PT Day One and Exercises for the Week

Physical therapy began today (13 days post op) with a different therapist than my usual because he is on vacation.  Bree was a great substitute and had even been working with another teacher who also had this procedure done, so I felt like I was in good hands.

The session lasted close to an hour, which I was not expecting since my pre-op sessions were 30 minutes.  Bree spent a good portion of the session asking and answering questions and gathering information.  She recorded a lot of information in the medical records.  

She was very helpful, informative, and supportive.  My psoas is far from healed and it was quite noticeable especially when she had me sitting and asked me to try to lift the knee of my operative leg.  I kind of laughed for a second because I could not make my leg budge no matter how hard I tried.  I put as much brain power into the movement as possible and after what seemed like eternity, I was able t lift it about 1 inch.  She compared this movement to my non-operative leg, which I was able to do with ease.

I was given 9 exercises to try this week.  She would like me to complete 2 sets of 10 and to perform the exercises 1-2 times per day.  It is expected to experience some difficulty and even some noticeable pain, but she reiterated that any pain should be minimal just like if you were working out.  If the pain is sharp or does not discontinue after stopping the exercise, she said that is not okay.  I should then stop the exercise or complete fewer repetitions.  

I am not certain of the order I am supposed to complete them, but from left to right:

1.) Strengthening Quad Set--Tighten muscles on top of thighs by pushing knees down into surface.  Hold 5 seconds.

2.) Strengthening Hamstring Set--With foot turned in, tighten muscles on back of thigh by pulling heel down into surface

3.) Strengthening Hip Abduction-Isometric--Using ball or folded pillow, push outside of right knee into wall.  Hold 5 seconds.

4.) Strengthening Hip Adduction-Isometric--With ball or folded pillow between knees, squeeze knees together.  Hold 5 seconds.

5.) Strengthening Hip Flexion--Bring leg forward keeping knee straight

6.) Strengthening Hip Extension--Pull leg straight back

7.) Strengthening Hip Abduction--Extend leg out from side

8.) Trunk Stability--Bridging--Slowly raise butt from floor, keeping stomach tight

9.) Self-Mobilization--Heel Slide

My leg/hip/back was noticeably sore afterwards within 20 minutes.  I needed a few things from the store, so my mom took me to get the items, which was probably a bit too much for right after the therapy session.  I came home and iced immediately.  

I would like to ask about the hip flexion exercise because I've been reading about not activating the hip flexor for a while after having the psoas released.

Out and About Day 11 and 12

As expected, nothing too new to report.  On Saturday I did test out the YMCA and went on the stationary bike for 15 minutes without resistance.  I did a few pushups, some planks, and some of the PT exercises I had done pre-op.  Everything felt pretty good, but I did notice my psoas quite a bit later on in the evening.

Today I woke up feeling great and we were able to enjoy the warmer weather and take the kids to the park.  I did my fair share of sitting and visiting with my mom who is now in town.

Despite feeling great, I do have pains in my lower back and butt.  I have no idea if it means something is wrong, is typical post surgery, or is the result of compensating.  I am at a point where I believe I could definitely do more, but understand that if I do too much, it will only cause problems.  This is difficult for me to swallow.  I will be glad to meet with my actual therapist, who knows me, and can help me through more of this.

Who said you couldn't have fun after hip arthroscopy?

So this may have just happened...

Driving this bad boy was stop and go the first few minutes, but eventually I got the hang of it.  To be honest, it probably didn't make the shopping experience much easier.  At least my hip got a little bit of a rest.

Uneventful Day 10

I wish I had some more exciting things to report.  Each day I wake up with less pain.  Until I begin physical therapy on Monday, my days will probably continue to be similar.

I think the kids are getting used to just relaxing...

Watching Frozen, again, with two of their buddies.

Dr. Ho's recovery plan involves resting, icing, doing ankle pumps, pendulum swings, and heel pulls.  Since I haven't been lying down as much and I am not experiencing poor circulation or swelling, I have been doing fewer ankle pumps and heel pulls.  Instead, I make a point to perform my pendulum swings.

This is me standing on the first step of our stairs with my operative leg hanging off the side.  

This is the first part of the circular motion.

This is the second part of the circular motion.

 The first few days my circles were much smaller.  I continue to increase the size of the motion each day.

This is the final part of the circular motion.

I typically do about 20 forward and 20 backward about 5 times a day.  If I am sitting in a chair, I sometimes pull my knee up and I also massage the incision area when I think of it.  I can feel a little bit of scar tissue building near one of the entry points.  

I plan to add in my clam shells and other pre-op exercises I had been doing.  I would prefer to wait until my first physical therapy session, which is on Monday, but I am also extremely eager to get this party started.

Day 9 Post Op and What It Looked Like

Day 9 has been fairly uneventful.  I spent much of the day resting, but was fortunate enough to have some friends get me and the kids out of the house for a little while.  Later in the evening, two very good friends delivered meals for my family and I am truly overwhelmed by the support we are receiving.

Once people hear that I had surgery (and before that I was having hip surgery), they assume it is a hip replacement.  Obviously, it wasn't, but here are some pictures from the scope.

This is the first page of pictures I was given.  Top two are getting into the area, next two are looking at the bruising and inflammation, not sure of the next two, and the bottom two are assessing the extent of the tear.

This is the second page of the pictures from Dr. Ho.  You can see the important shots in the next two pictures.

The top picture shows the excess bone or FAI.  The bottom picture is what he removed.

This shows him moving things around to determine how torn the labrum is.  Based on his discovery, Dr. Ho decided to leave the tear and allow it to hopefully repair itself.

8 Days Post Hip Arthroscopy

I have been very fortunate to have the love and support of family members and friends to assist in my recovery.  As I mentioned a few posts ago, I carefully planned the best time to have my hip arthroscopy in a way that would best suit my family and recovery.  My two children, 5 and 3, have been with my family 2 hours away since Saturday.  About a half an hour after they  left, my husband said to me, "I don't know what we used to do without kids."  The house was quiet, things were put away and stayed in their little homes for nearly five days.  My husband and I enjoyed some quality time together just relaxing and allowing my body to heal.  I am forever grateful for my family as a result.

As scheduled, Tony met my dad half way for the great kid exchange.  While they did have a phenomenal time and were spoiled rotten, I do believe they missed us.

It didn't take too long for the kids to get back into their normal routine of chaos.

During the great kid exchange, I took about an hour to do some spring cleaning in my dresser and closet.  I sat on a bench as I sorted through clothes and reorganized things.  For the rest of the day, though, I chose to rest and tried to ice as much as I could.  

My hip continues to heal, but I am noticing lower back pain.  Towards the end of the evening my outer hip and deep inside the area was bothersome.  I used my fist to massage while I lied on the couch and tried to perform some subtle movement like a physical therapist probably would.  

My physical therapy is scheduled to begin on Monday and I am both excited and nervous.  I mentioned to my husband that I am worried about the fine line between pushing myself to get a better stretch and improve range of motion vs. doing too much.  As an athlete and runner specifically, I am used to aching.  I am used to running on tired legs.  Jumping right into the pool and starting to swim like I did the day before surgery seems feasible in my "athlete" mind.  However, I don't think that is exactly what the doctor ordered.  

1 Week Post-Op

It is amazing to see the quick healing that is occurring for me.  I am truly thankful and I hope things continue in this trajectory.  Yesterday was my first day completely by myself.  Dr. Ho informed me that putting more weight on my operative leg would be allowable and he permitted me to take small, careful steps while in my house.  I was able to do quite a bit of this today, but did spend much of the morning sitting upright in a chair and working on some scrapbooking for my children.

The neighbor lady was nice enough to come visit.  We enjoyed lunch and sat at the table chatting away for nearly 2 hours!

After she left,  my outer hip hurt quite a bit, so I lied down and iced the area for at least an hour.  I took it easy the rest of the day and caught up on the latest news.  The down time allowed me to gear up for a grand adventure with my husband to see Divergent.  He had asked me a couple days ago if I had wanted to go and, and at the time, it seemed like this would have taken herculean effort.  Well, like I said above, it is impressive how different just a couple of days have been for me.  I packed an ice pack and we were off to movie as soon as he returned home from work.  I was fine most of the time, but noticed the outer hip to be annoying.

Afterwards, I iced for at least an hour and headed off to bed.

6 Days Post Op

Today was a great day.  I had my first follow-up appointment and was eager to meet with Dr.Ho again.  I was able to take a shower again and fended much more gracefully this time around.  As I was allowing my incision area to get some air, I snapped a picture.  The was the first real glance I managed to take since I am typically so queasy.  The red area is some sort of reaction to the surgery dressing, it doesn't bother me.  I can hardly believe the surgical skills of the doctors to be able to make such progress with such small entry points.

We made it to his satellite location and played the waiting game, again. 

 Barb, his nurse, removed the sutures, and eventually Dr. Ho saw me and allowed my questions to guide our appointment.  Without my prompting, he informed me that I'd be able to begin physical therapy fairly soon.  This was music to my ears.  I was worried I would have to beg and plead for a more aggressive recovery, but it seemed obvious to him that I was ready.  He let me know that I am probably ahead of schedule in comparison to other patients, but I still need to be very cautious.  He wants me on crutches for another 3 weeks and says I can drive when I feel I am ready.  I've been off the pain meds since Day 2, but I am not ready to give it a try for at least another week.  He believes I will be more than ready to return to work on April 7th, but would like to see my sit 50% of the time, limit my walking during the day, stay out of the hallways, still use my crutches during work, and try to ice with a freezer pack at least once during the work day.  

He also reviewed the pictures that I was given from my surgery and specifically discussed my case.  Dr. Ho said I was lucky we caught this "so early" to which I responded, "2 years is early?"  He said, "Well, whatever you've been doing, you did something right."  I was kind of surprised to hear this since I really did push through a lot of pain over the last few years, but thankfully I didn't do too much damage.  He said that there was noticeable bruising and irritation inside the hip area from the CAM impingement.  

Despite all the rubbing, only a partial tear was formed and with the excess bone now gone, he said the tear should actually heal itself.  I was glad to hear this.  The psoas was also then rubbing from the other side causing more irritation and he was able to release that, which will also make movement much easier for me. I did ask him how likely it is that something is going on with my left hip and was disappointed when he reminded me that the body is often symmetrical and it would not surprise him if I see issues on the left side at some point in my life.  At the same time, however, he reiterated that physical therapy for both sides should help if there are any early signs of problems on the left side.

All in all, I came away from the appointment overjoyed.  I hope to schedule my PT for Monday and will have my first day alone tomorrow.  

First Few Days of Recovery

I am not going to lie.  This is one of the hardest things I've had to do in my life.  While I am not in any significant pain, and even weaned myself off of the pain medication within 24 hours, it is difficult.  I find myself frustrated and emotional at times.  I think I'd pick to go through child labor or run another marathon instead of recovering from hip arthroscopy.  I tell myself that I should feel fortunate that this is what I have to experience.  There are many other people experiencing things that are way worse.  I realize I have a long road ahead of me and that scares me.  I wonder if I've made the right decision.  Will I be better off when everything is said and done?  I hope so.  Until then, I am taking one day at a time.

My days consist of lying on the couch, on the blow-up mattress, lying in the bed, and more recently sitting in a hard chair.  I consider myself a pretty coordinated and athletic girl, but it is taxing thinking through how to maneuver my body and my crutches and such.  I am very careful with my leg, but it seems you can not be too careful.

During the first day or so, I was awake for a few hours and then would sleep an hour or so.  I iced nearly all day and forced myself to pump my ankle, do my heel slides, and on occasion my pendulum swings.  Sleeping at night is the worst.  My back gets tired, I have to interrupt Tony to help me move or get up to go to the bathroom, I get hot, I get cold, etc.  I dread going to bed each night.

Thankfully, each day has gotten a little easier.  The stiffness is a little less, the tricky moves aren't so tricky, and I'm beginning to return to my old self.

Here are a few highlights:

Monday/Tuesday: Talking and texting with more people than I have the entire last year, knowing I'll be off of work for a little while, eating my Frosty

Wednesday: Seeing my kiddos, spending time with my Dad and husband, receiving even more texts and check-ins

Thursday: Easier movement; changed the dressing---wow, that thing weighed a ton!  Delicious food from Mom

Friday: Even easier to get around, less pain, SHOWER, warm weather which allowed us to take the kids to the park and my first outing, a visitor with a delicious quiche, spending time with my sister

Saturday: Less pain, able to sit in chair for awhile, less time icing, quality visit with a dear friend, who brought cookies, reading The Fault in Our Stars (which has been on my to do list for 2 years), sleeping in my son's bed while he (and sister) is away with my loving family



Sunday: Productive morning getting lesson plans done, less pain, SHOWER, outing with hubby, dinner out

Tomorrow I go for my first follow-up appointment.  I have MANY questions for Dr. Ho including how to change his conservative recovery plan to a more aggressive one and the ramifications of only addressing the impingement and psoas release but not repairing the labral tear.

Stay posted as I chronicle my progress..."I am not afraid. I was born to do this."

Surgery Day

To say I am a planner, is a bit of an understatement.  As a teacher, I plan every second of every part of my day.  I factor in all the what ifs and any possible blip that might take my lesson "off course."  When March 18th arrived, I had carefully calculated all of my moves and even the moves of my friends and family in order to adequately provide for my family.  It was a bit surreal when everything started happening and I was a bit emotional.  

I slept fairly well the night before and since we didn't have to be to Chicago until 11:30 or so, we had time to see both kiddos off to school, I swung by school to drop off one last bit of paperwork, and Tony even voted in the primaries.  We made it to the University of Chicago Medical Center with ease and were PLENTY early.  I had figured this would be the case (I am the planner afterall).  We parked and found our way while I carried my crutches in.  Instead of going directly to the waiting room, we attempted to relax in the nearby cafeteria and caught up on social medial  

Here I am pretending to be cool and collected while  Tony had something to eat.  Surprisingly, fasting since midnight didn't seem to be too difficult.  

I knew I wanted to check in around 11:30 as suggested, so we made our way to 2c Ambulatory Surgery.  I anticipated being called back around noon, but it seemed as if Dr. Ho was running behind schedule.  Every other person in the waiting room was called before me and finally around 1pm, they called me back to pre-op.

Immediately after entering the pre-op area, the nurse instructed me to pee in a cup.  I found this a bit ironic since I had been fasting and without liquids for over 13 hours at this point.  I thought to myself, there is no way I'll be able to make this happen, but sure enough, I produced.  I tried to make small talk with the nurse as she asked me a bunch of questions and took my vitals.  "Your blood pressure is a litlte high," she remarked.  I reminded, "I am about to have hip surgery.  I think that is to be expected!"  

Dr. Ho stopped by and initialed my right hip and asked if I had any questions, I didn't.  He told me it would still be at least an hour or so.  By about 1:45 they allowed Tony to join me and then the waiting game continued.  The anesthesiologist made her way in and went over everything.  Apparently I neglected to think through the breathing tube that would be placed in me during surgery and that new information started to worry me, but there was no turning back.  She also mentioned that the surgery could take between 2 and 5 hours...that was another surprise.  

We were waiting for Dr. Ho's fellow to go over paperwork for me to sign and finally around 3pm he arrived and was greeted by my, "Hallelujah!"  I thought it was funny, apparently he didn't.  I asked him how long he thought the procedure would be and he assured me it would be closer to 2 hours.

Pre-Op

Finally around 3:30, it was go time. They gave me a little bit of a sedative and said I could pretend it was a nice glass of wine. I recall being wheeled in and transferred to the operating table. There were about 5 people in there and they began prepping me. Before I knew it, I was out and in the recovery room. The surgery was complete by about 5:30 and Tony was back with me by around 6pm. I must be quick to come out because they said typically patients take closer to an hour. I was happy because I knew the delay would make it harder for us to return to Champaign the same night like we had wanted to. I wasn't in too much pain and I even was able to talk to Dr. Ho. He assured me everything went well and informed me that he was able to release the psoas and trim the bone, but was unable to repair the tear because it would have caused more damage.

I continued recovering well and the nurses were okay with us traveling back to Champaign.  They gave Tony the post-operative care guidelines and showed him how to use the ice machine.  I decided I had better try to go to the bathroom before leaving because doing it at the hospital would be  way better than doing it at a gas station.  I didn't really have to go, but was worried I would regret it a couple hours later.  In classic Jill form, the bathroom trip may have involved a fainting episode on the toilet accompanied by two nurses rushing to my assistance.  Other than that, we made it back home safe and sound by around 10:30.

Tony treated me to some Cheez-its, a Wendy's Frosty, and some french fries.  For the first time in my life, I didn't finish my fries.  

Years Later

Hello there!  It's been nearly two years since I updated my running blog.  This is due to being lazy as well as a change in my physical capabilities.  Since the last posting, I've managed to run at least one more half marathon and some shorter distances.  I did take a hiatus and focused solely on yoga.  I became quite the yogi and the instructor even suggested that I become certified.  All of this was as a result of the continued ITband and hip pain that I was experiencing.

I continued working out and stopped running July 2013.  When the pain continued even after stopping running, I returned to physical therapy and my sports medicine doctor.  After a few sessions of physical therapy, I was not improving.  I stopped all impact activity and began swimming only in October.  The sports medicine doctor, Dr. Zimmermann, finally agreed that there was probably a bigger issue than the ITband pain and the hip bursitits he had diagnosed me with and scripted me for an MRI.

In November of 2013, to Zimmermann's surprise, he suspected there was a small tear and noticed abnormal shape to the femoral head of my leg.  He discussed my options and referred me to get an MRI angiogram that would better show the tear and see if his suspicions were correct.  By December, I learned that I had FAI impingement and a partial tear.  Nobody in the area performs hip arthroscopy, so I would have to go to Chicago.  Dr. Zimmermann also prescribed a lidocaine injection because he said surgeons like to see that step taken before considering surgery.  I got the injection at the end of December and it was HEAVENLY.  I had no pain whatsoever.  Unfortunately, it wore off, like I knew it would and the constant pain in my groin and hip returned.

The very condensed version of the story is that due to some health insurance delays, I wasn't able to see Dr. Shane Nho until January and only learned that my insurance wouldn't cover him anyway.  He was my preferred surgeon, as it seems everyone I've talked to has gone to him.  He practically does this in his sleep.  After some emotional strife, I moved on and got my second opinion from Dr. Sherwin Ho out of University of Chicago.  I was very impressed and he spent a significant amount of time with me.  He confirmed what Dr. Nho had said about surgery and agreed that my case was less severe than others he had seen.  I scheduled my surgery for March 18th and discussed recovery with Dr. Ho.  Given the length of this injury, I have read A LOT about this.  I was completely caught off guard when I learned that Dr. Ho's recovery regime is very conservative in comparison to other top surgeons.  This caused yet another freak out, but I was able to talk with him over the phone and this helped ease my concerns.  He scripted pre-op physical therapy and Andy Eheart and I worked together again after our stint in July.  


These bands became my best friends and I continued my swimming and core strength exercises pre-surgery.

Along with organizing pick-ups, drop-offs, time-off, lesson plans, etc., I prepped the house for my surgery.  This included getting crutches, an elevated toilet seat, a shower seat, and a gripper.

Before I knew it, the long awaited day of the surgery arrived.