Tuesday, March 25, 2014

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

Friday, March 14, 2014

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

Monday, March 10, 2014

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.

Monday, March 3, 2014

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!

Tuesday, October 15, 2013

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

Monday, July 29, 2013

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


Monday, July 22, 2013

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