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

Tuesday, April 22, 2014

Unexpected Drawbacks

Just passed the six week mark, and all is going well. I'm walking in the house a lot without cane or walker. Doing my best to stay slow and symmetrical. 

Though the pain is still there, I'm taking Tylenol less and less. Mostly just when I bump my activity level ahead too much all at once. When that happens, I do some lying around the next day. I have some tension in the upper left quad, a result of new or overworked muscles...or both. Yoga always helps!

I'm looking forward to my visit with the surgeon on Thursday, although I have a feeling it's going to be short and sweet. I'll let you know how it goes.

In the meantime, here's a list of some unexpected drawbacks of THR recovery. 

1. Say goodbye to the foot on your operated leg
Since you can't bend more than 90 degrees for 3 months, you can't get up close and personal with the foot on your operated leg. So, cut your toenails before you head into the hospital, or give yourself a last pedicure.

2. One wet shin
For the same reason, you can't dry all the way down your operated leg after the shower. I just wave it around a bit before I put my pants back on.

3. Limited cat petting or lifting
It's  not easy to reach down to cat level standing on one leg with the other behind you, though it's possible. What's really a challenge is picking up the cat, as usually I use two hands, and that requires expert balancing skills.

4. Bye bye fancy boots (sniff...)
I have a new pair of boots I adore, but the left is inexplicably tight, and they zip up on the side. I have worn them a few times with my loving partner's help, but I usually clop about in clogs. If I have to take my boots off when I'm out, at the physio for example, I'm forced to ask for help to get that left one back on.

5. Looking like a disabled person
It is interesting to be out in the world using a cane or crutches. People look at me sidelong, or ignore me. I know this state is temporary - but they don't. It gives me a little window into how it feels to use walking aids every day, for the rest of your life. My three month flirtation with sticks and wheels and small steps is really nothing to complain about. 

6. Getting nowhere fast
Do you remember the old man character Tim Conway used to do on the Carol Burnett Show? If you don't, he has this slow shuffle of small steps. Tim Conway Wheelchair Sketch It feels a bit like that when I walk. Walking down the hill after the bike race the other day, I kept having to step aside to let people pass. I guiltily remember striding ahead of my ex in the snow, leaving him and his aching knees struggling along in my footsteps. I am humbled.

Today's Quote: “There is nothing noble in being superior to your fellow man; true nobility is being superior to your former self.” ~  Ernest Hemingway

Sunday, April 6, 2014

Four Weeks Down, Eight to Go!

Saw my favourite physio this week, John Manley out here in Sooke. I can go at no charge to the Adanac Clinic at the 'Jube' (aka Jubilee Hospital), but it's a long drive, and they didn't do much for me last time. John was happy with my progress. He ask me to let my hips swing side to side with my walk, which hurt a bit in the outside of my right thigh. He also suggested a slight pelvic tilt, as my pelvis is tipped quite a bit forward, to avoid the pain.

Don't overuse your arms
John also encouraged me to just 'tap' my cane, and to rest my hands lightly on my walker. I was rejoicing in my upper body strength early on in my healing. It makes it easier to get around, the fact that I can propel myself with my arms, connecting to my back when i need to, without any ache in my shoulders. Turns out at this point, though, the idea is to let the legs do the work, keeping my steps small, my gait slow and steady. Sigh.

It is getting a bit old, all this walking slowly. Though I am doing better, walking more often and smoothly without my walker, I still ain't goin nowhere fast. Though I can use my golfer's reach to lean forward, it's pretty awkward getting down to the floor. When I washed the windows the other day, I did all the top half, then laboriously got down to the floor to do the lower windows on my knees.

It's very one-sided
When I do yoga, I have to roll from my back to front, or vice versa, via the right side, pushing off the left foot before the knee comes too low.  As for sleeping, only on my back, or my right side, often with an icepack. At least this time, it's easier to get in and out of bed, as my operated side is the left side. Much easier than when my right hip was sore.

I asked the physio if I should try lying on my left side, even though it hurts. He says it could bother the incision, and it would be best not to.

 I asked if was okay how I've been leaning forward, keeping my hip at less than 90 degrees by tilting my pelvis. John replied that we're trying to avoid torsion, which I understand as moving too much at the hip socket. There's a longer definition here:, along with plenty of other useful info about various types of hip pain. So I need to be more cautious about my angles. It feels from the inside that part of the problem is pushing off with the operated leg to stand up.

I am going to write a book about all this. Collect about 10 stories, meld them together with useful information, and e-publish it. There is a lack of information out there, and, though the system here in BC is efficient and helpful, I know I would've loved to read some other people's stories of hip surgery, before I went through it myself.

Today's Quote: "Walk as if you are kissing the earth with your feet." ~ Thich Nhat Hanh

Wednesday, April 2, 2014


Three weeks plus, and the pain is abating. Less Tylenol. I started the week with walking up a flight of stairs on Monday, followed by a very small series of even smaller standing poses on Tuesday. Wednesday it felt like a very large fist in a steel glove had pounded my left hip. Did some more lying around, watched The Moulin Rouge. I'm feeling better.

I keep meeting, or hearing about, people for who THR has been recommended, who are putting off the surgery. For some, it comes from a doctor's recommendation. There was an ex-dancer I spoke with in Montreal who was told by his doc to wait as long as he could, and could barely walk by the time of his operation, 8 years later. He wished he hadn't waited so long. There are others who choose to live with the pain, than go through the operation and recovery.

It took me awhile to get used to the idea of having surgery. I remember the phone call when my doc told me I needed a hip replacement. I cried. A lot. Somehow I thought there would be a less drastic solution to the growing pain I'd been living with.  I think it was a good 18 months, maybe two years before I was ready to go on the list for hip replacement surgery. When I finally did, I wished I had done it sooner. I was lucky to be able to go on the cancelation list, and both times jump to the front of the line through someone else's misfortune. Though going in for surgery with only a week to get used to the idea is a bit intense.

For sure it's an intense surgery. The recovery period is long. But it could be worse. Brain surgery, for example. Chemotherapy. Some kind of 'ectomy where you have something removed that you'd rather not. It's true that this surgery is elective. You can choose to live with severe arthritis. Many people do, by choice, or by necessity. Just pop pain meds all the time. Don't depend on being able to run for a bus, or get down on the floor to play with the kids. For a physical person, getting the procedure done seems to me a no brainer.

I was told I'd have a 6 to 12 month wait, and I've heard of longer. It can take time to find just the right surgeon. I'm so lucky here in Victoria. We have a pool of excellent surgeons grouped in a new 'Rebalance' centre. The Joint Replacement Clinic guides you through the pre- and post-op process. And it's all covered by our health insurance - unless you get ceramic hips, which I did. Worth every penny, though, for longevity.

Against the 80 or so (if we're lucky) years of a lifetime, 3 months, or even the full recovery period of a year to 18 months is tiny. It feels long from here, but short on the other side, I remember. Right now, the little steps of improvement are exciting, but underwhelming. Each week passes slowly. I still have two months to go, as of tomorrow, and it seems interminable.

My memories comfort me. Last time, once the three month mark was over, it was so liberating to slowly stretch out my tight muscles. The only thing holding me back was the degeneration in my left hip. The endless recovery became short as it receded into memory. This time, I'll be able to pull out all the stops. It's going to be so good!!

 I am so blessed that I can go in to surgery with a week's notice. That I don't have to go back to work, and sit in a desk all day with an aching hip, or use my crutches to clump around a sales floor. When I broke my elbow twenty years ago, and had to register for college wearing a soft cast, my left arm in a sling. Every little thing was so difficult. A day that was already intense, with endless forms to fill out, line-ups to navigate, and decisions to make brought me more than once to tears. I was in pain, and one hand short for things like carrying books and opening doors. It was hell.

Today Zack drove me up to the platform on the hill to meditate. We sat in a patch of sunlight, looking out of the Sooke Basin, and were serenaded by spring birds. This afternoon, I might repot some plants on the deck. If I get tired, I'll chill on the couch and read 'Tiny, Beautiful Things' by Cheryl Strayed. (You can find her here: I am truly blessed with a supportive and loving family. I am so grateful also to you for coming with me on this journey. Namaste.

Today's Quote is from the very inspiring Cheryl Strayed: "Your life is here and now. And the moment has arrived at which you’re finally ready to change. I know it. The thousands of people reading these words right now know it. And you know it too.. We have the power to heal what needs to be healed. We get to give ourselves that."