This morning, while doing Qigong, the Prevena started to squawk. I turned it off and on a couple of times, hoping it would reset itself. When that didn’t work, I got online and looked up the alarm code. It indicated that my pump was full, but when I looked in the window, I didn’t see anything and had never noticed any drainage in the unit itself. So, I was puzzled. The instructions said to call my doctor if this happened.

Of course, the Reno Orthopaedic Clinic is not open on Sundays. I called and got the answering service. They took down all my information and my issue and said the on-call nurse would call me right back. And she did. She asked if I could see if the pump was full and I told her it didn’t look like it. She said the pump often stops around day 5-7 and the alarm can simply be part of it shutting down. She asked if I had any swelling , heat or pain and I told her I hadn’t since the surgery. She instructed me to cut the tubing flush with the bandage and put a piece of tape over the end, and then throw the unit in the trash. So, I did. Seems a shame to waste a medical device like that, but I guess they make them that way…

Once I cut the tube, the bandage puffed up. Davis had told me it would do that. Here’s what it looks like now:

Alas, I have lost my farty little friend! I am no longer tethered to the Prevena pack. All I have left is a poofy saddle bag on my right thigh! I’ll take it. No more worries in the grocery line.

My leg is having a party, celebrating being free at last! It is truly amazing how fast this recovery is going. I feel my whole body breathing a deep sigh of relief.  It’s like I’ve been all crunched up on my right side, drawing the leg protectively into my body and not using it fully because of the pain. I can already do things pain-free that I haven’t been able to do all year. For example, I can do belly dance hip drops and figure 8 moves that have been impossible. I can lean forward on the leg, though not very far yet. I’m starting to get my forward and side lunges back, and was able to do 24-short form Tai Chi this morning and sit cross-legged for meditation!

I had a couple of tired days on Thursday and Friday, which is pretty normal and often more about getting over the anesthesia and all its various effects. Today I feel great! I have had virtually no pain since Wednesday, so I stopped all the pain meds. So far so good. I’m not even using Tylenol. In fact, the leg is less painful now than it was before the surgery!

Physically, my body has already moved on. It’s over. Emotionally, however, I go from anger to sadness to relief to gratitude to joy and sometimes back again. I’m angry that this brutal piece of hardware was placed in my body and it hurt so much that it really set back my recovery. I’m sad about all the pain and disability I suffered for the last 13 months. Every time I’m able to do something which has alluded me all this time, I cry all over again. When I touch the cable, which I keep on the kitchen table, I tear up. When I notice how much better I feel as I move, that I’m not off balance and favoring the leg, I feel relieved. I don’t feel like I’m 80-years-old anymore. And then there are those ever-increasing moments of gratitude and joy. It is finally over and I am whole again. There were times in this process when I wondered if that would ever happen.

I do want to say in support of my most amazing surgical team, Dr. Shukla and Davis, it wasn’t your fault. You did the right thing by putting a cerclage cable around that femur. I was the one who stubbornly kept walking on a totally destroyed hip until I stressed my femur. It already had bone spurs when you started. The wise and prudent thing was to support the femur until it could knit around the implant and repair any micro-fractures that might have occurred during the replacement. On this end of it, I have two solid replacements that are holding perfectly and I have equal leg length for the first time in my life. I also noticed, looking at my wet footprints at the pool the other day, I am no longer duck-footed! I have real hips for the first time in my life and I can walk again. For me, this is a medical miracle! I will be forever grateful to the two of you for the magic you’ve worked in my body. Without you, I would be in a wheelchair.

What I do want to say is that this piece of hardware does not belong in the human body. I realize that this is the cerclage system that comes with my Smith & Nephew implants. Why they are still using this cerclage system is beyond me. But there is a better one that uses a polymer system and a connector that lies flat against the bone and doesn’t have sharp ends, both for the safety of the patient and the surgeon. Here is a link (which may be helpful for my fellow hip people, or any of you who have to have orthopedic surgery):   http://www.kinamed.com/products/orthopedic-products/supercable. I think I could have tolerated this cable better and might not even have had to have it removed. I found this site when I was Googling problems with cerclage cables.

I do plan to discuss this with Dr. Shukla and Davis at my follow-up appointment. But, I also want to share it here, especially for my fellow hipsters. From my perspective, Dr. Shukla and Davis are gifted in their ability to perform minimally invasive replacement surgery, which causes very little disruption to the muscle tissue. I had the benefit of experiencing this on my left side–I was able to walk unaided in 4 days! It took 3 months to walk as well on my right side, because of this cable. It seems a shame to ruin the amazing work they do with a piece of hardware like this! My hope in talking with them, and in sharing this here, is that others might be spared the pain I have gone through.

On a lighter note… Me and my new friend, the Prevena pump are figuring out how to better live with one another. Scott discovered that it could be disconnected from the bandage for showering, which I did yesterday and it felt wonderful! I also found two pairs of pants I can put the tubing in and still get around. I located my old western belt, which the pump case belt loop fits over, thankfully. So, I am mobile and can drive! In fact, right now, I’m going to the store to go grocery shopping for dinner.

I must say that this unit is pretty amazing. There is absolutely no swelling, bruising or pain in or around the incision. But, it does have one little quirk… It farts. That is the sound it makes about every other hour when it suctions. So, pray for me that it doesn’t do that in line at the grocery store!

Today was my third surgery in 13 months to remove the cerclage cable placed around my right femur after my hip replacement on that side. It has done its job of holding my femur together while the bone knitted and formed around the stem of the implant. But, it has caused me a lot of pain and disability for these 13 months and it became very clear it had to go. 

Here’s the email I sent out this afternoon (I was actually able to comfortably sit in my chair at my computer and do it all by myself!):

Hello All!

I am so happy to report a quick, successful, pain free surgery and I was home by 9:30! We couldn’t believe how fast it all went, and easy, compared to hip replacements.

I went in at 7:00 and was out by 7:20. By 8:00 I was conscious and by 8:15 clear. They had me dressed and out the door by 9:00. Unbelievable!
I’m taking it easy at home, but feel well enough and can actually sit to write this email, so thought I’d do it myself. This also works well for Scott :-). 
You cannot believe what a nasty thing I’ve had around my femur for the last 13 months! No wonder I was having so much trouble and pain. It is large, with square rough edges. The end where they cut it after cinching it tight post-hip replacement (imagine a metal zip tie) is very sharp and frayed. If you aren’t careful while handling it, it can cut your finger. And that was rubbing on my soft tissue all this time! I started to cry when I touched it and felt how sharp and rough and bulky it is. I attached photos so you can see it. Scott, thought to add the quarter to show the size. I took one close-up of that sharp, frayed end. I’m so glad I decided to have this surgery to get that nasty thing out of there!

I don’t have pain, though I am taking 1/2 a Tramadol every 4 hours to make sure I don’t get any when the blocks wear off… The really cool thing is that my muscles seem to be unaffected. I can walk, touch the floor, sit, bend my knees, reach my toes in a chair–all the things which are impossible for awhile after a replacement. I attached a photo of me doing tree even, on the surgical leg!

I came home with a new bandage (there’s a pic of that too). It comes with a battery/suction device that draws fluid out of the wound, so there is less chance of infection and improved healing. the surgeon explained that when he goes into the same incision a second time, there is greater risk and that this bandage system seems to ameliorate that significantly. The bummer is that I have to have this attached to me for the next two weeks! That means no pants and it’s getting too cold outdoors to be without them. I’m also not sure how I’m going to shower… May have to get creative with that! But, if it keeps me from getting an infection, I’m all for it in spite of the inconvenience. 

My sense is when that bandage comes off, I’ll be doing awesome. I’m already noticing that the snap is gone when I flex my muscles. It is now fluid and easy like the other side. I also discovered that I’m already standing more on that leg than I have been. I usually favor it and list to port when standing. I have had to consciously remind myself to stand on both legs, but already that is changing! Isn’t it amazing what our bodies can do?

Thanks to all of you for reaching out and keeping me in your prayers and thoughts. I always feel swaddled in all your love when I go in for a surgery. I dearly hope this is my last.

Much Love and Gratitude,
Rhonda

We decided to take a trip to the Redwood Forest and the Trinity River to soak in nature and all its good energy before my cable removal surgery. It was such a needed sojourn! 

Here are some of my favorite photos:

I came back renewed, yet still having difficulty psyching myself up for my third surgery in thirteen months. But, hiking through the hills of the redwoods, I had so much pain that I knew there was no option. It was the first time I’d done hills since my hip replacements, and even with hiking poles, it still hurt. I really don’t want to live the rest of my life with this kind of pain and disability. I want to be able to hike moderately in beautiful places and not fight this anymore. So, it has to go.

One more day. Tomorrow I spend half the day in pre-op appointments and then, at 7:00 a.m. on Wednesday, the cable will come out. Happy Halloween! Pray for me. 

I’ll let you know how it goes on the other side, when my head clears.

Wow, it’s hard to believe I’ve reached the one year mark with my right hip! Unfortunately, I am still struggling with that danged cerclage cable around the femur (aka The Zip Tie). I did a new video which demonstrates the problems I’m having functionally because of it. You can see it at this link:  Rhonda’s Hip Adventure Videos.

So, I went to see my surgeon for the one-year follow up appointment on September 18th. Both he and Davis watched me demonstrate for them what is on the video. Dr. Shukla had me stand next to him, so he could touch my thigh as I contracted my muscles. You can both hear and feel the snap of the muscles over the cable. I winced with the jolt this always gives me and he winced right along with me. I will always remember him looking up at me with his cherub face and telling me he was sorry, but he had to do it. I could tell by the look in his eyes that he understood how much pain and difficulty this cable has caused me over the year. I looked down and said, “I know you had to do it. We always agreed the structural integrity was the most important thing, and you nailed that. You told me the cable might bother me and if it did, we’d take it out. So, let’s just take it out.”

It was one of those sweet moments you never forget, when compassion shines through and you realize why you trust this man to help you function again with your legs under you and without pain. I know we are getting there. One last surgery to go. 

On October 31st (Halloween), they will take out the cable. It will be about a 20-minute operation. They will cut a 2-inch incision into the bottom of my current scar, part all the muscles to the bone, clip and remove the cable, and put me back together. I’ll have a different bandage this time that has a battery-operated catheter in it to remove fluids and help it heal faster. I’m looking forward to getting that thing out of there and seeing what I can do then!

Leftie is doing very well at four months, getting stronger and more flexible all the time. I occasionally get a little stiff and sore if I overdo, but mostly I can’t even tell I had a hip replacement on that side. I can’t wait to feel the same way on the right side!

I am at that magic 90-day mark when they say you are over the biggest hump of your hip healing. It’s WAY BETTER with this hip and I continue to be very grateful for this. My walk is back to normal, though I am still working on the stamina to go longer distances and to stand longer. Here’s the latest video of my walk (the last one):   Rhonda’s Hip Adventure Videos.

As you can see I no longer have a limp or stiff hip. Yay! I can do a mile pretty easily now and 2 miles once a week. I did learn this month that doing 2 miles three times in one week was a bad idea and I set myself back and had more pain and stiffness as a result. It’s taken a couple of weeks to get over that. I was just so excited to get back on all my familiar trails and favorite places… But there is nothing like pain to encourage you to return to your Goldilocks Zone!

My new routine includes swimming three times a week, walking a mile once a week and 2 once a week, plus short walks around the neighborhood more frequently. I also do Tai Chi and Qigong every morning for 30 minutes to wake up and warm up. I do yoga 3-4 times a week in the afternoons to stretch, keep up my core and upper body strength and work on my one-legged balance poses which strengthen my legs and improve my balance. 

I tend to move from one activity to another (sitting, standing, moving) at least every hour. This seems to keep me from having too much pain and stiffness by overdoing any one activity.  I can sit for 2+ hours if necessary (e.g. to watch a movie or performance). I do some stretches and flex muscles around the hips in my seat when I sit that long. 

I am down to taking 1-2 ibuprofen at night and one dropper of CBD oil for sleep. This is working well. 

I continue to have problems with bearing weight and really contracting the muscles in my right leg. At this point, I am solid in my plan to request the cable be removed at the end of October. I see my surgeon to discuss this on September 18th, so I’ll include the result of that conversation and some video footage of the problems I’m having with the cable in my next monthly update. 

Until then, I’m cruising along, staying in my Goldilocks Zone and listening to what my body tells me. It’s amazing how smart it is! You would think by now I’d be better at listening to it instead of what my head’s agenda is. But, the tricky thing is I still don’t know when I’m overdoing it until I’ve done it and then it’s too late! My advice to my fellow hipsters is take it easy and slowly build up your stamina and strength, even if it feels like you could keep going.

I have some exciting new milestone moments to share! My healing continues in leaps and bounds these days, surprising even me. I AM SO GRATEFUL!

This week I made it out to the Hemlock Grove for the first time in over a year. This is a very sacred place for me and it has been so hard to be unable to get there for so long. When I entered the grove, I started to cry and couldn’t stop for some time. It was like seeing a long lost friend. I could  feel all the special energy filling me up, restoring me at some deep level, like a drink of cool water for a parched soul. I laid back on the bare trunk of the old fallen Hemlock and stared up into the canopy. Evans Creek chuckled through the little meadow in the center. When my tears finally stopped, I knelt beside it and rinsed my face. I stayed until I felt complete, then wandered home slowly, stopping along the way to stretch my hips and legs. It’s about a 2-mile hike round trip, so I got stiff and had to loosen up and rest before continuing on. I was pretty sore the next day.

Today, I went out again with Scott and his family who are visiting. Luckily, one of them had a phone and took these photos:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yesterday I swam 1000 meters again for the first time since my second surgery! It felt effortless with no ill effects today. I didn’t think I could make it back out to the Hemlock Grove after doing that, but I did and I didn’t even have to stop this time! I guess we’ll see if I can still walk tonight…

I’ve been able to resume most of my yoga, but still struggle with one-legged balances, particularly the extensions out over my right leg (first hip). I am aware that I am favoring that leg all the time and it is weaker than my left. I’ll do the best I can with it until the cable can be removed in October. Then, we’ll see what I can do!

This morning I had my 6-week follow up with Davis. He was in one of his vintage suits with a very cool pair of shoes–such a dapper guy! I showed him my one-legged balances and demonstrated the difference between my right and left legs. I can easily hold a balance in any direction on my left leg (Hip #2), but I can’t stand on my right leg (Hip #1) and extend my left leg behind me. As soon as I try to extend out, my IT band hits the cerclage cable (zip tie) and gives out. I told him the PT’s and I discovered that when I do one-legged strength exercises, I’m stronger on Hip #2 and Hip #1 is atrophying. I asked to have the cable removed, if at my annual follow up in September, I am still having the same problems and cannot restore the strength and balance in my right leg. He agreed and said he would document it. He said, “If it really bothers you over the summer, let us know and we can schedule you for surgery to remove it.”

I am relieved that this didn’t require a fight, but wonder what the insurance company will say? Most of it will be on me, due to our high-deductible plan, so hopefully they won’t object. I’m certain at this point that if this doesn’t improve significantly by September, I want that cable out!

Overall, I told Davis, I am so thrilled with what they have done! I feel like I am structurally strong and balanced and I am having no other issues. This recovery is so much faster than the last one, and I’m very grateful for that.  They did an awesome job! I made sure he knew that I have never questioned the need for the cable and I’m glad they made the call they did, it has just been a sucky recovery because my muscles don’t like it. Fortunately, that is fixable.

This week I continued to make progress. I was able to walk a mile a few times, and I got up to 750 meters in the pool! My usual is 1000, so I’m pretty darn close already! My next goal is to work up to 2 miles and get back out to my favorite Hemlock Grove. My yoga and Tai Chi practices are getting back on track, except for those one-legged holds and strength moves on the right side. My flexibility is returning quickly, including being able to cross the left leg over my midline into a supine twist. Yay! That always helps my back release tension and it feels so good!

At this point, my restrictions are all officially lifted, so I can play at will and see what my body tells me. This is always a fun day! Last time I was still limping and experiencing pain, especially with walking very far and trying to go up stairs. This time, I have none of these issues. This is what I’d expected at this point last time. I remember Davis telling me it would come in 7-12 months and not to worry. I’m so grateful to be this good already, to not have to go through 7 months of painful frustration.

My annual follow-up is scheduled for September 18th. At that appointment, we will decide on the cable removal. If we decide to do it, I think I’ll aim for later October, before the holidays and after camping season. I don’t want to miss another summer and I’m good enough to get out there now! So, onwards and outwards into the world!

I will continue to do at least a monthly post for the next year, so my hip readers can see how things evolve over time.

Big highlight of the week: I was able to walk about 2/3 of a mile in the forest at Lake Tahoe! I didn’t think I could make it that far, but it was not a problem and I was just sore afterwards. Nothing a couple of ibuprofen couldn’t take care of. I am so stoked! Yesterday, I went down to Idlewild Park and walked along the Truckee River. This is one of my favorite places to walk. I haven’t been there in a year. I was able to say hi to the huge Cottonwood tree who feels like a long-lost, old friend. Again, I was able to go 2/3 of a mile. This is as far as I’ve been able to go without dying for the last year. I’ll bet I can make a mile next week and just keep slowly increasing it from there. It feels so good to walk again!

I realize that walking is an important part of the way I connect with myself and nature, and I’ve missed it more than I knew. I can’t wait to get back into the forest and be able to do hikes again. I’m content for them to be shorter and less strenuous than they once were. I booked our first summer camping trip in July, which is very exciting! We will go out in our cute little teardrop, Pearl. I’ll add a new category to the blog and start chronicling our fun adventures in her.

Pearl in the Redwoods, May, 2017

I also returned to my meditation cushion for morning practice:

 

 

 

 

 

 

 

After my last post I was able to shave my legs and do a pedicure. Oh, the simple things in life that make all the difference!

This is the point where the hip settles in to my body and the muscles begin to loosen up and strengthen. I can bend down and reach the floor now. I no longer have anxiety about dislocating the implant. However, I continue to move slowly and mindfully and to be very careful not to overdo it. That, my friends, is the golden trick. I have to thank my right hip for all the instruction it gave me on that subject!

This morning, I decided it was time to take all the PT props out of the guest bedroom now that I can get on my yoga mat on the floor in the back room. That is always a big moment, signaling a return to normal. It’s all happening so fast, I’m having a little trouble keeping up. But, I’m not complaining!

This afternoon, I returned to the pool again for the first time in 5 weeks. It was glorious to be back in the water! I oozed into it and stayed until I was pruney. I was able to do about 13 laps, so about 650 meters, which isn’t bad for my first day back! I also did 2 laps of walking front and sideways. Again, I am amazed at the difference between the hips, how much easier this one is than the last. I was so unsteady when I first started going to the pool last time, and I didn’t do that until 3 1/2 months after the surgery! I spent time in the warm water therapy pool, lollynoodling around luxuriously. (Lollynoodling is my word for when I float aimlessly around the pool, whirling and swirling, suspended on a noodle.)

Special Note: I made a video of my favorite stretches after a hip replacement (posterior approach) and added it to Rhonda’s Hip Adventure Videos. If you are one of my hip readers, you might want to check that out.

I’ve been doing well with not overdoing things for the last week. No major setbacks. I can walk about 1/2 mile now, with a couple of stops along the way. I do this about every other day. I’m still doing morning Qigong and Tai Chi. In the afternoons I add some strengthening exercises from physical therapy and also do yoga on my mat on the floor, now that I can get up and down off the floor safely.

I’m able to drive, go to the store and manage carts and grocery bags. I can stand long enough to prepare meals, clean up and do some light chores around the house. I can shower without the grab bar and long-handled brush, since I can easily reach my feet now. I think I’ll try a pedicure this week and see how it goes–shave my hairy legs! The raised toilet seat came off this morning.

I’m off the Celebrex and using ibuprofen occasionally for pain. Some days I don’t use anything but the ice/compression machine and stretching. I do continue to use the CBD salve and sublingual oil at night and I’m happy to say that I’m sleeping like a baby!

I’ve massaging vitamin E oil into my scar morning and night. It is laying down nicely and closing up now. It is important to work with scar tissue starting in the third week so it doesn’t set in. Use gentle circular motions. When it is healed enough, you can hold the center of the scar with one finger and then use a finger on the opposite hand to gently stroke and pull the scar out towards the ends. This is a helpful technique for smoothing out scar tissue.

I graduated from physical therapy yesterday. Last time that didn’t happen until week 7. Lori said she had never graduated someone this quickly, “But, I can’t give you anything that you don’t already have and that you can’t do for yourself.” And I know this is true. It is up to me now to work out my own therapy and healing process, staying in that precious Goldilocks Zone.

I came home from the appointment and cried. I am relieved that this rehab is so easy compared to the last one. But I also feel disoriented. Suddenly, so much is behind me already! I’m trying to catch up to that emotionally. I also realize fully how hard it was for me last time–frustrating and disappointing. I struggled so hard to get better (just like I did all those years I had pain and thought it was a soft tissue injury/problem). This is an old pattern of mine. Beating my head against a brick wall, because somehow that is going to get me where I want to go. I hope that I have learned from this experience to stop when I catch myself doing that and examine what I’m trying to force. I’m learning that acceptance and surrender, while working persistently and gently at one’s edge, is a much better approach!

Hopefully, I can remember this wisdom as I move into the summer and all the things I want to do that I haven’t been able to for so long. Pacing and patience, Rhonda. Be gentle and kind with yourself. (I think that message is for all of us.)