Thursday, August 6, 2015

Crutch





7/16/2016-The first surgery is almost a year old now.

It's bridge running season and we've been even busier than usual.  Diesel is going about his usual Sports Society for American Health ambassador running life.  I've never met a dog that loves to run or loves runners more.  These are his people.


My friend Jody and I have learned how to wield chainsaws.
 We're making trophies for an existing event, Roughneck, and for another event we are launching, that I cannot quite announce yet.  Ooooh!  Titillating you!  
 

Meanwhile, my husband Richard, completed his first crossfit competition.  He participated in the scaled division.
Then he crawled out of the arena.  
He placed 10th, which is pretty great for someone who has had 3 months of crossfit training, and had that time interrupted by a hip flexor tear and a major oral surgery.  Don't let his look of agony fool you, he had a blast.

I'm making progress, but still struggling with my hips, primarily my right hip...my problem child to begin with.

  It's frustrating.  I probably need another CT scan with contrast, but I cannot afford another $5000 out of pocket, only to have this problem roll into 2017 and have to start over paying another $5000 out of pocket.  I requested a scan at my last two 2015 appointments with the orthopedist, but he refused.  It gets a little tough during the bad days when I wonder if a different answer would have had a different outcome.  But it's not fair to speculate and I will find out eventually.

I have been working on my running form.
 I take advantage of the downhills at the SSAH-Bridge Runners training runs.  I did okay last night.  Not great, but I got through it.  Then today, I kicked a ball for my dog, heard and felt something pop in my right gluteal, and had to lie down on 100+ degree Texas concrete and fry like an egg for a moment until the discomfort let go.  

It let go. I got up and went on about life. 

Between running errands and heading to the gym, a man in a white SUV pulled up next to me and signaled for me to roll my window down.  Complying, expecting to hear I had a flat tire or had maybe done something accidentally to offend him, I was caught off guard when he smiled and yelled, "50 miles?"  He was referring to a very old sticker on the back of my car.  When my brain caught up, I smiled and replied, "Yes, sir.  All of it on foot."  He power pumped his arm out of the window and yelled back, "Way to go!"
It was motivating and crushing all at once. I completely appreciate his acknowledgement and support.  I'm grateful for his unintentional reminder that I went for it while my body still could. (I was sick with multiple issues when I did most of my ultra running, road cycling, adventure racing, marathoning, triathlons, body building, etc. That's a story for another day.)

But I'd give anything to be that athletic girl again.  There are so many things I wanted to do.  So many goals now that I may never accomplish.
 I'm not ready to say won't ever accomplish.  I'm still fighting.  Because that's all any of can ever really do, right?  Keep fighting.  


Start blog in chronological order with the entry below.


8/5/2015-Hip labrum repair, cam and pincer correction, bone spurs and other extra bone removal, iliopsoas and umbilical hernia repair. Oh yeah, and some piriformis release. Surgery day!  Surgery was a breeze.  The car ride home was even manageable.  I needed to wee a lot. Post op instructions came with orders to sleep in booties velcroed to a foam barrel. It's surprisingly comfortable.  Around 2:30am I awoke with an urgent need to tinkle.  Rich snoozed heartily on the other end of the sofa.  I am not allowed to bend at the hip so there was no way I could reach them and no way I could walk in them.  I was trapped in that [insert profanity]. I called his name softly, getting louder and louder as panic set it.  Here I was trapped in the booty-barrel prison unable to get out of it with a growing urgency to pee and a husband that can sleep through hurricanes.  True story.  He slept through both Ike and Rita. The situation was dire. After two minutes of loudly screaming his name he finally woke up and managed to get me to the bathroom. Whew!  I maintain my status as a continent adult. 

8/6/2015-Post op Day 1.  First day of PT (physical therapy).   I walked in like a rock star.    I was a solid ten out of ten!  They could not believe how well I could move.  Another lady was also there for PT.  Six months ago, she had the same surgery by the same doctor minus the bonus hernia repair. She said she barely moved for four solid weeks.  My ability to ambulate was blowing her mind.  Talk about stroking my ego.  I'm a very competitive healer.  I was FEELING GOOD ABOUT MYSELF! Then I went to the bathroom and got toilet paper stuck
Right hip
in the back of my shorts.  I couldn't get it out.  I had a paper tail. Oh dear baby Jesus! They had to turn me around and dig it out of my britches.  Humiliating. That may have lowered my average.

Richard, adorable husband

8/7/2015-Post op Day 2.  I slept most of the day.  Richard is exhausted and slept quite a bit too.  Napping is not something he does so this recovery is wearing on him.  He's still an angel. Not complaining.  He loves me.  That only makes me more determined to be as independent as possible and to get him a good night's sleep in our bed. So today while he went to pick up the lovely meal our friends Blair and Charlie Foxworth provided, I crutched my way over and climbed the stairs.

 About halfway up I realized I was committed to the task.  If you've ever run long distance you will recognize the feeling.  Once you are out on a run, the only way to get back is the way you came.  It's actually one of my favorite moments, my favorite thing to feel.  It's just me against the world.  Against the odds. Against myself.  It's the moment my spine goes solid, my heart beats determination and my mind creates a game plan. I know exactly who I am and exactly what I can do. I made it!  I looked around the upstairs as if it might have disappeared or radically changed in the two days since I've seen it.  Then I crutched my way down the stairs before Richard could come home and catch me in the act.  He handles it better if I am successful and tell him later rather than witness whatever shenanigans I might be up to.  I didn't do it because I thought I couldn't fail, I could have very easily found myself stuck on the stairs waiting for him to come home, but a fear of failure is no way to go through life.  

A picture of us both wet at a much happier time
8/8/2015-Post op Day 3. Shower time! According to my instructions, I can remove all bandages and shower today.  I have a bad reaction to most adhesive tape so I scratched all of the bandages off yesterday.  My skin is red from the adhesive, but intact.  I don't regret it.  We knew going into this surgery that I would be unable to flex my hip more than 90 degrees.  We don't have a low edged, walk-in shower so we made plans for me to shower outside.  Thank goodness this is Texas and it is 100 degrees outside.  It worked out even better than expected and without the constraints of shower walls or a tub to contend with, Rich was able to maneuver freely to help me.  I had enough privacy that I'm not expecting any nude photos of the experience to show up on the Internet.  Mobility is such a luxury.  So is shower privacy.  Ever tried shaving your armpits underneath a giant, wet T-shirt?  I feel like I'd be a good candidate for the next space mission.  Someone write NASA.

8/9/2015-Post op Day 4.  Pain and fatigue are wearing on me.  The hernia repair is more painful than the hip, but the hip makes it harder to sleep.  I must sleep on my back with my surgical leg straight and slightly internally rotated, my feet strapped to the foam barrel. I'm a side sleeper so this is tough.  I insist Richard leave me alone for an hour or two every day so he can get his workout in. He leaves the dog in charge of my care.  Good job, dog.
If everything I have read about the hernia repair is correct, the pain should significantly decrease in the next few days.  Once this happens, I plan to crutch around my neighborhood in the ultimate display of power.


8/10/2015 Post op Day 5.  I decided today was the day I would start to wean myself off of the painkillers.  I don't like them and I feel a responsibility to be functional as soon as possible. The world won't stop without me, but I am half of a team in this marriage and it's hard to see my adorable husband carry all of the weight.  It's true, but also self-imposed and ridiculous.  I know it.  I still struggle with it.  
Adorable husband
Lateral incision-I took the stitches out
Anterior incision, the angry one
The  pain from the hip has been throbbing, aching.  It's painful, but manageable.  The pain from the hernia repair, however, feels like Satan's fiery claws have split me open and left shards of evil to twist through my soul.  It never stops hurting.  It hurts when I breathe, it hurts when I eat.  It hurts when I laugh or basically exist.  During my outside shower, which felt amazing, we noticed one of my incisions is a little angry looking.  We decided a little dab of antibiotic ointment can't hurt. 

 Rich ran through the house looking everywhere for antibiotic ointment.  He came back with puzzled expression on his face.  "I couldn't find the Bacitracin, but I found like four tubes of hemorrhoid ointment." Raising one eyebrow he inquired, "Do you have another medical condition that we need to discuss?"  I held my abs and laughed so hard I thought the pain might kill me.  I keep hemorrhoid ointment around the house because it is good for shrinking things; everything from bug bites to saddle sore to eye bags.  I'm not secretly hoarding hemorrhoid ointment.  We've been so focused on this surgery and the upcoming races and all of the other stresses of life that we hadn't laughed that hard together in days.  Laughter is something Rich and I do well.  It's probably as basic to our marriage as love and respect. Why am I stressing so much?  I think I'll take another painkiller and laugh with my husband tonight.  Life's pressure will still be there tomorrow.   
8/13/2015-Post op Day the Gemini in me has lost track and the world sucks!  I cried a lot today.
No! No pictures today!  Sad face!
 I'm not much of a crier so by a lot I mean seven silent tears like you used to see that Native American man shed on those old anti-pollution commercials.  I cried in PT. I cried at home.  In front of Richard, I sobbed five great big sobs while he stood there rationalizing with me.  I'm miserable.  Not well enough to be good and not bad enough to have it all go by in a haze.  After PT, we had an impromptu lunch with friends.  While everyone was away from the table ordering, a thin man with tattoos and the look of a life lived pushing up against the edge of anything with an edge, came over to the table.  Reading the misery on my face I didn't know I had left unguarded, he put his leg up on a chair and hitched up a leg of his blue jeans showing me his prosthesis.  "I've got five of these beauties now, you know.  I stayed awake for two solid days and then had a bad wreck on my Harley."  He said it without self-pity.  He reminded me that it all heals.  It all heals. Everything heals.  


8/17/2015 Post op Day 12.  I care enough to count again now that it feels more like progress and less like an unending sludge of days.  From 9AM to 4PM I was out of the house doing combination of PT and Sports Society business.  We have a race coming up August 21st.  So what's it like to be 12 days post op?  The abs are feeling like they won't rip free and leave my guts spilling out anymore.  I'm finally a little less bloated.  If you ever have an umbilical hernia repair, expect a lot of abdominal swelling.   Dr. S, the general surgeon,  said he bullet-proofed my abs and considering that most of the wounds are on the side of the leg I can use and not the side of the operative leg. I'm starting to believe him.  Those abs have done a lot of work whether it hurts or not because they've had no choice.  And the leg?  It's weird.  It never has hurt in the context of regular pain.    It's more like this uncomfortable feeling that wears on me the longer the day goes on.   I lie!  I lie!  It hurt.  It hurt quite a bit.  I must have been on painkillers when I originally wrote this.  I have two tiny incisions.  You've seen those. Hard to believe so much surgery can happen from two tiny wounds.  Now that some of the healing has really progressed, I can devote most of my time to loathing the foam barrel I'm sleeping in.  I can get myself out of those stupid booties at night to go potty.  I can't get myself back in them though and no marriage can survive one spouse waking the other one up every night in the middle of the night for two straight weeks.  I've opted to be married and satisfied using a firm, king size pillow to keep my leg in slight internal rotation all night.  Being locked into sleeping on my back makes my gluteals go to sleep.  Tingly, numb gluteals wake me up and the second I'm awake I have to go make tinkle. SIGH.   My second loathing would be the brace I'm supposed to wear when I'm doing any more ambulating than going to the powder room.  It keeps me from flexing the hip past a 90 degree angle.  It's hot and it digs into the abdominal surgical area.  So painful.  Still not as bad as that stupid foam barrel. I asked why avoiding external rotation and not flexing past a 90 degree angle were so important and my PT told me that those activities place stress on the labrum.  It makes sense so I am compliant with those two things.  I really don't mind the crutches, the third piece of recovery gear, this experience has made me aware that I need is more shorts with pockets.  Tomorrow I go see the othro for the first time since surgery.  Nervous.  Hoping for good news.


8/18/2015 Post op Day 13.  
Pre hernia repair
Fancy disposable shorts
On the mend
The hernia is healing well.  It was small.  It was also surprisingly painful on a run, especially a sprint.  While it wasn't crippling, I decided to have it repaired while it was still small.   As I said earlier, Dr. Shimer promised me he could bullet-proof my abs.  I plan to test that.  Maybe not literally.  My entire abdominal area is still slightly swollen and I'm retaining fluid. Someone else wrote about surgery and said they retained fluid too.  It doesn't look like it in the pictures yet, but the abdominal area looks much better.  Flatter.

The ortho appointment went well.  I received my op report and some fancy disposable shorts for a follow-up X-ray.  Dr. C told me I could wean off of my crutches.  I was delighted.  He also told me I could free myself of the leg brace and the stupid barrel contraption in a week.

Op Report-Crossed out Tear should read Repair
8/21/2015 Post op Day 16.  Race Day.  My husband started a non profit in 2010 and named it the longest name possible on the face of the earth, Sports Society for American Health. SSAH for short.  (He's an biomedical engineer turned children's book author so he can be a bit wordy.)  15 years ago, he was speed skating competitively.  As part of his training, he would skate across town to his job.  One day a driver failed to yield the right-of-way at a stop sign.  The bumper of the automobile shattered Richard's lower leg.  The first EMT on the scene looked down and said, "Oh, they are going to have to amputate that."  The chance of amputation was high.  He was young and athletic; this was devastating news. The doctors gave him a 30% chance of saving the leg.  He went through three surgeries, including a fasciotomy, in less than a month.   If they could save the leg, he wasn't expected to walk for a full year.  Following his doctor's guidelines and consulting his Physical Therapist brother-in-law, he not only walked, he won a national speed skating event.

Skating was harder now.  A friend named Ray Solis talked him into road biking and later triathlons.  It had an impact on Richard.  Being a biomedical engineer he recognized the impact fitness-rich circulation, functional muscles, organs that could withstand trauma and repeated anesthesia-that his physical health in general, had on his recovery.  It was something he could no longer take for granted.  He had a desire to share it with an area ranked as the 5th unhealthiest in the nation.  Sports Society was born.  He started out hosting cycling races, speed skating races and triathlons.  Now we host several running events, a cycling time trial and a children's duathlon.

Today is the day we direct the Sabine Causeway 5K.  That means I have to work.  The race is a 5K spanning a bridge that connects Texas to Louisiana.  The runners run over and back-twice.  It's a beautiful evening race with an incredible sunset.   That meant I was going to have to be seated or standing for about 9 hours straight.  Not an easy thing to do yet. Most days I am depending on getting prone and icing my hip between any activity to get work done.  I won't have that luxury.  I took just enough of my leftover painkillers to take the edge off so I could make it through hosting the race.  For me that means half of a Percocet. We have a very experienced, capable crew of race volunteers.  The race went smoothly. YAY!  I used one crutch during the race.  I've been ambulating around my home without it, but I knew this day would be too much and too dangerous without an aid.


Race Crew-I'm wearing green...and a visor...and I have my thumbs up.  :-)

8/22/2015 Post op Day 17.  OUCH!
8/23/2015 Post op Day 18.  OUCH!
8/24/2015 Post op Day 19.  We're getting there.  Finally.  Ice, rest and getting back on the crutches two days
8/25/2015 Post op Day 20.  They let me do this in PT today.  Well, not stand on the railing of a bridge, but they did let me stand on one leg.  It was sort of scary, but liberating.
 I go to Triangle Therapeutics which is a great facility.  They have a full gym complete with high end equipment in another area of the building.
8/28/2015 Post op Day 23.  I'm finally able to get on an upright bike.  I also have permission from my PT to do some light upper body weights.  

8/30/2015 Post op Day 25.  The sacroiliac area on the operative side has been killing me.  This is very similar to the pain I had before the surgery.  From the reading I've done, most people feel this in the front, in the groin.  My worst pain has always been in the gluteal region.  Specifically, in the sacroiliac, central gluteal and at the greater trochanter.  Sleep helps.  The pain increases as the day goes on.  I'm still not encouraged to flex my hip beyond 90 degrees and I cannot stretch my piriformis, some of this simply muscle tightness, but the fear is always there, the fear that the surgery won't work, that it will fail and I'll be faced with having it again, or worse, with only the option of a hip replacement.  
9/1/2015 Post op Day 27.  MRI with contrast of the left hip, the good hip.  Symptoms in the left hip crescendoed about three weeks before I had surgery on the right hip.  The left hip is less painful in the gluteal and more uncomfortable in the front of the hip.  I suppose that's more typical for a labral tear/FAI, assuming I have one.  I've found stats claiming 30% of people have this issue in both hips.  Of course I wanted Dr. Internet to tell me it never happens; that to have FAI in both hips is impossible.  Curse word!

 The common response to telling people about this surgery is "Oh, okay, so you did too much."  People assume that I wore out my joints with cycling, swimming, lifting and running.  That is inaccurate.  I may have unveiled it sooner in my life, but the current medical thinking is that this condition is caused by a malformation of the bones in the critical growth years, in childhood.  I didn't start exercising, really exercising until I was in my 30's.  I grew up water skiing and I did make a stab at running cross country one year, but the truth is I didn't fall in love with athletic activity until later in life.

So what happens in an MRI with contrast?  I undress and lie on my back.  My groin is cleaned and draped to keep the field as sterile as possible.  The joint is X-rayed.  The radiologist uses lidocaine to deaden the area.  It's a painful area.  Lidocaine is a painful drug.  Lidocaine works by moving into the cell and blocking a sodium channel responsible for pain. Pain occurs when sodium moves into the cell and builds up in this channel until an electrical impulse is large enough to be sent to the brain. Remember sodium is an ion.  It has an electrical charge.  It's not that I don't have pain, or that my nerves aren't aware of something happening, it's that they cannot build up sodium to send the ionically charged signal to the brain. So it never gets processed as pain.  It is not this action though, that makes Lidocaine painful.  From what I understand, it is the pH of the solution that makes it burn.  Once the area is numb, the radiologist slides a needle down to the joint and injects a contrast.  He takes another X-ray to confirm everything has landed in the right nooks and crannies.  I'm immediately taken over for the MRI.  The MRI is fast.  Lying on a hard surface, with my feet taped together so that the left hip is in internal rotation, holding my muscles tense so as not to move is taxing on the right hip.  By the time everything is done, my left hip hurts due to the extra, unwelcome fluid in the joint and my right hip hurts from everything else.  On the car ride home, I find everything hurts.  I'm tired.  I'm sick.  I just want to get in my bed and lie down.  An hour later we are home.  I take half of a pain pill and one of my leftover muscle relaxers and spend the rest of the afternoon in bed.  


9/2/2015 Post op Day 28.  Richard instructed me to rest today so as soon as he left the house I did what any reasonable person would do and hauled myself to the grocery store.  Rich has done a great job of taking care of me, but my body is craving more vegetables, more nutrition.  Richard is a machine that can apologetically run off of pizza and hamburgers.
 Sometimes I almost hate him for it.

So I bought all of these fruits and vegetables and turned them into meals.  It took me all day.  Wash, chop, cook, sit down, rest and repeat.
  • On the menu:
  • Swiss Chard and Lentil Soup with Sausage
  • Dark Chocolate Chili with Steak
  • Chicken Curry 
  • Almost Blair's Salad 
  • Fresh Fruit Bowls
  • Ginger Soup and
  • Black Bean and Egg Breakfast Burritos

Leah at The Loft trimmed my hair and straightened it.  If I could just reach far enough down my leg to shave around my ankles, I'd almost feel pretty again.  DAMN MY T-REX ARMS AND LUSCIOUS LEG HAIR GROWTH!  On the days I fail to contort my way down there without breaking any of the leg bending rules, Rich shaves it for me.  Did I mention that he is amazing?  All you women should be swooning over my man.
If I find out tomorrow the other hip has to be done, I'm buying a long-handled razor online.
If you think I'm kidding, click here
The pain is mostly in my lower back today.  I wish I could say it wasn't fatiguing, but it is.   I'm so ready to feel like a normal person.




MRI of the Left Hip
9/3/2015 Post op Day 29.  Even though I knew, it still left me fighting my emotions. Air squeezing out of my lungs. Tears stabbing and threatening my eyes.  Hope exists in spaces deprived of sunlight and oxygen.  Hope thrives in conditions incompatible with life.  Hope is hard to kill and painful when it dies.

 Logically, I know this is okay.  Emotionally, it takes away exercise for a longer period of time.  Exercise is what I use to cope with stress.  Exercise is sanity.  Running, cycling, swimming, kayaking, mountain biking, weight lifting-these are my reasons to exist.  Promoting health.  Encouraging people to find their athletic potential and thus their life potential- it's not just my work.  It's my joy.  I miss being a part of it.

So now I wait for the next surgery date.  Dr. C also ordered a corticosteroid shot for the right sacroiliac joint.  We agree that the SI pain needs to be addressed. It's hard to wait.  Rich and I are self-employed with no paid time off.  It's hard for both of us to work around this.  There is good news.  Dr. Cascio released me from PT today.  I will go to my appointment tomorrow, but then I'm on my own.  He is also very pleased with how well the right hip has responded to surgery.  I feel bad.  I was so caught up in my disappointment that I forgot to tell him how grateful I am for his help.

AHHH!  I'm losing my tan!
9/13/2015 Post op Day 39.  I find myself doing more and more things without thinking about the hip.  I realized what I haven't mentioned is the lateral cutaneous nerve and how it feels after surgery.  I get flashes of fast, stabbing burning shocking pain below the lateral incision.  Those little witchy lightening bolts don't seem to be related to any specific movements so I can't avoid them.  That doesn't stop me from trying.
Years ago, I had two big dogs and no fence.  There was no way I was surrendering my pets to an animal shelter and no possibility of erecting a fence.  I settled on an electronic system with a shock collar to keep the dogs contained.  The dogs learned that a warning chirp came before they entered shock territory and this sound allowed them to relax and patrol their borders. No chirp, no problem.  Chirp, back up and no shock. It was a great solution. They did well with it.  Learned it fast, loved having full run of the yard.   One night, I walked outside to feed them and found my poor dogs pressed up against the house, afraid to move.  Without moving his head a centimeter, the male rolled his eyes up to my face and then out to the yard.  I realized the crickets sounded just like the warning chirp.  I uncollared them for the night as they both audibly sighed and relaxed.   The lateral cutaneous nerve pain is my shock collar.  It gets better as I go.  I haven't felt it in a week or so now, but like the dogs, I'll heed any warning chirps.

Today was absolutely beautiful so Rich took Diesel skating and while I rode my mountain bike.  Again, it's not smart to be riding a bike at all, but it keeps the crazies at bay.  I do what I have to do.




9/14/2015 Post op Day 40.  I showed up to be a part of one of the fantastic local running groups tonight.  The Golden Triangle Strutters is a free group started by two brothers, Jeremy and William Fermo. It's a completely free club that meets at least once a week.  It's pretty neat and it has spurred a lot of pride. It's good thing that's happened, putting this area on the running map.  We're considered the 5th unhealthiest region in the United States.  Such a shame as this area is full of great people, but groups like Sports Society for American Health and the Golden Triangle Strutters are chipping away at it. This area can also be tough to break into. Fitness groups create a great opportunity to socialize.  This is an incredibly friendly group.

I'm the idiot doing jazz hands
So I showed up tonight hoping to walk a bit.  A friend offered to walk with me and by the time it was over I'd hoofed it for 2 miles, enjoyed some good conversation, and played with one frisky golden retriever.  The hip burns a little post walk, but it was worth it.  If the world ever does collapse, I'm convinced that it's the amateur runners, the Saturday cyclists, the fitness enthusiasts, the weekend warriors that will step up and lend a helping hand.  It's hard to explain, but having spent over a decade around recreational athletes, it is undeniably in their nature.

9/18/2015 Post Op 6 Weeks and 1 Day!  Everyone who has had surgery knows that the 6th week is the magical week for surgery.   It's the day you can usually go back to all activity and/or work.  It's the day you are released from care.  The day that you can resume all activities! It doesn't quite work that way for activities with this surgery as I was told early on that this is a 4 month recovery.  For that reason, you won't find me running any 5K's yet, but it still felt good to hit the six week mark.
Very thoughtful T-shirt gifted to me from my friend Robert.

On Wednesday the 16th, I sat in Dr. Cascio's office and completed the surgical registration process to have surgery on my left hip on the 28th.  Rosie is my office nurse.  She's fantastic.  She's a bulldog about caring for her patients and a fantastic communicator.  She remarked on how quickly my right hip recovery was progressing.  That felt so good to hear.  The thing about FAI surgery is that it is more painful that a complete hip replacement so sometimes it's hard to tell if you are making progress.  I did ask her how long it would hurt. It's rarely more than mildly painful, but even mildly pain is fatiguing.  I try not to push my body into doing anything that would require taking anything, even something as mild as Tylenol, for pain.  That's my barometer for activity. Rosie said it was not unusual for pain to last as a long as 6 months.  Pre-op and hospital pre-admit took a total of three hours.  A person could make a career out of being a patient.

On Thursday the 17th, I went the monthly social run hosted by our local running store, On The Run-Beaumont.  I won a pair of free Saucony running shoes!  It couldn't have come at a better time.  I was just looking at my old pair of running shoes and wondering if their wear patterns would be good for me now that my body will be a little bio-mechanically different.  Who knows, but like any good sports enthusiast, I have my superstitions.  

9/25/2015 Post Op Week 7.1. Dr, Cascio's office called with my left hip surgery time on Monday.  I'm first case. Go me!  Less time to be hungry. 

Meanwhile, my right sciatic nerve flared up yesterday because I wore stupid shoes.  My friend Greg asked me to define "stupid shoes".  It was a fair question and something I've been pondering for a long time now. 

Shoes were originally invented to protect delicate human feet and enhance walking. Shoes were the garment king of functionality! Somewhere along the way, shoes took an ugly turn as heels grew higher and more torturous.  Read this great article from the New York Post to learn more about the history of high heels. 
From wedges to kitten heels, to stilettos- high heels more prominently display our lady lumps, make us look taller, thinner and more like a goddess.  Yet, more than once I've watched a woman hobble across a room in obvious pain.  They say their shoes are comfortable. It's a lie.  There is no such animal as a comfortable high heeled shoe. It's mythical like the unicorn, and the bra so cozy you'll never want to take it off. Liars!  Bras and shoes are in a race to come off as soon as a woman hits the door of her home.  Often them come off simultaneously.  Ladies, am I lying? 

By the very nature of having a hiked heel, all of the wearer's body weight ends up on the ball of the foot. The tendons underneath the foot get stretched into an unnatural position. Delicate toes get crammed up against the toe box or strap as your feet naturally slide forward. High heels are the antithesis of footwear.
 But I have my weak moments.  I, too, want to be closer to a Victoria's Secret model in legginess than my 5'2 (5'3" if you're asking for my weight) frame will allow.  I wore my evil multi-colored, super adorable leather wedges yesterday and my hip fought back.  Damn it.

9/27/2015 Right Hip-Post Op Week 7.3.  The next time I blog it will be about both hips.  Surgery on the left hip happens tomorrow morning.  I'm handling it well on the outside, but on the inside I'm screaming.  I've asked a lot of my right side in a short amount of time.  Some of it because of my work, some of it for my sanity, some of it because I knew it would become the hip on which I depend.  My right sciatic nerve is a diva.  I'm not pain free from the first surgery. I'm still exhausted.  How will I cope with bilateral hip weakness and pain?  How will I cope with more fatigue?  How will I cope with even more anxiety about my surgical outcome? 

I never realized how important the pelvis is to stability and power.  I have always known I have a drive to be physically independent.  Weakness, dependency, fragility-hate words.  I didn't spend countless hours learning to swim, building strength, cycling, and running mile after mile, because I'm a person that deals with vulnerability well.   Raging under my surface is a desperate need for strength and self-sufficiency. It's not enough to live, I need to thrive.     

9/28/2015 Right Hip Week 7.4~Left Hip Ground Zero.
 I pranced into day surgery, threw my arms wide open and announced that I, Valedictorian of Day Surgery, had returned.  Nobody even looked up from the nurses station. Unless you're GI bleeding from your nipples and allergic to oxygen, nurses aren't all that easy to impress.  Oh well, they were all very nice and my stay was uneventful.  They even made sure I had my scopolamine patch to stave off anesthesia nausea.  The anesthesia was good.  Really good.  Almost no nausea and what I did have went away with medication and slice of lemon cake.  I ate the whole thing.

Dr. Cascio had a full load today so I don't know what all he did yet, but he remarked on the amount of arthritis I had in my less symptomatic hip.  I guess the MRI/contrast didn't tell the whole story. 
The Shackles

The post-op drugs are good.  Really, really good. Ice is a staple. I managed to behave myself for the day.  The left hip is swollen, as is my abdominal cavity.  All normal.  It hurts when I get up, so I spent most of the day in bed.  Also normal.  If the right hip/sciatic nerve hurts right now, I'm not noticing it.  Bright side!  Write more later.  For now I must lie around in my shackles.

9/29/2015 Post Op. Rt Hip 7.4 weeks/Lt Hip Day 1.  I only woke up once with pain during the night, but for the most part, ice and post op medications have kept me fairly comfortable. I woke up several times trying to pull my feet out of the booties and roll onto my side.  I'm a side sleeper and I indulged myself with the support of a great pillow three or four weeks after the right hip surgery.  Now I have to break myself again. 
 I started PT this morning.  It is very common to start PT one or two days post-op.  The dog and his boy helped me get ready.

 PT consisted of an assessment, some scar mobilization on the right side and passive ROM of the left.  Have I mentioned how much I love Triangle Therapeutics?  I plan to medicate, eat and sleep the rest of the day.  Lofty goals.  


9/30/2015 Post Op. Rt Hip 7.5 weeks/Lt Hip Day 2.   
It's been a fairly uneventful day.  Rich left me alone some this morning to help his father with some home repair work and I was completely fine.  I think Richard was more nervous about leaving me than I was about being left.  I'm ambulating pretty well.  I can't carry anything with crutches.  That's a bummer.  I use a backpack to help me get items from point A to point B, but it doesn't work for all things.

My abdominal cavity is quite swollen from the fluid they used to open up and visualize the hip space, but my body will eventually absorb it.  It's uncomfortable.  I feel like I ate my way through three Thanksgiving dinners.  Looks that way too.  I'm coping with help of stretchy pants.

10/5/2015. Left Hip Post Op Day 7. Put on shorts using crutches as chopsticks.  It's always good to learn new skills.  Not being able to flex my hips past a 90 degree angle has been the mother of ingenuity.

Removed sutures.  Steri stripped wounds.  Wish I hadn't been too surgically beat up to think of that the first time around. Oh well, that side will just have a wilder scar.

I haven't written much this time.  I've been tired and extremely frustrated having just done this whole bit.  Rich did take me to a local botanical garden.  I desperately needed out of the house.  We went to Shangri La, in Orange, Texas.   It was lovely.  I ended up with the extra wide wheelchair still being too fatigued to crutch any long distances.  The garden employee claimed it was the only one she had left.  Mmmmmm...hmmm...sure.  Insult to injury.  I know I've been a calorically bad girl.

10/12/2015 Right Hip Post Op Week 9/Left Hip Post Op Week 2.  Post op appointment with Dr. C tomorrow.  I'm dreading what he will probably have to say.  All he told my husband after surgery is that I had a lot of arthritis and he spent most of his time "digging out arthritis".  He also told Rich he was able to buy me "many, many more miles." That's not the report we wanted.  We wanted to hear that I had very little arthritis and a decent amount of labral tissue to save.
 The first conscious thing I remember asking Rich after surgery was how it turned out.  When he told me what the doctor said, it was agonizing.  Not even the post op medications could keep me from feeling the pain.  Both of us know it's now become a race to keep any more deterioration from happening, if that's possible, before medical science can make enough leaps to start replacing natural articular cartilage. While I could technically have a hip replacement, they are not without their problems and having one done so young means I would probably be looking at another one in my lifespan.  That's not exactly appealing.

Rich said he sat there in the recovery room with me deliberating how or what to tell me and went with the blunt approach in the end.  He said he thought about when he almost lost his leg and how hearing they might have to amputate was the hardest blow and that once he'd been dealt that, hearing anything else got easier.  So far nothing else has gotten easier and I'm not looking forward the details. 
10/13/2015 Right Hip Post Op Week 9/Left Hip Post Op Week 2. 
How my left hip op report reads:
How I feel:
It isn't the worst news in the world.  He actually took the position of telling me anything is possible, but that running less is probably better for me than running more.  At least I can run.  Logically, I understand this.
Emotionally, I'm still sure he meant to say, "Run all you want. Running increases your awesomeness and aids in the regeneration of cartilage.  You should probably eat daily cupcakes while you're at it. Studies have shown cupcakes are extremely beneficial to joint health and six pack abs."

It's not over.  I have cartilage damage and a rotator cuff tear in my right shoulder that is next on the chopping block.  Several years ago,  I was unintentionally  knocked off my road bicycle at high speeds and rode the ground with my arm pinned underneath my head.  I ended up with a fracture and apparently some other damage.  It is possible that this same accident caused all of my hip issues.  It's also possible my hip were simply congenital as I wrote earlier in my blog.   I'll never know and it doesn't matter.  The end result is the same. 
10/26/2015 Right Hip Post Op Week 11/Left Hip Post Op Week 4. 
Dr. Cascio's office called with the surgery date for my right arm.  The last surgery in this long chain of events is scheduled for November 9th, which is exactly two days after we host the Pleasure Island Bridge Half Marathon, 10K and Kinsel Ford 2 Mile.  I'm so ready for all of this to be over.  I'm exhausted.  It's hard to explain to people that this is a long recovery and each surgery digs the ground out from under me a little more when I haven't even found my footing from the first one.  Chronic pain adds to the fatigue.  Tylenol and other over the counter medications don't even touch the pain.  So I go along doing only what I have to do, giving in to prescription pain meds when I can't take it anymore.  2015 has been a rough year.  I get very impatient with myself about healing.  Then I look at the tiny incisions where they bored into my body- 
all the way down through layers of muscle, fat and nerve to work on my bone and think to myself that if those aren't healed, how can anything inside be healed?  Patience.  Patience is hard. I need to be back to work, pushing, making things happen.  I do work, but I'm limited.  I need to be able to support my friends. I do engage, but I'm limited. I need to pull my weight around the house. I do cook and clean, but not as much as I should.    The stress is incredible.

 I did go to a great Halloween party Saturday night.  I had a blast.  It took meds to get me on my feet that long, but for a few hours I felt normal.  It was so good.  Looking forward to a time in life when being around people, having no pain, having energy is my normal again.

11/11/2015 Right Hip Post Op Week 13/Left Hip Post Op Week 6/Right Shoulder 2 Days.
I haven't written much recently because we have been so busy preparing for Pleasure Island Bridge Half Marathon, 10K and Kinsel Ford 2 Mile.  We've also had an Aflac account in the middle of all of it. I did manage to edit 6 chapters of Richard's 4th book in the series Adventures of the Elements.

 The left hip has healed beautifully.  No pain.  I could almost forget I had anything done to it.  The right hip which was more symptomatic, is still a bother.  Dr. Cascio seems think it is the piriformis having trapped the sciatic nerve for so long that is causing my remaining pain.  My neurologist friend said it could be two years before that nerve heals enough to settle down.  In the meantime, I'll just have to live with it.  It also may never heal, but I'm not banking on that.  I'm a competitive healer.  I will get through this.
The weather was less than cooperative for the Pleasure Island Bridge Half Marathon, 10K and Kinsel Ford 2 Mile on November 7th.  Many weekends of heavy rain built up the mosquito population to a point they were militant.  I swear, they were flying in organized formations and attacking.  They ate through my OFF like it was barbeque sauce.  Then the light rain that had been predicted turned into a torrential downpour. (Don't blame the weatherman.  He is working with limited data because there is no weather information in parts of the Gulf of Mexico.  He did his best and frankly, he is almost always right.) 
 Despite all of the misery, the runners were remarkable.  Smiling, happy, splashing around in puddles and slapping mosquitoes off of each other.  I've said this a thousand times and I'll say it again-If you are in charge of hiring, hire a runner.  They can take adversity.  They can get through almost any challenge.  They are excellent problem solvers and capable.  They will do the toughest job with a smile. 
Unfortunately, island parking is a field.  Early in the week, we went to flag the low lying areas of the parking lot, having been assured we would have no problem in the lot with the predicted light rain.  But we didn't get light rain.  We got Hurricane Race Day.  Rich, myself and Big Mike are the three responsible for putting the race on.  Everyone else is pure volunteer.  Because of the rain, our volunteer numbers were down. One group that had actually committed wrote us at 6:30AM race morning to tell us she had excused her volunteers from duty.  Yikes!  Of course, there is no time to check email or messaging an hour before the race starts with everything else that has to be done, so we didn't find out until that night what had happened to them.  Luckily, the Lamar State College Seahawks Softball team showed up in full force and with their help we were able to make it work.  
Again, follow this team and if one of these ladies ever shows up for an interview, hire her.  They worked hard, without complaining, through some rough circumstances.  They will get the job done.
Back to the parking lot, once the torrential rain started, the field turned into gumbo.  I knew someone had to go help people get out of there, so I took the job.  I have one rule about volunteers: I never ask them to do anything I won't do myself.  I went out to the field and helped people find higher ground and get out of the parking lot.  This involved pushing about 11-13 cars out.  My right hip hurt so bad from two solid days of standing, bending, and not resting, that I didn't know if I could do it, but I did.  Eventually, Brian Beard, another fantastic volunteer, fired me and took over.  All I can say is that I was very moved by the people that jumped in to help.  I was also very touched by how easy-going the runners were about the mud.  Not one person still has a car in that field and that is all because of the teamwork of strangers. Again-hire an athlete, they know how to work as a team.

Sunday, we took everything out of the truck to dry it out and sort it.  Then Monday it was shoulder surgery time.  I had a torn bicep, a torn labrum and a torn supraspinitis tendon.  I'm really starting to believe my problems may have come from one pretty gnarly road bike crash I had several years ago.  Especially, because of the arm fracture I suffered at that time. I rode the ground on my right side with my right arm pinned under my head and my feet still clipped into the pedals.  I could feel the asphalt grinding out the flesh on my inner elbow as my head rested on it.  I remember calmly and clearly thinking how much it hurt, but the force was too strong for me to release it out from under my head and let my helmet take the brunt of it.  All of my injuries in the impacted limbs are telling the same story. I  could be wrong though, and it still doesn't matter.  Life happens.
 
As part of the pain control for shoulder surgery, the anesthesiologist inserts a catheter which feeds Ropivacaine into the arm to numb it.  I don't think mine ever did work very well.  I woke up screaming in pain in the recovery room and that is something I just do not do.  I kept telling them stories about how tough I was.  I have no idea why.  I guess I wanted them to take it seriously.  They did.
I also told them several times and had a band reading tape allergy.  They taped it anyway.  Last night it had to come out.  Prematurely.  The tape has already begun to blister my skin.  You can see the redness in the photo.  Maybe even some of the blistering. Now all I have to do is try to keep myself from scratching it.  So hard. It itches!
The good news is that all of the rest since surgery and probably some of the drugs has eliminated my right hip pain for now.  I'll take it!
So what is next on the agenda?  Well I am hoping against all odds and common sense that I will be out of the sling and able to lead the Christmas Light Ride.  This is completely free bike ride around town to look at Christmas lights.  Everyone decorates themselves and their bikes.  It's a blast!
The big race is coming February 27th.  The Exygon & Baptist Hospitals Gusher Marathon, Exxpess Mart Half Marathon and Kinsel Ford 5K featuring the ExxonMobil Heads or Tails Cycling Time Trial.  Hopes and prayers that my limbs are strong enough to make it through the beast.  It's a big event, with little rest, long hours and physical requirements.  I'm very grateful for all of the volunteers.  These changes would not be happening in SETX without you.  I am reminded of that every day.  It's a beautiful thing."

12/11/2015 Right Hip Post Op Week 17/Left Hip Post Op Week 10 /Right Shoulder 4 Weeks.
A month has passed since shoulder surgery.
Thoughts on shoulder arthroscopy:

*Fingers can go to sleep? What time is it?  3AM.  I want to straighten my elbow
*Did she not see me trying to get through the door with one arm?
*Hand nerves, quit randomly dropping my keys.  It's embarassing.  Look at him smiling while repeatedly picking them up.  Nice guy.  Bet he's good with babies.
*I love you, Netflix.
*Will I ever be able to put my hair in a ponytail again?
*Wiping with my non-dominant hand is unsatisfactory.
*Handwashing involves getting up on my tiptoes and leaning my whole body over the sink.  Tall sinks demand acrobatics.  I will not skip handwashing!
*Getting in and out of the sling is like strapping into Nascar.
*Does every shirt I own pull over my head?  Most button-up shirts do need to be ironed.  I hate ironing.
*I'll never get these underwear situated.
*Jean pockets, stay right side in...please.  
*At least I have an excuse to skip the bra. Can anyone tell I'm not wearing a bra?
*I wonder how long my underarm hair will grow?  I've never actually seen it at its full ginger glory.
*Humidity, wonderful.  Hmmm...risk damaging the surgery to put my hair in braids or just leave the house looking like My Little Pony.
*No, I can't meet you for lunch, because I eat like a toddler with my left hand. 
*HOW CAN NOT MOVING MY ARM HURT SO MUCH???!!
*I'm getting out of this sling.
*I need this sling.
*I'm getting out of this sling.
*I need this sling.
*I'm getting out of this sling.
*Flip flops go with dress pants, right?
*I throw like a girl with my left hand.
*Quit looking at me with scorn, Diesel!  I know I can't throw your tennis ball for crap!
*I wonder how long I can get away with not wearing a bra?
*Left-handed people of the world -passenger side seatbelts, passenger side car doors, scissors, light switches, right-side toilet paper holders- I'm sorry I haven't been more sympathetic.
*I should hold the door open for that stranger.  She looks like her arm hurts.  I wonder if she is left-handed.  Oh she is!  Peace out, my sister.  I share your struggle. 

12/12/2015 
I had a disappointing appointment with the orthopedic surgeon on Thursday. It's taken me until now to be able to talk about it. I'm in chronic pain due to the stage 3 osteoarthritis, but I'm too young for a hip replacement. Even if I opted for a hip replacement, he says I cannot run on it. I cried all day long between visiting gyms, marketing Sports Society events in Lake Charles. 9-11 years of being in more pain and limited in what I can do does not appeal to me. I'm considering my own bone marrow for stem cell. It's expensive and not covered by insurance, but Rich and I both feel it is my only hope. I'm considering hosting a 5K to help cover expenses. A few close friends suggested setting up a donation page, but I feel like I'd rather do something that helps other people improve their own health, decrease their own risk of osteoarthritis. I'm a doer by nature. I'm afraid people will think I'm selfish for doing so and not support it. I'm a little fragile emotionally. This has been a hard hit to take. I've still not come to total grips with it. It's so unfair. I'm no stranger to chronic pain. I lived with stage 4 endometriosis. I ran three ultras, one marathon, several halves, raced triathlons, cycled thousands of miles, among other things with chronic pain. I can ignore a lot of pain. I cannot ignore this pain. I'm fighting back, but it is making my life smaller. 

When I got the news, I died a little inside. I'm logical though. I've been reading a lot of medical research and talking to people who have tried the treatment. My own stem cell could help. Should help. At least there is an option. I am battling not to feel sorry for myself. I know I'm fortunate. I know people face bigger battles. It isn't that I think I should be grateful because some people have it worse. It is that I think I should be stronger because people face much bigger adversities with the hearts of lions.



12/21/2015 Right Hip Post Op Week 19/Left Hip Post Op Week 13 /Right Shoulder 6 Weeks.

My brain and my body have been fighting all week.  On Tuesday I went to the social run at On The Run-Beaumont, the local running store.  On Thursday I hosted the Christmas Light Ride.  On Friday I went to the GTS Tacky Sweater Run  My brain loved it.  Social time doing some of my favorite activities with my favorite people! My body loved it less.  I've paid for it in hip pain.  Emotionally, it was worth every moment of doing the work I love and being with people I enjoy.  Physically, it was draining.

I keep trying to go to the gym, do activities, that will rebuild joint protective muscle.  I do believe this is an extremely important process for healing.  I have been gentle, but all activity seems to be punishing. It's very frustrating.

I've not been sitting around feeling sorry for myself though. I've been actively pursuing stem cell.  Just so there is no misunderstanding, these are my own cells from my own bone marrow used to rebuild cartilage.  The orthopedic surgeon removed the impingements and other knobby, hateful things chewing away at my articular cartilage.  That's great.  It should slow or stop any more damage.  What I seek now, is a way to improve/repair the damage that has been done.  That's where stem cell comes into the picture.  It isn't that I expect it to return my joints to normal.  It is that it has the potential to make small improvements to my damage which will should reduce pain and restore mobility.  I have my first appointment with a stem cell facility today.  I'm nervous.  I'm emotionally invested.  I want it to work.  So you must be thinking, "What about placebo effect, Amie?  How do you know it won't simply be a matter of your emotions wanting it to work so badly that you ignore it if it doesn't work?"

I can't.  I can't ignore the golf ball sized swelling that remains on my lateral right hip.  I can't ignore the atrophy in my right gluteal.  I can't ignore pain that only allows me 4 hours of sleep a night, with medication.  I wish I could.  If I could there would be no point in writing this blog.  I'd be out riding my mountain bike, running the roads, swimming across lakes and kayaking with the alligators.  :-) So wish me luck and stay tuned for details. I plan to share my entire experience through this new leg of my journey.

P.S.  Pun intended.  

1:36PM
 I've met the doc and had prolotherapy which I will explain in more detail a little later.  Right now I have approximately 50cc's of fluid (dextrose solution) spread around the joint capsule, tendons and muscle tissue.  OUCH!  I feel like this:

12/22/2015  The Morning After Prolotherapy. I'm doing well.  It feels a little like my gluteals have been used as a speed bag, but I'm able to move around surprisingly well.  I've been ordered to rest this week.  I'm not a great rester, but I'm going to work very hard to be compliant with this request as it is important to let a healing reaction take place and not arrest the process with joint use.
So what is prolotherapy and why is it a step in reducing joint pain?  Prolotherapy involves injecting a joint or tissue with an irritating solution, such as dextrose, to trigger a healing response.  It is reportedly useful for tightening loose ligaments and improving tendon pain.  It causes inflammation, which is a painful, but necessary step in the healing process.

 Think about what happens after you cut your finger.  The wound bleeds, turns bright red, gets puffy and starts to heal.  Think about what would happen if you kept cutting your finger.  Instead of healing with a pretty smooth tissue that eventually fades into your skin, the wound would most likely heal with thick, gnarled scar tissue.  This is what can happen to tendons if they are injured and not allowed adequate healing time.  It's very difficult to complete rest tendons, especially if you don't realize they are in jeopardy.  (This holds water theoretically at least. Medicine is a rapidly changing science so remember we only know what we think we know.) Thickened scar tissue contracts the skin around it.   It is tight, less flexible and doesn't do the job as well as the tissue it replaces. Imagine the impact this has on movement, the joint and the tissues around the thickened scar tissue.  It can cause pain.  Using prolotherapy gives my body another chance to kick start the healing process and try again to lay down smooth, more supple scar tissue, the type of tissue that will function more like the original material.

Ligament laxity, ligaments are strong fibrous bands designed to connect bone to bone.  They can be injured much like tendons.  When they are injured, the muscles around them contract and work to do the job of the ligament.  Muscles are designed to do some of this work anyway, so it is not a stretch to see how muscles can become recruited and overworked if the ligament is not performing.  According to my doctor, having a loose ligament is sort of like having a tire out of true.  Instead of rotating the entire surface on the roadway, it wobbles a bit making contact in patchy areas.  If you think about how a joint is designed to work, you can see why having uneven contact is a problem.  Prolotherapy has been shown to improve ligament tension which helps get the joint back into its correct rotation.  I've had the surgery to remove bone spurs, so getting the femoral head rotating smoothly and evenly in the hip could be beneficial to my body.  (Again, this is medical theory.  We only know what we know.)  According to my doc, failing to tighten the ligament before using stem cell, would probably result in a less successful procedure.

So now I wait.  I've heard rumor that a study will be released in 2016 showing that prolotherapy alone can allow the body to produce more joint cartilage.  Maybe prolotherapy will be all I need.  I won't know without a few weeks to see how I respond.  My doc is fond of reminding me that I think like a nurse.  That what we've all been taught is cartilage in the joint is what prevents joint pain.  He indicates that there is probably more to it.  So theoretically, it is possible to have an improvement in cartilage, but not necessarily an improvement in pain.  That's a scary thought.  It's also possible.  I know this from reading medical research on endometriosis.  It is well known that different stages of endometriosis are not necessarily correspondingly painful.  In other words, a patient with stage 4 endometriosis found during surgery may experience mild pain, whereas a patient with stage 2 endometriosis may have much higher levels of pain.  This baffled medical science for a number of years.  Until it was discovered that those rogue endometrial implants can develop their own nerve supply. For more on innervation of endometriosis read here:

I'm hopeful though.  Even if an improvement in cartilage fails to provide an improvement in pain, it could still allow me to keep my joint long enough to be a candidate for a hip replacement.  Not what I'm after, but I'll take what I can get. 

1/21/2016 Right Hip Post Op Week 23/Left Hip Post Op Week 17 /Right Shoulder 10 Weeks.
STEM CELL-MY OWN, from my bone marrow, known as autologous stem cell transplantation.

It's been four weeks since prolotherapy. I thought I would take a moment to catch you up on what has happened.  Pictures blow:
1.  I learned a little bit about welding with the help of my friend Robert and started making a miniature oil derrick for the upcoming Gusher Marathon.
2. I walked the Sea Rim Striders annual New Year's Resolution Run and had a ball with my friends at the club sponsored breakfast afterward.  
2.  Richard, my husband, ran the 2016 Chevron Houston Marathon in my honor.   I had no idea he was going to do that.  He's just precious!  I originally registered to run the full myself in January of 2015, but three joint surgeries threw a little monkey wrench into my plans, so optimistically, I am now registered for the half marathon distance of the 2017 race.  (What do runners do when they can't train?  Why, sign up for races they can't run of course!)  
4. And finally, we got a wonderful behind the scenes look from the people that make the Chevron Houston Marathon that included hearing from the volunteer that suggested the blue cones.  Blue is Houston's color and she thought they would look incredible in the photos instead of the regular orange cones.  She was right. 


Now to get to what you want to know-Has prolotherapy make a difference in my continuing right hip pain?  I delayed writing this part of the blog for as long as possible so I could give a deep and honest answer.  The answer is no, not exactly.  I did have a couple of days with less pain.  The sharp, stabbing, burning pains that have been my near constant companions for almost four years receded a bit and that was pretty nice.  I had a few days where I needed less pain management.  The TENS unit with no medication or plain Tylenol instead of something stronger, I was a big fan of that, but realistically, I did not get enough relief to imagine a life without pain control, even if I refrained from all of the activities I love; running, swimming, cycling, lifting, mountain biking, kayaking, skating, etc. 

It was fairly discouraging.  Now what?  Did I charge on to stem cell, an expensive process, and hope for the best?  Did I see this as a sign that to do anything more would be unhelpful?  Rich and I spent a lot of time talking about the pros and cons as we saw them with Rich consistently taking the position that any hope of rebuilding cartilage and/or reducing pain was worth a shot.  (Those two things are not necessarily related.  According to my doc, medical science doesn't know exactly what causes joint pain in relation to cartilage or exactly how stem cell transplantation seems to reduce the pain.  It could be by causing cartilage regrowth or it could be a healing process with the nerves. ) My position came with less clarity.  It felt unfair to my husband to spend another $6,000 of our family budget on something that might not help me at all, even though he was not complaining.  It was hard, hoping autologous stem cell might give me my pain free life back, but also knowing if I tried and it didn't work that I would out of options.  Holding on to unspent hope is priceless.  In the end, we decided to go for it.

BILATERAL HIP AUTOLOGOUS STEM CELL TRANSPLANTATION.

THE PROCEDURE:
I signed the necessary forms to give consent for the procedure and underwent two blood draws.  I'm not sure of the exact amount of blood they took, but it looked like 20-25 vials of 4-5cc's so I'm guessing about a 125mls tops, which I won't even notice is missing.  They use the blood as a medium for the the stem cells.  They want the growth factors out of the plasma. The med techs actually process it to look for the amount of growth factors in the plasma before the next step of the procedure.  I had 7 times the average amount.  Go me!  

Next, they had me lie down on my stomach with my hips propped up on a pillow as they sterilized the area.  I was wearing a hospital gown.  They did let me keep my underwear on.  Surprising, how comforting it is to be allowed to retain your underwear during a procedure.  It's the little things.  (<---Gratuitous pun.)
(Tip-ladies, wear a thong.  Gentlemen, I guess you could too.) 

 Doc chose to extract marrow from my left hip.  He injected lidocaine to numb the tissue full to the full depth of the gluteal, down to the surface of the bone.  Once the area is deadened, they use a drill, moving through the layers of gluteal muscle, to penetrate the bone.  Unfortunately for me, this is where things went wrong.  Despite trying two rounds of lidocaine, I didn't quite deaden properly. ( This is highly unusual so don't worry about it.  It WILL NOT happen to you.)   I felt sharp penetrating pain, heat and pressure. @#*%$@#! I was suddenly aware of a bone I did not want to be aware of.  I tensed my upper body while trying to keep my lower body still and relaxed.  

It hurt! My face turned red. I tried not to cry.  Tears left my eyes against my will.  Because we'd just watched "The Revenant", my colorful imagination quickly pictured the tail end of an arrow swaying from my backside.  Don't move your gluteal, Amie. Hold the arrow still!  (Ha Ha, very funny brain.) Don't quit breathing.  Don't squeeze, breathe, don't squeeze, breathe.  Once they penetrated the soft gooey center of the bone, they slowly extracted stem cell rich bone marrow.  He had to drill in a few of spots to get enough marrow.  They were very caring.  I refused to quit.  In about ten minutes it was over and I was able to look back over my shoulder to assure myself there really wasn't an arrow dangling from my ass. 
After a few minutes, I sat up and drank a little water.  I'd had the fire knocked out of me and there was still more to come.  The marrow was tested for stem cells.  According the tech I had plenty and they were beautiful, meaning thick and well-formed. I had 4.5 million stem cells in the volume measured compared to the average of 3.5 million.  So far I was exceeding the average levels for both stem cells and growth factors.  Great!  

And just like that, it was over.  I've been ordered to rest for the next two weeks.  Lying down is better than sitting, sitting is better than standing, crutches are better than full weight-bearing. "Rest, rest, rest," they insisted. 
I'll be climbing the walls in about three days.  I did get permission to get into the pool after the first week is over.  I don't feel much like going anywhere today.  My butt hurts.  :-)





2/17/2016 Day 29 Post Stem Cell



If you are following this blog because you're in the same predicament, it might be time to get your hopes up.  

Granted, I'm not pushing my body.  I am gently and slowly returning to exercise per doctor's orders.  So while this is not a true measure of where things stand, it is improvement.  The pain was so bad before that I couldn't sit or stand without being miserable.  Lying down on my back was about the only position that gave me a modicum of relief and even then the pain was still terrible.

 Every single minute of every day was pain.  That is starting to flip. It's pain less often now.  It's still every day pain, but it's not all day pain.  The last three days I've really noticed a difference. The intensity is certainly starting to decrease too.  It's not as soul grinding as it was.

My sacroiliac area is currently the most fussy (before it was SI, the center of my glute, my groin, and my lateral hip and thigh.)  I'm not out of the woods yet, but I'm getting a little more optimistic that this might actually work.  Fingers crossed!
P.S.  I mentioned stem cell to an old cycling and genuine hippie friend.  He quipped that I should call him when they start offering stem cell of the brain.  Ha!  Me too, Wayne.  Me too.  In the meantime, may we enjoy not remembering........
What were we talking about?

2/2/2016 Right Hip Post Op Week 25/Left Hip Post Op Week 19/Right Shoulder 12 Weeks/Bilateral Stem Cell Hips 12 Days
Bilateral Growth Factor Injections into the Hip Capsules.

12 days?  Has it really only been 12 days since I had stem cell?  It feels like it has been months.  It's been a painful 12 days, even more painful than normal.  The left hip flared up after stem cell and settled down within a few days.  The worst part of the left side was an allergy I had to the tape they used for a pressure bandage where they extracted the marrow. Redness, itching, blisters-I knew I was in trouble when it woke me up that night.  (Yes, I told them I had a tape allergy, but it happened and they weren't trying to hurt me.) My friend Aimee Coco suggested using Milk of Magnesia on the rash.  That works great.  If you ever have a tape allergy, this remedy is worth a try.  It still takes 3-5 days to settle down, but the MoM dried it out and made it less intolerable.)

The right hip has been a different story.  It never settled down. The already painful right hip just become more painful.  Inflammation is a welcome reaction with stem cell, so all of the usual things used to combat it are prohibited. No NSAIDS, no antihistamines, no cortisone, no ice-no fun.  Still, if this worked in the long run, short-term misery would be entirely worth it. I would grit my teeth and only take stronger, prescription meds when I absolutely couldn't take it anymore.  I went in for my appointment today to receive more growth factors dreading more injections into my already sore and miserable right hip.

This time as she drew my blood, I asked exactly how much she was taking.  She took 42-8ml tubes of blood.  Like, I've said before, this part is painless and easy.  I don't even notice it.  After separating the plasma, which contains growth factors, they inject it-using ultrasound guidance- into my hip joints. The left side was easy. The right side hurt so badly I tried to tap out on the exam table. Jesusmarymotherofchrist, I don't think this is normal.  I think a lot of people find this process easy.  My right hip is unusually aggravated. Don't let my experience scare you. 

Now I wait. It could be as long as 9 months before I see any improvement.  I hope not.  Say a prayer, cross your fingers, do a stem cell dance-I could use the positive thoughts.

I did mention the intense chronic burning in my lateral right thigh.  The doc quickly latched onto it and said he felt it was neuropathic pain caused by the surgical incision. He said he has had a lot of success using subcutaneous prolotherapy for this type of pain.  It told him to go for it.  He injected dextrose right under the skin in about fifteen spots. That burned.  They challenge my naturally cool exterior.  I could tell when he was on an area of irritation when the  burning intensified.  Fingers crossed that this will help touo!  I'd hate to think I went through all of this pain and expense not to be pain free or a little bit better looking.  :-)


2 Days After Bilateral Hip Capsule Growth Factor Injections.

What doesn't make you stronger kills you.  Did I die?  Last night little psychedelic rainbows flitted into my vision and proceeded to tap dance on my head.  That dreaded M word, the mother of all bad words, had struck. <MIGRAINE> Nausea, vomiting, aura, light sensitivity-the whole nine yards.  Hip capsule injections give me a headache each time, but this was the first full blown migraine.  The injections make my knees, neck and ankles hurt too.  Nerves work through chemical messengers.   I can only assume this process increases inflammation and lets loose a flood of chemical messengers that proceeded to party on my soul.  Bastards.  It will get better.  It might even get better forever.  I'm holding onto my hope. 



5 Days Later.

Friday night my right hip burned and ached so intensely that I couldn't be caged up with it for another minute.  Rich was asleep and I was not waking him up. The man needs his sleep.  This is as hard on him as it is on me. Nothing he could do for me anyway.  So I got in my car and spent three hours driving responsibly and listening to music.  Driving hurts.  Sitting is torture.  Solo focus on the pain is worse.  I'd rather be driving.  Really I'd rather be running, cycling, kayaking or swimming, but driving would do. When the pain gets this bad for this long, I understand why people cannot face a lifetime of chronic pain.  

This entire hip experience has  brought me as close to feeling hopeless as I ever want to feel. I pray technology makes major leaps in our current methods of pain control. I have a lot of empathy now for chronic pain sufferers.  The options aren't good.  The drugs are short-acting, mind-altering and chock-full of nasty side effects. But chronic, unrelenting pain will chew apart your soul. It's the proverbial rock and a hard place.  

More than anything, I think this drove me to seek stem cell the most.  The moment is forever solidified in my mind when the orthopedic surgeon's PA said, "There is nothing more we can do for you.  Would you like a script for hydrocodone?"  Would this be my life?  Coping with pain?  Using meds?  Waiting for the next script?  Would I become addicted?  Would the windows of being Me get smaller and smaller until I was mostly The Drugs?  No, thank you!

I thought through all of this as I drove.  The hardest part about the unknown is that there are no answers.  I came home and fell asleep around 4AM.  Surprisingly, I felt less pain when I woke up.  Yesterday I was able to go to the store, get healthy foods and cook.  From a low to a high!  I was taking care of myself, us, again.  The rest of the day wasn't bad.  The pain never crescendoed to a decibel that demands either it or me live in my skin.  It stayed a nice steady hum.  I slept on a heating pad last night and again, I woke up with it manageable.  Maybe, maybe this is the beginning of the end.  I know it's still a long way to go, but maybe I can at least believe I'm on the right road.




4/17/2017
I'm about 12 weeks post stem cell now.  If you haven't read the blog (and there is a lot to read) I had three joint surgeries before stem cell starting in August of 2015 and ending in November of 2015, then I followed up with prolotherapy and stem cell bilaterally to my hips in an effort to stimulate some cartilage growth.

Three months later, I'm still not sure it was a good idea.  I am sure it wasn't a bad idea.  I hit a pretty intense period of sacroiliac joint irritation that left me bedridden and miserable until I finally reached out to my friend Rebekah, a physical therapist.  (She does traditional physical therapy as well as a form of therapy known as hippotherapy, which involves using horses to help kids walk.  She's pretty cool.)  Rebekah was able to explain that my right side was out of place and how to get it to go back into place.  I did the exercises and stretching she prescribed, got a massage with my friend Melinda McWherter and am now making progress.  I'd actually like to have prolotherapy on that area in the future, but we've been working 16-18 hour days and there's no way I'm getting to Lafayette any time soon.  



I know part of the problem is that I've learned an abnormal movement pattern. Because the hip resists flexion, because it hurts to move through a normal range of motion, I've learned to walk by swiveling my pelvis around my spine, gunslinger style.  Bad ass, but not good.

So I'm running a little with extreme caution.  Low mileage, good form, lots of walking breaks.  I'm lifting, but using very little motion that involves flexing the hip for now.  Until I can regain normal movement of that area, I don't want to stress the SI ligaments or do any number of other stupid things. It is simply not ready to be regularly and fully loaded with weights. 
 I'm also swimming.  Swimming is a little challenging because my right shoulder is still not 100% after surgery, but swimming has been great for strengthening everything.  

I wish I had more to say, but I don't.  I'm learning not to aggravate the SI joint. I'm fighting for full range of motion and strength, without irritation.  (I cannot take anything for inflammation for at least six months from the date of stem cell-Think that's easy?  Ha! Try it.  No antihistamines either.  So forget sleeping during times of high pain unless you have something prescription for sleep.) For someone 
as bull-headed as I am, the mental aspect has been tough.  I just want to charge through recovery, guns blazing.  And take Ibuprofen. :-)


5/23/2016 

So I'm here again.  More Prolotherapy.  (My posterior region feels hugely swollen!) This time to my bilateral sacroiliac (SI) joints and a bonus cautionary refresher round to my right hip.  

The SI joint is a held together by strong ligaments.  The theory is that my right SI joint is a diva and moves too much.  The SI joint is designed to go into a stable position and provide an anchor point for movement, as well as move juuuuuust enough to be a shock absorber for the spine.  Our body asks the SI joint to know when to move and when to stay still.  That's a lot to ask of one little joint.  If it's functioning correctly, you'll never even know you have one.  Thank your lucky stars!

  When it moves too much, surfaces get raw, muscles hold tension and nerves get irritated.  In my case, the piriformis muscle spasms as it tries to hold the joint in place.  When the muscle spasms, it cranks down on the sciatic nerve, which is  the Hulk of nerves.  When it gets angry it burns, it stings, it aches, it's like a giant toothache in your leg, buttock and back and it tries to destroy your soul.  It's brutal.  You can't set it aside.  It's always with you.  

I went back to my doctor's office and asked him to try Prolotherapy on my right SI joint. He upped the ante and opted to do both sides. Prolotherapy hurts!  Needles, pushing volumes of fluid into tiny spaces-where it doesn't belong, irritation from the solution-it hurts!  It hurts during the procedure, and then for about another 10-14 days post-procedure while your body works to heal the "wound".  

Generating a healing response is the whole point of Prolotherapy.  

Not volunteering for any extra pain, I asked him why we had to do both sides of the SI joint when only the right side was bothering me.  He explained that it's a ring-like connection and he's found the best results involve making sure you address the whole ring.  

Damn it.  It made sense.  I could see how leaving one side of an O-ring stretched out might be a bad idea.  I had no choice, but to pretend to be cool about it.


As we talked, they asked a few times how much improvement I think I've had in my hip joints from past Prolotherapy and stem cell.  

The left side seems to be perfect. It's always been less fussy, but now it seems even better.  I think it is going to hold up just fine.  

On the right side, I have so much pain from the SI joint that I can't tell.  I've had some really great days, but when you're in the pain haze, all you can focus on is how bad it feels.  I kept stingily low-balling the percentage.  

But then as a sat down to write this blog, I realized that I did not hesitate to go back and do Prolotherapy on a new area.  Would I have done that if I hadn't noticed any improvement in the hips?  No way!   Absolutely not!  That means on some level, I am aware that this is working. Really working!

I did notice that the Prolotherapy into the right hip joint did not hurt as much this time.  The right hip joint is definitely less raw.  The right SI joint, however,  feels very raw.  This gives a bit of reassurance if that makes any sense.

So I'll keep my hope, and I'll nurture my optimism, and be grateful for a doctor and his awesome nurses that have worked very hard to help me.





6/21/2016 UPDATE!

  

I RAN LAST NIGHT!   I ran last night!  I ran last night!  I didn't run fast, or the whole time, or even most of the time, but I did run!   It required the use of medications, but I did it!  That wasn't possible before and I'm not suffering much today.  HUGE improvement!  
<----------PROOF!

My friends Elise and Melanie helped me.  
Posing with friends after the run
<-----Elise.
Having friends means having people that build you, give you courage.  I've tried so many times to run and suffered so severely during and after the efforts, that I was starting to get a little gun shy about it.  A lot gun shy actually.  I refer to those efforts as my false starts.  I would try and then suffer so badly that even lying flat in bed hurt enough to make me want to crawl out of my skin. When the pain is intense for days without ending, you begin to think that maybe being pain-light (never completely pain-free) is enough.  That you'll give anything to have the privilege of getting through a normal day. 

 It's frightening to think that this time, the pain might not resolve and I'll be stuck with making a decision that I know will end my running-a hip replacement.  I'm not willing to go down that road.  I'm just not.  If I could run on a hip replacement, I would sign up for surgery tomorrow, but I simply have worked too hard to be this Amie, athletic Amie, to let her slip away.  She is my identity.

For a long time now, I've been avoiding my running friends.  It hurts too much to see them doing something I cannot do.  It overwhelms me with helplessness and frustration.  I guess if I were a bigger person, I would be content with being happy for them, but I'm not.  I'm selfish.  I want to be with them. Step by step.  Part of the joy and the bonding comes from struggling through the run together.  Injured reserve is a lonely place to be. 



Last night was magic.  I think I hooted and hollered and heckled and high-fived everyone I could get my hands on as they ran the opposite way, heading back to the finish, when I wasn't even at the turnaround point yet.  I love cheering on other people.  The farther back I am, the more people there are to cheer.  There is no bad place to be in a run, except on the sidelines, when you aren't sure you'll ever be able to get back in the game.


I've been swimming quite a bit.  I'm a terrible swimmer.   I like it, but I suck water.  (Not literally.  Anymore.  That part is better.)  Swimming is lonely.
Swimming is isolation.  I enjoy getting into my own head and my own rhythm, but, sometimes, I cannot face the solitude.  My friend Jody has recently been helping with that.  She's my rock.




We hosted the first bridge run of the summer. Through Sports Society for American Health, we host two bridge races: the Sabine Causeway 5K and the Pleasure Island Bridge Half Marathon, 10K and 2 Mile.  (Neighbors Emergency Center and Kinsel Ford are big sponsors of those events, SHOUT OUT!  Thanks for the support!  We cannot do it without you.)  Leading up to those events, we head out to the Sabine Causeway on Friday nights and run or walk the bridge.  

We host free group training opportunities over the bridge.  There's not much elevation in our area.  Sea level.  I think I've mentioned that before.  Bridges are our hills.  Bridge running makes us better runners.  It makes flats easier and it makes it a better experience if you run anywhere else, as most of the world does have some elevation.  It's also beautiful out there.  It feels a bit removed from the hustle and bustle of daily life. You can join the group here if you are interesting in running with us-SSAH-Bridge Runners.

The first bridge run last Friday, June 17th, reminded me why we do it.  Why we struggle year after year to bring events and opportunities to Southeast Texas.  It reminded me of who I am.  Whom I have become along the way.  Why I am fighting so hard to get back to it.  All you have to do is look at the photographs to understand.  It's about the people.  It's about life.  Vibrant, beautiful life. It always has been. 



Flowers on the Louisiana side of the Sabine Causeway

Cresting the top of the bridge.
Lying on the ground to capture great photos.  It was over 100 degrees this week.

Runners, friends and SSAH volunteers.







21 comments:

  1. Good luck on your recovery! Amazing progress!

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  2. I had double hernia operation at one time. I found out a persons eye lids are attached to their abdomen. It hurt to do anything! I pray you feel better soon.

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  3. Praying for a speedy recovery....stay strong, but take it easy......love ya chic!

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  4. I hope your recovery is speedy! You need to get back to your full Amie self.

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  5. Oh you in all your fullness of life, charisma, and awesomeness! I can bet if any of your faithful readers were in the same kayak we would be whining with a double dose of cheese! But ye, oh ye full of zest, spunk, and abs of steel, ye inspire! You make us want to be better humans! He never gives us more than we can handle but you are absolutely allowed to feel. Sadness, pain, bloating, and tears are all allowed. Yes ma'am, feel all the feels! The feels signify life. The feels are who we are and reminds us of the feels worth fighting for. The feels of determination and drive, the feels of competition and victory, those feels will overcome the current icky feels! But while the feels are getting themselves on track and the body heals, know that you are loved BIG!!!

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    Replies
    1. This was so nice I'm too overhwelmed to reply. What am I going to do without you when you move?

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    2. We will have a long distance relationship! It can work, I know it can! I love you too much for it not to!

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  6. Amie, this is amazingly well-written, hilarious and tender, and damn girl you're such a stud!! Wish I had your pre-hab musculature! Thank you so much for sharing your blog with me, your fellow bilateral jacked up hip surgery friend! I am totally inspired by you and I *totally* agree that it's the athletes (recreational or otherwise) who'll be the heroes of the zombie apocalypse. (My running group here in DC talks about it periodically.).
    I'll be tuning in for your upcoming installments and am wishing you a very thorough and speedy recovery, one little victory over barrels and braces and crutches at a time. :) -Mary Beth

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    1. Wow! Thanks for the kind words, Mary Beth! I'm so grateful to have found you on FB. It means so much to find another harcore, uplifting soul going through this.

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  7. Amie you got this. As John says "keep your chin up". Thinking of you

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  8. I am so sorry Amie. I knew there were "issues", but not to this extent. I think the "Fund Run" is a great idea. I want to help with it....let me know what I can do. Prayers continue.

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    1. I'm borrowing that term-"Fund Run." No worries. I have good days and bad. I push through regardless most of the time. Life happens to everybody. Keep those prayers coming. I have it on good authority that Jesus voted you "Best Prayer for Joint Issues and Lumber Projects." He said you're too cocky about your vegetable garden so He's not helping you there. :-)

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  9. I'm wishing you a speedy recovery. I always ask about you everytime I see Richard. He lets me know how you're doing and what procedure you had recently, if any...he better be giving you my hugs and love that I send. You're always in my thoughts & prayers.

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  10. Dear you are awesome!
    I`m following your blog with a great pleasure with Google+
    Please follow me back - Sunny Eri: beauty experience

    ReplyDelete