Sunday, April 27, 2014

Week Eight Post-Op

PT was pretty uneventful this week.  I told them I wasn't able to complete all my exercises last week since my hamstrings were so sore, thus they didn't advance anything too much.  I am now doing skater squats with a band around my knees and walk-out bridges.  Those were familiar from my first round of PT before surgery, so no worries there.  Since my Monday appointment at PT, my hamstrings have been feeling much better.  My muscles are starting to wake up and get accustomed to being used again.  I can't wait to get rid of the mush that my legs have become over the past two months.

I think I am almost back to my normal walking pace.  Walking feels great.  In fact, I am starting to think that my operated hip feels even better than my non-op hip when walking.  It's smoother, not as tight.  That's a pretty scary thought.  While I am not having any significant pain in my "good" hip yet, there's a very real possibility that it will eventually fail on me.  During my first appointment with Dr. Keene he looked at my X-Rays and said that my right (good) hip looked worse than my left (going to be operated on) in terms of abnormal bone structure.  At least if I have to go through this again, I won't spend years trying to figure out what's wrong with me.  But I really, really don't want to have to go through this again.  Dr. Keene will probably be retired by the time (if) my right hip goes bad and I won't want to trust a new doctor with it.  I know I shouldn't think about the "what ifs", but it's always going to be in the back of my mind. 

Monday: 2.4 mile walk
Tuesday: 10.9 mile bike ride
Wednesday: 12.4 mile bike ride
Thursday: 2 mile walk
Friday:  10 mile bike ride
Saturday: 13 mile bike ride + 2 mile dog walk
Sunday: 1.2 mile dog park walk + 1.8 mile dog walk

The big news this week was that my dog came home on Saturday!  She stayed with me at my parent's house while I was there, but then got transferred to my best friend's house for most of the month of April.  I needed to make sure that I would be able to handle all of the walking that came along with taking care of her, as she's fairly high energy even at the age of 9.  So next week will be a test on my hip to see how it does with increased walking. 

Yesterday I absentmindedly jogged down a flight of stairs.  I didn't even realize I was doing it.  It didn't hurt, so I'll take that as a good sign. The timeline to return to running seems to vary wildly between people and surgeons after this surgery.  I've read about people starting to run as early as 8 weeks, which is where I am right now, and as late as 6 months.  I am absolutely not ready to run yet, both mentally and physically.  My PT told me that the most optimistic result would be 12-14 weeks post-op.  I am not in any rush to start running again.  I would prefer to error on the conservative side and I can be happy enough this summer with just biking and hiking.  My tentative plan is to wait until July/August to start running, which would put me at 4-5 months post-op.  Of course, that's subject to change.  I seem to be healing well without compilations, so maybe I will feel differently in a month.

I am happy with my decision to have surgery in late winter/early spring.  The better I start to feel, the nicer the weather becomes.  It's been encouraging to correlate my healing with the coming of summer.

Content to finally be home.

Sunday, April 20, 2014

Week Seven Post-Op

I am continuing to feel better every week.  I was back at work full time this week and sitting in my chair is definitely easier than it was previously.  I am walking faster and going to the store amongst normal people isn't scary anymore.  I feel like I can blend into the crowd now.     

This week at PT we advanced some of my strengthening and stability exercises.  I am now doing partial lunges, side stepping squats with resistance bands, more squat type stuff for my glutes, and one legged bridges.  I am finally feeling like my glutes are getting some good work, since I woke up the next day a little sore (sore muscles, not joint.)  I don't mind the muscle pain, but I must say that my hamstrings were pretty painful for a few days following.  On my own I am also doing planks and calf raises.  (A side note on calf raises - you can't not use your legs for over a month and then break out 50 calf raises.  Ouch.  I felt that one for a good few days afterwards.)  My range of motion seems to be almost back to normal, aside from some certain movements, which they said will come with time.  PT also gave me the green light to "walk for exercise."  They were pretty ambiguous about the distance, but I figure as long as I am pain free, then it's okay.  My gait still isn't perfect (feels only very slightly off), but I'm reasonably sure I look like I normal person walking down the street now.  Walking on flats is definitely easier than on hills.  I slow down significantly on the hills yet. 

Monday: Grocery store (this was a good enough walk that day for me)
Tuesday: 1.8 mile walk
Wednesday: 1 mile walk
Thursday: 2 mile walk
Friday: 2 mile walk
Saturday: 10 mile bike ride
Sunday: 10 mile bike ride + 1.3 mile walk

I have determined that biking is magic.  Sometimes I will wake up with a small limp or some minor pain, but after I've hopped on the bike for a while it's instantly gone.  Maybe it has to do with that "motion is lotion" saying about your joints.  Speaking of biking, I rode my bike OUTSIDE for the first time on Saturday.  I stuck to as flat of a route as possible and just took it nice and easy.  Low gears, easy pedaling, plenty of coasting.  The few hills I did encounter I just put it in a super easy gear and spun away without getting up off the seat.  It felt totally fine and it was great to get outside.  I hadn't been outside on a bike since November, so the first few minutes were like, "Wheeeeeeeeeeee!"  I stopped at a picnic table half way through and took a 5 minute break.  I wound up going 10 miles in about 55 minutes.  Ridiculously slow, but the point was just to get outside and enjoy myself and see how it felt.  My ride on Sunday felt even better and I was faster, so I can't complain about that kind of instant progress.  I'll consult with PT on Monday just to be sure, but hopefully this means I can start to bike outside a few days a week!

I can now easily sleep on my operated side.  I don't really even think about rolling over in bed anymore.  It's just normal aside from the pillow between my legs, which I think I'll continue to use for a while just in case.  (In case of what, I'm not sure, but it can't hurt.)  When going up and down stairs now I have that little urge to jog, since that's my typical behavior.  I figure that's a good sign that my brain wants me to jog, even though I won't be doing that anytime soon.  I would say that the only normal movements I am still having difficulty with is getting in/out of the car.  I am still careful about my leg and use my hands to lift it slightly.  If I forget, I'll get a small zing of pain to remind me that there is still a lot of healing going on inside of me. 

Sunday, April 13, 2014

Week Six Post-Op

This week was all about returning back to normal.  I was still only at work part time, but I am starting to feel ready to put this fragile stage behind me.  I am moving much better now.  I can bend over and touch my toes, cross my legs both ways, sit indian style, and sit with my op-leg foot on the knee of my other leg.  I can't think of any positions right now that would bother me.  However, being stuck in my desk chair at work was still slightly irritating if I didn't get up and move around enough.  Nothing to warrant even ibuprofen; it's just annoying. 

PT really did a number on me this week.  The lady clipped this belt (looked like a seat belt) around my leg and around her at the same time and did all sorts of weird pulling and pushing to try and increase my ROM.  I'm still having pain bringing my knee toward my chest when I am on my back, but apparently that's normal.  I'm now doing mini squats with a band around my knees and then walking sideways and forward.  I also got permission to walk a mile outside and then slowly increase to 30 minutes.  The first time I walked a mile on Tuesday was pretty difficult.  It felt like a long way to walk and I could definitely tell I was slowing down toward the end.  But by Saturday, it became a lot easier.  I've found that if something feels hard at the beginning of the week, I can expect it to be a lot easier toward the end of the week.  Healing in action and all that.  Mileage this week:

Monday: 8/10 of a mile
Tuesday: 1 mile
Wednesday: 1 mile
Thursday: 6/10 of a mile
Friday: Rest
Saturday: 1 mile
Sunday: 1 mile

I am still riding the bike every day, but toward the end of the week I started alternating my easy spinning with a little resistance.  Adding in the resistance actually makes me feel like I'm doing a workout.  It feels good to sweat again, even if it's just inside my living room.  For some reason I've found riding the trainer a lot more tolerable this year than last year.  I don't know if it's because I've adjusted my bike so much that it fits better or if because I am just desperate for something to do.  Either way, I've been listening to music and happily going for 30-40 minutes at a time.

On Friday, I got to move back to my own house!  Staying with my parent's was extremely helpful for those first few weeks.  I couldn't imagine doing it on my own or mostly on my own.  Long distance relationships are certainly not very helpful in these types of situations, so I was lucky to have my parents close enough to take me in.  I didn't have too much to haul between houses, but my dad did most of the heavy lifting.  I did pick up a big duffel bag and twisted or rotated oddly and tweaked myself pretty badly.  I was limping most of the rest of the day, but iced off and on and woke up feeling fine the next day.  I guess I still do need help with some things, but I feel mostly back to normal in terms of day to day type of activities.

I think the most important thing to note over the past six weeks is that while I've had various pains, I have not had any of my pre-op pain.  None.  For the first time in almost 2 years, I have no groin pain.  It's pretty crazy to think about.  I can roll over in my sleep again!  Rolling over in bed probably caused me the most acute pain before.  I can't wait to discover even more things that don't cause me pain anymore.

Two of my three scope wounds.  The other is on my outer hip.

Friday, April 11, 2014

Post-Op Appointment #2 and Learning About Healing

I am finally caught with my blog and am posting in real time now!  I had my second post-op appointment yesterday.  It went just fine, but it was mostly pointless.  Dr. Keene had a 30 minute delay, so things were pretty rushed.  After spending too much time in the waiting room, I was finally called back.  Some resident/intern guy came in and wanted to compare my ROM from my right to my left.  He was a little too rough for my liking on my operated side - pushing and rotating my leg with the same force as my right.  Ummm, hey dude, I just had surgery 5.5 weeks ago!

I had to fill out some form regarding my pain and activities.  Dr. Keene came in and we chatted for a few minutes.  He just wanted to know that I was healing well and that my incisions weren't causing me any pain.  Check and check.  I asked about restrictions and he said I had none.  I asked about biking and walking and he said not to increase too quickly, but I could very slowly increase time and resistance.  I scheduled another appointment in 6 weeks.  He said that the most progress is made in weeks 6-12, so that was exciting to hear.

Today it has been 5 weeks and 4 days since surgery.  5 weeks and 5 days since I've run.  I've only recently remembered to start looking at the big picture again.  It's hard to convince myself that there's an end game to this whole thing.  I've been so consumed with never ending pain for 2 years that it's hard to realize that I'm actually on the road to getting better now.  I have a hard time describing my situation as chronic pain, as I hardly suffered like people with true chronic pain do.  However, it really did take over my entire life in a way.  I had to stop doing the things that I loved to do.  I wondered every day how bad it was going to be.  It dominated my thoughts.  It was just something I eventually accepted as part of me, because you can't move forward with your life without accepting that.  When you're running an ultra and you're alone in the woods in the dark, you are supposed to make friends with your pain so you never feel alone.  So I asked my pain out for coffee and it stayed a while.  It's not that you stop thinking about it, it's that you just get used to it.  The pain becomes your new normal.  I'm trying to remind myself that a new normal is coming yet again. 

What has amazed me in the last few weeks is the feeling of healing.  That might sound silly, but I had forgotten what it was like to heal.  After you've exhausted a dozen options and given up on having anything change, to be able to watch yourself make progress and GET BETTER is indescribable.  I know I am still early in this process and I have a very long way to go, but I'm hopeful that there will come a day where I don't think about my hip.  I want to go through the motions of a normal day, come home from work and go for a run with my dog and lay in bed pain free that night and think, "Huh.  I'm missing something here."

Every day that I walk a little farther makes me smile.  I walked 1 mile last night.  I may have ran 63 miles in a day before, but damn if I wasn't proud of that 1 mile. 

Week Five Post-Op

This was the week that marked my return to (semi) independence.  1.)  My parents were leaving for Virgina for a week to visit my brother.  2.)  I was going back to work part time.  I was stuck tying my shoes all by myself.  We joked that I could probably pay the neighbor kid next door to come over and tie my shoes every morning, but I managed okay by myself.  I still couldn't bend down to do it, but I could bring my foot up on my opposite leg.  It was nice to be on my own for a while.  I very slowly navigated around the grocery store one afternoon.  It felt weird to be out in public and be moving so slowly.  Some people gave me funny looks; I needed a sign on my back that stated I just had surgery. 

At PT this week, they had me starting to do mini squats and balancing on my operated leg, as well as walking forward and sideways in the mini squat position.  I was a little worried about incorporating new exercises when I was just getting my walking legs back, but I didn't have any pain or problems.  I felt like my gait was starting to normalize after a little over a week off the crutches.  I obviously wasn't going anywhere fast, but my limp was getting less pronounced.  PT said my range of motion was getting a lot better and continuing to improve.  It's really important to work hard on your range of motion since you have a limited time frame to get it back. 

I feel like I went back to work at the right time for me.  I could have gone back earlier, but it wouldn't have felt right.  The plan was 4 weeks totally off, 2 weeks back part time (4 hours/day), and then back to my normal full time hours.  Those first few days this week were tiring and I was very ready to get out of the desk chair by the end of my 4 hours.  My joint felt mildly uncomfortable by my limited positions.  I missed my recliner.  It wasn't bad, but I guess I didn't realize how much normal things still made me tired, even after a month. 

In the middle of the week, I was dog sitting for my brother's little 5 pound dog.  He was fun to have around because he was so easy to handle and I could actually take him for a walk and not worry about being pulled over.  We decided to try and make it around the block (approximately a half mile).  Toward the end I was dragging pretty badly.  My leg was just really tired and I was starting to get some pain in the joint.  Getting back to the house seemed so far away!  When I got home I iced it and took some ibuprofen and all seemed fine an hour later.  A few days later I was able to walk a half of a mile with no problems.  My walk schedule this week looked like this:

Monday: 1.5 miles (last walk on crutches)
Tuesday: 2/10 of a mile
Wednesday: 1/2 of a mile (dog walk)
Thursday: Rest
Friday: 1/2 of a mile
Saturday: 1/2 of a mile
Sunday: 7/10 of a mile

Sleeping was getting a lot easier.  My movements in bed were almost totally pain free and I could sleep on the operated side with only a little bit of weird feeling.  I am still sleeping with a pillow between my legs; I'll probably continue to do that as a precaution for a while.

Hanging with the little guy on a nice day.

Thursday, April 10, 2014

Week Four Post-Op

After 3 weeks and 1 day, I was officially given the approval to wean off the crutches from PT.  They told me I could go down to one crutch for a few days and then to no crutches, but I wound up skipping the one crutch phase.  I tried it for a few hours around the house and it just felt awkward.  I felt better just slowly walking normally, so that's what I did.  PT had me doing "gait training" where I would walk backwards, side step, and make sure that I was walking without a limp.  They told me to take my crutches with me outside or if I went anywhere such as the store.  I was comfortable walking in the house, but being out in the world without the crutches felt like too much too soon, so I was happy to follow that advice.  I continued going for my crutch walks this week, but I was getting a cold and feeling a little run down, so I only "walked" 3 days for approximately 5 miles.

On my second full day off crutches I walked normally around the house, drove myself home to get my mail, did some laundry at home, and then at the end of the day that big tendon that runs down the inside of my leg was little sore.  I used The Stick on it and that felt good.  The joint itself felt fine, but tendonitis is supposedly a common side effect from this surgery, so I'm trying to be really aware of that and stop and take care of small issues before they become big problems.  I was just so happy to be able to carry my own coffee cup (or beer!) around the house again.  
You have to treat yourself to good beer during recovery!
On Saturday it was so nice outside and my walking felt that it was progressing well enough indoors to go for a VERY short jaunt outside without the crutches.  It was probably not much more than 1/10 of a mile.  It was slightly scary and my leg felt clunky and heavy, but I walked about 4 houses down the street and then back.  (Normal suburbia type neighborhood.)  It didn't hurt, but I wasn't trying to push anything.  I was walking very slowly at this point.  I just couldn't move very quickly and I had to concentrate on each footstep.  The dog and I had a good time sitting on the deck in the sunshine later that day after my big outing.  

It's a hard life.

This week was the first week I was able to put my own socks on.  I would sit low (think toilet) and take the foot of my operated leg and place it near the opposite leg's knee. It was still a bit of a struggle, but I was able to do it.  It was easier for someone else to tie my shoe on that foot, but I could have done it if needed.  Every day seemed a little easier and every day I woke up with slightly more range of motion and less pain than before.  If I moved in a weird way or twisted wrong, I would get a little jolt of pain, but over all I didn't have pain in my daily motions.

Since I was told I had no sleeping restrictions, I very carefully rolled over to my operated side one morning to test the waters.  I probably laid there for 10-15 minutes.  It felt weird, but not painful.  Kind of like Princess and the Pea.  I could feel something was off, but it was very slight.  I was still taking my good leg and hooking it underneath my operated leg to get into bed every night, since I didn't want to stress my hip flexors too much. 

Tuesday, April 8, 2014

Week Three Post-Op

The beginning of week 3 felt pretty similar to last week.  I still couldn't walk, I still couldn't put on my own socks/shoes, and I was still spending most of my time in the recliner on the laptop or watching Netflix.  I could, however, crutch walk.  So crutch walk I did.

Monday: 1.3 miles
Tuesday: 1.5 miles
Wednesday: Rest
Thursday: 1.8 miles
Friday: 2.1 miles
Saturday: 1.3 miles
Sunday: 1.3 miles

Apparently it's a little weird to most people that I was going for "walks" on crutches.  A FedEx truck honked at me, lots of people initiated conversations from their yards, kids stopped and stared, and one guy in a car even slowed down to tell me that I was "ambitious."  But I am happiest when I am outside, so I was glad to be out there.  My wrists did get a little sore toward the end of the week though.  And I was building up plenty of arm muscle!

I don't remember any big accomplishments this week, but every day I still felt a little stronger, moved a little easier, and had less trouble doing every day things.  I read that a lot of people seem to hit the doldrums during this phase in recovery, but I felt okay.  I just kept getting outside and trying to keep myself occupied.  With my dad's help, I baked cookies one night.  Toward the end of the week, I remember cheating on my crutches a little and taking a step or two in the kitchen without them.  I was feeling ready to be off them, especially since at PT I was able to comfortably balance on my op leg.  PT exercises that week included the same as the previous week, but adding in more weight shifting plus bridges. 

Week Two Post-Op

I started PT this week at 8 days post-op.  I scheduled my appointment with the same PT who I had worked with pre-surgery, hoping that her knowledge of knowing me beforehand and seeing my struggles would be helpful.  The first session was pretty uneventful.  I told the story of how I wound up making the decision to have surgery and we did some light range of motion exercises as well as more glute and quad tightening.  I also laid on my back and did heel slides.  The ROM exercises included log rolls and laying on my stomach with my knee bent at 90 degrees and slowly swinging my foot outward and then inward like a pendulum.  My dad would help me with this exercise at home.  Even though it had only been a week, she had me doing some weight shifting too, to start loading my operated leg.  She had me stand on it full weight bearing once, but that was kind of scary even though it didn't cause any pain.

This was the week I started going on short crutch walks around my neighborhood.  The weather was finally starting to get warmer and the snow was melting, so I was happy to get outside.  I started out by crutching down the street and back.  Then around around block.  Then a little longer than around the block.  My energy was starting to come back and I was anxious to do something.  I'm not very good at sitting for long periods of time; probably part of the reason why I run so much.  I crutch walked 3 days this week for a grand total of 2 miles.

At day 10, I went for my first follow up appointment.  Turns out my surgeon was on vacation that week, so I would just see his PA.  The PA said I looked good and took out my stitches.  This didn't hurt at all; I could hardly even feel it happening.  I asked about transitioning off crutches and he told me that even if I was feeling good that I needed to stay on them to protect all the work that was done in there.  It was a pretty quick appointment, as Dr. Keene wasn't there to go over everything with me.  I would see him at 6 weeks post-op for all the details. 

I started sleeping better as I got more comfortable sleeping on my side.  My lower back pain also started to go away this week, since I was moving around more and sleeping in a more natural position for me.  I was still biking with no resistance with no issues at all.  I still wasn't holding onto the handlebars, but just sitting straight up and biking.  I felt that pinching sensation when I leaned forward, so I figured the handlebars would come with time.

One of my friends came to take me out to dinner and get me out of the house one night.  It felt good to go somewhere and to be out in public.  I was a little worried about sitting on a hard restaurant chair for so long, but it turned out to be okay.  I was a little achy toward the end, but over all it didn't really hurt.  Having a beer didn't hurt either!

Sunday, April 6, 2014

First Week Post-Op

Surprisingly, the first few days were easier than I expected.  I was prescribed narcotics and a hefty dose of ibuprofen, but I stopped the narcotics after just 2 days, with essentially no pain transitioning to just the ibuprofen.  (Dr. Keene prescribes the ibuprofen not just for pain, but as a precaution to stop the bone from growing back.  I had to take 2400mg a day for two weeks.)  Going to the bathroom was still challenging, mostly due to the stiffness of my bandages and not being able to bend my leg much.  I was also stuck in compression stockings on both of my legs for a few days. 

Being on crutches was annoying, but not as terrible as it could have been, as I was allowed to be partial weight bearing on my operated leg.  My paperwork said that I would be on crutches for 2-3 weeks. 

I had a few simple PT exercises to do at home for the first week by myself.  Things like ankle pumps and tightening my glutes and quads.  I wouldn't start formal PT until 8 days post-op.  I had read that Dr. Philippon had his patients on the bike with no resistance less than 24 hours after surgery, so that was my plan.  If one of the best hip surgeons in the country had his patients doing it, I'll be damned if I wasn't going to do it too.  My parents were skeptical, but Dr. Keene gave me the okay, so they helped me up on the bike.  I had the option of my mountain bike on a trainer or the stationary bike downstairs.  I chose my normal bike on the trainer.  I definitely needed someone to help me as well as a small stool to get on for a while. My first time was awkward and very difficult to get my operated leg all the way around.  I was very hesitant and doing a full rotation was comically slow.  A good tip is to raise the bike seat as high as possible and don't reach for the handle bars at all.  I held onto the wall next to me for the first few days.  Days one and two I didn't do much spinning; I just oh-so-slowly rotated my leg with the help of the pedals.  Then on the 3rd or 4th day, I could magically pedal like normal (still holding onto the wall.)  Then I really felt like I was getting some good range of motion work in.  Once the bike felt more comfortable, I transitioned to three 10 minute sessions a day.

I spent most of my first week alternating between sitting in my recliner and laying on my stomach on my bed (which you are supposed to do to gently stretch your hip flexors.)  When I was in the recliner, I tried to remember to turn my ice machine on.  I had no swelling that I was aware of.  I think the ice and elevated legs helped with that.  After a few days of sleeping on my back and spending most of my time sitting/laying, my lower back got very achy and painful.  I didn't have any hip pain, but my back acted up for the first week or two.  It didn't start to feel better until I started sleeping on my side and getting up and around more.  I think it was around day 5 or 6 when I started rolling over very carefully to my non-op side with a pillow between my legs to sleep.  I was told I had no sleeping restrictions, but it still made me a little nervous since so many other surgeons make their patients sleep on their backs in these crazy feet booties for up to two weeks.

I took my first shower 3 days post-op and it was utterly exhausting.  I felt more drained afterward than if I had gone for a 20 mile run.  My mom had to help me take off my layers of bandages and then tape me up with Glad Press and Seal over my incisions.  Getting in and out of the tub was challenging as well.  The easiest way I found to take a shower in a standard bathtub was this: Put a stool in the bathroom right next to the tub.  Sit on the stool and have someone help you swing your legs around into the tub.  Stand, shower, use the stool for support to turn around, etc.  When getting out, stay standing in the tub and put the stool outside of the tub.  Sit on the stool and have someone help you swing your legs out of the tub.  Now if you have a nice walk in shower, then you're luckier than me! 

My big outings during my first week were crutching down the street and back for a "walk" and my dad driving me home to my house to get my mail.  It felt so good to go for a drive in the car after being stuck in the house for days!

Excuse me, I believe you stole my spot.

My parents were in charge of walking my dog.

Happy Hip Arthroscopy Day!

Despite the horrendously cold and long winter, surgery day approached before I knew it.  I was not a surgery virgin, so I wasn't nervous about going under/general anesthesia or the whole surgery process.  People kept asking me if I was nervous, and my reply was always, "I'm not nervous for the surgery itself; I'm nervous about the long recovery!"  It was an outpatient procedure and I was happy not to have to spend the night in the hospital this time.  My surgery was scheduled for 7:30am (first of the day), and we were instructed to arrival at the hospital at 6am.  My mom was going to be with me for the day and I was going to temporarily live with my parents post-surgery while I recovered.

We were taken back to what would be my room for the day.  I was instructed to take off everything and put on a gown and robe.  The anesthesiologist was the first person to arrive and we chatted for a few minutes.  I let her know that it was not uncommon for my resting heart rate to get into the low 40s.  We also discussed how I had gotten nauseous after my previous surgery and this time around I was given a small patch to put behind my ear, which ended up being a great idea.  I had no nausea at any point. 

Dr. Keene came in shortly afterward and signed his name on the hip he would be operating on.  A nurse came in and started my IV and then it was basically just a waiting game.  Finally we were ready to go, and I said goodbye to my mom and they wheeled me away.  I remember being wheeled away and getting moved from the bed to the operating table, but after that it was lights out and magically I was waking up hours later in recovery.
Upon waking, the pain wasn't bad.  I think I rated it as a 4.  They wheeled me back to my room and my mom was there.  I was given my phone and able to update facebook and reply to some text messages and let my boyfriend and others that I was indeed still alive.  At some point the anesthesiologist came back to check on me and informed me that my heart rate did get down to 42 during surgery.  I'm glad I warned her!  I had great nurses during this time who were very sweet and attentive.  I was given a slushie (melted popsicle and sprite mixed together) and animal crackers.

Dr. Keene came in a while later to give us the updates on surgery.  He shaved down part of my femur, shaved down part of the hip socket, cut away a small part of my labrum and stitched up the rest of the labrum with one anchor.  My labrum had been torn from about 12 o'clock - 2, which is one of the most common places for it to tear.  He told me that my cartilage was bubbled and irritated from where the femur had been hitting it, but that there were no signs of arthritis and that was he optimistic about my recovery.  I did not have any microfracture done and he did not need to release my psoas.  All in all, pretty much what I expected. 

Since this surgery is outpatient, they want you to try and get up and get moving fairly early so you can go home.  I had to go to the bathroom, so they encouraged me to use the crutches to get myself to the bathroom about 20 feet away.  I tend to be an easily fainting person and have been known to get light headed from next to nothing.  Well, I made it to the bathroom, but I got extremely dizzy when I got there and had to sit on the toilet with about 3 nurses putting cold compresses on my head and neck while I rested.  Instead of having me crutch back, they sat me in a wheelchair and wheeled me the short distance back to my room.  They took my blood pressure and it was 90/55.  Oops.  Way too early to be getting up.  I drank more soda and ate more animals crackers while I rested and they pumped me full of bags of fluid.  When I got up the next time an hour or two later, I was able to successfully get to the bathroom and back.

Being able to support myself on crutches without fainting meant it was time to go home!  I would say we were probably home by 4pm, as my parents don't live too far from the hospital. I don't quite remember what I did that evening, but it probably involved sitting in the recliner with a laptop.  I was able to go to the bathroom by myself, but it was a bit of a struggle.  My hip was quite bandaged up, as well as having the pad to my ice machine underneath all the bandages, and it made me quite bulky.  The ice machine was pretty neat.  It looked like a cooler with a tube attached to a big pad.  You filled the cooler part up with ice and water and plugged it in and cold water would circulate into the pad that was wrapped around my hip.  It felt amazing. 

That night I was able to sleep in a bed.  The easiest way to get into the bed was taking my non-operated leg and hooking it underneath my operated leg and using my "good" leg to lift my lower half onto the bed.  I laid on my back and stuffed pillows underneath my knees and on my sides and slept fairly well like that.  (Probably thanks to the drugs more than anything.)

The Mystery Injury Solved: Labral Tear and FAI

My pain first started in June 2012, at around mile 15 of a 100K trail race.  It was a very dull ache in my left groin that was mild, but nagging and annoying.  I don't think the distance had anything to do with bringing on the pain; I think it was just a coincidence.  Had I not run that 100K, I think the pain would have started during a routine run later that summer, but luck has it that it started for me at the beginning of a day I was going to run for 17 hours.  I had run a 50K just three weeks before with no issues and about a month before that had finished a 50 mile race feeling great.  So while it would be easy to blame the distance, I honestly believe it was just strange timing.  The 100K was my big race of the summer, and I finished it, despite running for the next 47 miles with an ache in my groin that would turn out to never leave.

Later that summer I took time off, hoping rest would be the cure for this annoying ache in my groin.  It was probably 4-6 weeks of very reduced activity and I started to feel better, so I resumed running in August.  I was scheduled to pace a friend at her 100 miler in September and needed to get my mileage back up.  I don't have a whole lot of memories from that time, but I must have felt a little better because I continued to run.  I ended up pacing for approximately 12 hours for my friend, but I popped ibuprofen a few times during that run to quiet the ache in my groin and I stopped earlier than I wanted because of the pain. In October I ran a 50K, paced at 24 hour race over night, and finally ran a half marathon the first weekend in November.  The half marathon was ugly and painful.  I knew it was going to be my last run for a long time.  I limped for a few weeks after that race.  For the next 4 months, I would not run at all.

I finally broke down and saw my doctor in December 2012.  She sent me for X-Rays of my pelvis area and referred me to sports medicine.  At the time, I was told my X-rays looked "normal."  When I saw the sports med doc, he was concerned I had a femoral neck stress fracture and ordered a regular MRI and gave me a pair of crutches to use until we got the results from the MRI.  I did not feel I had a stress fracture (no symptoms, no acute pain) and specifically asked for the MRI with contrast dye to check for a labral tear.  He told me the contrast dye MRI wasn't necessary and to use the crutches in the meantime.  I threw the crutches in the trunk of my car and didn't touch them.  A few days later I had the results of my MRI -- no stress fracture.  He told me it looked normal and gave me a diagnosis of tendonitis and shipped me off to PT.  I tried PT from January 2013 - April 2013 with absolutely no results.  They had me doing a lot of glute strengthening with the theraband.  Despite 4 months of rest and PT, my pain levels had hardly changed.

The one thing that actually did help was finding a sports minded chiropractor.  In late February I started seeing him and having both Active Release Therapy (ART) and Graston done.  These sessions were pretty damn painful, but I did finally get some relief.  Looking back now, I think he manipulated so much soft tissue around my joint, that it was able to move smoother.  Unfortunately, these gains were short lived.  I had maybe a month of hope and some mostly pain free shorter runs before the pain came back.  In June of 2013, a year after my initial pain started, I had a run so terrible that I wound crying from the pain and took the shortest way home possible.  I gave up.  I was tired of going to the doctor, to PT, to the chiro and running around town going to all these appointments and paying co-pays and fees, etc.  I decided I would stop trying to run and just bike over the summer and give myself a break and go back to the doctor in the fall.  I was convinced there was something seriously wrong with me.

That summer I started bike commuting to work, dropped my injury weight, and felt stronger.  But biking isn't really my thing and I wanted to run.  Whenever I ran, I still had the same pain.  Some days were better than others, but it just never went away. I went back to sports medicine in November and saw a different doctor.  He ordered the right MRI (MRA) and I was finally diagnosed with a torn labrum in my hip and femoral acetabular impingement (FAI.)  In simple terms, FAI is when you have too much bone on your femur and/or hip socket and the extra bone starts damaging your cartilage in the joint.  When all of the conservative treatments fail (and for most people they do), the only options left are surgery or nothing.  Here is a better explanation:

I scheduled surgery for March 3, 2014, due to conflicts with my work schedule and not wanting to be on crutches through the worst of winter.  My surgeon would be Dr. James Keene in Madison, Wisconsin. From all the research I did about this, I learned that surgeon selection is very important. You don't want just any ol' ortho to operate; you want someone who deals specifically with hips and has a large number of these under their belt.  Dr. Keene studied with Dr. Byrd of Nashville (one of the pioneer surgeons behind hip arthroscopy) and has preformed over 1000 of these surgeries.  After meeting with him, I was very comfortable with him and trusted him and his expertise. 

I will try my best to continue to blog through this process and detail my return to running ultras.  There's not a lot of good information out there on this surgery as it's still fairly new, so I hope to record my return and help others who have suffered through this as well.