warm air into it. Though my ears were full of the hum of the air, I could hear a rhythmic banging. In my stoned state, I called out a few times 'Hey! What're you guys doing? What's the banging?".  No one replied, and when I asked them before being wheeled out, they said they couldn't hear me either due to the noise of the machine. Good thing! 

My roomie, Flo
I got into the operating room, out of recovery into my hospital ward much sooner this time. I wasn't lucky enough to have a private room, or a great view, but I did learn a lot from my roommate. Her name was Flo, 91 yrs old with dementia and epilepsy. She doesn't always remember to take her meds, and this year, same as last, her husband found her on the floor having a seizure, in which she broke her hip. So, just like me, second time round of hip surgery. That's where the similarity ends. She doesn't remember where she is from one moment to the next. All she knew for sure is that she wanted to get up and go home. So if she wasn't taking off her gown so she could get dressed, she was removing her IV, or trying to sit up. Her husband and the nurses explained to her over and over, "Flo, you've broken your hip, you have to stay here and heal." To which she'd reply 'Ah!" as if she'd finally understood, only to to go back to trying to escape. I was impressed with the kindness of the nurses, and the fact that they never resorted to tranquilizers, or strapping her down, which I remember happening to my Grandma.

As before, I was complimented often on the speed of my recovery, how soon I was able to sit up in bed, swing my legs off the side and walker myself to the bathroom. With Flo as an example of the more usual hip replacement patient, I understood why. On my third day after surgery, I was practicing stairs, and checking out. On Flo's third day, she was lifted into a wheelchair, to practice sitting up for awhile. Poor Flo. I hope she's gone home by now. She really helped me to count my blessings!

The pain seemed worse this time. There is a screaming entry in my journal from the day after, saying, "It hurts too much!". Though I haven't experienced it, I suspect it's like childbirth. The pain recedes into a distant memory, with other happier details plastered over top of it. Already, I don't remember how badly it hurt that day, less than a week ago. 

Drugs
On that note, I've been juggling meds, to manage the pain. My first night home from hospital was a bit intense. First, the hospital bed that changes positions at the push of a button really helps with getting into a comfortable position. Second, there are more drugs at the hospital. Every four hours or so, I got 2 tylenols, 1 celebrex (anti-inflammatory) and two dilaudids - and 2 stool softeners. They send you home with a prescription for Dilaudid, and no advice other than '1 - 2 every 4 hours'. The next morning, I decided to supplement a bit with Tylenol, which has helped a lot. 

On the stool softeners, there is some pain I do remember from last time - wicked constipation from the drugs! I thought my healthy, high fibre, home diet would kick it out, but it wasn't enough. So this time I'm taking a couple healthy scoops of natural fibre in water every morning, and everything's moving smooooothly. Sorry if that's TMI, but I thought you'd like to know if you're going into surgery too. 

Same as last time, I have to take an anticoagulant for a month, the same time every day. The change was that this time each does was a little needle in its own packaging, that I had to stab myself in the belly with. I'm not afraid of needles, but I've never had to self-administer. I was not keen! Luckily, when the surgeon came to gave me my walking papers, he said I didn't have to use that method. In fact, I can just take 325mg of Aspirin every day. Phew! Also preferable as those needles were worth about $25 each, ringing in at a few hundred dollars for the 28 days.

Today's Inspiration is from Pema Chodrun ~

There is a story of a woman running away from tigers. She runs and runs and the tigers are getting closer and closer. When she comes to the edge of a cliff, she sees some vines there, so she climbs down and holds on to the vines. Looking down, she sees that there are tigers below her as well. She then notices that a mouse is gnawing away at the vine to which she is clinging. She also sees a beautiful little bunch of strawberries close to her, growing out of a clump of grass. She looks up and she looks down. She looks at the mouse. Then she just takes a strawberry, puts it in her mouth, and enjoys it thoroughly. Tigers above, tigers below. This is actually the predicament that we are always in, in terms of our birth and death. Each moment is just what it is. It might be the only moment of our life; it might be the only strawberry we’ll ever eat. We could get depressed about it, or we could finally appreciate it and delight in the preciousness of every single moment of our life.

My Left Hip!

Well, it's been awhile since I've checked in. My right hip has healed up really well. I still need to do some work on strengthening the external rotators, but other than that it feels better than new. Even the torn hamstring I've been flirting with since I overstretched jumping a hurdle at 13 has vanished. Better living through surgery!

The fly in the ointment is the left hip. It has been getting stiffer and sorer. To the point that, on Thursday morning at the end of yoga, I said to Zack that I'm ready for my next surgery. That we should manifest it to happen soon, so I can get it over with and move forward with two healthy hips. And what happens? Just got a call from the Joint Replacement Clinic, there's been a cancellation, and I'm booked in for Tuesday, March 4th. Needless to say, I'm a bit overwhelmed, but excited!

It's a little easier this time, having gone through and come out the other side. I remember how last time I just went to sleep, woke up, and it was done. How the pain after that was the pain of healing. I do notice in reading through my blog a hint of impatience, a soupcon of frustration. I'm going to try to meditate this time, to help with the acceptance part of my healing.

I've jumped through my hoops - got my lung, heart and hip x-rays, a blood test, talked to the pre-op nurse and pharmacologist. I've collected my sock pull, walker, reacher, high seat, crutches and toilet seat from the Sooke Loan cupboard. I've had the Last Hot Tub, the Last Yoga Practice, the Last Supper and the Last Glass of Red Wine and Square of Dark Chocolate. I have my pink sponges ready to go for the Last Shower. 

My bag is packed, the mattresses in the living room for the Last Family Sleepover. Tomorrow I have to be at the Royal Jubilee Hospital (the 'Jube') at 7:40am. Guess I'll be going into surgery at 9:30 or 10. Wish me luck!