Back in the swim

So before all this hip saga started, I was an active chick, sitting still was not on my to do list! I enjoyed tennis, table tennis, running, biking, dancing, skating, swimming, anything that involved being active and being outside enjoying the fresh air. All the jobs I had involved physical activity and my first full time job, even though it was an 'office' job, involved running around town various places and up and down stairs all day. For the first 6 months I didn't even have a chair to go with my desk and never noticed! For the last 3 years though, I slowly lost one activity after another because of the pain factor, even though I tried to hang on to some things like dancing, many of my activities faded into memories as I couldn't deal with the pain or my body just wouldn't do as I asked it to.


Since my surgery, it has been my long term goal to regain all these lost activities as much as possible. But 9 months out I am still getting there, rehab is such a slow process, you don't want to do yourself anymore injury and you have to keep reminding yourself that for 3 years the muscles didn't work properly. The first part of rehab was simple, learning how to walk properly again! Remembering to flex the hip, straighten the knee before heel strike, and land on your heel and not toes like I did before surgery. Spreading the weight bearing evenly between both limbs and not just the unaffected side all the time. I even had to retrain myself to stand on both legs not just one. Even though I found this quite hard at the start is was the relatively easy part. Once I had mastered this, I was ready to start on the big stuff! Once your muscles have regained some of their strength, you then need to build up endurance.
Running long distances for fun is out of the equation, if I am to have my hip last a reasonable time before a hip replacement I have to look after it and running is not classed as 'looking after my hip'. Oh well, I'll just have to find something else to do for exercise. I had been going to the physio pool for hydrotherapy exercises twice a week, I spent half an hour at the side of the pool doing various stretches etc that are much easier in the water. But by now I'm thinking I really need to start swimming and prove that I can actually still swim, I am past my sideline exercises!
So a couple of weeks ago I took my goggles and took the plunge, after my warm up exercises I decided to try out the slow lane. I swam 12 lengths the first time and was quite happy with that achievement, I thought-leave it small then it is easy to improve on next time! Well the next time I was able to swim 22 lengths and this is half a km! I was so proud of my achievement even though I was bright red in the face after my effort. So now I am keeping up with my 22-24 lengths twice a week till I get to the point where they are quite easy and I don't get so short of breath and tired. I am hoping by the end of the semester I will be able to swim a whole km-how great would that be!

My Diary

I have this love/hate relationship with my diary. I love it because I need it and I would be totally lost without it but at the same time I hate it because I wish I didn't need it and it is a hassle writing in it all the time!

I'm not talking about a "dear diary" no, just one of those day planners that everyday people use to organise their schedule. It just happens that mine is more than just an organiser-its my memory.
Ever since my head injury, I have a non-existant memory and have to rely on written memos to remind me to go to appointments, what and where my lectures are each day and any other important appointments and also bills, library books and birthday reminders etc. It also serves as a good place to write random things like what pain I am experiencing today, what I want to talk to someone about and to remind me to do things like vaccum my room, do my washing and watch tv!

The only problem with this system is you have to actually remember to write in it! I can hear you say "how hard can that be? When I do, it is great, although you also have to remember to look in it too. But my biggest problem is actually remembering to write in it and I don't mean I don't try, I do-but its amazingly hard. I get my diary out, find a pen and then the date and then sit there and go "what was I supposed to be writing in this....?" Sometimes I have several things I spontaneously remember I need to write and while writing the first thing I have forgotton the others. I find this so frustrating and annoying and so I go through periods of not using it. Whats the point if you don't remember to write things in the first place-what use is that, it cant remind you then, thats why I hate it. But its not the diary's fault, the poor thing tries hard, I mean it has lots of space for me to write whatever I want, it never gets lost and it holds lots random bits of paper I decide to put in it. I just wish it was able to read my mind and write things in itself, then I could never hate it-how useful that would be!

What NOT to do during First Aid class

So as part of my application for physio (providing I get that far) is supplying evidence of a current first aid certificate. What could be hard about that? Everyone knows you can have a lot of fun during first aid class while learning how to save a life so I got organised and signed myself up. 16 hours of interactive role playing, goofing about and of course learning.
So Day one was ok, we spent the day learning primary response DRSABC, CPR and choking protocol along with stuff about medical conditions. So we get down on the floor ready to prove our ability on the manikins-piece of cake, or so I thought. Who would have known that kneeling down sitting on your knees leaning forwards would cause so much pain? Its the most awful position I have put my hip in since surgery and by the time the day was out I was crazy sore. I tried to put my body in a different position, kneel on other knee, stick operated leg out the back so my hip wasn't so flexed (if you can imagine that position then I guess you will be laughing about now) bend down try to give rescue breaths and start CPR, ok for the babies but certainly not on the adults-"this poor guys not going to last very long if he's relying on you to save his life" kind of thing, we were rolling around the floor in fits of laughter and in danger of failing our assessment!

Another thing I had trouble with was being put in the recovery position, my hip dosn't like internal rotation but I cant lie on that side yet either so when my partner attempted to put me in the recovery position my knee wasn't anywhere near the ground like it should be and she was worried I was going to "roll back on my back and be in danger of closing my airway and dying" (hypothetical of course) needless to say we had tons of fun!
Apart from those slight inconveniences the day went well and I was looking forward to the next weeks class!

Rule 101 - what not to do during first aid class

Try to refrain from injuring yourself during a class exercise, the actors have set up a car crash site and don't want all the fun ruined by you falling down the stairs!

Oh sorry, I think I missed that instruction and certainly didn't do it on purpose!
I have no idea how it happened, one minute I was walking into the room, the next I was sprawled at the bottom of the stairs wondering how I got there. I felt so embarrassed, it was weird as I was shaking like a leaf and couldn't talk properly and didn't dare move for fear of falling again. It was so funny because the first aid tutor was right on to me doing the whole reasurance thing (just like she had taught the weekend before) and all I wanted was to be swallowed up by the floor and disappear. One guy was concerned that I was in shock! We think I rolled my ankle on one of the stairs and it certainly feels like it but apart from that I have masses of bruises all over my hips, knees, elbow and a very sore wrist to show for my little trip. Nothing like a little more than you bargined for-luckly we had done all our assessments so I had passed the course and didn't waste all that money!

The road to surgery and beyond...Part 7...Beyond...

It’s the next step that is the hardest part by far and I have to say that 9 months out I am still recovering, still making progress and still have post op goals I want to meet.

Even though my surgeon told me that it can take a full year to recover to a certain point, even though I had others tell me the same I really didn’t believe that it was that big a deal, surely how hard can this recovery thing be? Now I have experience, now I know better, rehab is the hardest most rewarding experience in my life to date.

Another thing-if anyone had told me that I would be up and walking on crutches less than 12 hours post op I would have laughed in their face, even now I think back in awe of the physio, she must have been one tough cookie because I sure as hell wasn’t thinking about even moving a muscle and the next thing I was standing up out of bed being handed my crutches and told to walk across the room! It amazing how that makes you feel, even though you have tears running down your face because of the pain, you feel shocked and full of motivation and determination-I can do this!

There have been numerous milestones/goals so far in my recovery. Each one bringing joy and restores the motivation/determination as sometimes you feel like it all gets too much and is way too hard.

I weaned off one crutch, was able to put my own socks on, walk around the mall with one crutch, cook dinner for my family, had to relearn how to walk properly (this is much harder than it sounds), regain balance and be able to stand on one foot, finally get rid of the other crutch, TIE MY LACES for the first time in years! Walk without the funny penguin waddle gait. Walk several miles without surgical pain, run for a little on the treadmill, start using weights in the gym to strengthen my weak muscles just to name a few, there have been so many I cant remember them and there are still a few to go-I would like to be able to get my foot in a good position so I can cut my own toenails and even put on some nail varnish would be nice!

I have since had my hardware removed (just recently) so I am back to strengthening my muscles and building up to running again but all in good time, it’s the hard work that makes you appreciate the small things and I for one will never take for granted the ability to walk in a “normal” fashion. Every now and then I reach a new goal and celebrate the achievement, there are still celebrations ahead!

BUT the single best thing about all this? The pain I lived with constantly before was gone when I woke up after surgery and has never returned-EVER, thank you so much for giving me my life back!

The road to Surgery...Part 6 - Surgery!!!!

Surgery is the easy part (just forget the freaking out beforehand) you get a date, prepare for that date, arrive and get quizzed by the admitting nurse, have your surgeon arrow and sign "the body part", wait half a day and then finally they come and whisk you away. The anaesthetist puts as many holes in you as it takes to get the IV in and the final "what side are we operating on" gets asked and then, only then do you start to feel like its really going to happen. But its easy really, you get "put under" they slice you open, chop your bone, dislocate your hip, have fun monkeying about in there “fixing” things and then when they are done screw you back together and sew you back up. All the while you know nothing till you gain consciousness and then the surgery is all over, piece of cake – who am I kidding, this is when all the hard work starts! I don’t remember being in recovery, I was there a good few hours and so was my Mum! She had spent the whole day at the hospital with me leaving the rest of my family to fend for themselves and when I was in recovery the nurses got her to be with me. I had a bit of a hard time, was really sick and they had trouble getting my pain under control because I’m allergic to NSAID’s-oh the joys. My Mum informed me that I didn’t say anything random (in fact I didn’t say much at all) but several of the people who came and went while I was there were “interesting” hmm…

The road to Surgery...Part 5 - Meeting the Surgeon

So now I wait to see the surgeon, all the time wondering whether or not he is going to think that what is wrong with my hip warrants surgery (should it really affect me this much? Am I just making a big deal about nothing, should I just be able to deal with it?). I cant take all this stress-I worry way too much.

But the weeks of waiting weren’t in vain; I got hold of my MRI report and find that it showed something more than the doc told me about. I ring up and ask what they think this sentence means and got told “oh that could mean anything we don’t take any notice of that” so curiosity sets in and I start searching online for some answers.

I find something I don’t really want to know, don’t really know if I have understood right since it wasn’t mentioned to me before and therefore cant understand why they wouldn’t have known the implications it creates. But at least now I am aware that this may be more than we originally thought. That what “could” be wrong with my hip may not be just the quick fix arthroscopic surgery I have been informed of. Yay more to worry about but at least now I have some inkling that this is just the beginning of understanding what is going on. Until I get to see the specialist surgeon all this is just speculation so I try and tell myself I am making too much of it, after all I’m no doctor…

My Mum took me to my appointment and we were early, I was so nervous that I made her sit in the car till just before my appointment time as there way no way I was going to sit in his waiting room! I made her come so she could write down everything he said since my memory is so shocking.
First impressions-I have no idea what he first thought of me, he asked me what the problem was and I just sat there frozen! Thank goodness my Mum was with me and she explained I had a head injury and then started explaining what was going on!
After that not so good start, things went on much better, we pulled my films out and my original so called “normal” x-ray came out. Not so "normal" surprise surprise-he could see perfectly where my problem was! The relief was immense at the same time I felt angry that all this time there was a reason but no-body had seen it.
He did a small physical exam, nothing compared to what others had put me though, he decided not to carry on as he could see quite plainly that I had some issues and didn’t see any point in putting me through more pain than was necessary.

Then he looked at my MRI films and discussed options, (needless to say the extra findings on the report I didn’t get told about had a big bearing on surgical intervention).

The official diagnosis-anterior superior labral tear with bony impingement on the Femoral head or CAM FAI (Femoroacetabular Impingement).

So instead, the arthroscopic surgery I was led to believe was the answer to my problems basically turned into (in his words) “not an option” I needed major hip surgery!
I was so glad I had done my own research and had already prepared myself for this senario otherwise I think I would have properly freaked out at the thought of more intense surgery!

My impression of him? I love him!!!! He spent lots of time explaining everything, treated me like a human being and because I have some knowledge of anatomy etc he explained things on my level using terminology I understood and even gave me the journal article of the surgical technique! He provided information on how he learned the surgical technique (as it is a relatively new surgery and not many surgeons have this expertise) and really gave me lots of info so I could make an informed decision and didn’t rush me through all my questions. All we had to do now was wait for surgical approval and then schedule a date.

The road to surgery and beyond...Part 4 - Test results

Test results

So finally the tests were done and I was waiting for the results, I hate waiting! It kills me the not knowing part, all the time you are waiting, someone knows what your results say and that someone is not you. All the time you are waiting, thoughts are spinning round your head:

What if they don’t find a labral tear?

What if it really is arthritis and there is nothing they want to do about it yet?

What if I need a hip replacement?

And my worst nightmare…what if nothing showed up - what will they think of me then?-I swear I am not making this hell up.

Thank goodness I didn’t have to wait long to find out, the doc rang me up to schedule an appointment-I was finally going to find out for myself.

So it goes like this, chit chat – how are you feeling today? …I'm ok thank you (anxious as hell, I just want to know what they said-cant you tell?)

Your walking is a bit better today. …I haven’t been up to much lately that’s all (please don’t decide just because I’m walking better that I'm ok cos really I'm not)

How’s everything else going since I saw you last? …Sorry? (Ok enough already, I NEED TO KNOW what my results say….NOW)

Ok then so he put me out of my misery and relieved my worries – something showed up on my MRI’s, SOMETHING SHOWED UP-I want to run and jump and scream and shout! I don’t know how to explain how I felt except immense relief and also excitement. This was the first time I had proof that there was something wrong with my hip and the necessary information to go on to the next step what ever that was going to be.

At this point all I was told (and shown on my films which was kinda neat) was a labral tear in my hip, apparently an unusual diagnosis as not many doctors are aware of this pathology in this point in time, never mind my fantastic physio had already come to that conclusion! He explained the anatomy of the hip detailing what the labrum and capsule etc was (needless to say I have since found out through my anatomy lecturer he was slighty wrong but never mind, he tried).

Next step was to be referred to an ortho surgeon who specialised in…yup you guessed it – labral tears in the hip!

The road to surgery and beyond...Part 3 - Tests

Waiting for Tests

This gave the doc some time to reflect on my hip “issues”. It is a well known fact that hip pain can be referred back pain, that’s fine I understand but please don’t forget that I have very limited passive movement in my hip joint. Surely that has got to count for something even if you aren’t totally convinced by my “my back is fine it’s my hip damit!”
It all came down to cost (the reason he had to reflect), whether I just got a hip MRI or if I got my lumbar spine done at the same time. They don’t like having to pay out lots of money for tests and MRIs aren’t the cheapest things in the world.
The good doc reflected and decided that both were warranted (I felt so special), and to make me even happier he informed me that I would need dye injected into my hip joint prior to the MRI-WHAAAAAAT? The cartilage in the hip joint needs dye so that it will show up properly in the images.

I had a bad experience with a previous MRI so I was freaking out about that and then freaking out about the intra-articular injection and also freaking out that the MRI would show nothing and then what would I do? Can you see I was worrying way way too much?

The test itself went well; the guy who did the injection into my hip (not the most wonderful thing to go through but certainly not undoable) was really nice and made me feel as relaxed as possible. The lady doing the MRI kept me calm and talked me through everything and all through the scan let me know that I was doing great and how far we were through and that she was getting good images etc and I felt so proud that I made it through the hour and a half-when you put your mind to something you can do it.
And then it was over, now all I had to do was wait for the results to come through…. And did I mention-they put some local anaesthetic in my hip and for the first time in so long I could tie my laces without that awful pain-amazing!

To be continued…

The road to surgery and beyond...Part 2 - Diagnosis

...so after that fall down the stairs I was now desperate for an answer to my problems and some relief but it wasn't an easy task...

Diagnosis

This was the second hardest part, the fun part. How to get someone to believe that there is SOMETHING WRONG with you. Do you know just how hard it is to get someone to actually give you some credit when you are in pain?

Just because I am young doesn't mean there is nothing wrong.

Just because x-rays were "normal" doesn't mean you discredit your patient, x-rays are not the be-all and end-all.

Just because you deal with attention seekers doesn't mean you get to label me as one of them, hell I took over 2 years to finally decide to get checked out (does that spell attention to you?).

Just because you don't have any idea what is going on doesn't mean you fob me off with some nonsense (I would admire you if you admitted you didn't really know but were willing to help me find out or send me on to someone who might).

And lastly just because you are a doctor doesn't mean you can't listen to another healthcare professional occasionally when they have an idea of the cause but are not able to order the diagnostic tests required!

A physio saved my hip and my sanity; he treated me with credibility and gave me the strength to persevere when I wanted to give up - HE ACTUALLY BELIEVED ME! He even tried to talk to a doctor for me and explain what tests needed to be done but no, the doc knew better. But thanks to Steve I soldiered on and finally found a doc who listened to my story, did a good exam and cared enough to help me find the cause of all my pain (thank you Doc, between you, Steve and my wonderful surgeon I am now looking forward to "being normal"!)

This was just the beginning of a diagnosis though, tests needed to be decided on, ordered and then the waiting game for them to be done!

To be continued…