1,5 years after complete hip fracture

18  MONTHS  POST  OPERATIVE

 

Funny cute dog celebrating his birthday party

 

Some of you might be wondering why I was  MIA  for the last few weeks. I had major security issues with my blog and had to shut it down.

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Much has happened since I last had the pleasure.

About a month ago I felt a big push in my recovery. It really feels like pieces are falling into place. Finally.

 

I went on a pretty far away trip which involved a lot of sitting, just getting there, and once there, we walked and walked and walked. All day long. Up to 11 miles/ 18 km a day and on a “slow day” a minimum of 6 miles/ almost 10 km.

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At home I am back in my garden and can do 1-2 hours of garden work a few times a week. I try to take turns with one day garden work, the next day gym, to not stress things out too much.

I can do so many things again , it’s amazing. On an average day, I just do my things and most of the times I am pain free and not even aching. (The cortisone shot from beginning of May still seems to work too.)

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A few things are still difficult for me, like sports. That progress is reeeal  s-l-o-w.

 

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My gym status is right now:

  • Elliptical, 13 minutes/ level 1
  • stationary bike, 15 minutes/ level 1
  • treadmill – walking,  NO  incline, 20 minutes/ medium pace

 

Not spectacular but not bad for where I am coming from either.

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I tried tennis again, after having to take a 6 months break because of a frozen shoulder (also super fun!), and that would get the headline “felt great while I did it…”

 

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The aftermath was not pretty. The following night my hip and the surrounding soft tissue was deeply throbbing away and kept me awake till 5 am. Good times… Till everything had calmed down again took about five days.

I guess the pounding on cement was not ideal and my hip & the soft tissue is not used to doing “real” workouts anymore. In comparison, skiing was easier. That I did nicely already at 13 months PO.

Next time I will bury my hip under ice and take Ibuprofen afterwards. On purpose I didn’t do this last time, to “see” where my hip is at. If I numb it up with ice and a handful of Ibuprofen right away, I can’t tell how it truly feels. Makes sense?

I still have soft tissue issues in my hip, groin and thigh but it’s getting better too.

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Overall I am really happy, life has picked up again and even though sports are still quite limited, except for that, I can finally say… I feel like  ME  again!

That’s all I ever wanted.

 

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Still rocking the flare.

Week 6 of my hip, throwing hissy fits for no reason.

I really tuned things down, no exercises right now, which I really miss, and only doing my normal days. Nothing strenuous, no “pushing it”, not even normal PT specific and hip friendly exercises, for god’s sake.

R hip still does not like it. It likes it so little that the L hip is now more often than not unhappy too and this is far from cool – dealing with two cranky hips. I thought I did that already and was done with it.

 

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Of course my great plan of “let’s get the bike ready and go for a quick ride in the park” did not happen either. I honestly thought this “whatever it is” would blow over within a couple if weeks, but I guess not.

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In two days I will see my OS.

I don’t want to know what’s going on because the whole hip circus is getting old, but I need to know. Small but important difference. My hip journey is now 6 years in the making and I deserve a break.

Let’s see what the expert says and we go from there. Fingers crossed for good news.

 

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12 week PO update

I saw my orthopedic surgeon for my 12 week follow up appointment and it was good news.

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My X-rays showed some bone growth but the fracture has still not healed all the way. Things are definitely moving in the right direction though.

Signs we were looking for:

  • No malunion – check
  • No AVN – check
  • No nonunion – check
  • Alignment is still good – check
  • Screws have not shifted (two of them losened up a bit because walking puts compression on the bone but it’s still within the norm) – check

I was given the go ahead to work towards weaning off crutches, which is a process over several weeks as well.

He really wants me to work on bearing more weight so I don’t get “de-conditioned” which I thought was kind of funny. I mean, after being on crutches full time for 12 weeks, there is nothing left of my op leg – he is concerned about muscle mass?? A bit late for that, I’d say.

Ideally, he wants me to push myself a bit. “Push yourself but don’t do too much”. The famous thin line to walk on.

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I asked about bone pain and he said, this is normal and to be expected since the hip is not used to carrying weight anymore. It will get better with time. (So basically back to my comfort zone – icing at night. The freezer,  my BFF!)

He gave me permission to drive again and I should practice in some quiet neighborhood first, to see if I can shift my R (op side) leg quickly enough from the gas to the brake pedal.

I also should continue physical therapy and “proceed with caution”.

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PT was good, the place was hopping.

I did all of my exercises and as a highlight….. I was allowed to practice walking on one crutch!!! It was not painful but my op leg felt  stiff and weak at the same time, if that makes any sense.

This weeks home exercises include trying to walk around some in my home with one crutch only. Outside the house still two.

I am not walking fast, pretty slow but still, it’s improvement! Before any upgrade to walking faster, I always have to take two steps backwards and walk slower first.

On the way out from PT I saw a lot of commotion on the staircase. Reason for that – the elevator broke down, so you had a long line of people on crutches and walkers trying to battle the staircase and I am happy to say, I was one of the faster ones on it.

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You will never guess what my first luxury was at home! Walking on one crutch  AND holding a cup of tea – at the same time. Thank you very much!

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All in all, things look promising. I still have long ways to go but for the moment I am very happy and have a hard time trying to wipe that grin that goes from ear to ear off my face.

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The countdown is on!

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In 48 hours I have my big six week follow up appointment with my OS. It will be then decided how Majesty hip is doing.

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My head is buzzing with potential diagnoses and all different kind of “what if…” scenarios and the individual domino effects.

I read up about AVN, malunion, nonunion and don’t like any of those but it also will be decided how much my bone has healed already, if I can start with PT or I have to give it more quality time on crutches and continue the waiting game. A little bit more weight bearing would certainly be nice, not just for my other hip, but also for my hands, elbows, shoulders and SI joints.

 

I “should” get good news though. I have my age working in my favor, except for my drama queen hip I am fit and healthy, my bones are strong without any sign of osteoporosis ; I eat a clean diet and no junk food, I don’t smoke and I don’t drink.

Plus I “feel” like some healing has taken place already. Fingers crossed for good news.

 

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I continued making research and started thinking outside the box a bit and voila, I found a whooping four young people, with a complete hip fracture!

It was comforting to see others having the same questions and going through the same thing but their protocols but recovery timelines could not have been more different from each other.

  • Some were partial weight bearing right after surgery whereas I am toe touching for six weeks.
  • One guy was outside on his bike three weeks after surgery – I can do 5 minutes on my stationary bike every other day without resistance and so slowly, the monitor does not even bother to turn on, at 5 weeks PO.
  • Another fellow started partial weight bearing after 10 weeks on crutches and it took him 1 year to come back.
  • And one crazy guy started jogging (!) after six weeks PO already.

 

Interesting read but not really helpful since they vary so much. Since there is NO way I will start biking outdoors anytime soon or start running on the treadmill next week, this was the most helpful and realistic tip…

 

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It will be what it will be. I’ll update when I know more.

 

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1 month PO!

Finally! 1 month post operative. Another hurdle tackled.

Lots has happened in my momentary small world last week. For example, I got my operative report from the hospital. Was an interesting read.

It also stated “no complications.”

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I was lucky that day anyways, the orthopedic surgeon on call was specialized in “trauma and hip”. I could not have had a better OS than that.

This was her and her physicians assistant, “the morning after”.

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We also got the bill for my little adventure.

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Holy smokes!!!! For sure our most expensive three days ever, anywhere, but thank god the insurance paid. Three amen for that.

The bill was two pages long and listed absolutely everything. Cost of the ER, the operating room, anesthesia, all the meds I was given; the screws in my hip are over $ 4,000 and so on.

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Most of it made sense, two things didn’t.

Not sure how they ever got to $ 1,095 for PT services and over $ 300 for “occupational therapy”.

I had exactly four PT sessions. On PO day 1 I was given non weight bearing exercises to do with my legs in my bed and I sat on the edge of my bed. The whole show lasted 20 minutes.

My PT came back the same afternoon and I crutched a few minutes around in the hallway and showed her, I can manage stairs on crutches. 20 minutes.

Same the next day with the differences that my PT put me in a wheelchair to eat my lunch, left and didn’t come back. It was not very nice to sit all alone in the room, trapped in a wheel chair and you depend on peoples mercy. I had to ask for her several times to come back. Pissed me off.

And in the PT room, I almost fainted after doing the steps.

Except for that I had the same 20 minutes four times. How can that end up as $ 1,095??

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And to list the “occupational therapy” with $ 300 is a joke as well. She came in and said, she just wants to be sure I know how to dress and shower by myself. I gave the shower a go and (fainted almost again towards the end) and that was it. I showered without assistance.

(Thank god. That would have been too much for me. It was one thing to have your clothes cut off your body by two guys , to have to use a bed pan was also something I could have skipped but at least I could shower by myself!)

Her whole speech and existance in the room was five minutes.

I find it odd but I am not making a stink about it since the insurance is covering it.

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I am getting very interesting comments regarding being on crutches these days by the way.

The other day I was in the supermarket. I was asked what happened and answered  “I broke my hip”. The first lady asked “if I am in a cast” (how do you put a hip in a cast???) and the second said “did you at least have fun doing it? “ People are weird.

Being on crutches gets two reactions, either people are super kind and help you out with doors ect  OR  they make weird statements. Not a whole lot in between. I am sure I have more comments coming my way as I progress in my recovery, but I have gotten the alien look a bunch of times already when the hip fracture came up.

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Talking about crutches… my mobil legs arrived!

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They are much better for the arm pits but the shock absorbers took a bit of getting used to. They are louder than regular crutches, pretty light but I found the grips very hard on the hands. Not sure why the reviews said, “there is no more fatigue and one can crutch on them forever”. Not me. Crutching is tiring and I am in good shape.

I put my crutcheze pads on the handles  PLUS  got special weightlifters gloves. They have build in cushioning and it helps too.

The gloves are comfortable but made me laugh.

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To me they look like gorilla palms…don’t they?

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The instructions for the crutches were awesome too. Quote “Walk as naturally with them as you can”. Hm, last time I checked there was nothing “natural” about it when you are toe touching!

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My op side thigh keeps shrinking away, atrophy starts on day 11 according to my OS. It’s scary to see it getting skinnier and skinnier every week. Will take me many months to build up again.

I remember this from my last hip surgery rehab. “For every week you are on crutches, your body needs six weeks to build up muscle mass again.” (Fun little spring and summer project right here…)

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Pain wise I am doing pretty good. It’s around 2/10 during the day, the hip  WILL  start throbbing quickly though if I do too much and end up like a 4/10.

Nights are mixed. Not really bad but some nights I can’t find comfortable positions for my op leg or I am aching. I can sleep on my back, my left side is okay, tummy feels great but the right is not there yet.

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Taking a shower is still an achievement. Not so easy if you are toe touching only and have to balance on wet tiles. The shower bench helps out tremendously even though it looks a bit different than this scene…

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…it’s more a matter of “fifty shades of purple”, looking at my op side foot. During the day I rest and ankle pump away or crutch around for keeping the circulation going but in the shower that foot looks creepy.

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People keep asking my why I even went skiing after two hip surgeries and want to know if I will go skiing again.

I went skiing already 10 months after hip surgery and had a great time. The endurance was still not there but I skied!

And yes, I have full intentions of going again. Why not? I live for winter,  love to zip through the powdery snow and feel the cold, fresh air on my cheeks. This is freedom and happiness to me.

I took this picture last year in Colorado. How can this not look perfect?

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Of course it is “safer” not to, but I am not the slave of my hip. I will do whatever it takes to get strong and healthy again and then, I am back on the slopes.

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To finish up, I want to quote an orthopedic surgeon, talking about recovering from hip fractures and why recovery can be challenging.

“It takes a vast amount of energy for a young person to break normal, healthy bone – some estimate as much as 1,700 pounds per square inch or more – compared with the significantly lesser amount of energy required to fracture osteoporotic bones.

The direction that the energy takes as it enters and exits the bone, as well the position of the limb when the trauma occurs, results in the fracture pattern and the type and severity of the fraction.

Despite the fracture patterns sometimes appearing the same in healthy, strong bone versus osteoporotic bone, it’s a very different injury because the energy and trauma needed to break healthy bone is much greater.

The increased energy also imparts significant injury to soft tissues that surround the bone and result in tissue tearing and bleeding.

When I care for a patient with a fractured hip, young or old, I always explain that the recovery is often more difficult than it is for someone who undergoes elective hip or knee surgery or replacement. This is due to the greater damage to the soft tissue and bone in a trauma patient compared with the elective hip or knee patient.

While the hip fracture patient is an energency, the elective patient can be optimized both mentally and physically prior to surgery.

Also, the patient with a broken hip often has a more difficult rehabilitation after surgery. The broken bones and injured tissues must heal and frequently the fracture pattern dictates that the patient delay full weight bearing on the injured lower extremity.”

Just some food for thought from a surgeons perspective.

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