Wednesday, June 25, 2014

It's the Little Things

It's  true that expression is way overused. But it can be so true. On the one hand, I have a very BIG excitement as with every day I have less pain in my hip, and more facility of movement. Sometimes it wells up inside me with such a powerful force, I feel as if I could explode with the joy of it all. The poignant side is to realize each day with more clarity how really tied down I was, how impinged the movement of my legs was. 


Rooftop terrace Sayulita, Mexico.
This photo was taken in February of this year, on our Mexican holiday. We were lucky to have this terrace over our beach apartment, where we practiced yoga every morning. When doing Warrior 2 before arthritis started showing up in my hips, my feet were wide enough to bring my thigh parallel to the ground. It is strange and uncomfortable, to feel your muscles get tighter, no matter how soft you visualize them, or how often you stretch them. It feels so big and wonderful to be on the other side. To feel my hip joints releasing and opening. 

It's the small details that are somehow the most profound, the most telling. Here's a list of little things that give me so much joy these days:

1. I can sit cross-legged again.
For as long as I can remember, I have been a floor sitter. I eschew chairs, and sit cross legged on the carpet. But as my right (the first to go) hip got more and more and more painful, I had to sit with my left leg tucked under, and right extended. It was a big deal to arrive again at sitting cross legged after the first surgery, but it quickly retreated as the left hip descended into pain. Now I can sit up straight, legs crossed!! I'm still a little stiff in the left hip, but it's getting better all the time. In fact, this morning I crossed my right leg over into half lotus. It's like finding a piece of myself that was lost. 

2. I can walk in the woods.
With losing the range of motion in my legs, and pain in every step, walking in the woods with my dog(s) became a chore. I began to stick to the flat, as it's tough to step over logs with tight inner thigh muscles restricting the movement of the legs. The fear of pain makes it tough to jump down off rocks or slide down a hill. I feel so much more at ease now, walking deer trails and hilly terrain, hugging huge trees. I am still cautious of falling, and weak in my legs. Even so walking is such a rediscovered joy! 

3. I can ride my bike.
First my right, then my left hip, would pinch at the front when I rode my bicycle. Raising my seat helped a little, but gave me less pedalling power. My right knee used to turn outward, and the heel inward to bang against the frame of the bike. Now I can ride pain free, though just like for hiking, my legs are weak. But they keep getting stronger. 

4. I can skip!
I'm not sure if it was the pain, or the lack of cartilage in my hip(s) or both, but I've been grounded for years. With hip pain, you can't run for a bus, and you can't 'Skip to My Lou.' I was trying to show my step-daughter the can can a few months ago, and couldn't bounce. But the other day, I was in a group of dancers and without thinking, I started skipping...and laughed out loud! So joyous to be able to do that simple movement.

5. I can shake my booty!!
I was in the kitchen cooking the other day, and started dancing. Maybe it was the pelvis circles I'd done with my yoga class the day before, or maybe my hips were just ready to move, but I started to boogy like I haven't for some time. The hip pain prevented me from shifting my hips side to side. I did my best to take the opportunity to be more expressive with my arms, torso and head, but it sure is awesome to be able to shake it again.

6. I can (almost) Cartwheel!!!
I haven't tried yet. But soon. Once my hip doesn't hurt. Once my muscles are longer and stronger, I'm going to work up to a Cartwheel. That will be the true sign that I am back on my...hands?


Today's Quote: “Dance, when you're broken open. Dance, if you've torn the bandage off. Dance in the middle of the fighting. Dance in your blood. Dance when you're perfectly free.” ― Rumi

Wednesday, June 18, 2014

The Last Physio Visit

I was just about at the three month mark when I went to see the physio. He invited me into the big room with the mirror and watched me walk up and down a bunch. He said my gait had improved 'dramatically'. It seems that like my yoga practice, and the physio exercises I've been incorporating have paid off. The exercises I've been doing are:

1. Little Bridge
Lie on your back, arms at your sides. Slide your feet on the floor towards your head until they are under your knees, hip width apart. Squeeze your  glutes to raise the hips, stopping when there is a straight line from knees to shoulders. Hold for 20 - 30 seconds, then lower slowly. Try to bring the two hips to the floor at the same time. This works Hamstrings, Glutes and Core.

2. One Legged Bridge
Go up into the bridge, then lift one foot a few inches off the floor. Hold for a few seconds, then put it down and lift the other. It helps to put the hands on the hipbones, so you can feel if they are level.
An excellent exercise for Core Stability.

3. Leg Extension.
Lying on my back with my thigh over a bolster or block, I extend the leg to straighten the knee, hold it for a few seconds, then lower my foot. This strengthens the quads.

4. Clamshell
Lie on your back, knees bent, then roll onto the unoperated side. Feet should be in line with hips, knees bent at 90 degrees, head supported by the arm. Put the other hand on your upper hip as a reference. Without moving your hips, lift the top knee away from the bottom one. Eventually you can wrap do the same exercise with a Dynaband. This works the Gluteus Medius and Maximus.

I've also been doing my best to walk with my feet parallel, and my pelvis tucked under. Sounds like it's working...but maybe too well.


The "Bad" News
John says that I've changed my movement patterns so drastically, that I can't stretch yet. He advised me to let the muscles, bones, and fascia settle into their new places before moving on to lengthening my hamstrings, and softening my tight hip muscles. Sigh.

On the Other Hand...
On the good side, he said that by August 1st, no one will be able to tell by looking at me what I've been through. John gave me my walking papers. He says there's nothing else he can do for me.

Moving Forward
Already I am getting comments on how well I walk. What I really care about, is that the pain is dissipating. I can lie on my operated side. In fact I can sleep in any position I like these days, which is so exciting! 

I so appreciate being able to move more freely. I am mostly keeping my restrictions, but not too strictly. Pun intended. I have been told more than once by friends that I walk very differently than I did. I really didn't know how much I limped, how ungainly my walking pattern looked to others. I only really see it, see myself moving in my mind's eye, now that it's over. I am so blessed. 


Today's Quote: “You have to participate relentlessly in the manifestation of your own blessings.” ~ Elizabeth Gilbert

Monday, June 2, 2014

Dislocation???

I am almost at the three month mark, and have been getting a bit concerned about my hip. I don't remember this much pain, and it seems that there is more swelling that there should be at this point. At least that's how I was feeling a week ago. I had started to wonder about dislocation.

I called the surgeon's office yesterday to make an appointment for my next check up. After I saw him at six weeks, he'd asked to see me again in 2 months, rather than in another 6 weeks. So, I spoke to the orthopaedic nurse to ask about whether I can start moving again, as my 3 months of restrictions will be up before I see him.

She said I can lift some restrictions, not all. That I can ditch the tall toilet seat and the cushion. I didn't tell her that I haven't been using either for a couple of weeks. My physio said it's 'torsion' that I need to avoid, to keep the hip healing well. I think that's the painful feeling in my hip that comes from pushing up with my left foot after sitting on a low seat. I always only push up to standing with my right, and keep my left leg extended on the way down and up.

It's partly due to that bit of disobedience, and partly because of the pain and swelling in my hip, that I have been wondering about dislocation. I was worrying that it could be gradual, that my greater trochanter was slowly moving out of my hip socket, causing the swelling and pain. A bit scary, as the surgeon has been pretty dire about dislocation, its attendant pain, and going back under the knife.

So I looked up dislocation after THR on the net. The information I found was very reassuring. What a wonderful resource we have at our fingertips! Turns out that's not what happens. If my hip were dislocated I'd be in excruciating pain and not be able to walk. Phew!

The nurse said I can expect some swelling and pain, along with various pops and snaps, for up to a year. She said I can start stretching, but gently. Hurray!


Today's quote: If you don't like something, change it. If you can't change it, change your attitude. ~ Maya Angelou  (RIP Ms. Angelou...)


Wednesday, May 14, 2014

Notes from 10 weeks Past Surgery

I have nothing really new to report. Still walking with my pelvis tucked, feet parallel and hips swaying. Or trying to. Still practicing patience in waiting out my three months of restrictions. Even so, here are some reflections from this place on the path.

1. My hip hurts. A lot. 
I just went back to read last year's blog. I don't remember it being this sore. The outside is tender to the touch, so I still can't lie on my left side. It also hurts to engage the external rotators. I've gone back to taking Tylenol. 

2. Both of my legs are weak. 
Six months of recovery in the last two years equals a lot of inactivity and muscle wasting. My hamstrings, quads and glutes are shadows of their former selves. My body feels dificult to lift. Perhaps because I am about 20 lbs heavier than my usual weight. It's hard to practice what I believe, to accept the roll at my belly, the extra flesh on my back, with love and compassion, when I miss my usual athletic self. I'm aching for dance class, acroyoga and bike rides on the Galloping Goose. 

Inspiring women like me to love their bodies as they are, here's Taryn Brumfitt. Taryn Brumfitt video


3. Zack cut my toenails
The second time around, I took care to cut the toenails on my left foot before I went in for surgery. Even so, they were appallingly long by the end of month two. Especially the baby toenail. I was in danger of slashing an ankle with it. Probably my own. Anyway, my partner Zack cut my left toenails for me. Thanks, Zack.

4. Inside to outside
A couple of weeks ago, I noticed a little black bump at the bottom end of my (I thought) completely healed incision. Over the course of a week, it wiggled its way out until it was a 3mm piece of thread sticking straight out, like a long, thick black hair. A bit alarming, as the little hole it sticks out of goes straight into the centre of my recent surgery. The perfect little tunnel for bacteria from our hot tub to invade my healing capsule. I was planning a trip to the clinic, and hopped in the shower. Then, as I ran my hand over the thread, it detached. Problem solved. I put a little Polysporin around the tiny hole, just to be safe.

5. Back on the Chain Gang
I'm able to carry my massage table again, and therefore back in business. Hurray! I love my work. You can book a Clearheart Bodywork treatment with me at 250-208-0300 or email peaceinpresence(at)gmail.com. I have also resumed setting up Personalized Restorative Yoga Programs for one, two or three people. I'll be teaching yoga at Ahimsa again in June. 

Come take advantage of the inspiration I've been soaking up while recuperating up here on Ming Mountain. I'll be so very pleased to share it with you.


Today's Quote: Healing takes courage, and we all have courage, even if we have to dig a little to find it. ~ Tori Amos

Monday, May 5, 2014

Physio Visit

I went to see my favourite physiotherapist, John Manley, the other day. He asked me how I was doing, I responded that my hip's feeling good, but I'm getting impatient. He said I've been impatient as long as he's known me. Maybe it's just the changes I've been going through in that time...

Put a Pebble in my Shoe
I told John about the one leg longer thing, and he seemed unsurprised, and furthermore, unfazed. He left the room for a minute, and came back with a chunk of insole and some scissors. He asked me to cut it to fit in my shoe, and feather the straight bit close to the instep. He said to try not to make a mess. John has rather a dry sense of humour. 

So I cut it to fit, put it in my shoe, and we went out into the big room with the mirrors to test out my walking. I've been focussing on keeping my gait even and my feet mostly parallel. I've been encouraging my hips to swing side to side a bit, but they're not very willing - yet. Turns out I've been missing an important detail. 

Debutante Slouch
John says my pelvis still has an anterior tilt of about 30 degrees more than it should. It's how my body has learned to move to avoid the pain in my hips. He asked me to walk and tilt my pelvis. Then to tilt it more. It felt like I was tilting A LOT! As if I were Steve Martin doing the pelvis forward walk for his character in Two Wild and Crazy Guys on Saturday Night Live in the 70's. https://www.youtube.com/watch?v=dpFNC7puU2M  

As I walked forward and backwards up and down the room, tilting my pelvis and relaxing my shoulders, I could feel a subtle response in my lower back. John said this will open up the fascia at the front of my hips, and bringing the vertebrae into alignment at the L4, L5/S1 juncture. This will in turn bring my thoracic and cervical curves into line. Once I'm past my restrictions, he'll give me some exercises.

Range of Motion, Clamshell and Mini Bridge
After that, I lay on my back on his massage table, and he checked my range of motion. He says it's exactly as it should be at the moment. He checked the activity of my external rotators by having me lie on my side with my knees bent, and open the top knee. He suggested I do this exercise, gently, to strengthen them. I remember he had given me that exercise before, but I'd forgotten to do it. Damn! 

John also asked me to lie on my back and lift my pelvis, coming up to a small bridge. He invited me to lift my right foot a little off the table, which was hard to do. Then I did the same with my left. Not quite so difficult, but still challenging. In fact, after a few reps of each side, my left hamstring started to cramp up. I have been noticing when I walk uphill that my hamstrings and glutes are weak from my long recovery period, and they need work. After I walked up the long set of steps from the beach the other day, leading with right foot, the top of my right hamstring was sore for about a week.

On Patience
As for the impatience - yes! I am very impatient, and for good reason. Almost 4 years ago I moved back to BC from Montreal. A few months later, I met my now partner, Zack, along with his kids, Noah and Piper, then 12 and 9. At first, we were a very active family, hiking, biking, swimming, diving, boarding, skiing, etc. etc. But it was soon after I met them, that I was diagnosed with osteoarthritis. Over time, my pain grew, and the list of fun activities I could do, shrank. No more running, jumping on the trampoline, and playing Survival in the forest for me.

Also, with one hip surgery last year, and the second this year, that makes 6 months, or half a year of movement restriction. Last year, as I was rejoicing in the new movement potential of my right hip, my left hip started to give me trouble. Just as i started to rev up my movement potential, it slowed back down again. Compared to my old life in Montreal, where I rode my bike everywhere, taught three yoga classes each day, danced contact improv and attended regular contemporary dance classes, I live the life of a slug. 

So, of course it will be SO AMAZING when this last month is over. Which is still a long way from the end of the healing journey. John says it takes 18 months all told to heal up after THR. But, to be able to move for the rest of my life, or until old age slows me down, the wait period is short. On the other hand, it's been so long, and most of my time with my family I've been hampered by arthritis. To be able to stretch and bend, run and jump, turn cartwheels and stick handstands. To be able to teach, to dance, to ski, surf and bike with my stepkids -  I can't wait to have my life back!!!


Today's quote: "Life isn't about waiting for the storm to pass; it's about learning to dance in the rain."  ~ Vivian Greene

Saturday, May 3, 2014

Last Post Post-Script

After writing my last blog post, finishing up with the surgeon saying my left leg is now a bit longer than my right, I went out to the village. I was wandering around in a gift shop, looking at cool stuff, when I realized my left leg felt significantly longer than the right. More than I had ever noticed before. It was disturbing, having just been thinking about living with different leg lengths, and not being so pleased about it.

Then I looked down at my feet, and saw that I was wearing two different shoes. I must have slipped them on without looking. They clogs feel similar enough that I hadn't noticed while, but the red one has a slightly thicker sole. No wonder that leg felt longer! I felt rather silly, yet relieved at the same time. I continued with my errands, telling the part of me that was concerned about embarrassment with the reassurance that people mostly just look at faces, not at feet.


Today's Quote: "They say 'put your best foot forward' but which one??" ~ Rolf Harris

Wednesday, April 30, 2014

Six Week Surgeon Visit

I went to see the surgeon last week for my six week visit. I parked, walked in then realized I'd forgotten my cane. They recommend you keep using walking aids, to allow the muscles to heal evenly, and avoid creating bad movement habits. I can walk easily without my cane, though I usually take it with me for longer walks, as my hip starts to get sore. My walker has become and extra seat for visitors, and a rack for drying towels. The crutches I borrowed from the Sooke Loan Cupboard languish against the wall beside the door. I haven't used them once!

I spoke with the nurse, Colleen, for a long time while waiting for the surgeon. She checked my incision and said it was healing well. She wasn't thrilled I cane-free, but watched me walk, and said it looked good. I feel like a bit of a rebel, but I have been doing my physio, yoga, and taking care to walk evenly. I'm working on getting my pelvis in line and my hips swinging. Hoping to join a Zumba class for fun, fitness and mobility.

Getting Moving
I asked her about impact, once I've finished my three months of restrictions and am onto getting moving again. Turns out she's an ex-pro skier, maybe a bit older than me. She said it's the impact that creates the damage, and that her knees were starting to go from too much 'mogul-munching'. She likened my new hip to a Ferrari. If I 'drive' it carefully, I'll get a lot more miles out of it than if I grind through the gears and race it on bumpy roads. Makes sense. I'm still hoping to get some jumping in on the dance floor, but I won't be running any marathons. I'm fine with that. 

I've been itching to get moving, and thinking of taking my bike for a ride on the Galloping Goose. The Goose is a former railway bed, now a nice, relatively flat and wide path through the woods. The nurse said it would be okay to ride it, the only danger being falling off my bike, tearing my healing muscles. We agreed the wise choice is to wait until my three months are up. Sigh. 

Heredity vs Lifestyle
We also talked about heredity as the cause of arthritis. She felt it was a large factor, but that a lifestyle including lots of impact was also a contributor. My younger sister, who has not had such an active life, has recently developed hip pain. We're hoping it's a result of a fender bender, not the first step on the path to hip replacement. Only time will tell. 

Colleen asked how my hip felt. I replied that my left leg feels a little longer than my right, but my physio had said it was probably a result of the healing in the joint. It does feel rather full and stiff in there. She said it might feel like that for up to six months, and that it takes at least a year for the various clicks and pops to fade away. 

Revision Surgery
I asked her about revision surgery. She told me that it involves chipping the prosthetic out of the femur. She brought me a demo prosthetic to show me the small holes that the bone grows into, one of the reasons for the restrictions in the first three months. I have heard of cemented versus non-cemented prosthetics. The cemented version could have more risk of dislocation, but be easier to remove for revision. The nurse, Colleen, said that hopefully by the time I need revision, in 20 or 30 years, they'll have some fancy new technology that will make it easier. 

Surgeon Says!
The surgeon arrived, he said my x-rays look perfect. He checked out my gait and pronounced it good. He re-iterated the three month precautions, and chatted a bit.Then just before he left, he dropped the bomb. He said my left leg is 1/2 an inch longer than my left! That if it stays like that, I can just wear a lift in my shoe. Not the best news for someone who spends a lot of time barefoot. He talks so fast, and I was so surprised, that I didn't manage to ask him anything more about it. I will when I see him again, in about 2 months. 


Today's quote, to celebrate Shakespeare's 400th birthday: How poor are they that have not patience! What wound did ever heal but by degrees?  William Shakespeare