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!

Six months later...

Happy belated Thanksgiving!

I can't believe it's been over six months since my surgery. My new hip feels like new, and moves much more freely than it has for years. Unfortunately, I notice these days in my left hip signs that I remember from the deterioration of my right. I initially thought these pains were temporary. That if I just did a little more yoga, or changed my sequence, or tried the right healing practice, they would go away. Turns out the only way to make them go away was to have surgery!

I've been trying to stick to an lectin-free, which seems to make a big difference. Since the surgery, and the advent of harvest, I've been enjoying fresh tomatoes and potatoes from the garden. But my left hip is getting so achy, it's time to dust off my self discipline. Here's a link with some useful info on lectins http://www.marksdailyapple.com/lectins/#axzz2holUCSIH

To get back in shape, I have hopped back on my bike. When I lived in the city, I rode everywhere, but out here in Sooke, the car is a more efficient way of getting around. I've been taking some rides on the Galloping Goose trail, and have even biked into the village a few times. It's such a lovely ride, surrounded by trees, on a wide even path, hardly anyone else around. I highly recommend it!

As I ride, my right hip circles fluidly, but my left pinches at the hip flexor. In the past, as my hip got more and more painful, I raised my seat to open up the angle at the front of the hip, taking the pressure off. These days my right hip, knee and foot stay easily in line, but my left knee swings out to the side, and my heel rubs the frame of the bike. The pain in my left hip decreases as I warm up, and it feels very healing for the joint to do half an hour of easy spinning. It's does my heart and soul good, as well. I was missing riding my bike!

It's quite the exercise in delayed gratification, having the left hip degenerate as the right hip increases in capability. Stretching feels so good these days, the quality of the muscle fibre more willing to release and elongate.  My left leg is still willing to stretch, though the flexibility in that hip is decreasing. I have been waiting to be able to sit cross-legged without sitting on blocks, but it turns out I'll have to wait until after surgery #2. Though I can now sit cross legged on the floor, my left knee is higher than my right, and the hip feels tight. I'll be back on the blocks very soon, I think.

In honour of autumn, the Equinox, and new beginnings, I have expanded my morning routine. I am drinking lemon juice and water, doing neti pot, tongue scraping and oil pulling. Besides the health benefits of these practices, it is a real boost to start the day with some self-care. Though it takes time, it's a wonderful and effective reminder to myself that I am worth caring for. Try it!

I am so grateful for the meticulous hands of my surgeon, and the competence of the hospital staff. For my loving partner and family, who have been patient and considerate during my healing process. And for the concern and caring of my community of friends, who have stood by me during my descent into pain, and my joyful recovery.


Here's an appropriate Thanksgiving poem:

Be Thankful

Be thankful that you don’t already have everything you desire,
If you did, what would there be to look forward to?

Be thankful when you don’t know something
For it gives you the opportunity to learn.

Be thankful for the difficult times.
During those times you grow.

Be thankful for your limitations
Because they give you opportunities for improvement.

Be thankful for each new challenge
Because it will build your strength and character.

Be thankful for your mistakes
They will teach you valuable lessons.

Be thankful when you’re tired and weary
Because it means you’ve made a difference.

It is easy to be thankful for the good things.
A life of rich fulfillment comes to those who are
also thankful for the setbacks.

GRATITUDE can turn a negative into a positive.
Find a way to be thankful for your troubles
and they can become your blessings.

Author Unknown

Back on my Feet!

Today was the my first day back to standing poses without my restrictions. Very exciting! Generally, it felt so good to allow my body to gently extend further, although there were a few disappointments.

Surya Namaskar
To stay true to my 'don't bend not past 90 degrees at the hips' rule, I have been doing Sun Salutations with a block under each hand. I also released my right leg backward, and bent my left knee as I lowered my hands to the blocks. The nice not-restricted feeling of reaching my hands towards the floor, was tempered by creaky, stiff muscles. I don't know why I was so surprised! I am moving like a stiff-as-a-board beginner. Very humbling. 

In Surya Namaskara B, I have been doing a looong squat, while my partner moves through Warrior I on the the right side. My quads still need strengthening. I was happy to leave the squat behind (who likes squats??), and it was a treat to step forward into Virabhadrasana I on the right side for the first time in months. My hip is still sharply painful with downward pressure on the right foot. 

Ardha Chandrasana
When I did Half Moon pose on my operated leg, I dropped into a familiar, joyous sensation of flying. I actually felt more stable, and more fluid in my right leg, than on my left.  The more ease I feel on the right side, the more I notice the beginnings of same downward spiral on the left, starting with the same tight, sore feeling in the adductor. Standing on the left, my hip feels tight and held, the SI joint close to seizing. Damn.

Virabhadrasana 1 and 2
Both Warriors feel tighter and stiffer on my left hip. A bit discouraging. Still, I will keep working with a vision of fluidity, encouraging the freedom in the right hip inform the left. I'm sure it will help that with the left hip, I know what I'm dealing with. I have many more tools at my disposal. I hope I can keep it healthy for a long time. 

Shades of Past Practice
In gently stretching my muscles into the poses, two things were apparent. 

1. As my right hip becomes more fluid, my left hip is probably going to tighten up. I will do what I can, with diet, exercise, and visualization, but... It's kinda sad I don't get to enjoy two healthy hips at once until after I get my left hip replaced. But. It is what it is.

2. I remember doing standing practices, something like six months ago, feeling very distracted. After I'd corrected Zack the umpteenth time, he diplomatically asked if my mind was a bit busy. I centered myself, and burst into tears. "I can't be present - it hurts too much!", I said. I'm so lucky to have left that pain behind!

I love my practice for many things, but especially as a barometer of the changes in my body from one day to the next, from one year to the next. I am so blessed to have achieved a high level of fitness and facility before my hip seized up. To be able to move forward again is such a phenomenal gift. I am dancing in my head ALL the time these days, and can't wait to get into the studio. I'm looking at teaching some classes in the fall.

I have so much more appreciation of my body and its abilities. This is such a journey of staying present with what is.

Today's Quote: 'Don't it always seem to go, you don't know what you've got til it's gone." Joni Mitchell

12 Week Surgeon Visit

I went to see the surgeon on Thursday, the day before my 51st birthday. As usual, it was a bit underwhelming. He started off by saying the X-rays showed my left hip looks good, but the right one is pretty bad. After my shocked "What??" he said, "oh, was it your right hip I did?". I think he was having a busy day.

My Left Hip
He says the left hip will also need to be replaced, eventually. He assured me that since I've already been through it, I'll know when it's time. I'm still hoping to postpone it as long as possible with diet and yoga. It is the irony of my healing process, that as I joyfully find more movement and fluidity in my healing right hip, I can feel the deterioration growing in the left. 

Range of Motion
The doc didn't even mention taking the restrictions off, although I've been feeling it's time for the last week or two. We even took the stinky tall toilet seat off a few days before my appointment. He said I can never cross my right leg over my left, without risk of dislocation. I wasn't expecting any 'nevers'. But he did give me the green light to stretch, gradually and carefully.

Activities
I asked him whether I can get back to mountain biking, bouncing on the trampoline, and acroyga. He said biking is okay, but single track or road riding are preferable to downhill mountain biking. He said I could break either hip by crashing on rock. Bouncing on the tramp is fine, but he recommended against seat drops or flips. I also asked him about acroyoga, which he said was fine, though I don't think he knew what I was talking about. 

A Gift
The surgeon's way of helping me decide what to do or not do, is by telling me that I've been given a gift, and it's up to me to choose how to take care of it. High impact activities, like running or playing basketball, will shorten the life of my new hip. Not that I was about to take up basketball, but I would like to be able do some leaps and jumps in dance class. I figure he doesn't know the added benefits of yoga practice. That engaging the tensegrity body, and strengthening muscles to support joints, will prolong the life of my new hip. I hope. 

Happy Birthday to Me!
Anyway, I had a wonderful birthday. There are so many things I haven't been able to do. I put my own sock on my right foot. I didn't have to use the sock pull, or ask Zack to do it. I dried the lower half of my right leg, rather than letting it air dry. I don't have to reach my right leg back anymore when I bend down to feed the cats, or cuddle a dog. I'm getting better at walking up and down stairs just like everyone else, rather than taking one step at a time.

It's not over yet...
I still have pain in my hip, and I can tell I need to be cautious about stretching. I'm dying to try cartwheels and handstands, but I'm going to wait until things feel completely healed. I have been reading a bit about dislocation after THR. It sounds like something I'd really rather avoid. 

I can't wait to get back to dancing, to riding my bike, to doing acroyoga. I could, if I allowed myself, dwell on the fact that there are certain yoga poses and dance moves I'll never do, or have done for the last time. That it looks like I won't be downhill mountain biking with my wonderful family. And that one day I'll have to pay another $2000+ for another ceramic hip, and go through all this again. But really, I am SO lucky! I could still be living with the pain and stiffness I had just over three months ago. I could be hobbling through the woods when I walk the dogs, gingerly stepping over logs because of my restricted movement. Instead, I feel like I'm preparing to fly!


Today's quotes: 

“People usually consider walking on water or in thin air a miracle. But I think the real miracle is not to walk either on water or in thin air, but to walk on earth. Every day we are engaged in a miracle which we don't even recognize: a blue sky, white clouds, green leaves, the black, curious eyes of a child -- our own two eyes. All is a miracle.”
― Thich Nhat Hanh

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“Walk as if you are kissing the Earth with your feet.”
― Thich Nhat Hanh, Peace Is Every Step: The Path of Mindfulness in Everyday Life

Things I'm happy to say goodbye to.

Well, I had this beautiful long post all written, and it vanished into cyberspace. Has that happened to you? Kinda took the wind out of my blogging sails for awhile. I'll rewrite it - I think - but in the meantime here's what I've been simmering on lately. 

Welcome Post-Surgery Changes

1. No more tension in my right hip
When standing, I would often notice the external rotators of my right hip (aka my right butt cheek) clenched. I would relax them, only to notice them tense again moments later. I'm sure this was a holding pattern in reaction to pain. Now, though my hip still hurts a bit from the surgery, this butt-squeezing has melted away. When I check in, I notice myself standing evenly on both feet, with no extra tension. There is still a little tightness, but I'm thinking I need to do some hip-swaying dance to relax my hips, get them swinging with my stride again. Bellydance, anyone?

2. No more pain at front of my right ankle
The morning after dance class, and after karate, as well as during yoga practice, the corner where the front of my ankle joins the top of my foot was sharply painful. The pain would abate, only to return the next week. After surgery - gone.

3. My toes touch
My right leg has been outwardly rotated at 45 degrees for a few years now. I remember the moment of deciding that forcing it to stay parallel in yoga practice created more pain in my hip, and wasn't useful. The muscles in the inner thigh are weak, and I get a certain knotting of the muscles at the front of the right hip when I walk uphill, which is the proper muscles remembering to work. But it is a joy to stand with my feet in Tadasana, mountain pose, all 10 toes facing the same direction. I love setting up for Urdva Danurasana, a backbend, and just touching my toes together before I press up, to make sure both feet are parallel. Like rediscovering an old friend.

4. I'm taller!
I measured myself about a year ago, and I was 5'8". I couldn't believe it. I've been 5'9" since I stopped growing as a teen. I couldn't figure how I'd lost a whole inch. I think two things contributed. First, the compression in the hip joint with the deterioration of cartilage. Second, the pain was causing my hip flexors/psoas to shorten, making me stand with my pelvis tipped forward, my lower back arched. i realize how much, as I rehabilitate and stand straighter. There is a sweet, spacious feeling  across the front of my hips into my belly. So I measured myself just for fun the other day, and there I was 5'9" again! I feel like I was given something back I didn't know I'd lost.

5. I can run!
Well, not like I'm going to do a marathon anytime soon, but at least I could run for the bus if I had to. At some point in the last couple of years I stopped being able to run. It's hard to explain why. It was partly pain, but also I just felt to stiff to run. I spontaneously broke into a run the other day, just because I could. Only from the car to house. It felt wonderful!

6. More mobility = more enjoyable walking

Sashia on the pipeline

I realized on my walk today how much easier it is to walk up hills, and on uneven terrain. Before surgery, it was getting tough to step over logs, and I felt a bit unstable and scared of falling. The tightness in my inner thighs hindered my mobility, as did the limited range of motion in my hips. Last week I graduated from sticking to the pipeline (an old, unused pipe that's like a sidewalk behind our property), to following trails and deertrails up the hills and through the underbrush. I'm not completely healed up yet, but I'm so happy to be able to move again.


Isn't this an amazing journey? I feel blessed to have fallen into that hole of reduced mobility and pain, and be lucky enough to come back out again. It changes you, living with pain. It's different, learning to be a person who has to say 'sorry, I can't', instead of one who says 'sure, let me do that!' 

It's good to know both sides, to learn empathy for others. I have much more understanding these days of seniors, of others with disabilities. I am better at slowing down to help, to be patient, to offer a kind word. I know what it feels like not to be able to trust your body. To wonder whether or not to say how much you hurt. Sharing our pain, and our joy, is the way to empathy and compassion.


Today's Quote: There are no mistakes, no coincidences. All events are blessings given to us to learn from. - Elisabeth Kubler-Ross

Core Stabilization and Strrrrretching!

I had another physio visit yesterday at the Royal Jubilee Hospital. With a lilting Irish accent, David watched my gait, and pronounced it 'goot'. He said, however, that I need to lengthen my hip flexors and energize my transverse abdominals. The pain in my hip flexors over the past years had caused me to increase the curve in my lumbar spine, relaxing my abs.

Core Stabilization
David asked me to lie on my back, knees bent. He put something slippery under my right foot, and his fingers lightly on my belly. He asked me to slide my foot away from me about a foot, then back. I told him I felt my abs working. David explained that my rectus femoris were working, when they should be relaxed. That my transverse abdominals aren't doing their work of stabilizing so I can move from the leg.

Then David offered a lovely image. To imagine my heart to be connected by a string to my diaphragm. As I inhale, the diaphragm bows downward, and the heart rises up, lengthening the string. With the exhale, the drum skin of the diaphragm  and the heart move towards each other, shortening the cord. He left me to breath like that for 5 minutes.

Then he asked me to picture the framework of core stabilization surround my core. The transverse abdominus as a girdle across my belly, and the multifidus winding through the erector spinae, stabilizing the back. At the top, the diaphragm, and at the base the pelvic floor. So ever since, I've been passing to check if I'm engaging, gently, this core support. 

As my core becomes more stable, my hip flexors and psoas are opening. Backbends feel awesome! I had not realized how omnipresent the sense of pain and tightness at the front of my hips had been. How when I lay on my back to stretch on leg, the hip flexor of the other leg was the first place I felt the stretch. 

Stretching
I can also feel the beginnings of how glorious it is going to feel to stretch my inner thighs. The first place I felt pain was the right hip flexor, probably in 2002. The second was the inner thigh of the same leg, after a workshop in 2007. It never healed, both adductors becoming tighter and tighter, until when I tried stretching, it felt like pulling a thick robe. Solid. Immobile. Now the feel loose, fluid, willing to let go and elongate. But not yet.

The day before my birthday, July 18th, I have my 12 week visit with the surgeon. I'm hoping I get the go ahead to start some gentle stretching. Can't wait!

Today's Quote: Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won't feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It's not just in some of us; it's in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others. 

~ erroneously attributed to Nelson Mandela, actually written by Marianne Williamson. Let's send some healing thoughts to Mr. Mandela, hospitalized with a lung infection. He is 94 years old. 

Prepare for the long haul

I've been told more than once that I limp less now than I did before my surgery. Which makes me want to consider my healing finished. But it's a long process. In fact, as I move forward, I realize that my sore hip was affecting me more than I understood.

It's a weird thing, how chronic pain seeps into one's life. At first a few twinges, a pulled muscle that doesn't go away. Pain after a long, beautiful walk with the dogs. I saw most clearly how far things had progressed when I saw myself through the eyes of my brothers and sister last Christmas.

I still have pain in my hip, but it's changing every day, for the better. I walked the dogs today, and felt a familiar lightness slipping into my psyche like an old friend turning up for coffee. I realize now in coming out of the pain how much it was affecting me. Much as I do my best to accept what each day brings, each 'no' carries a little sadness. Each 'sorry, I can't jump on the trampoline', or 'I wish I could come skiing too'. Even 'sorry, I can't help you with that', doesn't feel so good. 

Surgeon Visit
So I'm excited to be on the mend, to be moving forward, though my visit to the surgeon on Friday was a bit anti-climactic. He and the nurse were happy with my progress, and after watching me walk agree I'm okay to walk without a cane. 

The sad thing is the precautions stay. The family was hoping to say goodbye to the tall toilet seat, that gets stinky quickly. Not yet. So I still can't bend past 90 degrees, cross my right leg past the midline of my body, or twist at my right hip. For another 6 weeks, and maybe another 6 months after that!

The Precautions Continue
Turns out the precautions are not just to avoid dislocation. It's important to allow the body to build some thick scar tissue around the joint capsule, for long-term stability in the joint. Sigh.

So, here are the things you get good at in the looooong recovery from hip replacement.


1. Golfer's Reach
Since you can't bend forward at the hip 
without going past the recommended
90 degrees, one leg trails out behind 
when you bend down to give the dogs 
their bowls, sweep fluff into a dustpan 
or...pick up a golf ball.

2. Sock Pulling

I have borrowed this ingenious contraption, called the sock pull. It makes it easy to put a sock on my right foot, since I can't bend towards that leg. 

3. Uneven Downward Dog
This is how I get up and down from the floor, through a downward dog with my right leg extended. It makes me think of older students, who have looked at me with disbelief when I asked them to sit on the floor.

4. Asking for Help
I can't reach forward from sitting to pick up a cup from the coffee table. So I ask for help a lot. It's a good thing.


I'm doing my best to stay patient, to be in each day, and not look forward to the day the precautions are off and I can stretch my muscles out. It's going to feel sooo good! But I'm not looking forward to it or anything. Not at all. ;)



Today's Quote: There is no way to Happiness. Happiness is the way. ~ Buddha