My Zebra Medical Journey: 5 Weeks Post-Op

Monday, July 13, 2009

5 Weeks Post-Op

Today is 5 weeks from my RPAO. I can not believe how far I have come, but yet there is still so much yet to do! I am able to do more and more each day and I am slowly regaining muscle strength, but I still have a few more weeks of no weight-bearing, which makes it difficult to regain strength. There are many things I can do which include:

Taking a shower/cleaning up by myself
Being able to pick up my leg and get into/out of the car by myself
Crutch fairly long distances lol :)
Get dressed without help, which includes getting shoes on and off!
Creatively carry things with my crutches ;)
Take only a few painkillers a day
Sleep with only waking up once during the night - Thank God!
Mastered stairs on my cool crutches
Regained some flexibility in my hip (I can move it laterally, pick up my knee like marching, almost kick my butt with my foot, etc...)

I am still swimming about once a week, which helps with range of motion and flexibility and this past week I started biking without resistance. I did a total of about 4 minutes without pain or any problems. The recovery is definitely a slow process, but I can see progress. The thing I can't wait to do most is get back to driving my car. I miss being able to take myself places and feel fully independent.

Also, this week brings a lot of happiness because I am getting a Mini Australian Shepherd, Chloe. She was born on 25 May 2009 and is only about 6 weeks old. She is black and white and will be the new addition to the household. I truly think she will help in my recovery as motivation to be able to play with her and something else to focus my attention on. I am very excited!

I have had a lot of doubts over the past few weeks, but I want to allow myself to recover before making any decisions in regards to my future in the Army. I just want to be at peace with whatever path it leads me. This has not been an easy journey and I have a long way to go, but I have also come along way in these past few weeks.

4 comments:

JenJuly 15, 2009 at 8:43 AM
Wow, Ashley, I have finally had a chance to read through your posts. You are being so tough! I hope I can get through as gracefully as you have been able to. Thanks again for all of your help and your emails, it is so much appreciated!

Jen
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ASpallaJuly 15, 2009 at 4:39 PM
Jen,

I am glad that I can help others through this very difficult process. It is not easy and I think it would be impossible to do it alone. I am glad that I can pass along my experiences to others and hopefully you will do the same! Health advocacy is my passion and what I plan on pursuing in grad school! This is just a start. Having an outlet and someone to talk to who truly understands is such a blessing in a time like this. If you need anything, don't hesitate to ask!

Ashley
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HipRNJuly 16, 2009 at 5:37 PM
Hi Ashley,
I've been following your blog off and on and I just wanted to say what an inspiration you are! I'm pretty close in age to you (I'm 28) and I will be having the first of my 2 surgeries on Dec. 29th. It's a long ways off yet, but I'm sure it'll be here way too soon:) I just wanted to know if you really thought the surgery was worth it? I know you've written that you've had doubts but if you really think on it, with the structure of the hip and the amount of pain you have now (not including surgical pain) do you really think it was the right choice? I am having doubts and terror myself b/c there are days when I really don't have a lot of pain, but then there are days where I'm really hurting so I know there's a reason I'm having a PAO! Maybe you could shed some insight for me:) Hope your recovery continues to go well and congrats on your new puppy!
Marcie
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ASpallaJuly 17, 2009 at 9:05 AM
Marcie,

I do have many doubts that I made the right decision and as I talk to other hippies who have gone through this they reassure me that these are normal feelings and when the healing is over it is worth it and they would do it all over again. I have to keep that in mind throughout my recovery and it is not an easy task and there are days where you are down, but then you realize in just a few weeks post-op that you have come so far. I believe that in the end it will be worth it, it just is not an easy task!

Ashley
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My Medical Team

Dr. Wyatt Horsley - Internist (IU Health)

Dr. Joshua Wellington - Physical Medicine/Rehab. & Pain Management Specialist (IU Health)

Dr. Alexia Torke - Palliative Care (IU Health)

Dr. Ravi Misra - Infectious Disease (IU Health)

Dr. Robert Nelson - Immunologst (IU Health)

Dr. Makram Hajj - Cardiologist (IU Health)

Dr. Michael Millis - Hip Preservation Surgeon (Children's Hospital of Boston)

Dr. Presley Swann - Hip Preservation Surgeon (Methodist Sports Medicine)

Dr. Joel Wells - Hip Preservation Surgeon (UTSW)

Dr. Brian Dierckman - Hip Preservation & Shoulder Surgeon (Elite Sports Medicine)

Dr. Todd Bertrand - Hip Surgeon (Franciscan)

Dr. Michael DiDonna - Hand Surgeon (IU Health)

Dr. Matt Horn - Chiropractor (Premier Family Chiropractic)

Noah Campbell - PT (Team Rehabilitation)

Surgeries

1. Lt. knee Lateral Release (May 2003)

2. Bilateral periosteal stripping, deep & superficial compartment releases (Porter - 26 Dec. 2006)

3. Bilateral anterior & lateral compartment releases, superficial peroneal nerve release (Porter- 18 Dec. 2007)

4. Rt. hip PAO, arthroscopy, labral debridement & ligament repair (Scheid & Maiers - 8 June 2009)

5. Lt. hip arthroscopy, iliopsoas release & labral debridement

(Maiers - 11 Feb. 2010)

6. Rt. hip arthroscopy, femoral osteochondroplasty, ilipsoas release & labral repair (Maiers- 10 Aug. 2010)

7. Rt. hip hardware removal, scar revision (Millis- 11 Jan. 2011)

8. Rt. varus femoral rotational osteotomy (Millis - 20 June 2011)

9. Rt. trochanteric transfer osteotomy and femoral blade-plate removal (Millis - 6 April 2012)

10. Lt. shoulder arthroscopy, capsulorraphy (5+ sutures), closed rotator interval, repairs (Dierckman - 17 Jan 2013)

11. Rt. trochanter/femoral hardware removal & debridement (Dierckman - 2 July 2013)

12. Rt. hip/femur infection IND (Dierckman - 14 July 2013)

13. Lt. hip arthroscopy w/anterior & posterior labral repairs, CAM & Pincer Resection, endocscopic IT band release, open capsulorraphy (Dierckman - 26 Nov 2013)

14. Lt. hip superficial infection IND (Dierckman - 21 Dec 2013)

15. Rt. shoulder arthroscopy, labral repair & capsulorraphy (~4-5 sutures), repairs (Dierckman - 31 Dec 2013)

16. Rt. hip arthroscopy, labral repair, Pincer resection, femoroplasty, capsulorraphy, gluteus medius repair, open femoral trochanteric revision (Domb - 8 Aug 2014)

17. Spinal Cord Neurostimulator Implant (Wellington - 21 Oct 2014)

18. Rt. shoulder arthoscopy, capsulorraphy (6+ anchors), labral repair (Dierckman - 20 Nov 2014)

19. Spinal Cord Neurostimulator pocket revision (Wellington - 20 Jan 2015)

20. Emergency Surgery for Spinal Cord Explant for Infection IND (Wellington - 21 Jan 2015)

21. Spinal Cord Neurostimulator Re-Implant (Wellington - 4 March 2015)

22. Lt. shoulder arthroscopy, capsulorraphy, labral repair (Badman - 29 Sept. 2015)

23. Lt. hip open surgical dislocation, labral reconstruction w/allograft, femoral osteochondroplasty, acetabuloplasty & LPAO (Swann - 8 Dec. 2015)

24. Lt. hip wound closure IND (Swann - 4 Jan. 2016)

25. Venous Access port (TIVAD) placement (Halum - 26 April 2016)

26. Rt. Total Hip Total Arthroplasty (Swann - 22 Nov. 2016)

27. Rt. Hip post-THA infection IND (Swann - 13 Jan. 2017)

28. Venous Access port explant (Halum - 18 April 2017)

29. Rt. THA Explant Spacer placement for infection (Swann - 21 April 2017)

30. Rt. THA Spacer explant, femoral osteotomy (Ongwijitwat- 29 June 2017)

31. Rt. Hip, Femur surgical bone biopsy & hip aspiration (Ongwijitwat - 25 April 2018)

32. Lt. Hip Hardware removal (Ongwijitwat - 29 May 2018)

33. Rt. Carpal tunnel release & De Quervain’s release (DiDonna - (5 Feb 2019)

34. Lt. Carpal tunnel release & De Quervain’s release (DiDonna - 28 March 2019)

35. Rt. Hip hardware removal & abx spacer implant (Swann - 26 Aug 2019)

36. Rt. Hip spacer explant, IND, bone resection (Swann - 14 Oct 2019)

37. Rt. Hip IND, bone resection - emergency (Bertrand - 25 March 2020)

38. Venous Access port (TIVAD) placement (Halum - 20 May 2020)

39. Venous Access port explant (Pyko - 28 May 2020)

40. Rt Hip IND, bone resection, complex closure (Wells - 12 June 2020)

41. Lt Hip endoscopic IT Band release, bursectomy (Dierckman - 3 March 2021)

42. Lt. Hip PAO hardware removal (Bertrand - 4 Nov. 2021)

EDS, Hip Dysplasia and Other Basics...

EDS: Ehlers Danlos Syndrome (EDS) is a group of inherited connective tissue disorders. There are 6 subtypes. I have Classical - Type 1. Classical EDS affects 2 to 5 in 100,000. Connective tissues are made up of proteins that support skin, bones, blood vessels, and other organs. They make up about 80% of the human body. Classical EDS patients have significant skin involvement, abnormal and poor wound healing, abnormal scarring, wounds and skin that tear open and the skin is soft and velvety to the touch. Patients can also present with an unusually large range of joint movement. The loose joints are unstable and prone to dislocation, chronic pain, and early-onset arthritis. There is no cure and treatment plans are individualized.

There are secondary conditions that are caused by EDS like dysautonomia which effects the autonomic nervous system. In my case I have severe burning nerve pain and a harder ability to control my BP, etc. Raynaud's syndrome is another disorder that branches off EDS that makes you very sensitive to hot and cold temperatures and effects circulation.

Hip Dysplasia: is a congenital condition in which the ball and socket joint don't fit together the way they should. In my case, the socket is too shallow, which causes uneven pressure on the joint, a premature breakdown of cartilage and early osteoarthritis.

PAO Surgery: A periacetabular osteotomy is a surgery in which the hip socket or acetabulum is cut at 3 different spots, so that the acetabulum can be repositioned for better alighnment. By re-positioning the acetabulum you are able to reach the coverage that is needed. Once the acetabulum has been shifted to its new position titanium pins and screws will be used to fixate the fractures until they heal.

FO: A Femoral Derotational Osteotomy is a surgery in which the femur is cut through the bone or a wedge is cut out so that the femur can be rotated into the correctly aligned position. Then they will use either a blade-plate or a titanium rod and screws to fixate the femur in its new position until the fracture heals.

CRPS: Complex Regional Pain Syndrome CRPS is a chronic and progressive (nerve) pain disorder. CRPS is marked by intense burning or aching pain. Patients may also experience swelling, skin discoloration, altered temperature, abnormal sweating, and hypersensitivity in the affected area. The cause is unknown although most cases occur after trauma to the body (surgery, fractures, etc) and there is no cure. It can spread to other parts of the body. Treatment focuses on relieving the pain. There are 2 classifications for CRPS which are: CRPS Type-1 which was known as RSD or Reflex Sympathetic Dystrophy and CRPS Type-2 which was known as Causalgia or sympathetically mediated pain. Both Types have the same symptoms, but in Type-2 there is a known damaged nerve.

It is believed to be connected to EDS