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Wednesday, August 12, 2015

Post-op update take II-random thoughts from the trenches

  Well, now that I'm nearing the two week post-op time frame, I figured that I'd throw together a random conglomerate (this is kind of going to be all over the place, but hey, that's the beauty of a personal blog vs. a college thesis) of thoughts and updates on how the process is going!  So far, I've been pleased with the overall progress, although I still have some battling to do.  So, read on for the details, for those who also are killing time :)

  The first few days post-op, when I'd last blogged, were mostly marked by trying to stay awake long enough to get work done (I might have made a few math mistakes on training schedules here and there...), as I tried to work through the fun effects of anesthesia, pain meds, and sleep that was disturbed by the combination of that horrible leg contraption thing and, well, crutch trips to the bathroom to get rid of the 10lbs of swelling in my body.  The "anti-rotation night brace" became the bane of my (and Dave's) nighttime existence.  I only had to wear it for a week, and I barely even made that.  Sleeping on my back (or trying to) is hard enough for me, so throw in having my feet strapped into some contraption, and I was NOT a happy camper.  Plus, the velcro on that thing was so industrial-grade that every 3am bathroom trip had to be preceded by rousing Dave up to release me (I would have had to bend my hip too much in order to reach it myself).  During the last few days, I kept managing to somehow subconsciously get my left leg free during the night, and I'd wake up with my right hip hurting anyways from trying to get it released as well.  I made it until 3am the final night before I completely ripped it off for good.  Anyways.  I was given Ambien for that time, which, although I'm not really a medication kind of person, was wonderful after months of having tons of trouble falling asleep.  The pain meds got old really fast, though, and I was off of those in just over 24hrs.
Where the night brace ended up after vacation-randomly thrown on the driveway.  I wanted to leave it there.

Gross stitches picture.  I'm still amazed at how small the incisions were.  They shaved bone through these!  The marvels of modern medicine.

Some attractive bruising.  Thankfully, I was also told yesterday that my thigh was still a bit swollen with post-surgical fluid, not just post-surgical inactivity :)

Princess band-aids and a get out of swimming note from athlete Paul!!!  Totally awesome.
   After the first few days, thing began to slowly improve in terms of mobility, function, ability to stay awake, comfort, etc.  At a week, I was allowed to bend my hip past 90 degrees, which was a big step in terms of being able to do things like get dressed and tie sneakers-it's the little things.  I actually haven't even gotten too bored yet-between coaching work, those continuing ed courses that I finally got around to, a couple of PT visits, and twice daily sessions of easy bike rides, rehab exercises, and some upper body band work to at least pretend like I cared about losing swim fitness, I kept fairly busy.  Last week, Dave and I were able to head out to Massachusetts for our annual Cape Cod vacation with my family.  Even though I couldn't really do too much other than lay on the beach while he trained, I was grateful to be able to unplug, get myself off of the couch and into the sunshine, and spend some time with my family.  I've been to the cape every year since I was not even two, so I wanted to be able to make it out there, surgery or no surgery.  I wasn't able to go into the water (no incision submersion for two weeks) and I definitely ached a little bit inside from time to time thinking about how much I've loved running out there in the past, but I still hobbled down the beach on crutches stuck my feet into the ocean on the final morning.  The last time I'd stood with my feet in salt water was back in Mexico two mornings after my crash, when I'd hobbled down to the shore with a cane, having no idea the extent of anything yet.  As I let the warm Atlantic waters lap at my ankles again Sunday morning, I was able to pretend as if somehow, in some strange way, all of the down times were being washed away, back out to sea as well.
There was a bunny!  He was my friend while I did my easy trainer spin one morning.  Dave wouldn't let me take him home, though.

On our final day, Dave met up with Ray and swam across a lake and back.  I watched a yellow lab play fetch, which was better than swimming.

At one point, Dave and I ended up in charge of  our just under 2 year old twin niece and nephew.  This happened.  #babysittersoftheyear
  Then...there are my feelings towards said crutches.  This is my fourth stint on crutches in my life.  I always used to think that crutches would be the greatest, most fun adventure ever when I was a little kid...NO.  The first time that I used them was for a couple of days when I sprained my ankle (on a track, thus starting my history with injuring myself on flat, smooth surfaces) back when I was 14.  I think that I used them for about two days, and it was mostly so I could take the elevator in school and feel special.  The second time, I had a stress fracture in college, and walking all over campus was preventing it from making much progress.  I remember not being a huge fan of navigating my way from the farthest student parking lots ever (thanks for not giving me any sort of special parking permit, UB doctor...I still remember) on them with 9000lbs of books in my bags (nerd), but when I was done for the day, I'd just leave the crutches in the car, and then walk normally around my apartment.  Then, I used them a little bit last winter when I was more acutely fractured, but mostly just for distances, and, in retrospect given how prolonged the healing had been then, definitely not as much as I should have ("as tolerated" is a slippery slope for anyone that trains day in and day out to override pain).  So really, this is the first time that I've actually HAD to use crutches to get around even short distances, and if nothing else, I now have a huge amount of appreciation for anyone that's stuck with them for a longer period of time.  Two weeks is basically nothing, and I've wanted to chuck them out the window and/or beat someone with them on many occasions.  At one point before my sister intervened, one of them was being used in a sword fight (along with a broom and a noodle) between my older nephews and another little boy while on vacation, and I was fine with letting that one happen.  Everything takes 17 times as long with crutches, and I never really appreciated my ability to carry stuff until I could no longer carry stuff.  They're also kind of gross, when I think about everything I touch before touching them.  I've used a lot of Clorox wipes on those handholds.  Very, VERY thankfully, yesterday I was given the a-ok to start weaning off of them a couple of days early.  This is also for the betterment of our house, which has been raised a level from its normal kind of gross state with my total inability to clean.  On the flip side of that, at least Dave had to admit that even my normal half-assed housecleaning is sort of helpful.  Also, I will say that I'm rather impressive with crutch skills.  Far better than my bike skills-not that that's saying much here.

   On another random note, I feel that the completion of that whole tooth implant thing deserves a shout out here.  As some background, because I think this is only something that's been frequently mentioned in passing but never fully explained, I was born with two baby molars with no adult teeth underneath.  Last summer (in July, as reminded by my facebook memories earlier this summer, which is my random daily entertainment), after numerous cavities and fillings, one of them finally reached the end of its reasonable life.  Sigh.  It was pulled (ok, it was really like, 2/3 of a tooth by that point).  After a few months, when enough healing had supposedly taken place, I went in for tooth implant attempt #1, three days after my last completed IM in Chattanooga, and several hours after talking to Jesse and deciding that I'd race IM Arizona that fall.  That implant caused tons of problems and pain, I missed more training than one could get away with when trying to pull off two IMs seven weeks apart, we decided that I'd do Coz instead, and then the damn implant fell out anyways, four weeks later.  It was probably trying to tell me something.  Then Coz happened.  I found out about the fractures (and my low vitamin D levels, a risk factor for dental implant failure) a few days before my next mouth check.  I wasn't healed enough yet to try again.  Dental implant #2 eventually went in, this time 3 days before I was originally cleared to run.  It was successful.  Eventually, I had one more step (getting it dug out of my gum and a new healing cap put on) before the final step of the whole process (getting the crown put on) in July.  As I was walking into the building for that appointment, my phone buzzed with my MRI results about the labral tear.  For whatever reason, the novocaine didn't seem to work as well as normal as I had my gum cut into that day, but I didn't even care about the pain right then.  Finally, Monday I crutched my fixed-up hip in, and happily laid down in the chair to get my mouth completed, once and for all.  Let's get this wrapped up, the dentist had said upon viewing the crutches and asking about the surgery, and get some good going in your life.  For whatever reason, I found myself staring at the butterflies on the ceiling, and feeling weirdly, unexpectedly emotional-but good, happy emotional-to be finishing off the whole tooth thing.  Like my hip these days, the tooth still feels a little bit weird in me-not quite mine yet, like I can't believe that it's supposed to be there and be ok, like it's too large for the space it's in (it's not, I've mirror verified plenty of times that it actually sits well within the bounds of the surrounding teeth), but I'm getting used to it.  Somehow, I feel like that whole thing ending means that the whole pelvis/hip thing is going to be over soon enough, too.   

   Otherwise, I had my post-op visit with Dr. Giordano yesterday.  I got to see cool pictures (anatomy nerd) of my stitched up labrum, cleaned up joint capsule, and shaved down bone.  The damage that was beyond the normal wear and tear of a 30 year old lifelong athlete was all consistent with trauma, which made me feel better about my long-term joint health.  So far so good with everything, and I was given permission (have to appreciate the doctor that understands the athlete-he even brought up something he did that should help me be able to ride in an aggressive position without pain down the line) to be able to push ahead of protocol a bit in certain areas (strength exercise progression, weight bearing, range of motion), but with plenty of warning to not push it in others (basically, anything that involves too much use of the hip flexor).  Scar tissue buildup now and tendonitis down the line are the biggest risks.  Naturally, a large part of me is saying, it's been long enough, let's go already!, but then the health care practitioner area of my brain that governs logic instead of just dreams is telling me to listen, because another setback would just NOT be fun anymore.  I remember last March hating my December self for not being smarter about everything, and I don't need to repeat that.  Athlete or not, my collagen needs time to build up and my tendons are just as prone to inflammation as anyone else's.  Right now, I'm up to 2x40min spins on the bike.  I'm able to handle about a "normal" recovery wattage as long as I sit up with my hands on the bar pads, but I'm not pushing it.  In a couple of days when the final scab has healed off of my incision (mmmm), I'll be allowed to get into the pool and do some pulling.  Next week, I start aquatic therapy, and I also was told that I can start a little bit of light elliptical work.  Somewhat mercifully, I'm actually not allowed to water run due to the resistance on the hip flexor.  I'm not upset about this.  So all in all, not too bad.

   Finally, there's that whole pesky mental state part of it all.  Physical pain doesn’t phase me too much these days; it’s there but I can deal with it, and after 8.5 months of some sort of pain daily, I feel like I'm working towards the end of it.  The fractures were far worse, and if it starts to get sore, I just head over to the couch and stick my leg out until it fades.  How I feel has little to do with what's going on with few inches of space between my femur and my lumbar spine these days, and more to do with what's going on in the few inches between my ears.  I keep thinking back to this winter, because that's all I know.  One minute I'm happy and encouraged because I'm already ahead of the game compared to where I was back then, and at least my upper body is intact and I'm not terrified of my bike anymore.  But, then the next minute I'm just angry at myself, angry that one stupid moment of fumbling with a water bottle, something that took me so long to master but had become so second nature could cost me this year that I was so well set up for, angry that I just had to screw around with it trying to get, what, a couple ounces of fluid that were left out, angry about the moment I first started to lose control and tried to correct, because all I did was send myself flying off of the road instead of possibly just ending up with some road rash, angry that all of that battling back I did throughout the frozen winter that was in vain, because more was lurking.  Why didn't you see Dr. Giordano then??  Why didn't you know to suspect anything else?, I've been chastising myself, even though all logic tells me that I had no way of having any clue.  I'm angry that I can't compete, and angry at the jealousy that keeps sneaking into me when I watch others doing so-plenty of others have been or are in my shoes or worse, after all.  When it comes to running...I'm empty.  Fact of the matter is, in 18 years of running competitively, this is the longest period of time that I've ever gone without being able to consistently run.  Plain and simple, after running ~20-25mi/week for one little month out of the past 8.5, I think it's ok to ache a little bit for it by now.  I can work at maintaining fitness in other ways, but there's no substitute that's going to fill that hole for now.  There just isn't.

   Really, though, I'm fine and happy enough and encouraged enough the vast majority of the time.  Of course I have my moments when I fire off an an upset email, feel that anger and bitterness, or simply slip away into myself for a little bit; I think that makes me human.  Race pictures, people out running, driving down Titus and imagining myself running, frustration when I can't just put on a pair of shorts normally, certain songs, anything that makes me think about where I want to be right now can trigger me.  I've learned not to fight it-I let the tide pass, it never takes long, but not before I bottle a little bit of it up first.  Whenever I make it to mile 20 of an IM marathon again, to that point in every single marathon I've ever run off the bike where my HR starts its little dip until mile 24 when I wake the heck back up, I want to be able to look back on this particular type of hurt, to remind myself that whatever suck I'm feeling in the race pales in comparison to this suck.  The healthy, training, running, racing version of myself owes it to the post-crash, post-op, post-whatever I am now version of myself to deal with it.  And, like in an IM, the low moments always do pass quickly enough, as soon as I get back to focusing on what's right and gratitude and everything that's still pretty awesome about my life, which is basically everything other than one stupid joint.  I haven't let any low times prevent me from getting whatever I can do that's productive and moves me towards the end goal done.  So, overall, all is good.  Almost two weeks out now, and I'm glad that I had this done and got it over with!  For now, I'll take what my hip gives me, and I'll keep looking forward to getting back out there :)

The Bailey is also looking forward to this summer being over.  Summer=loud scary noises from the sky and sheepish hiding in the basement.

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