I'm cured!

Or close enough.

Just got back from the doctor. I rode my motorcycle and walked in, no limping (but I have to really think about it when I walk).

He watched me walk, we discussed things I need to be careful about (dental work), and told me to see him in 6 months. He'll take x-rays then, and if all is good, don't need to see him for a couple more years.

He says I can do any activity I feel up to doing. I told him I've already been diving and he says no problem.

At this point, the final mental weight has been lifted.  I want to try bicyling, running, etc. again.  He just warned me not to break anything, so that's pretty much what I've been doing all my life, so I'm back!

Picking a physical therapist

I did a smart thing.  First of all, I picked a PT where they had aquatic therapy.  And this facility is a good one- the pool they use is big enough to do walking exercises for several people at once.  I've seen ads for other facilities where all they have is a big tub.

But the other important feature of my PT, which wasn't intentional- was to have a female therapist.  Who also has two female student assistants.

It's had several benefits.  When they do work on my scar, I don't mind.  One of the male students offered, and I skipped the scar therapy that day.

But, the 'workout' aspect of therapy works as well.  I'm sure that I try harder when a woman is asking 'can you do this', or 'let me know if you get tired'.  The answer to the first is 'yes', and to the second is 'of course I'm not tired.'  Sure it is sexist at some level, but it actually works- were it a guy, I would flat-out say something like "I don't like doing that."

The therapists (unlike the office staff) make it a workout I look forward to- even the men.  But I hope the workout won't be too much longer- I'm ready to start on my own I think.

Drying out

My Physical Therapy has been migrated from the pool to the gym.

That is a good thing it turns out.  Water is very helpful- it gives resistance to movement and buoyancy to allow motions that would be difficult on land.  But that same buoyancy limits the actual forces I deal with.  I've improved to the point of really needing to strengthen the big muscles of my legs.

In the gym, I ride a type of bicycle (push pedal), do squats, stretches, step-ups, pull against rubber bands, etc.  It is very effective.  I feel like I've been working out afterwards.  Muscle soreness- the good kind.

More PT

I've been going three times a week, I can really feel myself get better.  I've moved on to v2 of my at-home exercises, so I must be getting stronger.

I also notice that my flexibility is much better.  I was able to almost do a split in the water today.  I can bend my knees to my chest now too.  When I get re-evaluated, I'm sure that will be a huge improvement.

I'm still walking with my cane.  It definitely helps my gait when I use it.  Yesterday I walked and did some light cleaning in the garage without it all day.  And I hurt afterwards.  I notice that my gait suddenly got sloppy too.  I started walking with that hip-hop 'hitch' as my hip starting dropping.  I've been consciously making sure that doesn't happen, but walking without the cane just tires those muscles out.

Today in the pool I got a new therapist since my usual one was out sick.  It was a guy, which was cool; someone new to talk to.  But, when it came time for the 'manipulation' of the scar to help break up the scar tissue, I was like 'no thanks'.  I'll wait for one of the others to touch me there :)

Physical good. Mental Bad.

I've lost  my mind.  It's 37 degrees and ridiculous wind and I rode my motorcycle to physical therapy today.

Therapy is working great.  I've also been doing sessions where she is breaking up the scar tissue.  Afterward we did pool work, the treadmill and stretching.

I have to admit I took a long hot shower in preparation for the trip back.  And I still froze my ass off.  Brrr!

Aquatic Therapy

This was more like it.  I was able to work out in the pool at the physical therapist.  93 degrees and long enough to do some pretty cool exercises.

When I was evaluated, my range of motion was pretty good, but my strength was down.  So a bunch of exercises were all about building strength.

I did laps, walking back and forth in the water.  Did some treading of water.  Worked on the treadmill.  And probably the best one was simply walking up steps with my bad leg, letting the buoyancy of the water hold me up so I could go through the motion. 

I really enjoyed it and am looking forward to my upcoming three sessions next week.

First meeting with the Physical Therapist

I drove down to meet my PT today.  She's great.  What I didn't realize about PT is how much work *I* have to do.  For some reason I thought it was all machines and this and that. But it is more like homework!

She measured my range of motion and I'm not in bad shape, but both legs are weak.  So I've got all kinds of exercises to do, most of them lying down.

Something very interesting- I had assumed that not walking with my crutches or cane would be a good thing.  Nope.  Since I'm limping, I'm training my body to walk like that, which will affect my gait for a long time.  Turns out I need to get back with the cane and force myself not to let my hip sag when I move the bad leg.  It'll strengthen the hip, and prevent bad habits.

I'm trying to get PT in as soon as possible, so I'm back at the PT tomorrow and will be working in the pool, then three days next week!

Bony growth

I got a reading about my x-ray- and found this interesting note.

Findings: Left total hip arthroplasty without dislocation, periprosthetic fracture, or definite periprosthetic lucency. Cerclage wire remains in place about the proximal femur. There is some heterotopic bone formation adjacent to the left proximal femur. Joint space is preserved at the right hip. Minimal sclerosis the pubic symphysis, likely degenerative in etiology. Skin staples have been removed from the left hip since the prior examination. Impression: Removal of skin staples. Left total hip arthroplasty without radiographic evidence of complication.

 I of course, googled for this and found that it occurs in men- for some reason bone starts growing in soft tissue.  In extreme cases, it can join two pieces of bone that weren't meant to be joined- such as the femur and pelvis.  For me, I can see a swirl of bone cells in my leg.  They're low down, below the cable, so they shouldn't matter.  I've also asked the doctor and my radiologist friend and both of them said not to worry.

When are you going to quit limping?

said my wife as we left dining out tonight.

Can you believe her?  It hasn't even been a week yet since I took my first steps.  And she's been cautioning me the whole time.  Let me review- at the doctor last week he said "you can start putting full weight on your leg." and gave me a prescription for therapy.  And said "they'll have you move from two crutches to one crutch, to maybe a cane."  Well, I skipped all that and went straight to walking.  Haven't used the crutches for 5 days now.  So I think I'm doing pretty well, but now my wife is pressing me to get better faster- when I'm already ahead of schedule!  Sheesh!  :)

A day without crutches

My goal today was to spend the entire day without use of my crutches or walker.

I did it.

But I messed up. 

I went all day- I have to say I didn't get up at every opportunity, but when I did, I did my lurching walk.  I put away dishes, answer the doorbell, even went into the crawlspace.


It wasn't until the end of the day, when we went up to the theater to watch a movie that I screwed up.  I had a system of having my 2nd crutch at the top of the stairs.  I went up the stairs without my crutch, but for some reason, I grabbed the crutch and used it for a few steps and realized how silly it was and walked and put it back against the wall.  I'm going to blame it on an old habit.

Since I did it today- the first full day I was released from restrictions, I figure I can do all of them!

Out on the town

I went to dinner with a buddy of mine last night. 

And I didn't bring my crutches.

That's huge.  The little things I've been noticing getting better are becoming bigger and bigger.  I'm thrilled.

I'm free!

Went to see the doctor today (and no co-pay), and was thrilled!

He took x-rays, checked out the wound and declared me free to put full weight on my leg.  He wrote up a prescription for physical therapy and indicated that I was free of restrictions.  Which means, I'm allowed to move my leg in all directions, bend it, etc.  I asked about scuba diving and I'm allowed to start when I'm done with aids to walking (crutches/walker).  I think that'll be soon!  Too bad they're spotting icebergs off the coast right about now.

To celebrate, I did some short walks where my wife *didn't* yell at me.  In fact, she was happy about it.

That's never going to happen again

I don't think I've mentioned it here, but there's an uncomfortable tenseness with my old doctors.  After all, I went to a new doctor and got my leg repaired and finally on the way to recovery.

I did call my old doctor to tell them I had an upcoming surgery, so it's not like I just disappeared.  I'm sure they were somewhat nervous about that.

They were great guys and I really liked them.

So, I was pleased to hear this morning that my wife got a call from one of their assistants asking how I was doing.  Apparently they had been discussing me. She told them I was doing well, and was on the way to discovery.  When told, I thought 'hey, today they're both in the office, I should go by and say hello'.  So I called up the office, told the receptionist that I wanted to come by and say hello and that I was on my way.

When I show up, I tell the young woman at the desk I wanted to say hello to the docs and a few minutes later she says "I need to put this down as an appointment."  Hmmm.  I said "fine", then she says that I'll need to pay a co-pay. ?!?!  I said, this was just a social visit, and she said if the doctors want, she can refund the $30.  I go ahead and run my card through and a few minutes later I get called back to the back where I see the doc standing at the counter.  I speak to him a few minutes, shooting the bull, and then the other doc comes out and says hello, asks how I feel, when I'll be able to bear weight, etc.  Then we say goodbye and I go back to the desk to check out.

They didn't refund my money.

This kind of freaks me out, and pisses me off.   I was there for their benefit, because I'm sure they were nervous about the outcome of this entire episode.   I mean, they called *me*.  I never went into an exam room, was never examined, tested for range of motion or anything.  Just a social call, with a smattering of medical questions both ways (Yenni doesn't recommend much rock climbing).  And a bill to me and my insurance company.

Uncool.

I'm a big boy now

My son Max can still outrun me, and loves showing off how well he can jump.  But I'm just passed his skills in one area.  I can dress myself.

It's hard to believe, but I've not been able to get fully dressed by myself since the accident.  I've figured out ways to get my shoes on lately, but the sticking point has been socks.  Seriously.  Getting a tube sock over my foot needs some force, and some flexibility, and my wife has had to do it for me all along.

Yesterday, I managed to get dressed by myself.  Take that Max!

Fool me twice?

Things are definitely improving- I can do all kinds of 'tricks' that make me notice the different.

For example-

• I can get in my car now and swing my leg in... without picking it up with my hands.
• I can lift my knee while sitting, which I couldn't do last month.
• When I get into bed, I can swing my legs in without any assistance.

These sound minor- but they're huge in that I haven't done them since September last year.   I notice I'm getting stronger and the range of motion is increased too.

But, how am I going to get in shape after the expected release to more extensive activities next week?

I'm thinking of the most dangerous of conveyances... the bicycle.  Yep, tens of thousands of miles of motorcycles has resulted in nothing but scrapes.  A few minutes in the afternoon with the kids and a  bicycle meant three surgeries and almost a year of limited functions.

But a buddy of mine is a bicyclist and has convinced me it is excellent exercise.  And not even being able to walk this long leaves me in terrible cardiovascular shape.  I've never been huge on cardio, but this is a setback even to my moderate levels, so I need to do something.

I just hope the bicycle doesn't fool me twice!

My cool friends

Friends and acquaintances have come and helped me all along during my recovery.

A very cool one was today when neighborhood friends whom I had been diving with gave me a massive gift basket.  They continued to dive and said it wasn't the same without me and felt like cheering me up.  Bottles of wine (French, of course), cheese, beer, nuts, snacks.. delicious! 

It hasn't replaced the loss of diving all Fall, but it certainly eased the pain.  And it has me excited to get out with those guys again this Spring. 

Muscle pain

I'm not sure why, but I've had a lot of pain in my a^H gluteous maximum muscle the past couple of days.   I'm having trouble sleeping and have had to take more pain pills than I like.  I probably strained the muscle at some point.

A small victory

As I'm getting better I notice small things I can do now.

For example, I can lift my knee.  About a month before my surgery, I had lost the ability to lift my knee while seated. I'm not sure if it was the loose hardware or the pain, but it was likely muscle atrophy.  While seated I would look at my knee and try to raise it- but nothing.  Now I can.  Not high.  Not fast, but it moves.

But the big victory was that on the driver's side of the car, I can now get in.  Without having to lift my leg with my hands.  I'm not going to win any races, but it is certainly an achievement that once my body is in, I can move my leg into the footwell.  I haven't gotten there yet on the passenger side- I still have to lift my leg and move it across the door threshold, but that should come soon.

Kicking in the pool

A good friend invited me to the pool today.   I doubt I am authorized to jump in a pool, so I took it really easy.  I brought my fins and mask and did one-legged laps.  About 10 of them and I was exhausted.

But it was in a good way.  I'm a little sore, and I'm looking at that as muscles waking up. 

Thanks, Pete!

A reading of the fracture

The hospital has a nice portal where you can view lab results and such.  Apparently, a reading was done of the x-rays pre-surgery.

Indication: Closed neck of femur fracture.

Findings: IM trochanteric hip screw fixation of a basicervical femoral
neck fracture. They be extension of the fracture into the greater
trochanter. The fracture line remains evident with incomplete osseous
healing. There is some collapse of the femoral neck. Several small
ossific fragments are seen about the femoral neck. Ossific densities in
the soft tissues just lateral to the proximal femur are likely related to
surgery. Joint space appears preserved at the hips bilaterally without
significant degenerative changes. The sacrum and sacroiliac joints are
grossly unremarkable. There are numerous small lucencies within the
distal femur and proximal tibia which likely reflect disuse osteoporosis.

Impression:
Open reduction internal fixation of a basicervical femoral neck fracture.
There is some collapse of the femoral neck. The fracture is incompletely
healed.

Good but not great

I went to the doctor today for x-rays and a post-operative appointment.  I ended up somewhat disheartened, though I really shouldn't be.

x-rays went well, and I'll post them as soon as I get them, but it looks like a total hip replacement.  I got a shot of both hips and you can see that the geometry looks good.

When it came time to meet the doctor, we really didn't talk that much about the surgery- he confirmed again that it was not in good shape, even the acetabulum was showing signs of problems.  We did look at the x-ray and I saw what looked like a cotter pin on the x-ray.  He said he had to put some surgical wire around the bone to protect it as he put the new stem in the leg.  We also discussed somewhat my leg length.  I told him I thought it might be a little longer than the old one, but he countered that it was likely due to the old one being so short, and that some additional settling will occur with the new hardware.

He pulled out my staples and... told me to see him in three weeks.  I was expecting a change in my limited use status- maybe doing some other exercises, but as of now, the only exercises I can do are those in bed, some isometrics and leg raises.

I was disappointed.  I mean, Regis was back at work in 3 weeks- here I am not supposed to be putting weight on my leg and wearing compression stockings.

Stef tells me the big difference is that I've been out of it for over 4 months.  My muscles are very weak.  The doctor did mention that my bone is 'soft'.  Bone is pretty amazing that it requires stress to have it rebuild itself.  If it isn't being used, the body starts to take it apart.  If it is used a lot, it strengthens.  My legs have not been used a lot lately, so muscle atrophy and bone softness is why I assume I'm not being moved ahead faster.

Patience.

Dueling Nurses

There's an odd benefit that might serve some people well.  I got a call from my insurance company the week before and the week after my surgery.   It's from an RN (Registered Nurse) who called to help me prepare for surgery, and then the recovery.

She's really nice, going over my expected recovery and I've enjoyed chatting with her.  She asked about the post-op instructions and we talked about my aspirin binge. She was concerned so she called the doctors office to leave a message. 

The doctors office just called back and said to call them directly- I then went on to explain how it came about and they were fine about it.

The PA at the doctor's office said the headaches were from the oxycontin withdrawls since I had cut out the long-release version of the medicine.  She suggested I back off the aspirin, and take the short-release medicine for pain, and try caffeine for the headaches.

Headaches

I've been tired.  Not much appetite.  I sleep a lot.

But the one constant has been headaches.  I'm taking many aspirin a day.  I need to ask the doctor about this when I visit him this week.

I've been beat up

(post about post operative pain and bruising, with a funny response about how the other guy looked)

Debilitating hiccups

The worst part of my recovery was that I started getting the hiccups.  Hiccups are funny, right?  Not when it is every breath. 

It lasted for several days over the weekend, preventing me from doing anything. 

I'm pretty sure it was a response to one of the drugs I was taking.  The thing is- I can't remember which one.  I know it wasn't the normal pain killers, because I had been on those for a while.