7 months and counting

 

 

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“7 months post operative” sound like a long time but it’s really not. Complete recovery from this takes a full year and since I had a lot of quality time on crutches (20 weeks), that’s not even including building up the muscle mass again.

But I am doing good, I feel stronger and less achier every month but I still have ways to go. I can not really tell the difference between week to week but I sure notice a difference to how I felt two months ago.

~~~

Right now I am waiting for an appointment with an Endocrinologist. I read “if a womens estrogen is too low, it can hinder calcium from getting absorbed into the bones.” Pre menopausal stuff….

 

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~~~

My workouts are going fine, still 5-6x a week for about an hour a day. I try to alternate between the Elliptical & treadmill every day and add PT exercises, stretches, planks (of which I  HATE every single second!), elastic bands and light weights to it.

Right now I am at:

  • Elliptical 14 minutes/ level 1
  • treadmill 18 minutes/ 1.7 walking speed
  • stationary bike 17 minutes/ lowest level

And I admit it, by the time Friday comes around my op hip is tired and aches.

(The one thing I am still struggling with is reaching my op side foot for doing a pedicure or putting lotion on. It has gotten much better, in the first few months my foot seemed like mile away and was very, very difficult to reach. It’s much better but it’s not as flexible as the good leg.)

 

Stairs are no longer a problem, walking goes fine but I am not sure how far really. I know I can for one mile nicely but I have not gone for longer walks yet. Anyways, I am enjoying my summer and it’s nice to be out in the park like everybody else.

 

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It’d be nice to get back into other things too, like tennis but it’s still too early for that. I am not very good with walking backwards or sidesteps yet, leave alone doing it with quick footwork. I know it for sure, if I try it right now, I stumble over my own feet and smack on the hard court.

 

I’d also love to ride a bike again. A real bike. Outdoors.

I have not ridden a real bike in four years. I am always in some kind of hip surgery recovery mode. So that’s my goal for this summer, go biking for a bit.

My goals in general are very modest. If I can get to 20 minutes on the Elliptical, the bike and the treadmill after going through three hip surgeries, I would be very, very happy.

 

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Plot twist

6 months, 3 weeks PO

 

Since it is  VERY  unusual for somebody in the early 40’s to just “slip & fall” and have a complete hip fracture, it was time to investigate further. A  DEXA  scan was performed to measure my bone density in my spine and left femoral neck (my R, op hip, has too much metal in it. Go figure.).

My spine is great but my hip shows early signs of “Osteopenia”.

 

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Osteopinea is the step “before” osteoporosis. The bone is not quite as dense as a healthy bone but not as bad as one with osteoporosis.

~~~

Last time I had one done was 8 years ago, before my hip saga started five years ago and it came back with very good results, spine and hip.

 

I made research and know now that I got this probably because of being on crutches for so long and being very restricted. (3 hip surgeries/ 4 years = 44 weeks on crutches.)

To maintain good healthy bones you need a good, healthy diet and weight bearing exercises. My diet is indeed very healthy and I am quite active but I have not been able to do “sports” like I used to. I am either in recovery mode or doing physical therapy/ exercises since years.

My first two hip surgeries, combined with two stress fractures in my pelvis, took me three years to recover and now I am in my 3rd recovery and in my 6st month.

 

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In one medical article I read “if one is inactive or bedridden for a long time, it can cause it”. I am sure that’s it. EVERY  other question I answered with no.

  • Are you over 50? No.
  • Are you done with PMS? No.
  • Do you drink alcohol? No.
  • Do you drink soda? No.
  • Do you consume a lot of coffein? No.
  • Are you petit? No.
  • Are you small boned? No.
  • Do you drink a lot of coffee? No.
  • Does it run in your family? No.

 

Some other risks include being white and female. Guilty.

I have to make more research because the  LAST  thing I need are brittle bones. With Osteopinea also the risk for hip fractures increases. No kidding!!!

 

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My doctor prescibed me a diet, rich in calcium, take vitamin D 3 pills and exercise “more” which is a bit easier said than done because all of this aside, I am still recovering from a hip fracture and need to be sensible about it.

~~~

Looking back to December 31. 2017, my accident on the slopes – it really was the perfect storm and the last missing piece of the puzzle was just found.

 

Time to rethink and face another challenge. At least I know now.

 

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Big milestone!!

 

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Today I am 6 months post operative and hopefully things continue to go well for me.

The past half year was very tough, physically and mentally.  First the ski accident and surgery that came out of nowhere, trying to accept the situation and the fact that I had to start from scratch yet once again; deal with brutal pain the first few weeks, to doing my 20 weeks on crutches – learning how to walk again, do stairs and just little things.

Especially “the little things in life” everybody takes for granted are not so little, if you can’t do them on your own or not for a long time.

~~~

I seriously could not have done it without the endless support and care of my husband. He was and is there for me when nobody else was/ is. ❤

 

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This was my third and by far, the most difficult hip surgery recovery and what you learn very quickly is, who is a real friend and who truly cares. Let’s just say the list of people who stood by my side was very, very short. Teaches you a lot about people…

~~~

I started physical theraphy at 6 weeks PO with my PT and did home exercises on a daily basis at home ever since. I am still not done with it but the roughest part is over.

Now it’s all about endurance, strengthening, giving it time and waiting for things to fall into place.

 

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My range of motion is good in my op hip, the pain level is okay on most days but I still get achey quite a bit. On a good day I am on a 1-2/10 pain level, on bad days it can go up to 5/10.

My gait looks good but the more tired I get, the more I will start limping. Also, still lots of compensation going on which my good hip is not too fond of and gets upset too. (Good times when both hips are cranky…)

~~~

Stairs are working fine, if they are reasonable and my op hip is in a good mood. The more tired or achey it is, the slower the stairs will be.

Driving my car is no problem anymore and sitting in general is fine.

I am still putting a huge effort into my recovery and do my exercises. As I know from my previous hip surgeries – “happy hips are a lifetime commitment”.

 

Atrophy (as well as scar tissue & adhesions) is also still a problem I am working on.

At this point I can walk 1 mile/ 1.6 km nicely. Not as fast as other people, but not slow either. I also can do about 8,000 steps/ day and feel fine. A bit more is doable but I will get achey. 8,000 steps is a good day.

This was last weeks summary, according to my Fitbit.

 

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In general I feel good and I am happy again but I know there is still lots of work ahead.

Pretty much the only thing that is totally not happening right now is sports, anything beyond PT exercises. Hopefully this will come with time.

Till then, chin up and keep going.

 

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And… more PT!

Same week, more of the same.

Had physical therapy twice and my PT is really pushing me. The second I am not looking he sneaks another plate of weight on the leg press and exercises that are tough already are  REAL  tough now. Just when I think “this exercise is monstrous”, he tops it with something.

I have made my peace with “clams” by now but two exercises just got more advanced and are killers.

  1. walking sideways 8x with a super tough elastic band around my ankles. It takes everything out of me and burns my gluteus medius muscles to a point that’s beyond funny.
  2. getting up and sitting down from a chair 20x with a 4 lbs./ 2 kg ball in my outstretched arms  AND  an elastic band around my thighs, while the feet are wider than my shoulders.

They are both tough exercises but I really do hate the first one. That band is so incredibly tight, it hardly gives. I swear it’s the elastic band from hell.

 

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I am doing my exercises but I certainly have an opinion about them.

~~~

Did I mention already I almost fell at PT?? I was done with the elastic band from hell, which by the way is so tight it left my skin bloody as I noticed afterwards (!), and hobbled that one meter over to the bench to take it off, when I tripped and almost fell. That could have been catastrophic!!

~~~

Also, my PT thinks it’s a splendid idea to start doing incline on the treadmill. (I personally  KNOW  it’s not a great idea. Already before I broke my hip and I was “just” dealing with two recoveries from FAI & labral tears, incline was a baaaad idea.)

For the moment it is on the lowest level and only a few minutes at a time but I know my PT by now. Very soon it will get steeper and the minutes longer and then I will put my foot down.

 

Coming home from PT I was completely exhausted. So many exercises in a relatively short time, a few were made even tougher and to top it off – incline. I fell asleep immediately,  with my lower body feeling like dead weight. That’s the best I can describe it.

 

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~~~

Last week I tried walking a tiny bit more than a mile (2 km). I needed about 5 breaks and my op hip was not happy afterwards. So back to my mile. Obviously my hip needs more time.

 

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Why does it take so long?

 

5,5 months PO

Recently I got asked over and over again “why is your recovery taking so long?” Well, here it is….

The hip is not “just” a broken bone. The femoral neck is one of  THE  major weight bearing bones in the entire body and neither the fracture nor the recovery is a joke. It is considered a life threatening injury to have and can have many devastating complications, not just during surgery but also in the recovery.

My recovery is slow yes, but everything is going smooth and according to plan. What more could I wish for??

 

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People who ask “how much longer is this going to take?/ Is this ever going to end?/ Geez, this is going on forever!/ Why are you still in physical therapy?” and other charming questions don’t realize just how serious of an injury this is and how incredibly complex the recovery is.

Recovering from hip pinning is way harder than recovering from a  THR. Only young, healthy and active people will be given this kind of surgery, because it’s too tough for older people and they have a higher risks of complications, such as AVN.

~~~

I started off with “toe touching only” for six weeks, to really give the fractured bone a rest and was full time on crutches for 14 weeks, weaning off for another six weeks. So basically I spent the whole month of January, February, March and April on crutches and did not get far.

The recovery is very very delicate since you can not put “too much weight – too soon” on the hip, otherwise it re-breaks and then “the shit has hit the fan”, to be very blunt.

 

Everything has to be learnt all over again over the course of many months and hundreds of hours of physical therapy.

Simple things like “standing” on two legs for example, with the weight equally spread out, is not easy at the beginning and one has to learn to stand for “longer periods” of time, 5 minutes, 10 minutes ect. again.

Might not seem important but it is. How many times a day does one “just” stand? Brushing your teeth, putting make up on, cooking, prepping meals, ironing, standing in line  somewhere…, leave alone learning how to stand on “one” leg again.

 

Other tasks I can think of that everybody takes for granted but I had to learn again:

  • getting up from a chair/ low seated couch
  • unassisted showering
  • putting on socks & shoes by myself
  • getting in and out of a car
  • eventually drive myself again, whereas my op leg is the right
  • doing stairs
  • shifting weight forward and sideways
  • walking without crutches and walking altogether

 

The hip is a very complex joint and lays super deep within the body. It is surrounded by 17 muscles and being on crutches for such a long time will do a serious number on them.

Atrophy begins after 11 days not using muscles, imagine what the muscles look like after 140 days on crutches! Not much left.

 

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Muscle mass is disappearing very fast and it takes forever to build it up again. My OS told me “per week on crutches the body will need six weeks to rebuild the lost muscle mass”. So in my situation I am looking at 120 weeks. This will keep me occupied for over two years and I am working hard at PT.

~~~

Things one has to work on is getting your range of motion (ROM) back, get rid of the limp when walking and find your proper gait again; one must work on balance, the leg (and knee) is very weak because of missing muscle mass and needs to regain strength. With strength will come endurance as well and of course one has major muscle imbalance to deal with.

Not only the front to the back in the op leg but also from the good leg to the op side leg. While the op hip is still healing, my good hip has to take over and do overtime and being an operated hip itself, there will be the point when even that hip has had it and needs extra love.

 

One must also not forget that some muscles need more attention than others. The glutes for example, so important for basically everything but mine don’t fire properly which throws off everything. The muscles have to be “trained” again to fire  when needed. Another task that takes months.

I am not even getting started about soft tissue issues with scar tissue & adhesion build ups and issues with the pesky hip flexor which by itself can make life miserable already. (Soft tissue issues are very real and can take years to go away).

 

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And since everything is off balance and not working properly, SI dysfunction is never far away either.

 

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The bone will take up to a year to completely heal and till  ALL  of this has settled, calmed down, is strong enough again and balanced, it will be a while. I am not too concerned about the timeline. It will take what it will take.

I could go on and on with this, but my point is, this is a very complex and intense recovery. I am not dragging it on because it’s “oh so much fun”.

I am following instructions from my orthopedic surgeon and my physical therapist and between them and me; time, dedication and  A  LOT  of hard work I am getting it done. Maybe not tomorrow or the day after tomorrow but I know there is a light at the end of the tunnel.

 

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Working like a dog at PT

5 months, 1 week PO.

~~~

Back to PT twice a week, 1.5 hours each time and hard work. (If I am not in the best shape of my life after all this then I don’t know.)

~~~

Here is a summary of what it takes at 5 months + PO into the recovery from hip pinning.

 

  • 30x hip flexion on the table to warm up the hip
  • 30x rolling the big ball towards me, for  ROM
  • 30x hands free bridges on the big ball
  • 30x clams with a heavy resistance band around the knees
  • 30x sideways kicks for the adductors

 

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  • 20x walking sideways with second toughest resistance band around ankles
  • 20x walking “ ice scater” style with second toughest resistance band around the ankles (# burn baby burn)
  • 20x sitting down and getting up from a chair while holding a 4lbs./ 2 kg ball in my outstretched arms
  • 20x exercise with resistance band for the adductors
  • 20x exercises with resistance band for the abductors

 

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  • 20x hip flexion machine for adductors, 15 lbs./ 7 kg
  • 20x hip flexion machine for abductors, 15 lbs./ 7 kg
  • 20x hip flexion machine for flexion, 15 lbs./ 7 kg
  • 20x hip flexion machine for extension, 15 lbs./ 7 kg
  • and  REPEAT  with the other leg

 

  • 40x leg press with 70 lbs./ 35 kg with both legs
  • 30x leg extension, op leg  ONLY  with 30 lbs./ 15 kg
  • 20x walking the balance beam
  • 3x 30 seconds the wobbly board for balancing the body for- and backwards
  • 3x 30 seconds the wobbly board for balancing the body sideways

 

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  • 10x forward lunges
  • 10x sideways lunges
  • 10 minutes slow pace, walking on the treadmill

And in the end my PT stretches me out and gives my hip flexor some love.

 

I am pretty burned out after all this and both my hips need a rest. Most of the times I collapse on my couch and ice the night away but feel okay again the next morning.

 

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It was also good news to hear I have not lost range of motion over vacation time.

~~~

My daily pensum of home PT takes a good hour and I take turns doing the stationary bike, the TM and Elliptical, each twice  week, usually to warm up.

Stationary bike I can do 15 minutes/ level 1; Elliptical 8 minutes/ level 1 and the TM 10 minutes but it all adds up. One day per week I take off from PT, to give my body rest.

~~~

This week I added going back to  ART  treatment to the mix. I wanted to go sooner but I did not want to cross a busy road while still being on crutches. I wanted to be off them and be able to cross the road safely.

I saw this woman before, after my labral tear surgeries, she helped me where nobody else could. ART stands for active release therapy and is basically a deep tissue massage.

And not one of those “nice relaxing” massages either. ART is  w-o-r-k.

My therapist put me in various pretzel positions on her massage table and while she stretched my hip or leg, she dug her fingers into trigger points, manually broke up scar tissue & adhesions and found entrapped nerves.

I will see her now regularely again. Getting rid of scar tissue etc. takes time.

~~~

My therapist asked me which hip it was I broke. “The right.” “So, did they do the other one too?”

( Hmm?? It’s not like the surgeon pinned my hip and once she was done she said to her medical team “well, since we have her on the table… flip her over! Might as well pound some screws in the other one too. Just in case.”)

I try to only have one hip drama at a time.

 

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To finish off with some good news:

  1. stairs work much better now. Almost like normal and naturally “best” in the morning when I am fresh and my hip is rested. I am still sticking to smaller stair cases. If longer ones are present I choose the elevator.
  2. my PT said my gait does not look robotic anymore.
  3. (a little mean but…) I was not the slowest one in the park anymore. I passed one guy with a cane.

 

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Reality check at 5 months PO

I am back from vacation.

Had a great time and it was my first “sightseeing” vacation since my ski accident/ hip pinning surgery and I know now where I am at in my recovery (5 months PO).

The good news – I could do more than expected but I also learnt a few tough lessons.

At the airport I could walk to gates which where nearby, longer distances I still used the wheelchair assistance. Carrying my backpack not only slowed my walking down, it made me limp and used up more energy, faster.

~~~

I had my crutches along and would have actually used them but at the time of need I was stuck nowhere near our hotel (where my crutches were) and had to deal with the situation, without them.

One time in particular I completely misjudged the walking distance and not only ran out of energy but went into pure survival mode. Sights which I usually would have enjoyed and taken photographs of did not matter to me anymore; I shuffled away in slow motion, tiny steps and with a big limp, till the next bench. It was brutal. I would have given something to have access to my crutches at this point.

It was not that the hip itself was hurting, it was the missing muscle mass, on my op side. Atrophy is a real bitch.

~~~

Most days I stayed around 8,000 steps which is all I can do right now and not be aching. I overdid it a few times and paid for it, every single time.

 

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  • Pulling a heavy suitcase? Pain level 5/10 in the hip throughout the entire night and the whole hip joint felt bruised on the inside.
  • Walking up and down hills results in an aching hip.
  • Walking over cobblestone and uneven ground – hip is not very forgiving.
  • Hip flexor on my op side joined the party pretty much every day and gave a lot of  additional “joy”.

 

On the bright side, I was able to walk behind a waterfall; sitting in trains, cars & planes was not a problem and my icepack was a lifesaver several times.

~~~

I certainly had my moments in which I thought “this is so lame” – for example, trying to take part in a 90 minute walking tour.  Brilliant idea!

The group took off and I was always the last one and never heard a word of what was being said.

At some point I called it quits and left the tour. I could not keep up and nobody cared or asked if I was okay either. So, another one for the list, “guided city walking tours” – not happening at the moment.

I was slow to begin with but the longer the vacation went on, the more aching my hip became and the slower I walked. My good hip was aching off and on as well.

~~~

Overall I could do many things though and had quality time with the hubby. Things went better than expected but still lots of work ahead.

Endurance and strength I have to continue working on. But I am sure my PT will have some good exercises up his sleeve when I see him next week. No rest for the weary.

 

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