6 months post LPAO and 5 weeks post right hip scope

I was thinking the past week that I should talk about the left hip a little since 6 months is a pretty big anniversary for such a major hip surgery.  It seems eons ago at this point, I have to think hard to remember the days leading up to the surgery, the surgery itself, and the days right after.  Those were some rough days and I am so grateful that the strength of God and surrounding family helped me to get through those days.  The left hip at this point is “ok.”  I wish I could say good, but from the hip problems I suffer from pelvic and low back instability, and since all the muscles are connected to the hip/pelvic/back/legs/neck/other hip/etc… that hip is not where I would like it to be.  I basically suffer from significant weakness and poor endurance in all muscles from all that my body has been through the past 3 years.  I will say the last week and a half I have felt small improvements in both hips/pelvis/and low back in regards to having a little bit of stability starting to develop through PT.  I’ve been able to take a few 15/20 minute shopping trips to get a few errands done which is invigorating!  I am not pain free with these, but I am able to get through them with tolerable pain and the use of my Serola SI belt for added hip/low back stability.  My range of motion in my left PAO hip is adequate for daily things.  I would like to have more hip flexion to make painting my toenails a bit easier, but either scar tissue or possibly even the screws in there inhibit full knee to chest range of motion like I used to have.  I’m not complaining though, as being hypermobile it’s probably better for me to lack some range of motion.  My PT says what I have is very normal for most people, but I guess it’s just a new normal for me.  I only have pain in that hip if I try to do extreme internal rotation which I just avoid because it’s not needed functionally for anything.  I think it’s due to scar tissue or possibly the screws or weakened tight iliopsoas (hip flexor muscle that is pretty traumatized during the PAO surgery).  My PT says I have too much going on to try and pick apart all the little things, that we need to focus on basic general things first, then eventually if needed move to smaller, more specific things.  My scar on the left is looking better, turning lighter and is even whitish now in a few places.  I can feel two of the screw heads a little more prominently than before and I have to say that it’s odd.  My hips look nothing like they did before the 3 surgeries.  Obviously with the left hip socket broken and reconstructed it looks very different, but on the right I saw on my operative report that Dr. Ellis shaved down the AIIS which is not that common with a scope.  For most who don’t know what this is, it’s the bottom part of the hip that sticks out.  For example, if you lay on  your back your hips jut up towards the ceiling, and it’s the bottom part that juts up in the air (the most distal part of that bone closest to your feet).  When I used to lay flat on my back my hips jutted up really high in the air, now the right is hardly up and the left is slightly higher, but a weird shape.  I asked my PT why he would do that (a question I’ll ask him as well at my follow up visit in 2 weeks) and she speculated that that bone being so prominent could have been what was rubbing against my femur in flexion causing the large bone spur on my femoral head that caused the labral tear that caused the beginning of my hip journey.  Without shaving the initial cause of the bone spur (which he shaved off as well) it could have come back in the future.  Crazy!

So my PT’s plan for me in general is do basic stabilization stuff trying to get as much co-contraction of pelvic/hip muscles at the same time to re-teach these muscles how to work together again instead of work against each other.  I’ve been doing at least once daily a bunch of pre-pilates stuff to strengthen my transverse abdominus which has really been getting stronger and I can feel it kick in on it’s own a lot of the time now with things like walking, stairs, or bending to pick things up.  I still focus a lot on every movement though to make sure I am activating as many of the correct muscles as possible with all movements.  We have modified my protocol to stop doing anything that flares me up (like the bike and stretching the psoas).  After I do my exercises I feel better (pain in back and nerves is more tolerable), like I have some stability, but as the day goes on my body fatigues and the pain in my back and nerve in my legs gets worse.  I really have to take it easy.  When I feel my body starting to flare up I lay down for 10-15 min or more and rest, then I am able to do a little more after that.  On days where a lot is going on and my rest time is minimal my body is screaming in pain by dinnertime and I spend a lot of time with my heating pad those nights heating up and relaxing the tight/exhausted muscles trying to get some blood flow through them.  My husband has been using the heating pad followed by The Stick on my calves and sometimes hamstrings many nights a week to help relax those muscle groups which get tight from the nerves being flared up.  That’s been helping ALOT!  My PT did a variety of back tests on me to see if functionally I presented with a disc problem and I did not.  She truly thinks my back and nerve pain is due to instability paired with hypermobility, and the muscles are all weak and fighting to stabilize me and in the meantime pulling on my nerves in my low back and sacrum.  I sure hope she’s right, as I really, really don’t want to deal with a back problem after all I’ve already dealt with.  I do feel better after strengthening…..until I fatigue from activity and then the pain returns, so what she says makes sense.

Anyways, I started driving at around 3 1/2-4 weeks locally, then this past week started driving up to PT (30 minutes away).  It’s not greatly comfortable, but I have put my seat back pretty far to decrease the amount of hip flexion I’m in, and I’ve been able to tolerate it.  I finally cut my toenails tonight, which was possible but highly uncomfortable, and I was able to put my socks on with  my right leg crossed over the left knee (vs bending forward) as well today for the first time.  My right hip range of motion is great for this early according to my PT so she is not stretching me anymore.  Range of motion is never really a concern to me, as it seems to come back naturally with the hypermobility.  I prefer not to stretch too much due to this, as I think stretching on me stretches more my joints then it actually does my muscles, then when my ligaments get stretched I become more susceptible to injuries.

Thanksgiving is in 2 days and we are having my parents over to eat and hang out and I feel like I have a lot to be thankful for this year.  I’m thankful that God has put the right people in my path this past year to get a proper diagnosis and surgeries and recoveries and now finally a good PT, that we were able to spend time with Yago’s family and the great, great help they were to us this summer after the PAO, for my parents and the help they always provide to us here when needed without complaint, to my sister who has overcome so much in her hip journey/cancer journey/life in general and for the support she has given me mentally and spiritually during very difficult days, for my kids who can make me smile even on the worst of days and the beautiful little people they are turning out to be, for my dear friend Johnna who is ready a that drop of the hat to help with anything despite the large struggles she has going on, for my church family that has cooked for me and given me encouragement during some of the difficult days, for my husband who I can’t even put into words how incredible he is for stepping up to do everything at times, for being my cheerleader, for being my drill sergeant, for being my best friend and putting up with my crying/screaming/frustration/moodiness/etc…, and most importantly for my spiritual growth and the lessons I’ve learned from God in patience, faith, trust, and now in trying to learn to hope again.  I don’t know what the future holds, and I cannot hold onto the past, but I can live in the present and be thankful for what I have each and everyday of my life.  Do I hope things will improve and chronic pain will be a distant memory, ABSOLUTELY!!!  But I cannot place all my feelings and thoughts of the future into that all day everyday anymore because it is emotionally draining.  So I wake up with hope each day that I can make it through the day, I give thanks for what I have, and I know whatever I have to face God’s got my back.  Until next time….

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