6 week post op appointment and 1st bill

Today I saw Dr. Ho for my 6 week post op appointment.  He seems to be building a reputation of being notoriously behind schedule and I only ever am able to get afternoon appointments, which seems to make it even worse.  Today's 1:15 appointment finished just before 3pm and then a 2+ hour car ride bike home.

I have come to really like Dr. Ho and firmly support his approach.  Since he did a psoas release on me, it made me a candidate for one of his research studies.  He is examining the recovery period necessary to regain strength after the illiopsoas lengthening.  A physical therapist assessed my strength in a few positions and used some fancy dancy tool in order to acquire numbers for the study.  The therapist was very friendly and he reaffirmed my positive opinion of Dr. Ho.  He mentioned that I am lucky to have had a surgeon with so much scope experience because his recoveries tend to go quicker.  The therapist mentioned that he had other patients who had seen other doctors and the recovery was not good because their scopes "weren't as clean as Dr. Ho's."  That was great to hear.

I didn't really have much to ask Dr. Ho and didn't really expect much out of the appointment.  After refreshing his memory on the specifics of my surgery, he seemed surprised that I had returned to work after 3 weeks.  This was odd to me considering he was the one who encouraged this just 3 weeks earlier!  He mentioned that "with a person like me" he is okay pushing things a little more aggressively and gave me the go ahead to try a yoga class and hinted that I may be able to run before the 12 week mark.  Despite this, he was surprised at what seemed to be my lack of flexibility.  He said he would have expected more flexibility from "someone like me."--that must have been the phrase of the visit.  I have to somewhat disagree with him and contribute this to his (and his fellow's) haphazard quick movement and assessment of my leg.  Coming into the surgery, my flexibility was never a problem and compared to other group fitness junkies, I believe I am fairly flexible.  Now, obviously, post surgery, my movement on the operative side is more limited than in the past, but it seems to be coming along.  I will consult Andy, my therapist, but will add in some yoga and stretching to see what I can do.

I've read a significant amount about hip arthroscopy and recovery and would say that my experience is not unique.  Dr. Ho and I discussed the fine line between working hard to progress and doing too much.  It would be convenient if there was some magical tool that helped patients know when to stop and what worked best, but unfortunately, it is just trial and error.  I'll see him again in another 6 weeks on June 13th and, in the meantime, I intend to straddle the line between too much and not enough.

I also received my first bill related to my treatment from Dr. Ho which charged me the amount of the fluoroscopy from surgery day that my insurance will not cover.  I intend to keep a close eye on this and am willing to share what the total ends up costing me.  To date, with Dr. Ho, I've had 3 appointments with a $50 copay for each visit and now $249.73 for me to pay of the $1,921 billed to insurance.  Without looking back at my records, prior to surgery, I spent around $500 out of pocket on physical therapy and close to that (if not more)for my Xrays, MRI, and MRA.  I am not quite sure how my insurance measures up, but I am just thankful to have it and that I am satisfied with seeing Dr. Ho as my in-network provider.

Back at It

I survived my first day back to work!  Many of my students were happy to see me, concerned about my recovery, eager to hear about the last few weeks, and completely confused by my MobiLegs.  Other students, like L, who pretended to bump into me about 5 minutes into the school day, were less than impressed and could have cared less.

I had a hard time trying to sit 50% of the time and didn't realize how much I typically walk around my building and within my classroom.  I am NOT a teacher that just sits or stands, so it was tricky getting back into the groove and even harder to ask my students to do some of the little things I normally do simultaneously.  I ordered the bad boy below about a week ago in hopes that I would have it today for work.  Unfortunately it arrived on my doorstep after school.

This is the "B-Cool" Hip Wrap from a medical supply store.  Dr. Ho recommended that I ice during the work day and I couldn't find anything that I liked at Walgreens, Wal-Mart, or Target, so I went all out and ordered this $55 deal which included shipping and 2 long ice packs that fit inside the pouches.  I can't wait to use this tomorrow because I needed it by about 10:30am.  

I lasted 8 of my 9 class periods and left early to go to my physical therapy appointment with Andy.  Andy was thrilled with my progress, answered some of my lingering questions, and adequately worked through my session.  He did check some of my exercises, added a few, moved my leg around a bit (which I was really hoping would be added to my sessions), and massaged one of the entry points to work on the scar tissue.  I am supposed to add these two exercises and beginning tomorrow, the 3 week mark, I can do my exercises on both legs.  

I have a feeling this week is going to be long and tiresome with evenings spent strapped to my ice machine.  Thankfully I can get some of my lessons and grading done during that time and I have found myself efficiently completing my therapy exercises during bedtime stories with my kiddos.  

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.

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.