Mini progress!

7 weeks PO and two physical therapy sessions down.

That place is hopping! A constant flow of patients coming and going, whereas I am by far the youngest. The average age there is 65 and somehow I always get stuck with some old guys who work out right behind me, making weird noises. Eeeeeek!

To warm up I was told to do the stationary bike for 10 minutes without resistance. I swear, among all the high tech equipment they have, this was the wimpiest bike there.

 

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I was there for almost 1.5 hours and did all of my home exercises. My PT also did passive movement with my hip, to gain ROM.

He also did massage the scar tissue and the hip flexor. That needs major attention and I need to see an ART therapist for that, when I am more mobil again. It seems like I have quite a bit of really hard scar tissue in my thigh and of course adhesions.

He rolled out the TFL band too since it’s tight and I still have swelling in my upper thigh from surgery.

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The only movement I should avoid is deep flexion with internal roation. Also, still no green light for going in the bathtub. Requires too much flexion of the hip.

 

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My PT was happy with my exercises and we both could already see improvement. He gave me very specific exercises to target different muscles. Muscles that were in the sleeping mode for the last seven weeks and they need to be woken up again.

The home exercise program I was given takes me a good hour right now.

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I am definitely walking better than last week too. I had people with walkers pass me in the hallway, but better is better.

 

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I do get the feeling though that my PT rushes things a bit. Already at my first visit he told me about doing the anti gravity treadmill “ next time”. I am not a fan of the idea of doing it so incredibly early on.

 

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After all, I have not formed bone or even reached 25% weight bearing yet. So when he suggested it at my last visit,  I told him no.

 

Maybe later on, when I am more weight bearing and stronger but at the moment my fracture is still there and is only being held together by three screws, and the middle one is “too short” as it is, according to my local OS.

In his opinion it should reach more/ longer into the femoral head and even though I am not a radiologist, looking at the Xray, I see what he means.

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I asked my PT if he had patients my age with this kind of fracture before and was told “not too many”, which could also translate to “none”…. Hm.

He suggested to “put weights on the ankles” next time I do prone hip extension with a bent knee. (What part of me telling him that “I am a slow healer” did he not get??)

 

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There won’t be any weights on my ankles next time!! It is plenty to work with my own body weight, especially so early on.

 

I have read one should avoid “too much too soon” since it’s a very delicate recovery. If one pushes things one can end up with a stress fracture in the femoral neck and that on top of the still fractured hip would have me headed straight to a THR. I need that as much as a hole in my head.

Already from the exercises we did I was in pain afterwards. My night was miserable and my hip was very angry. It also did not help to have me double my time on the stationary bike within two visits.

 

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The verdict for this week is a good one. I am walking better, pain is in general low and PT is already paying off.

 

The next big hurdle is my 12 week PO follow up appointment. In a perfect world, the Xray should show hard callus and ideally, some new bone already. If not, then it means I am taking the scenic route in this recovery again and more quality time with my mobil legs.

 

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The next chapter in my story

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6 weeks PO and doing good. Pain is pretty low during the day, nights have gotten much better too. I am not sleeping on my op side yet but with the help of many pillows, I am halfway there. Progress!

My op hip still gets upset easily and then all I can do is rest, ice and wait it out.

Putting on socks is getting easier too but it also takes its sweet time.

 

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I have done more research on my injury and those are the sentences I read over and over again…

 

  • Femoral neck fractures in young adults are uncommon and often the result of high-energy trauma.
  • These fractures typically occur after a slip and fall. In a healthy, young adult it would be very unusual for the type of fall to cause a broken hip.
  • Hip fractures in young adults comprise a small proportion of the total hip fracture population. However they form a distinct and important sub-group, often presenting as a result of high-energy trauma.
  • Femoral neck fractures in physiologically young adults are less common than intracapsular femoral neck fractures in elderly patients.
  • Hip fractures in young patients are rare.
  • Femoral neck fractures in young adults are difficult to treat. There are substantial gaps in our knowledge regarding treatment and prevention of young adult femoral neck fractures.

 

Article like these are always a confidence booster and make me feel real special.

 

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Sarcasm aside, the absolutely  BEST  article on the whole subject I found so far is this one:  https://juniperpublishers.com/oroaj/pdf/OROAJ.MS.ID.555693.pdf

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United airlines really cracked me up last week with an E-mail too. This was their advertisement…

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Ha! I sure had my little adventure “beyond the slopes” when I ended up in the hospital. Not exactly how I had our week of ski vacation pictured.

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The most important event of this week was for sure my six week follow up appointment with my OS.

After changing into those weird paper shorts, I could really see the atrophy in my R  op leg. It’s scary, the whole quads on my R side seem to be gone.

 

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New X-rays were taken.

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Thank goodness it was good news! My fracture has not completely healed yet, we still could see the fracture line, but the healing process has gotten started and things are moving in the right direction.

According to my OS it can take up to 12 months for the bone to heal. So far no bone has formed, only soft callus, which is the step “before” bone formation as explained very nicely here…

 

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No sign of AVN, malunion or nonunion either, which is fantastic news!

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I am allowed to add a bit of bodyweight, about 25% for two weeks. After that I should try to bear 50% of my bodyweight for two weeks and work towards WBAT (weight bearing as tolerated) after that. I am also supposed to start physical therapy.

When I asked about aqua training as part of my physical therapy, I was told it is still too aggressive since it is an acute fracture. Maybe down the road we can consider it but not now.

 

Driving my car also has to wait unfortunately since it’s my R hip/ leg and going on the break would be too much weight on the hip. I either risk re-injurying the still fragil hip or causing an accident.

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The whole recovery should take between 3-4 months, meaning till “I can walk without assistance” (crutches or a cane). Returning back to sports takes a minimum of one year. Those are guidelines, knowing myself things will take longer as I am a very slow healer and of course one has to adjust along the way.

I know there will be lots to work on, like finding my gait and balance again, working on endurance, strength and building up muscle mass, getting rid of muscle imbalance and addressing soft tissue problems like scar tissue and adhesions. Lots of work ahead.

Besides, my OS said, the fracture I have is usually for 70 and 80 year olds. And of course I got the  THR  speech again, just in case something does not go according to plan.

 

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The increase in body weight from 10% to 25% should add compression to the fracture and stimulate bone growth by aggravating the cells a bit. So basically, those guys need a good smack on the back of their heads!

I asked how I can tell how much 25% of my body weight is in my foot and was told, to put my op foot on a scale at home till I hit the right weight. In my case it would be 46 lbs/ 23 kg.

 

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I tried it very gently but can not reach it. The most I reached was a bit over 20 lbs. Bummer since this is less than half what I should be doing but this is all I have so far. I have no strength in the op leg. Zero.

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My first walking experience with adding some weight to it was interesting and sloooooow. (I am turning into a sloth, I swear.)

 

I did some mini walks in our home and the op hip felt fine. The other hip was not happy about it, whysoever, but that’s the thing with hips – never a dull moment!

Walking with more body weight takes more energy and makes very tired. Those are my first impressions. But it sure felt good using both feet, especially since those were my very first steps of 2018, since my accident happened on December 31 last year. Happy New Years to myself!

 

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All together I am very happy how things are progressing and very relieved about the good diagnosis. I made appointments for PT and next week I am getting started. Let’s see what my new PT has up his sleeve.

Off to better things. ❤

 

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