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3 month post-op check-up with Dr Davidovitch / 8 days until the triathlon

My three month check –up post hip replacement . Well it didn’t start so well as I walked into Dr Davidovitch’s office black and blue.  After checking I’m ok and shaking his head in disbelief, my x-rays were checked out and I was basically given my graduation ticket.  Everything is great and I don’t need to go back for two years.  He also said it is ok for me to start jogging  (I kept quiet on that one).  I was so excited to hear everything is doing well that I forgot to mention that one leg is longer than the other.  I guess it doesn’t really matter , it’s something I have to learn the adjustments I need to make and be conscientious about doing the exercises or wearing the orthotics / heel supports.

Very, very grateful for his amazing work and for the incredible recovery the surgery allowed me to have.  My life is my own again: I don’t think about what activities I can and can’t do, I don’t take pain killers to sleep, I don’t plan days/evenings out around how far I can walk.                                                          I can do anything I want to do!

Bike accident

11 days until the triathlon.

I have been feeling great, following a 6 day a week workout schedule with once or twice a week doubling up on a swim and bike ride. My longest bike rides are 2 hours (and pretty continuous hills), I swim 30 -45 mins 2/3 times a week.  The most fabulous thing for me though is the running. I honestly kept to ‘doctors orders’ and didn’t do anything of any impact until I reached the three month mark – literally not even running across a road.  But at three months to the day I started with a 30 mins walk and inserted a couple of 3-5 minute runs within it.   As I reached home my husband was sitting outside the house and I think he saw my smile from way down the street as I rounded the corner.  Over the course of just three weeks I have got to 40 minutes of near continuous jogging.  It’s all very slow but feels amazing.  I’m so happy to have that activity back in my life – it’s so much more than physical; it’s my reflective thinking time. 

First time outside on my bike!! Felt so fabulous and wished I hadn't waited so long :(

Symmetry Physical Therapy and Tri ‘Training’

I am in my 8^th week of physiotherapy now; the first two being in-home physio and from then on 2-3 times per week at Symmetry.  http://www.symmetrypt.com/p_main.html      Choosing your physiotherapy company and physiotherapist is really important.  I based my choices on (as always) location – driving is baby-sitter money, and on what I perceived to be their sports emphasis. 

I am really pleased with where I go.  We work twice a week now and have built up to over 2 hour sessions which include stretching, marching with weights attached, 80lb leg press, elliptical, clam shells, hip raises, and balance exercises (including my personal favorite – the one where I balance on a sponge mat on one leg whilst assorted trainers throw balls at me  to catch - I’m very bad at this but would have been pre-op anyway).  

The physiotherapists there are all incredibly good. I work with Gary Abano who is very knowledgeable, he listens to my body’s progress, doesn’t let me push too hard, yet at the same time keeps moving me forward and adjusting my work each week. 

 On top of the physio I am managing to swim once or twice a week and I just reached the 1 mile mark, still swimming with a pull-buoy. At the gym I bike for about 40 minutes twice a week and am desperate to get outside on my bike – still not recommended but it had better be soon! I can walk non-stop for over an hour (outside of course – can’t comprehend using a running machine indoors).  I have started to build up the time on the elliptical machine.  It may only be 15 mins right now but I’ve been unable to run for well over three years and this is really hard work believe me!  I am hoping that this is working towards that first fabulous outdoor run one day (just a short one . not far or fast honest)   … fingers tightly crossed.

7.5 weeks

Things feel back to normal.  It’s great to be able to walk as far as I want, be active all day, drive long distances, lift strollers in and out of the car, cycle at the gym etc.  The reality is that things are not fully healed until 3- 6 months so my operated-upon hip reminds when I’ve done too much by swelling and feeling stiff in the evening (I’m supposed to ice it but haven’t managed to do that yet).  There’s only been once in the last few weeks that I’ve gone back to limping badly and that was on vacation where we drove for several hours and then walked for several more. It is definitely stiff when I’ve sat for too long and then I’m back to walking very strangely for a few moments whilst it works itself out…

After the vacation incident my family decided after the second day (this was at week 6) that I would slow everyone down too much on the third day’s visit to Busch Gardens. They rented a motorized wheel-chair for me.  This of course turned out to be where all the bags were kept and also the children’s favorite ride of the day!

5 weeks after surgery. Physiotherapy

I have been in Physiotherapy for 2 weeks now, going two to three times per week.  'Symmetry' in Pelham, NY http://www.symmetrypt.com/.  We focus on stretching, building strength, and balance; the sessions last from between 1 -2 hours.  As I’m learning the routines of exercises I can work more independently and the time is shorter.  It is not difficult but some are uncomfortable.  It’s good to have my boundaries pushed as I’m made to lay on my incision side or balance on one leg whilst bending forwards (thankfully the physiotherapists are trained not to laugh at my wobbles or sideways lurches). 

It has been great to drive again, this was at 3 weeks.  I pottered around locally for the first few days then of course pushed the limits and drive into Manhattan two days in a row causing my leg to painfully swell by the evenings. 

I am now at the point where I feel that pretty much everything is back to normal in terms of day to day activities but maybe that’s the reason I have more pain and swelling again in the evenings.  When it doesn’t hurt and you can get around as you used to it can be hard to limit yourself.  My physiotherapist told me that can be one of the difficulties patients have after the anterior approach hip replacement -  you feel so good so quickly that you can be in danger of doing too much too soon.  I do avoid doing the weekly food shop and don’t chase after my two year old or carry him when he’s throwing a temper tantrum.  I am enjoying swimming (still with a leg float) and biking on the bike trainer but of course no running…yet…

3 1/2 weeks later

Things are almost back to normal.  No pain killers, no crutches or walking aids.  I can drive, take the children to birthday parties, run errands - all back to a regular weekend.  I wouldn't do a big supermarket shop or go for a hike, but its great to be living life as normal already.

first swim and leg length

So, first swim today.  I was nervous, with images racing through my mind of myself not being able to climb in / out of the pool on the ladder and flying backward into the pool, arms flailing.  But it was ok; getting in a little easier than getting out.  After getting changed I walked past the mirror on the way to the pool and was distracted by my scar below the swimsuit line and the ugly bumpy swelling around it.  Not a great visual but it’ll change over time and is something I’ve decided not to dwell on.  The benefits outweigh the negatives.  Swimming felt great; I started with a strange version of breast stroke whilst I got my confidence up.  Then I used a pull buoy to support my legs whilst I free styled up and down.  How nice to move without using constant conscious thought and effort on how to do it correctly.  I wasn’t the fastest in the pool (am I ever?) but I certainly had the biggest smile when my 25 mins were up.   

 I am getting increasingly concerned that my legs are not the same length, with my operated leg being longer.  Dr Davidovitch said after the surgery he was pleased because that they were the same and so I hadn’t really given it much thought until the last couple of days….  He is an amazing surgeon and I am sure it is not easy to chop off part of someone’s femur and replace it with metal, plastic and ceramic and end up with two legs the same length.  However I am finding that as I stand straight with two feet together pointing forwards I need to bend my right leg in order not to tilt my hips. It is easier to stand with my left heel off the ground.  This seems to be pretty common with options such as redoing the operated leg, wearing supports in the opposite shoe (how does that work with stilettos?) and, waiting until the other leg is operated on and making that one longer to match.  It may also be due to muscles and will correct itself.   Hmmm,   I’ll see what my outpatient physiotherapist and podiatrist have to say on Monday.

20 days after surgery

Staples are out – the only visible marks from the operation now are a red incision about the length of my middle finger on the front of my thigh, and circle of small bruises on my stomach from the nightly injections.  Not bad.

The staple removal was pleasingly painless and the doctor’s visit all in was very short.  Once he could see I could walk without dramatic limping, my legs still looked the same length, and that I was getting back to normal life, I was dismissed until my 3 month check-up.   

The physio is beginning to ramp up a gear with some painful maneuvers to practice but, as with everything I’ve experienced in this process so far, they seem painful and even difficult for a couple of days then are pretty easy and merely uncomfortable. I am looking forward to getting back into the swimming pool – officially now allowed - but I’m nervous of climbing down into the pool so I’ll wait another week.

My walks around the block three times a day are a salvation as being trapped in the house is emotionally tough.  This is also coinciding beautifully with the start of an early spring.  I no longer take either crutch with me.  The final walk of the day I can’t walk without limping but its all going well and I’ll start walking further soon. 

X-ray of my right hip

2 weeks post surgery

It feels hard to believe that this time two weeks ago I was in the operating room – ready to start the journey of pain, frustration, re-learning, and accomplishments.

Today I celebrated my two-week-old hip with a walk in the sun, approximately 20mins, using only one crutch.  I even managed to get my own shoes and socks on (no laces though).   My PT has been directing me to slow down and stop ‘bolting from one place to another’, but to think about how I am moving. Stand up straight, hips aligned, heel down first, go slow.    It’s amazing to be out, walking properly!

I am walking around the house using no crutches which feels great, and am mastering stairs with only one foot per stair.   I am still having trouble sleeping (but what parent doesn’t anyway) and I lie awake waiting for the next four hourly pain medication.  My PT thinks that the reason some of my exercise are still so difficult – basically anything involving lifting my leg vertically – is to do with my abdominals still being so weak after having the baby last summer.  I trained my leg and arms muscles well for the post-surgery recovery with all the biking and swimming but certainly slacked off on abdominals …maybe this will motivate me….  On the plus side I have to replace all my trainers and soft soled shoes as they are molded to fit my previous hip alignment.  Continuing to wear them will be detrimental to recovering and learning to walk correctly with my new hip and could cause trouble with my left hip and my knees.  A great excuse for shopping once I can get shoes on and off easily in the shop. 

Chris and I have finally clued into the fact that the reason my blood thinner injections are so painful some nights and fine on others is more to do with how recently I took pain meds than with how /where he inserts the needle. 

 I am looking forward to heading into the city tomorrow to see Dr Davidovitch and, though I’m not looking forward to the staples coming out, I’m keen to hear how he rates my progress.  Hopefully he’ll be pleased and allow me to start driving.  Life will really feel as though its getting back to normal then. 

11 days after surgery

I’m  loving the spring weather we’re getting – particularly because I can get outside and enjoy it. I feel amazed by the fact that I can already walk very comfortably on the crutches.  I even managed a walk around the block with Oliver yesterday (a two year old seemed like a compatible pace – of course once he decided to make a bolt for it there was no way I could catch him so maybe it wasn’t the best decision ever).

I can now shower, get in and out of bed relatively easily, and have started to hobble slowly using no crutches around the bathroom or kitchen.  I have a weird swaying motion and its very slow but hey, I can make a cup of tea and carry it to the table to drink it sitting down instead of standing by the kettle. 

I am still living on four hourly pain medication of acetaminophen and oxycodone which makes me happy and mobile, sleepy, mellow, then grumpy, irritable and increasingly fidgety as I cycle through to the next dose.  I try to time phone calls, activities with the children and going to bed at the right times in the cycle.  (I imagine my family is working out when to be near and when to avoid me too).  Having said this, most of the time there is remarkably little pain when I think that just 11 days ago Dr Davidovitch was sawing off the top of my thigh bone.

First outing - only the supermarket but great to be away from the house. 9 days post op

6 days after surgery

I feel as though my leg is full of metal!!  I don't know whether it is the metal inside I feel or just the 15 staples on the outside, but it certainly feels weird: heavy, unresponsive, like there really is a metal pole in there somewhere stopping me from bending and moving properly.  However, as my 2 year old Oliver says, the incision does look “cooooool…like a train track”.

I’ve had the visiting nurse in for her visit; she is allotted 3 visits but says she doesn’t think she needs to come again unless I feel there’s a problem. That has to be a good sign.  She checked through my medications and confirmed that the needles that I have to inject my blood thinner with each night are not larger than those the hospital used.  Thankfully Chris does this and he is oblivious to my wincing, loudly.  

The Physiotherapist was also in.  She checked out the house, the stairs, front door steps.  She also left me a series of exercises to do three times a day, all of which are unchallenging and painless except for lifting my foot vertically upwards when I am sitting. This seemingly simple maneuver is still proving absolutely impossible. I feel totally paralyzed attempting that.  

I have been using the crutches 80% of the time today, abandoning my walker.  I even made it to visit two neighbours for a cuppa during the day. It felt so good to be outside, it was worth it even if I do feel a little extra sore this evening. 

I kept on top of the four-hour medications and have felt positive all day.

First Full Day At Home

I got very disillusioned last night about how many of my everyday basic activities I am currently unable to do.  Its the first time since booking the surgery back in the Autumn that I've felt that low about it all.

It took a long time when I went to bed to arrange the pillows in a way that I could get into the bed and that would hopefully be comfortable for the whole night.  After that I slept so well, only waking up once for more pain meds. 

Today went really well.  I pottered around the house with my walker and using one crutch on the stairs.  As its impossible to get up or down stairs without someone to carry my walker for me, I had to organise my time to make sure that whenever the babysitter went out with the children I was in the part of the house that I wanted to be.  It is impossible to carry anything and use a walker so I contemplated using a backpack to cart things around but ended up attatching a giftbag which I can get things in and out of easily to the walker, as well as my waterbottle with a ribbon.  Now my cell phone, magazine etc are not always in the wrong place once I've lowered myself into a chair.  And my walker looks a little less hospital-like.

The pain is minimal so long as I keep up with the oxycodine. 
 I think I deserve a glass of wine though tonight to go with it.

Day three after surgery

Day 3

A painful night which left me sitting in a chair for large chunks of it. The day was a small improvement in yesterday though, and psychologically, just knowing I was going home really motivated me. I got to see my incision site: about 7cm long, stapled every 3 mm with small metal staples.  I didnt have time to count them before the resident quickly strapped on the new dressing.  I had PT exercises and practice on stairs and walking, and needed  help with dressing to leave.  It will be a while before I can do that alone.  It took a while for the the usual hospital paperwork to be completed before I could be wheeled out of the hospital to Chris waiting in the car.  The drive was uncomfortable, though Chris did his best, and it was lovely to get home!  The children were satisfyingly pleased to see me, with Ella having made life-size anatomical drawings of how the inside of my body now looks.

It is wonderful to be home and I know I will heal much faster here and feel better mentally, even if the house is already presenting challenges that we hadnt forseen (such as there is a handrail only on the left side of the stairs which makes going up easy but down difficult).  I still feel as though I have no idea of the timeline for the recovery so Chris and I spent a long time discussing what additional assistive devices it would be worth getting hold of before deciding on none (we have the walker and the crutches  - which I am not ready to use yet). 

I had a glorious deep sleep this afternoon on my own bed and now am looking forward to a night of no bloodpressure / temperature / blood draws and 5 am enforced washes. 

It was wonderful to have Chris prepare, serve and clean up our family Sunday dinner but I know how frustrated I'll soon feel about him having to do all the work looking after me and the children all weekend after working all week himself. 

Day 2 After Surgery

Day 2 After Surgery
Despite all the wake-ups I managed a relatively decent sleep. (though the nightnurse dressed all in white with bleached white hair that shook me awake at 4am, waving a needle and saying in a strong Transylvanian accent "I vant to draw your blood" is still a disturbing image - and I'm  sure I didn't imagine it!)
Due to the improved sleep, and fewer drugs swirling around my system, my nausea was practically gone today. 
I was able to eat a little of each if my meals, which in turn made me feel increasingly stronger through the day. 
It's amazing how, when you feel physically stronger your mental attitude changes too. Yesterday I wondered if I'd made a mistake choosing to operate; if I'd be able to get better; if I could go back to doing what I could do before.  Chris asked me today if some of the previous pain in my hip had now gone. It took me by surprise as I hadn't given a thought to that since the surgery. Yesterday was a tough day, and though today is better, I can still only think of each small step that is in front of me - not the final goal. 

PT involved walking with the walker round the knee and hip unit several times during the day. I also went up and down the practice flight of stairs twice.  My steps are getting more fluid and less painful. The first few steps each time are very hard- as though my right leg doesn't remember what to do without me physically moving it forward with my hands. I  can also get myself on and off the bed though it is slow and painful. There are exercises to do in the bed and on the highchair, these are ok. 
The doctor removed the drain tube from the incision: painless but some impressive blood. It seems to have stopped now though. 
My surgeons assistant discussed that my goal should be to aim towards going home tomorrow. Strangely, after talking to Dr Davidovitch downstairs, he reappeared  an hour later saying that they both felt i should go home today. I'm suspicious about why the sudden decision change.  Maybe when you pick an aggressive surgeon he will continue to be aggressive about all aspects of hip replacement.... Maybe it doesnt look so good if one of his patients doesnt recover as quickly as he advertises? Anyway I'm not ready to go today so tomorrow it is. 

With my higher energy levels I was able to enjoy my visitors more today, also a few hours peace and quiet whilst I had the room to myself with no roommate. 

Arriving at NYU

A new hip! Brought to you by Stryker TM

Husband Chris here... Trudy was experiencing technical difficulties in the hospital and requested I provide an update. I’m pleased to report the surgery went well according to the doctor. First night was painful with little sleep complicated by nausea from the pain medication.  I was however blown away by Trudy, very slowly and with the help of a walker, making her way unassisted to and from the bathroom less than 24 hrs post op.  Baby steps for the time being but still encouraging.  Trudy was implanted with a titanium hip from Stryker Corporation. Hard to believe one of the Terminator like objects on Stryker’s website is now a permanent part of my wife’s beautiful body. That said, they look very resilient. Useful life is quoted as 15-20 years but as expained, there are no statistics to support this claim because you have to wait 15 years for the data and it's more likely they may last much longer.  Hopefully we'll never see the hip or it will be many decades before we meet again.  Hoping to have Trudy back home on Sunday. 

Day 1 after surgery

5am the nurses insist on bathing me, 6am they insist is breakfast time, although I am too nauseas to eat. After multiple medical staff visit for different tests and questions it is finally 8am and PT time.  I was really nervous about trying to move my legs off the bed and then learning to walk . Getting off the bed was hideous but walking with a frame wasn't too bad. It wasn't as intuitive as I had expected it would be.. "move frame, lean on frame, move bad leg, move good leg". Repeat. I am pleased with how I did and keen to take it a little further next time.
Visitors were lovely to see but the energy required made me sick. I was able to nap on and off (at one point so deeply that the nurse went into a panic trying to wake me) until x-rays and another attempt at walking.  This time nausea and dizziness stopped me from getting far at all. 
5 more lovely visitors left me feeling blessed but exhausted and sick.
Dr Davidovitch checked in on me. He says my blood count is ok, I shouldn't need a transfusion, and still appears to think going home tomorrow is an option. I can't see  that I'll be ready but here's to a good night sleep and not too much pain. 

Surgery

Recgonized the chair to needed wait in, pre-op by dr davidovitch's Star Wars Jedi Night. Surgery delayed by several hours but finally got walk into the operating room at about 3:00. 'Enjoyed' listening to the sounds of the surgical team counting out their knives; fortunately I had already taken out my contact lenses so could actually see them. After the IV was put in my hand I was out immediately.  I have vague memories of waking up  in the recovery room, talking with chris, and Dr Davidovitch coming in to say that it all went well. There are even vaguer memories of being much later to my shared room. 
The first night was very long, with very little sleep. I was happy and comfortable thanks to the morphine I put in with a push of my thumb every 6minutes. 

Today's the day

SO thirsty - nothing to eat or drink since midnight and my surgery isn't until 1:30 this afternoon.  Chris and I tried to think of what we could do with all the free time we have until we need to be at the hospital ( a whole 3 1/2 hours).  But we can't go for breakfast, its raining so no walk, most shops aren't open yet...oh well.

one day to go

The day has been so busy as usual that I havent had time to think about tomorrow, let alone pack, read, prepare.  It's now 10:45 and I've got nothing ready for tomorrow.
This evening I was starting to get nervous though, but when tucking in Ella for bed she looked at me and said " mummy will you ever be able to run around again?". Seriously, she did!  I never thought my arthritis had impacted on what I did with the children in a way that they would notice but children are always more astute than we give them credit for.   Anyway, I am no longer nervous, just back to feeling again that this is not just 'a vain or selfish option' , something that I should live with for longer rather than put my family through this.
I have worries about tomorrow but they are not about the important things.  How big will the scar be? Will it look really ugly?  How long will I have to walk around using crutches? What if the children run off with the crutches?  Should I move the things I like to eat to the top shelf of the fridge so I can reach them easily?  What should I wear home from the hospital? Leggings are comfy but if theres an enormous bandage at the top of my leg I wont be able to get them on...  Will I be able to get socks on with the assistive device?  I hate having cold feet.  Would it be awful to ask the doctor for an extra night in the hospital - I could really do with a break and an extra good night's sleep. Or will they wake me up all night to check I'm alive like they do after you've had a baby?
As I say, not the important things.   Time to take a shower and wipe myself down with all those wipes they gave me.  Hope I dont wake up having nightmares about knives and that crazy operating table they use for this.

CBS News Interview

two days to go...

In two days they will saw off  the top of my hip....    Hmmmmm....
Three years ago I thought I had been lax in stretching after runs and was having trouble running and even walking.  The stiff and inflexible hip I'd had for years was now really painful and uncooperative.  I was pregnant so had left it until after my second child was born then went to get it checked out (expecting a pescription for some physio).  Instead two hours later I wa sitting on the step outside a doctors office on Park Avenue crying over the fact that I had arthritis and wouldnt run again.  As the doctor put it "it could have been worse - we could have seen a tumour on the x-rays".  Maybe I was making a fuss over nothing but it really felt like a life-changing Big Deal to me, even though I unfortunately understood exactly what he was saying. 
Now, three years and another child later I have had enough:
enough of limping when I walk round the block with the stroller
enough of thinking twice about where to sit on the floor in the playgroup's circle time as I can't get up without a wall to pull on
enough of gripping the stair-rail white-knuckled with one hand whilst carrying my baby William with the other
enough of trying to explain to my 6 year old Ella that I cant help her to learn to ride her bike without stabilisers as I cant keep up
enough of taking a pain-killer every night just so I dont wake up in pain every time I roll over
enough of wearing flat shoes every time I dress up to go out as heels hurt and I'm scared I'll fall over
enough of watching my husband come home exhilarated from his runs each morning.
OK , thats enough of the self-pity , lets just say I was ready to do something about it.

I researched Hip Replacement (having been told thats my only option), and then doctors,  and finally settled on Dr Davidovitch at NYU's Hospital For Joint Diseases, in Manhattan.  An anterior approach, minimally invasive Hip replacement is the way to go..
..I hope.

 This is the last night I'm allowed a glass of wine, or two,  trying not to obsess about the surgery but dealing with the family's stomach bugs and head-lice infestation in the last 7 days has helped distract me. I am sure this is not the usual way people prepare mentally for for surgery.