Muscle Repair - My Perspective

10.5 months since I had my abductors re-attached to my leg.  I'd like to say that I had wild dreams of strutting down the street in high heels by now, but I think we all knew that wasn't going to happen!  My more modest dream of just walking without my stick is yet to materialise too.  I'm still hopeful though.

I think the recovery from the muscle repair took much longer than any of us thought.  Six weeks on two crutches and then a further few weeks on one crutch did nothing for my residual muscle tone (and metabolism!).  If possible, I seem to have lost a little more function as my quadriceps muscle has taken to doing EVERYTHING and now I can't stop it from taking over.  After 10.5 months I cannot lift my operated leg from a lying position and I was just able to do so prior to the muscle repair.  So.... I don't know what happened there?

The way I see it, right now, I am no better or worse than I was prior to the muscle repair surgery.  I'm hoping that in time, with continuous exercise, something might improve.  I've already accepted my stick as one cool accessory (I can get the last packet of pasta from the back of the massive supermarket shelves with that bad boy lol!).  My funky walk is something else - I'm disappointed that it doesn't seem to be evening out, but as long as I don't catch my reflection in a window or mirror, I'm mainly okay with it.

Anyways, as is becoming my mantra - I am still in NO PAIN.  That I am so so thankful for!

I have heard that some muscle repair surgeries can actually induce pain in the muscle due to scar tissue formation.  I either have massive nerve damage and just can't feel it (possible considering my (in)ability to notice how far advanced my osteoarthritis was?) or the repair did go well and scarring was minimal.  I'm going to go with the latter, psychologically more optimistic... ;o)

Related posts of interest:

• Ultrasound Results
• Injection fun
• 6 weeks, now walk

Okay, break's over....

Yes, I know. I'm sorry for not posting in what feels like forever. Sometimes you just want to forget about things for a wee while. Life has been a little hectic in the last few months and I'm going to take the time to share it soon.

This year is likely to feature another Bextastic trio of uncertainties revolving around my hip, my job, and probably where I live (maybe less so the latter this time). Life's never dull, that's for sure!

Have a good weekend! :o)

6 weeks, now walk

At last, 6 weeks is up!! WOO HOO

Let's dance! Let's not.

Right, now what? 6 weeks feels so long when you're on two elbow crutches. But I can now drop to one according to the letter I received from Mr. O a week out of hospital. I've been wandering around the house on one crutch and instantly I feel so liberated! With one arm free to carry something, anything, is heaven. I've not had two arms free since before my resurfacing and that's the goal... to ditch the walking stick too and walk unaided.

So I can't start physiotherapy again until after I see Mr. O next week to see what's next really. I had a wee cheeky abduction of my leg earlier 'just to see' what would happen! Er.....my leg moved outwards lol, but more importantly, I felt it in my butt where you should be feeling it. That was new!

I desperately want this to be it, the repair that gets me back on my feet properly. But without re-injury and I don't care how long it takes in physio, I'll do it. I'm still getting the odd painful twinges over the incision site and the side of my butt where I imagine most of the suturing etc has been done to reattach the muscle to the bone. The twinges are fleeting, not requiring pain relief and they usually come at the end of the day (using leg all day?).

I feel happy now 6 weeks has past, like some sort of danger point. My thigh muscles have wasted considerably in that time so I know I have a lot of work to do in the next few months. Once again, and I've lost track of the times I've said this.... BRING IT ON! Let's get walking :o)

Officially bored

It's official..... I'm now bored and restless and I don't want to sit on my ass anymore!

So that's been 3 weeks off work, at home, on my ass to get to this state of mind. 3 weeks.

I have actually been doing some work from home so I don't feel unproductive. I can't focus on work today. It's just the lack of change of scenery! Actually it might be more than that, as I'm currently at my BF's house for the first time in more than a month so if that's not a scenery change I don't know what is? Or maybe it's too little too late? We're even going out tomorrow night for birthday celebrations and I can't shake this horrid cabin fever feeling! I know tomorrow night will be fun, but today is dragging.

What shall I take from this: a lesson in patience.

How do I feel: like I want to put my pants on my head and run around the room.

Like curled ribbon

Mr. O told me to stay off my right leg for 6 weeks. His senior registrar told me to stay off my leg for 6 weeks. The physio's told me to stay off my right leg for 6 weeks. 6 weeks!!! Minimum....

Just let it go stiff, then we'll work on stretching and then strengthening.

Until yesterday, perhaps due to swelling, I had not noticed that the muscles have gone as stiff as a board! Just standing there (on crutches) I had the insane sensation that my left leg was longer, loose and floppy compared to my right. Then it twigged! The reattached muscles have stiffened up and when compared with my left leg, it feels like I'm curling up like christmas ribbon. I'm distinctly being pulled over to my right....in my mind, at least.

Here's hoping that this will be the ticket to shifting my hippy limp. It's a very odd sensation....

Injection fun

Forgot to mention that I also have to take Clexane again everyday for a month! That's a sub-cutaneous injection of a blood thinner to stop blood clots. Means I don't have to wear the lovely stockings or knacker my stomach with aspirin - and best of all I can now be seen in technicolour!!! ....

Have crutches, will travel

....or not, as the case may be.

I had the surgery to reattached my abductors muscles about 12 days ago (29th June). Both gluteus minimus and medius had completely detached themselves from the bone. When they went in to repair the muscles they were met with a completely naked femur bone over the greater trochanter (upper thigh) area as the ligaments tend to retract back when not holding onto muscles. How this didn't cause me any pain I do not know! I'm beginning to think I have abnormal pain recognition in my right leg??

The surgery went very well, apparently. However, it was more complex than originally thought, took about 2hrs and has landed me with more mobility restrictions than either of my last two surgeries combined! I found out after the surgery that they roughened up the femur bone at the reattachment site to help the muscles stay put. They also took out the screws holding the cup in place in my hip socket and mechanically tested the cup to check that it was secure (i.e. checking that a loose cup was not responsible for causing my muscles to detach ??). The screws did not go back in. I assume they were removed with an aim to stop the muscles rubbing over them (sawing through them) and that I don't need those screws anymore as the cup has knitted itself in with the bone of my pelvis. I sincerely hope so, as I'll be honest and say that I wasn't very happy when I was told they took the screws out. It wasn't consented for. But I do acknowledge that they had to investigate why the muscles detached in the first place. They also wouldn't remove them if they thought it would ultimately cause a cup failure - would they? I'm choosing not to dwell on this and just trust them. My leg's not fallen off yet lol

So originally I was told that I'd be in hospital for one night, two crutches at first and then down to one in a few days for 6wks, driving after a few days, back to work after a week off. Reality: two crutches at all times for 6wks then down to one, NO driving for the first 2wks and only when I feel confident I can move my lower right leg appropriately, no bending down to pick things up off the floor, no side-stepping to the right, and signed off work for a MONTH.

Bit of a shock to the system those restrictions. I'm basically not allowed to abduct to allow the muscles to fully heal. They said just let the muscle go stiff over the 6wks and then we will begin a stretching programme followed by strengthening. I'm not attending physio until after my 6wk appointment at the hospital - so no physio until after the 17th August. That seems ages away! It's not just the physical restrictions of remembering not to actively move my right leg sideways, it's all the little things that come with being on two crutches - carrying stuff around easily, no real cooking, showering....

Thankfully, between my mum and my partner the whole house is organised so when I'm in alone I can get to pre-made meals, clothes (top drawers etc), phone.... the list is long! My back pack is now my best friend and I've dug out my sock putter-onner that I needed last year (glad I never gave that away!). I can't sit on the sofa with a hot drink, but I can get to the kitchen table to sit down. Mmmm....thermos comes to mind :o)

I had the staples taken out last friday and everything already feels a million times better. They didn't go in through the full length of the resurfacing scar - about 2/3rds of it. So I think there were about 20ish staples, but I lost count again when the nurse took them out as I was too busy chatting trying to ignore the tugging sensations. Only the top half the staples felt sore coming out and I definitely believe I have lost sensation in patches over that thigh from previous surgeries. Double-edged sword there: probably prevented me feeling pain when the muscles detached, but pain is the body's warning system telling me something was wrong and I probably didn't get the message until much later (i.e. all that gym going to strengthen the abductors and no improvement, lets check out those muscles on US scan).

Despite the fact I know the frustration level will be high, I'm playing by the rules and parking my backside, doing nothing, letting everything heal. I do not want to have to go back in and have those pesky muscles put back on again!

Surgery scheduled

Just an update to say that I'm scheduled to have my abductor muscles sown back on at the end of June. Still waiting for the confirmation letter, but the 29th was mentioned. Not really thought about it much since being told I needed to have them surgically reattached. I suppose compared to the two previous hip surgeries this seems almost like a walk in the park! So that'll come back to bite me on the butt come the evening of the 29th June!!

I've been told that I should only need to take a week off work, can get back to driving after a few days (!! right leg), and I'll have to use one elbow crutch for 6 weeks minimum. We'll see regarding the driving! I do believe him on the rest after the resurfacing. I was told then that I could go back to work within two weeks - and I could have, but chose not to. Plus work told me not to, a month at least!

Anyhoo, got better things to do first, like a nice sunny holiday abroad with my other half!! :o)))

Ultrasound scan results

Last week I had an ultrasound scan on my right hip/thigh to check out my muscles for anything that could account for the excessive weakness I still have one year on from my resurfacing surgery.

During the scan it was obvious that my abductor muscle was not attached to the bone anymore. Sigh. Knowing full well what this would mean I decided not to speculate and wait on Mr. O's letter hopefully laying out 'what's next'. I got that letter today and it seems that we're just bypassing another consultation and going straight to surgery! As soon as I make the appointment. Big sigh.

In the letter: "The scans show that there is a small but significant detachment of parts of the gluteus medius and minimus [abductors] over the front and outer part of your right hip joint. The best treatment here would be for us to re-open the wound and re-attach these muscles using synthethic ligament material in order to get a really good attachment."

So, here we go again.... Round 4! Hopefully, as this surgery will not be as invasive as the resurfacing, it won't be so bad. Fingers crossed the detached muscles are still in good shape and haven't part-turned to fat (cos that won't help re-attachment!).

Nothing I can do, so, let's do it! Bring it on, I will shift this limp!!

One year

Today, exactly one year ago I had my hip resurfaced!

Today I was back at the Royal Ortho for my first yearly check-up.

Thankfully I can say that it is unremarkable news, the implant is EXACTLY where it was put one year ago. I have no pain or issues in my everyday life....in fact, life is very very good! Which is one of the reasons I haven't blogged in a couple of months.

I do still have unresolved muscle weakness in my abductors. I have been working hard in the gym and in physio to try and get my abductors to kick-in and start working properly. Without them, I'm stuck with this hippy-limp.

Last week at physio was a bit of a turning point in my treatment. My physio, who is a MSK (musculo-skeletal) physio, took me to meet some neuro physios (i.e. those that deal with people who've suffered neurological injuries or diseases that affect their muscles). The idea was to check I haven't suffered some nerve injury during the surgery that might be causing this muscle weakness and to see if they had any other exercise ideas that might trick my muscles into working correctly.

Four physios manipulating your body at once is both confusing and tiring I can tell you! For an hour and a half!!!! The short story is that everything is 'firing' correctly and as it should. But that my body has effectively forgotten how to co-ordinate it all properly. Chances are, I'm probably a long way off getting them to behave, but it should happen in time, with hard work and patience *sigh*. Somehow we're going to try and incorporate the exercises the neuro-physios did with me, which is no small feat considering it involved two other people! My physio said he's going to sort something out but to keep up my other exercises the now for the next couple of weeks. I'm curious as to how I'm going to do this.....

This was discussed today in the orthopod's office. The surgical team would like for me to have an ultrasound scan done on my leg to check that the muscle hasn't actually detached itself from the bone. Recall the nasty staples holding the abductors to the bone in the x-ray?! Yeah, ouch. Wouldn't that hurt though???? I can't say I'm in hideous discomfort any more than the average person after a session in the gym. I would have thought you'd feel something if a muscle had detached itself - that being said, I didn't feel the full whack pain of osteoarthritis at the moment of diagnosis. Mmmmm. Let's just say, I'm hoping it's not detached itself, because that would mean reattaching said muscle.....and as much as I like anaesthesia.....

Anyhoo, it's all good! Life is good! NO pain = good :o))))))

I love my hip. Can't believe that one year has gone by already!

Hippy Hogmanay!

The last day of a most momentus year for me....

I still can't believe it's been just shy of 10mths since the op. I confess that it is not at the forefront of my mind anymore and I'm aware that I haven't updated in a while. I can't say I've felt this good for nearly a decade! Yes, there are little things that remind me that I am bionic (airport security notwithstanding!).... I still put socks on with foot-over-knee for example, which might just be habit now, and I am still using my walking stick. Although, I keep leaving the bloody thing places cos I can walk without it, but I waddle somewhat (quack! lol). It's become the last thing to go.... Once the sloth-like behaviour of christmas and new years is out the way, I'm hitting the gym big time!! Mission: Waddle-be-gone!

Anyways, I hope that everyone has had a fabulous christmas holiday and may 2011 be pain-less for many!

Have a great Hogmanay folks, ceilidh with care!! :o)

sNOw anxiety

Well, it's that time of year again when the evil white stuff (the 'devil's dandruff' as one friend calls it!) dons the ground turning all those with bambi-legs into quivering wreaks! Remarkably, I'm not as terrified as last winter - because there's no pain!

I discussed my 'snow anxiety' with my physio last week because whilst out walking a week earlier my stick went from under me after hitting a patch of black ice. Nothing happened. Last year that would have resulted in groin pain. HOO-BLOODY-RAY! So we talked about it momentarily whilst doing exercise and he had to go and jinx it by saying "oh it won't be as bad as last winter, that was exceptional, it might snow, but it'll just last a day like it normally does!". Well the whole country's been sitting below 0oC for mmm....a week now, there's snow outside and it's iced up all the pavements. *sigh* thanks mr. physio!

I did take up a recommendation though. Ice cleats for the walking stick!

Genius! Been out with this on the stick already and it's great. It's not going to stop you losing your footing though!! Beware, but it means you don't have to worry about the stick going out from under you if you are still inclined to put weight through it. Yaktrax's are what you want for your feet (www.yaktrax.co.uk).

Thankfully I'm at a stage where I'm not actually putting weight through it and I could, if necessary, walk without it....but I'd be really slow and I'd tire quickly because the hip-gait-sway thing I have is still there. Although, the physio is paying off and it's going (just really really slowly!). I've no expectations of exactly when I might get rid of it..... it's not healthy to beat myself up about still having my hippy-gait because when it comes down to it, I'm not in pain, I have zero stiffness and can actually walk and do the stuff everyone else can do.

In the last 2 weeks I've progressed into the physio gym to push weights. I've been really bad about getting into the gym on my own time though! I'm still doing everything else at home and progressing through increased resistance in the therabands - including using 2 bands at a time, which feels a little like a bondage session! But, it works.

Talking of which.....

Memorable day

This is the date 5yrs ago I had my triple pelvic osteotomy.

This is the date 1yr ago I had my x-ray/CT scan that announced my osteotomy had failed.

If you asked me then if I'd be sat here 5yrs later with a bionic hip, I'd have said you better be kidding me cos I'm not going through THAT again! But here I am, 7mths on with a new hip and better than I ever was after the osteotomy.

If I knew this was going to happen would I have still had the osteotomy? Yes. The joint needed to be put in a better position and it did give me 3ish years pain relief, better than nothing and having an artificial hip at 27 right? Yes.

Having two major hip surgeries before the age of 32, not ideal. But better than living with osteoarthritis at age 32 (or indeed, 22 when I first noticed something was amiss).

Feeling very reflective this evening, but not in a bad way :o)

Flying therabands Physioboy....

....do what, physio at high altitude? physio on our road trip?

You reckon security will let me through with therabands or the flight crew not look at me suspiciously for using them [or the rest of the plane for that matter!]?

I like the idea of flying-fisio but I reckon it would probably make the top-ten list of things that annoy people on a flight!

To be fair he didn't suggest I do, but I am expected to keep up the good work when and where I can. Which is a reasonable request, but I think I'll pack the therabands into my check-in bag. Things are progressing, slowly but surely. There have been a couple of days here and there (visitors) that I haven't done my physio and honestly, you do fall behind and I can tell. So it really is important for me to try and get some physio in on vacation. Still a lot of work to be done overall and he reckons I'm still about 2 months off getting into the physio gym, but he has okay'd my pilates workout I wrote out for him. Which is great, because I can easily incorporate the exercises I have from physio into the pilates workout for double points!!

The spine curls into the bridge with leg extension exercise....we're aiming ultimately for 40-50 right? I asked him if he could do it, a confession, he'd struggle! He said that athletes would be pushing that!! Athletes, er....hello, this is little old me here, I can do 8 currently without collapsing.... one day, one day...

Toodle-oo, back soon.... [unless I get arrested for theraband misuse]

6 mths post-op

Oh my goodness, 6 mths since I had resurfacing surgery! I went to Birmingham last tuesday for a check up with Mr. O'Hara, my implant has not moved one iota and there's nothing on x-ray to cause any concern whatsoever - very happy days!

I've officially been free of osteoarthritis pain for 6mths and that has changed my life beyond words. Osteoarthritis steals people's lives....it won't kill you, but it'll wreak your life and you as a person. I've been given my life back twice now and hopefully this will be the last time before the age of 50 that I'll have to resort to surgical intervention to beat the bugger! No way this is stopping me doing what I want to do.... I might walk a little funky right now, but walk I can..... and I'm not sitting down or staying in anymore!!

The last month hasn't been the greatest psychologically on the recovery front, but I've come to the realisation that there's nothing I can do but keep moving forward with everything. It's done now and I'm pain-free, something that millions are not. I'm in this for the long-haul, so I'd better get comfortable...

Walking at 6mths post-op

If you're looking for the videos, well they've gone cos I can't stand seeing them! If you never saw them, let's just say that I walk like a heavily pregnant lady waddling at high speed, but without the bump..... It's going I tell you, that limp is bloody well going!!

The Bionic Traveller

I've decided to keep another blog about my travel adventures with my shiny new hip over at http://bionictraveller.blogspot.com/

In October I'm off with friends to New England and I'm getting pretty excited now as it's the first holiday I've had in a year! Last year I took 7 trips out of the UK and a couple others up to Scotland.....so you can understand my excitement!!

The last year has been an eventful one nonetheless mind. It's been almost a year since I took myself off to my GP to ask for a referral to my orthopod. Who'd have known that a year later I'd be seeing my orthopod for my 6 mth check-up.... 6 mths post-op! I went from having a moderate amount of pain, to hideous pain, to unlivable pain....to NO PAIN! It's been quite the journey all by itself. My hip journey is here for life I know, but let's include some other good schnizel ;o)

Let's talk about Sox....

We're doing it everyday! ;o)

Well, everyday since about 3.5-4mths post-op. Minus putter-onner you understand. But today, nearly 6mths post-op I put on my socks the way I used to, knee up to chest rather than ankle over other knee. I have been trying to do it for about a month now and not quite able to hook sock over foot with my knee up to chest. It means my ROM is increasing, yey!

It's the little achievements.... Today, putting socks on normally, tomorrow hiking up Kilimanjaro!! No, seriously....

Major Frustrations

I was going to write last week, that's how frustrated I felt about it all!

It's taken me nearly a week to shake myself out of a major hippy frustration. Even my lovely physio couldn't say anything to help! I wasn't being mardy, just fed-up-cannot-be-arsed-when-am-I-gonna-walk-properly bleurgh. If there was a pram, the dummy would have been chucked.

I've obviously reached that point. You know 'that point', where you're training for a marathon, writing a thesis, or re-learning to walk (as you do; 3 times over in my case to date) .... and you hit that brick wall, or worse, you think you're going backwards! As Homer Simpson said "Everytime I learn something new, it pushes some old stuff out of my brain" and it appears to be the same with my ass!! The more I work on it, the less it functions lol

All my muscles ached with the exercise and I think I irritated a tendon which was making the scar tender. All in all, I was officially frustrated. My physio was really nice and he was trying to tell me that I'd improved, I was hearing the words and smiling, but not feeling it. He's given me some new exercises to do and I'm a little happier about that - bit more variety.

This week has been much better, I can actually feel the muscles getting stronger. I still limp. I am not in pain, which honestly, I'd rather limp than be in pain anyday. I think it would be really hard for anyone to expect me to be 100% frustration-free with this situation.

I'll be seeing Mr.O next week too, hopefully it'll be just as unremarkable as last time! :o)))

Backwards?

Saw my physio today and whilst he said some of the exercises I've been doing have improved, I still need to work hard on the same ones, no new ones added to the regime - and I've to start seeing him every 2 weeks, not 3-4! I'm confused. Usually, one gets better at exercises and the time between appointments increases....

I'm sure it's not because I've plateaued on the exercise-front. I'm sure it'll become apparent, I have enough to worry about. I did have a bit of a blip at the weekend. I must have overdone stuff (although, it was only sightseeing and out on the town saturday night? not exactly hard-core work out) and it was painful to walk on sunday. It resolved itself by tues so couldn't have been anything more than a pulled muscle. I suppose after the failed osteotomy I worry that the resurfacing might fail...an understandable anxiety, but something I need to work on.

I showed him the x-ray/CT pictures taken last November at my first consultation that resulted in my hip resurfacing. His eyes just about bugged out at the size of the osteophytes on the CT scan - he said "how were you able to walk! Your femoral head had collapsed and those osteophytes..". He didn't say it insensitively, he was just amazed at how much damage had occurred and I was still walking around and not in hideous pain (last august-september; by january it was a different matter, I was on one crutch by then). And that it explains all the bad unruley muscles we're working so hard on at the moment to get me walking tall again!

It was mentioned that from the next physio session we're going to start working oblique ab's....mmm