Surgery Pre-Op & Testing

Yesterday I had my pre-op day and I had to return today for some additional testing before being cleared for surgery. My mom and I flew into Boston around 8am. We had a 6am flight out of Indy and were at the airport even earlier than that. I had finished my last summer class assignment the night before by giving my presentation early. It was real tight getting everything in prior to leaving, especially since summer classes are accelerated already! Let's just say that I was glad to have that part over. I had some last minute things to complete, but spent most of the night giving my aussie, Chloe, some individual attention with tummy rubs and cuddle time. I missed her before I even left. I even ask for pictures to be texted to me throughout the day. This is the 2nd longest time I have been away from her and I miss her like crazy. I ended up not going to sleep at all until the flight.

Yesterday was a VERY long day. Once we landed in Boston we dropped our bags off at the Devon Nicole House. It is housing for Children's patients who are coming from more than 50 miles and offers and more "homey" and affordable place to stay, especially for extended period of times. Once we dropped off our bags, we headed straight to Children's to start all the appointments. It was a little backwards from the traditional process that they use. I started with my pre-op appointment in the Ortho Department. I met Jill while I was waiting for my appointment. She is sooo sweet! She had follow-up appointments that day and after we were both done had plans to go shopping and out to eat. The wait was not long at all and then it was my turn. To my surprise Dr. Millis and Dr. Novias were not there because they were in NY, so my appointment would be with the PA, Erin, who I had never met. I was a little confused at first because when Dr. Millis and I had communicated via email, I was under the impression that he would be there. I still had questions nonetheless, so Erin did her best to answer my questions for about a half hour. A couple will have to wait for prior to surgery because she was not as familiar with my case, concerns, etc.

Questions I asked were:

How long will the surgery take? Approx. 3 hours

How long am I expected to be In-Patient? 4-5 days is expected

What type of hardware will be used? Blade-plate and screws

When does the hardware come out? Depends on bone healing, so can be as early as 4 months or 8+ months.

When I need my LPAO, can the right femoral osteotomy hardware hardware be removed at the same time? Yes

Will I need a scope in addition to the FO to repair the torn labrum? Possibly. It will depend on how I feel after surgery and if the ostetomy is able to take pressure off the tear. If it can not or the tear is large enough to protrude and catch in the joint then it can be done locally with Dr. Maiers. The last scope my labrum was soft and had already sustained 3 tears. There is a 50/50 chance of needing another scope.

Will I be using a CPM during recovery? It will depend on if Dr. Millis thinks I will benefit from one because of potential scar tissue build-up or stiffness.

What are my nerve & pain precautions? Anesthesiology highly recommends an epidural because of the nerve hypersensitivity and the better ability to control pain, etc. A pain team will be following up with care as well. I will also take Lyrica the morning of my surgery to help prevent flairs as well.

What will be my weight-bearing restrictions? 1/6th till 4 weeks, so about 15-25lbs at most.

Driving? Can not drive till I am able to lift my leg. During surgery the muscle is retracted and "shut-downs" for awhile. So, until it begins firing and some strength returns then it will feasible to drive.

EDS precautions? Left hip and shoulder have been increasingly more unstable. We are going to work on things one at a time, but probably during the first weeks I can work on rehab to strengthen my shoulder which will hopefully help until it can be addressed later on. The left hip will be addressed during some post-ops and will discuss options later. This was harder because I really wanted to talk to Millis about this, but will hopefully have a few minutes prior to surgery to mention my concerns.

Dr. Maiers will be doing my local follow-up so I will see Maiers for wound-care(I always have healing issues and get post-op infections because of my EDS), a follow-up at 1 and 2 months and then will be back at Children's for a 3 month follow-up.

After Ortho I went to PT. PT was super-quick because it was going over proper form with my crutches. She said I am a "Pro." You have to be for as many surgeries as I have had :) Then I was off to Pre-Admitting. This is where they double check your paperwork, do some vitals and pre-op labs, go over the medical history and see an anesthesiologist for a consult. This was not too long. Everything was fairly routine, except the Anesthesiologist wanted an Echo as a baseline because of my EDS. She just wanted to make sure there was not any abnormalities or issues they needed to be aware of. She was able to get me in the next morning. After some routine labs we were done for the day. I had to be back at Children's the following morning for an Echo and to check with the Blood Center about the blood I banked in Indy.

After about 5 hours at Children's we were off to meet up with Jill and shop Newbury Street, the Rodeo Drive of Boston. It definitely was!!! The stores were amazing. They had everything from Chanel, The North Face, Pet Boutiques and Forever 21. There was also some great places to eat. We ate a snack at a local bar and the home-style nachos were amazing! We all got to talk a bit and learn more about Jill and she explained some different things about herself as well as EDS. Once the shops started to close down and we were wiped we headed back to Jill's hotel. WE grabbed dinner at this Irish bar and restaurant near her hotel. After that we parted ways because we were wiped! Jill and I probably overdid it with walking and being on our feet. I definitely felt it the next morning :) I fell asleep without a problem!

This morning I had to get-up and go get an Echo in the Cardiology Department. It took about an hour because it was a baseline and needed to be thorough and get lots of measurements. I was able to watch Sweet Home Alabama during the test. The Cardiologist thought the images looked good and I was cleared for surgery!!! It was also nice to know that my heart looked good for now. We checked with the Blood Center about my banked blood and confirmed that he had made it to Children's and was ready for my surgery. Again, we headed about to the house, freshened up and headed out into Boston. We headed to the Prudential Center for shopping and dinner because it was expected to rain. On the way I got a call from the surgery scheduler and that my surgery had been moved up. Mind you that I had just found out about an hour before the time and it was already being moved. lol When Dr. Millis prefers it a certain way, he gets it a certain way ;) It was another long day and my hip have definitely been worn out. I am looking forward to doing the Trolley Tour through the city this weekend and see all the historical sites and some fun shops. Of course, we have to leave after the parade for the Bruins Stanley Cup win!! I don't mind sleeping in a bit and watching the parade on TV. I am not sure if I would be able to handle a lot of people, walking, etc., I am pretty worn out.

I do look forward to some fun this weekend. I have been overwhelmed dealing with everything and have so badly needed a break. I am uncertain if I will actually get it though because my mom has been so hard on me and we clash heads a lot. I just so badly want some fun and everything has been a problem lately with her, so its hard to enjoy anything. I don't know if I can handle a continuous beatdown. I am already very anxious about the surgery. I hope it helps and there is some good news because I don't know if I handle anymore bad news.


Jill and Me

A Few Days Left

It is currently in the wee hours of Tuesday, June 14th, 2011. I will be leaving for Boston in about 48 hours. In about 12 hours I will be taking my summer class finals early, leaving only a presentation to do tomorrow night. I really wish these courses would have been offered in the fall because the Professors were nice and the classes were pretty interesting. I took Criminal Law and Bankruptcy Law which only leaves 2 classes, I believe, for my Paralegal Certification. I am hoping to finish those in the fall on a part-time status and work full-time during the day. That is my goal anyway, barring any complications from surgery or recovery. I am fairly concerned about my left hip and shoulder because they are becoming more and more unstable from the burden they have taken. I am hoping PT, Dr. Millis & Maiers, and myself will be able to workout a plan to safeguard my other joints while my right hip/leg heal. I will hopefully find that out on Thursday during my pre-op, etc. I have an entire list of questions and have been adding to them as different things come to mind.

I have felt very overwhelmed lately with trying to finish classes (why I took summer classes, I don't know!), getting my apartment "recovery friendly" and all the last minute things that go on with traveling, etc. I have barely had any time to relax or do anything for myself. I desperately want a break and not one that involves my bones or a stay at a hospital. I have literally gone non-stop for over 2 years with 5 surgeries during that window. I have either been in school, working, recovering from surgery, surgery during breaks or during school, working full-time during breaks to pay for surgery, etc. There has been little or no down-time to relax and at this point I am desperate for some TLC. There has been no trips, weekend getaways, concerts, nothing. I so badly want some time off. I sit here with tears rolling down my face as I write because I feel so overwhelmed. I am trying to stay positive, but I know this is not the last surgery because my left hip still needs to be addressed. There has been so many moments in which I want to cancel and avoid this all together. I have my doubts that I can keep doing this. I am giving all I have just to keep it together and get everything accomplished in the next hours. I am just hoping that I get to enjoy some time in Boston before surgery on Monday. I am planning to meet up with Jill Thursday for a bite to eat and shopping on Newbury St. I hope that some company and cute shops will bring my spirits up.

Boston or Bust

The last couple weeks have been stressful and the next 10 days will only be increasingly more stressful. As the spring classes ended, the summer session started only a few days later, leaving no time for a break. The first weekend of my summer session I spent with my Army National Guard unit to do our monthly training and medical mission. Although I am not physically able to do a lot, it is nice to be in a medical unit where I do have a job and can feel like I am contributing to the mission. And, of course, I do love my unit! I have some very close friends or family and we can make almost anything fun. The downside is that the weekends are very long and with trouble or no sleeping it becomes very draining. I am hoping that after surgery with less pain and better function life will begin to return to normal, I will be able to sleep and function more normally.

SPC. Heather Moon, SSG. Angela Darrall, SPC. Lauren Guieb, Me

My baby, Chloe, turned 2 this year! She has definitely matured a lot and we have bonded very closely. I love her soo much and definitely spoil her as often as I can. The 25th is her birthday and I had planned to get her some favorite treats at 3 Dog Bakery and some new toys. The weekend prior to her birthday I noticed some small, hard growths on the side of her lip, which had not been there just a few days earlier. Sunday morning I took her to Banfield Pet Hospital to see her vet. The vet did determine that they were not cysts, but tumors and highly recommended having them removed and biopsied because there were concerning. Also, since she would already be under anesthesia he suggested dental scaling to maintain her dental health, etc. I agreed and we scheduled Chloe for surgery, but unfortunately, it would be on her birthday. Wednesday she went in for her surgery and dental cleaning. The surgery went great, removed the tumors, stitched her up and sent her home with some pearly whites. She would have stitches in for 2 weeks. A few days later I was trimming her nails and noticed another growth, but on her paw. My stomach sank. I felt so terrible because she may have to go through this process again and that the biopsies may not come back with good results. The following morning we were back at the vet. The vet determined that it was an interdigital cyst and not related to the other growth. It was an inflammatory reaction that is very common in dogs, especially with longer coats. Back home we went. That evening I noticed Chloe digging and scratching at her ear. I examined her ear and it was obvious that she had a bad ear infection. I tried cleaning it out and holding warm compresses on it because I did not have any meds and we would have to return to the vet again in the morning. Poor pup was so miserable. I held and tried to comfort her all night. Sunday morning when I woke to get ready to take her to the vet I noticed her making a strange noise and her whole body was convulsing. I tried waking her, but her eyes were rolled in the back of her head. Chloe had just had a seizure. I couldn't believe it and just felt so horrible for her. What a terrible week! Chloe and I headed back to the vet for the 4th time in 8 days. The vet took a culture of the discharge in her ear. It was definitely an ear infection because of the overgrowth of yeast. It was probably caused by the post-op antibiotics throwing of the yeast/bacteria balance. He looked at her paw as well. Chloe was given meds for the ear and paw. One of the meds would help with both the inflammation in the ear as well as the paw. We also discussed her seizure. He determined it was probably caused by the cumulative period of stress. It is not uncommon for high-anxiety dogs such as Aussies and Border Collies to have a seizure after a high or cumulative period of stress. It is something we would just have to be cognizant of. We were also able to find out the results of the biopsy which were negative, benign tumors. Whew! What a relief! I couldn't bare the thought of losing Chloe. Again, we headed home, armed with meds and would hopefully not return till the follow-up for the stitches. Within a few doses Chloe was doing significantly better and after a couple of days she got her spunk back!

Chloe's 2nd Birthday-May 25th

I am so glad that Chloe is on the mend because there would be no way that I could leave her sick in Indy while I would be in Boston. She is my fur-child and I need to make sure she is okay. I am just glad that she is feeling so much better. I hate seeing her in pain and sick. I only have a week and a half before I leave for Boston. There is so much left to do and yet, I am so anxious about another surgery. You think I would be use to it by now being that this one will be #8! I will be finishing my summer session a week early so I will be taking my finals, giving a presentation and turning in papers/projects before I leave next Thursday morning. Also, I need to prep and clean my apartment, pick up last minute items, clean, pack, and go to a couple last-minute doctor appointments. One will be to an ophthamologist because my "good" eye suddenly has periods of blindness or will be completely unfocused. I am worried it is related to my EDS. So, I will be having it checked this Friday just for my peace of mind.

Although my last few days prior to leaving are maxed with things to get done, I can not stop thinking about surgery. For the first time this weekend I thought about canceling it altogether. I get so anxious prior to surgery, but especially prior to major ones such as my RPAO and this FO. This is also more nerve-racking for me because this is a surgery to attempt to fix what was botched 2 years ago. This will also be different because my care team is aware of the EDS and consistent healing issues, but will also be having to deal with pain management problems because of the nerve hypersensitivity and the deterioration of my hip. I know I am in great hands with Dr. Millis and Children's, but I am still terrified. I know that my hip will never be perfect, nor will I ever be pain free but, it is hard because my case does baffle my doc and at best my hip may be 65-70%. This is a C-D grade range. I never liked anything below a B in school and especially when it involves my health! I also may need another surgery, maybe 2, to address additional issues. I will probably need to have a scope to repair my labrum again, but would be done locally with Dr. Maiers. That will be determined during recovery and how the hip heals. I will need to hardware removed after the bone heals, around a year minimum. This only addresses the right hip. During these last few years my left hip has had to compensate so much it has deteriorated. It is less stable, weaker, has chronic bursitis and consistent pain. This will need to be addressed within the next year because it is clear the scope is no longer helping the problems. This will be discussed during my pre-op appointment when we go over the game plan.

I am becoming increasingly more anxious as the days, hours go by. I was watching one of my favorite shows, House, and they were putting a girl to sleep for a surgery and the thought of that process for my surgery made my stomach flip. I have had moments where I don't want to do this; I don't think I can do this; Should I cancel? I have moments of doubts and wonder will this work? Should I cut my losses and quit now? I know part of this is anxiety and part of this is because I trusted a doc originally and it ended up disastrous. I know I will be in great hands, but it doesn't take away the history, the feelings, the pain. I just hope that this greatly improves pain and function. And I hope that I don't do this and then still need a re-RPAO or THR. That is probably my worst fear.