CHD+PAO=WTF!

Margaret Irene 6-19-2010 1:28 am 8lbs 13 oz 20.5 in

2010-09-11T19:34:00.001-07:00

First Moments

Natural Blonde Highlights

Bright eyes!

Big Brother Caleb and new baby sister!

Update

2010-09-11T19:03:00.001-07:00

Wow, I am terrible at this blogging thing. A lot has happened since my last post. Here is the short version. I ended up transferring my OB care to a midwife group at Iowa City. I went into labor naturally and was allowed to VBAC. I went through 19 hours of labor with no pain medication, but in the end had to have another c-section. Unfortunately I have an android shaped pelvis on top of the hip dysplasia. My type of pelvis is the hardest for babies to pass through. My daughter, Margaret Irene, was face up, her head and neck where tilted up instead of down, and she was 8 lbs 13 oz. None of those factors help when you have an android pelvis. My son presented in the exact same way, so my body for some reason puts babies in the absolute worst position.
Labor wasn't so bad, I had a doula and I was able to sit in the whirlpool tub for several hours, everything progressed very well, until it was time to push. I tried squatting and every other position available, but Maggie never budged from the zero station. After almost 4 hours of pushing, I knew that I wouldn't be giving birth naturally. She was so stuck against my pelvic bone that the OB sounded like she was giving birth with all the grunting she did trying to get Maggie out.
The thing I remember the most was that toward the end my left hip hurt more than the labor pains. It felt like I need to stretch it out and not put anymore weight on it. My left hip is still super weak and the pregnancy did not help. If anyone is contemplating pregnancy after the PAO I would recommend waiting a little longer before pregnancy. The hip did great during the pregnancy I don't remember having a lot of pain, no locking up, no feeling like I couldn't walk.
Emotionally this has been very hard for me, another surgery, the third in 4 years. I am grateful for my beautiful daughter but my husband and I worked so hard to have a natural birth. I really believed that I would be able to do it, and when it didn't happen I was devastated.
The second c-section was more difficult, my wound had to be re-opened because of all the scar tissue I had from the last one. Once again my wonderful husband had to take care of me. He had to pack my wound twice a day for about 4 weeks, and put up with my emotional break downs.
Today Maggie is 12 weeks old, I just went back to work last week and life is starting to get back to normal. I am concerned that I will have to have another PAO. I hope not, but righty has been stiff in the mornings and it takes me awhile to get going. I haven't had any follow up in a year since my pregnancy prevented x-rays from being taken. I plan to make an appointment for the fall, hopefully I will get good news and righty will behave.

1 year past LPAO & 34 weeks pregnant!

2010-05-07T16:31:00.000-07:00

It is a big day at the Carlson household, my one year anniversary from my LPAO. According to my husband, "It feels like it was a lifetime ago." I feel like it was a little more recent. If I wasn't 25 pounds heavier and would have kept up with my physical therapy exercises, maybe I would be feeling further along. Dr. Mckinley said my recovery would be slowed down by the pregnancy, he was right again! I have no issues standing all day at work or walking long distances. There is no more locking up of the left hip, but I do have a nagging pain in the back of my left hip that gets worse if I move the wrong way. I didn't start to notice this pain until recently in my pregnancy so I am hoping it is due to the extra weight I am packing on.
I have started doing prenatal yoga once a week. I feel great while I am doing it. (I do the best I can, I always was the most inflexible person I ever knew!) Unfortunately the day after I am SORE and then noticed this little nagging pain. I also discovered that my hip flexors in my left hip are really weak, which I have to say really surprised me. I can barely lift my own weight of the left leg when I am sitting down with legs extended in front of me. It is getting better though I can lift it a little easier than I did when I started the yoga class.
I am also seeing my D.O. again for manipulations. I am seeing him just as much as my OB for prenatal adjustments. In the beginning my left pelvic bone wouldn't move at all, now last week it is moving so hopefully that will mean success for my VBAC. I switched OB offices to have a group that is a little (not much) more supportive of VBACs.
I am really hoping to avoid a PAO on the right, I think it is still too soon to tell if I will need one or not, I am just taking one day at a time.

10 months post PAO

2010-03-13T15:13:00.000-08:00

It is crazy how time flies and how I keep meaning to post more often than I do. Since my last post we have found out that I am having a girl! We are very excited to complete our family. What could be more perfect than a boy and a girl?
Hip wise things have been ok. I do feel quite a bit of weakness in the left hip. I imagine it has to do with the lack of weight lifting I have not been doing. My OB does not want me to do a lot of lifting so I have been using the exercise bike a few times a week. It does help, but it is so boring! I have some numbness when I lay on my left during sleep, I always was a tummy sleeper and the belly is making that impossible. Thankfully there is no locking up so I am happy with that result! I do have pain in the left buttock now and then, I think this is do to the weakness and fact that I am adding the extra weight from the pregnancy. All in all the aches and pains are not much different than my last pregnancy.
In the back of my head I am worried I will have to have a PAO on my right. The relaxin released in pregnancy is great for birthing babies, but not so great for dysplastic hips. I have had some locking and weakness in the right hip. I will worry about that bridge later though. Right now the big dilemma is to have a vaginal birth after cesarean (VBAC) or not.
My last post said I was 85% sure I was doing a repeat C-Section, but now as it gets closer the thought of one more surgery is not appealing to me. So many worries though, wondering if my hips will allow me to do it since Caleb never got past my pelvis before. (He was 9lbs and face up - the most difficult position to push out!) I know the PAO should not have any effect on the vaginal birth, but my right hip bone is smaller than my left so in the back of my mind I wonder if my hips expand the way they should. Of course there is no one to answer this question. My OB's want me to do the C-section, they say I have a 13% chance of success with the VBAC based on how my last labor went. (Fully dilated and pushed for 2 hours with no movement from the "0" position) That percentage comes from a study done in 1997 though so I wonder how accurate it is anymore. The big worry is uterine rupture, only a 1% chance, but the outcome could be catastrophic and I am usually the worst case scenario type person. So, like I said not an easy decision. I would like to see if these hips and my body could do a natural childbirth, but still not sure if it is the right decision for me. I will keep everyone updated with my decision, I promise! I would like to thank all of the Hip Women on the yahoo group for their quick responses and great advice, it does help to chat with people who have been through the same things I am going through.

6 months post LPAO

2009-11-19T18:25:00.000-08:00

I had to look at the calendar to realize how long it has been since my surgery, so I guess that is a good thing. I had my last follow up appointment in Iowa City on October 16th. I didn't get to take any new X-Rays, because I found out that I am pregnant with my second child! It would have been nice to see how the hip was looking, but I can wait until next June to check it out. My doctor is not concerned at all about the pregnancy, just mentioned that my rehab may take longer. I can already feel my body becoming less strong. I have not been going to the gym. I have just been so tired! I plan to get back in there though, I need to exercise for reasons beyond my hip. My last pregnancy I came very close to being diagnosed with gestational diabetes. My last pregnancy ended in a C-section, so I am 85% sure I will have another one with this pregnancy. I say this based upon my experience with trying to push out a 9lb baby, my hips are not even in the picture and anyone who gets pregnant after having a PAO is able to have a vaginal birth.
Last month I was having pain in the back of my left hip, I worried that something had moved or fractured, but Dr. Mckinley said there was no stress fracture after examining my hip. I haven't had the pain since, so maybe it was in my head? I can sit for extended periods of time with my hip in the "captain" position (ie. sitting on steps, etc.) and it doesn't lock up anymore. When I bend down to tie my shoes there is still a slight pain after I get up, but nothing like it was. I wouldn't say the hip is perfect, but it is better. I think I made the right choice. I guess I am waiting to see how I am in a year. Next month I am going back to my D.O. that referred me to the orthopedic surgeon. I need to have my heel lift evaluated. Dr. Mckinley said that the surgery should have no effect on my short leg, but I feel like it isn't quite right.
My right hip has been letting me know that it is not feeling great. Last month it locked up on me for a second as I was going up some steps. I only had one instance of that, so I am hoping I can get through this pregnancy and keep my hip intact. I don't want any ligaments to loosen and make the hip more dysplastic than it already is! I really don't want to have a second surgery. The first was tough, not only on me, but my husband and family. I will post again after I see my D.O. and try to update everyone on the pregnancy/hips.

4 months post PAO

2009-09-07T19:23:00.000-07:00

Today in the honor of Labor Day, Logan and I cleaned the majority of windows in my house today. We still have our four season porch left to do, but they fold inward so we can clean them from the inside, so much easier. I know Labor Day is supposed to be a holiday for relaxing, but it was a beautiful day to clean windows and we don't get too many days together to work on house projects.
My hip has been much better. I can get up off the floor with no problems. I have even been able to get in the gym about 3 times per week. I can do about 20 minutes on the elliptical or around 2 miles. Then I usually do some weights. My hip used to lock up after doing the leg press machine. My hip doesn't lock up anymore, but I don't think it is 100% yet. I still fill a little weak after getting done with the machine, but it feels so good to be able to exercise. Slowly the weight I gained after my surgery is coming off.
All in all life is getting back to normal. I can even lay on my operated side to sleep at night. I still have numbness in the front of my upper thigh, but the only time I have real pain is when anyone presses on the area around my scar. Once in awhile I get a few aches, but I try not to analyze every one I have. I have some bad days, with stiffness in the morning, but some stretches and moving around helps a lot! I think I still have a slight limp, but I can't really tell unless I am really tired. Next month we go back to Iowa City. I was hoping I would be pregnant by now, but it hasn't happened yet, so I guess I will be getting more X-Rays.

13 weeks post PAO

2009-08-07T17:47:00.000-07:00

Well I am finally 3 months post my LPAO. I have to admit I am not very good with keeping up with my blog. I can't believe it has been almost a month since my last post. Mostly I started back to work the second week of July. The first shift was 4 hours, after standing for 4 hours my legs felt like jello. I gradually increased my time and my stamina has come back. I am now back to work full time. I can stand for the entire 8 hours as long as I sit down for at least 20 minutes for lunch. (No Pharmacists don't take very many breaks!)
Yesterday was my last day of physical therapy. In the beginning I went three days a week for the first 3 weeks and then went down to 2 days a week. I am convinced that physical therapy is why I have done so well. I started as soon as I could weight bear. At first the exercises were me just lifting my leg weight, now I am up to 5lbs on the ankle weights. I am doing lunges and sidesteps. It sucked while I was doing it. The pain and fatigue was a lot to bear on some days, but now I feel almost back to normal and my co-workers forget that I had a major hip surgery since I can walk around the pharmacy just as quick as they can.
I still have trouble bringing my hip upward in the "captain" position. My physical therapist said ankle weights and just lifting my leg will help with that. I also have a hard time lifting my body weight off the floor (from a kneeling position) but I can tell it is getting better. The therapist also cleared me for the elliptical. Whoo Hoo! I have about 15 pounds to lose to get down to my pre-surgery weight. Damn you skittles!
My pain level is quite low. If I take 800mg of ibuprofen in the AM, then I don't feel any pain. Today I didn't take any Ibuprofen and there is a slight nagging pain near the scar and in the back of my leg on both sides. I still have numbness in the front of my leg and my abdomen.
I will try to blog monthly from now on, unless a major development occurs. My next doctor's appointment isn't until October. So no news is good news.
I would like to thank everyone who helped me while I was laid up, I had lots of help and am so grateful for the support. Hopefully I will never have to do this type of surgery on my right hip, but only time will tell.

9 weeks post PAO

2009-07-12T12:23:00.000-07:00

Last Thursday was the 9 week mark after my LPAO. I marked it by going back to work. My job as a pharmacist requires me to be on my feet and walk around the pharmacy with quick movements from computer to fax to computer to the counter to verify and anywhere else in between. The first 2 hours went very well, but then my legs felt so tired and a little shaky. I kept going though, but by the end of four hours I was ready to go home and my limp got progressively worse. The good news is that after I got home and sat for a few hours I was feeling pretty good and was able to make dinner and be back on my feet. On Friday at physical therapy the exercises seemed a little easier, the therapist even added a 2lb weight. I think the standing helped. This weekend I have been taking care of my son on my own. It is the first time since my surgery. It feels really good to be getting back to normal. I have even been able to do laundry today and carry the baskets up and down the stairs.
This next week I have 3 more physical therapy visits and I am going to work 3 days. My goal is to last a full 8 hours. I know I will have to make myself sit in order to do it, but I think I should be able to accomplish my goal.
I don't know why I have been able to get back to normal so fast. I worked out before but was never very athletic. I think my stubbornness has helped a lot. When I have my mind set on something, I usually can make it happen. I guess it is true, attitude is everything!

Walking Again!

2009-07-01T10:40:00.001-07:00

I have been very busy since my last post. Last Friday we went back to IA City and took new X-Rays. Everything looked great so I was given the "all clear" to put weight on my left. I was told there were no restrictions on my movements. If I can tolerate it, I can do it. I was also cleared to drive again, which has been so nice!
Friday evening after my appointment we drove to my friend's cabin at Lake Okoboji. I used the crutches Friday evening but gradually became more confident so that my Saturday afternoon I had ditched the crutches. I have a very pronounced limp that I am working on. It is amazing how easy it is to forget the whole "heel, toe, and bend the knee." My muscles hurt very bad. Mostly in the back of my legs, in the hamstrings. Did I mention how weak my leg is? I can barely lift it upward when lying on my back. I have a lot of work to do, but I am excited to be working towards the end of this story. My mood has improved a lot now that I am able to help with the laundry, cooking, and grocery shopping.
Yesterday I had my first physical therapy appointment. OUCH! I think the most painful part was the massage on my scar. I was given some exercises to do at home and have another appointment on Thursday. I could tell that afterwards I was sooo tired. I took some ibuprofen and felt much better by the evening after I rested for a bit. I am so amazed at how quickly I can get tired and worn out. The other thing I could tell right away was some of the strength was coming back and it made walking without a limp a little bit easier. It is so nice to start to get back to normal!

7 weeks post PAO!

2009-06-25T08:21:00.000-07:00

Whew! I finally made it. Tomorrow I go back to IA City for X-rays and hopefully be told I can begin to weight bear. I hope I can, because I have been cheating. (Shhh, don't tell my doctor's office.) I don't recommend for everyone to cheat, but I have been feeling pretty good, haven't even needed to take tylenol for the past week. I have quite a limp, but I can take little steps. I am not confident to do it a long distance from my walker though! I even stood during my shower today, taking small steps around the tub to get clean. It went pretty well, but after cheating for the past 2 hours I can tell I am tired and I have some discomfort.
Today will be a short post, I will have more to report after my appointment tomorrow. This weekend my family and I will travel to Okoboji after my appointment in IA City. It will be a lot of driving, but I am so excited to have a mini reunion with my college friends. So stay tuned, the next post should be good!

6 Weeks PAO - Belated

2009-06-21T18:00:00.000-07:00

It has been a little over 6 weeks since my surgery. I was unable to post on the exact date due to the fact I was at a state pharmacy meeting over the weekend. I was a little nervous about the weekend, I would have to stay in a hotel and be on crutches for the entire time. Fortunately the hotel had a great handicapped accessible room complete with transfer bench. My husband was able to travel with me. I still can't put on my own socks!
Everyone at the meeting was really friendly and many helped me open doors and pull out chairs for me. I am glad I live in Iowa where the people are so friendly. I don't know if people would help me out as much if I lived in New York, for example.
I do wish I had a dollar for every time I had to say periacetabular osteotomy. Even in a room full of pharmacists I still got looks of shock and "periacetabular what?"
I must say I can not wait until next week. I go back to Iowa City for follow up x-rays. Hopefully I will get the all clear to bear weight on the left. I have been so ready to walk I gave it a shot last week. Just a little step to see what would happen. Unfortunately my muscles are so weak that I almost fell over. I have been trying to stand on both legs to try to put a little more weight to strengthen those muscles. I don't feel any pain and it almost feels normal.
For my final note, being that today is Father's day, I have to give a big thank you to my husband. He has taken very good care of Caleb and his one-legged wife. We have had a few frustrating times due to my controlling type "A" personality, but we always get through it. We both can't wait to get life back to normal.

5 weeks post PAO

2009-06-12T18:28:00.000-07:00

It is hard to believe that it has been five weeks since my procedure. Today I have not taken any narcotic pain medications, only tylenol. I still have some minor pain, but it is tolerable so I may not need to take any more percocet. Last week I had a couple of days where my pain increased, my back hurt so bad and my muscles felt so stiff, but today I am feeling pretty good.

I reached another milestone in my recovery journey - I put my own shoes on by myself! I am as excited as my two year old!

I thought I would share about some of the useful items I use in my daily activities. I have been able to shower by myself about a week after I came home. I attribute this to my awesome transfer bench. It comes out of the tub so I am able to back on to it to sit and then turn around into the tub. I also have my shower head on a hose so it is very easy to shower. I have a long handeled "poof" that has allowed me to wash my legs even in the early days when I could not bend forward. I also bought a shower caddy that sticks to the wall to hold my shampoo and soap at a handy level for me. I bought one made by OXO, the suction cups really hold very well. I also purchased some rails for my toilet. It was very easy to install. I never bought an elevated seat, I find the railings have worked fine for me. Lastly I think my walker is great for in the house. I like it more than my crutches for in the house, mostly because when I put my crutches anywhere they fall down. So I use my crutches to go up and down the stairs in my house and out in public. I did purchase a grabber, but I don't really use it. I was able to order all of these items from my pharmacy. Most pharmacies should be able to order them, I just paid cash from my medical flex account and didn't try to turn it into my insurance because I didn't want to bother, but I think some insurances will cover these home health care items. Some of these items might even be able to be rented, such as the transfer bench.

My toilet rails

Shower caddy that attaches to wall

My transfer bench

My shower scene

4 weeks post PAO

2009-06-04T11:10:00.000-07:00

My scar a little over 3 weeks post PAO

It has been 4 weeks since my PAO. I didn't get last week posted, I wish I could say I was too busy, but that would not be true. I just didn't feel like doing too much. I would say that has been one of the hardest things for me, keeping motivated. It is very easy to fall into moods that cause me to feel like doing nothing. I am going to try to keep busy from now on. I have tons of journals and CE that I could get a jump start on, plus I have boxes of pictures to put in photo albums, so I do have things to keep me busy. Besides, I can see the light at the end of the tunnel. In 22 days I will be back at IA City and hopefully will be told I can start weight bearing. So, I will catch everyone up to speed with my progress thus far. A little after 2 weeks post PAO, I was able to put my own pants on without devices. I am getting better everyday with movement, I can lift my left leg and turn my ankle inward to get my clothes on. I then have to sit on my bed to put my right leg through. I can bend down to pick things up, as long as I kick my left leg out. I am pretty good with my crutches. My walker is my mode of transportation in the house. I have a small plastic container that my husband made into a basket for me. It allows me to carry things from the kitchen and around the house. I have been left home alone for the past 2 days and it has been ok. My husband is able to help with meals during the day, but I could do it on my own if need be.

I take about 2 percocet per day. I try to get by without it, but when I am in pain, I don't feel like moving. I would take Ibuprofen, but I am still on coumadin and these two medications don't go well together. (I hate Tylenol!) I tried to see if my doctor would let me take Ibuprofen, but they do not. I don't see the issue, I have to get my blood drawn twice a week to monitor the coumadin dosage anyways. Oh well I will play the game. I am not wearing my TED hose anymore. I am supposed to, but they don't feel tight anymore and I don't think I am at risk for a clot. I move a lot during the day and my last INR was 2.0. (Normal is 1.5-2.0) Plus I hate those socks! They are so hot and itchy! I couldn't sleep with them on!

My scar area is healing very well. I still have some numbness around the scar and the top of my thigh is tender, but it isn't too bad. I am able to wear my old underwear and jeans.

All in all I think I am doing pretty well. I am worried about when I am finally able to weight bear. I hope I can get back to my old self as soon as possible. I am not allowed to do physical therapy until I can weight bear on my left. I am also trying not to gain 15 pounds! I can't wait until I can get back into the gym.

Two week follow up at Iowa City

2009-05-23T07:03:00.000-07:00

Yesterday Logan and I went to IA City for my 2 week follow-up. It is funny how time can seem to go so slow. Two weeks is really nothing, but it feels like a lifetime right now. It is hard to believe that I went through with the surgery and that the worst is behind me.
The drive was a little uncomfortable, I'm not used to sitting in the car for that long. Once we got there we bypassed the valet parking (dumb!) and went to the parking ramp like we always do. We found a spot fairly close to the elevator so I crutched from the car to the elevator. I thought we would be able to find a wheelchair at the sky walk entrance, there usually was every other time we had came to IA City. Murphy's law was in effect and there were no wheelchairs, so I crutched from the parking ramp to the exam room. Needless to say that was a little uncomfortable as well, but on the other hand I did it and I survived so that was a small victory. One of the doctors from Dr. Mickinley's group cam in and I told her about the weird groin pain and swelling in my groin, and the tenderness of my old C-section scar. She didn't seem too concerned and said it was probably from the way they had to open me up to do the surgery. (Pulling of the skin back and stuff) She then had me lay on the table and moved my hip around, flexing it in and outward. OUCH! Then she looked at my scar and said it looked great. A few minutes later Dr. Mckinley came in, he agreed that the groin pain was normal and it would go away as I healed. He also showed me my new x-rays with my lovely hardware. My hip looks almost normal now, minus the three long screws in my hip. My angle went from 0 to 27 degrees. (normal is 25-30) He seemed happy with my progress so far, he also moved my hip around but just up and down, no twisting, he knew that would be too painful. My next appointment is in 5 weeks and hopefully the x-ray will show that I can start to get off the crutches. I hope these next weeks go by faster than the last 2!
After the appointment we stopped at Williamsberg and did a little shopping before we went home. When we got home we made a trip to Sam's club before picking Caleb up from daycare. I took pain meds about every 6 hours today, which is more than I have taken the last few days, but I overdid it yesterday and by the time we got home, I didn't want to move from my chair. I am glad we got so much done, but I wish my healing would go faster!

1 week post PAO

2009-05-14T14:52:00.000-07:00

Well I finally got caught up with my blog. It is 1 week since my surgery. My butt hurts. I am tired of sitting, but find it to difficult to get in other positions. I have been able to make it out into the real world once every day. Monday it was to get my blood drawn, since the hospital social worker dropped the ball on that one. Tues I went to Scheels for different sandals & my Hy-Vee. Wed I went to Target & Bed Bath & Beyond (needed a good vanity mirror for applying make-up. I get tired standing on one leg all the time!) Today the visiting nurse came to my house to draw blood for my INR. After that Logan took me to the Home Depot so he can order wood to build a retaining wall this weekend.
I am able to get around pretty well with the help of my walker and crutches. My walker helps me while I am in the house while the crutches help me get down stairs and out in public. I tried to ween myself off the pain meds yesterday, again it didn't go so well. I talked with Tess and she said it is still early, so I shouldn't worry about that for now.
I can move my leg forward while walking with crutches, but can't move it from side to side very well. Sometimes I can lift it up to an ottoman, sometimes I can't. I think I have the downward motion figured out, that doesn't hurt as bad. I have had a bit of swelling in the left leg from my knee upward. It gets worse at night and feels very weird. The whole hip joint is just plain SORE and it feels very tight. I am told this is normal, so I will try not to envision bad scenarios with the joint.
Showering is not too bad. I am so glad I have the transfer bench for the shower, I don't know what I would have done without it!
Several times in the hospital I would wake up in a stupor and have to remind myself of what I did, and am so glad now that the past is behind me and I can look forward to a better future with a non-dysplatic hip. Now if rightly can hold out, only time will tell.

Alice in Wonderland

2009-05-14T14:29:00.000-07:00

The number one reason I didn't like my hospital stay was my roommate, "Alice". She was crazy, literally. She was on the floor because she had shoulder surgery on her right arm. It was in a metal brace that forced her to keep her arm extended straight outward. They had wanted to discharge her on the day of my surgery, but when they asked her where she was she said she was at St. Luke's in Cedar Rapids and it was 2002. She also lived alone in an apartment with 2 flights of stairs. She clearly was not ready to go home to take care of herself. Often I would make sure the curtains were closed between us because I didn't want to talk to her. This didn't stop her from talking. Sometimes she talked in her sleep, sometimes to me, and sometimes to the TV. Ahh, the TV, she never turned it off. Never. It was so loud and was the main reason why I didn't sleep. If I have to stay in a hospital again and may have a roommate, I will pack a night mask. I tried to use my IPOD to drown out the sound, but the charge ran out in the middle of the night.
Every other word out of Alice's mouth was a swear word and I never knew what she was doing. On Friday night, she had a bed alarm placed on her bed, so she got up several times and set off the alarm in the middle of the night. No sleeping in my room! I was a little nervous that she might hurt me. I couldn't move literally, she could and who knew if she would start to think some crazy thought and hurt me somehow. I kept thinking about the movie "Misery" when Kathy Bates crushes the leg of her captive. Luckily this never happened. She had so many good sayings that Sat night Logan and I had to jot them down, so as not to forget it. Here they are...
Scene: Hospital room with two beds curtains drawn for privacy.
Night 2: Alice had gotten out of bed and is looking around holding a blanket around her waist.
Nurse: "Where are you going?
Alice: To go look for a job.
Later... "No we are not all from Dubuque."
(Thankfully a nurse came in and got her to turn off her light at least when it was 11pm)
Night 3:
Alice randomly says: "So would you guys consider finding this?" "No, go and tell him he has to get out of there!" "Sounds like its...Ooh! I sorry!"
Alice talking to TV: "I think you should sleep on it!"
My personal favorite, "I didn't know I was a diabetic?!" Every time the nurse's aid would come to check her glucose before meals. Did I mention she had a huge baggie full of tootsie rolls and other chocolates?
The staff tried changing her pain meds, ruled out an UTI, gave her oxygen, everything they could think of to make her lucid, but I think she was just crazy, plain and simple. I wish Alice the best, she clearly can not take care of herself and it seems that she has no real help at home. I only wish she would have turned the tv off.

Discharge on Sunday!

2009-05-14T13:59:00.000-07:00

What a happy day! It started early, I never slept the night before, maybe a few hours. The Doctor's came about 6:30 in the morning, Logan missed them again. That made him angry, he could never time it right, except for Friday. They came and took the dressing off my scar, said it looked good and asked if I wanted to go home. I said yes, so he said he would write the discharge orders. Logan came a little later and I told him what the doc had said. I ordered breakfast and then we started to get me cleaned up to go home. During this the nurse came in and said she ran into a snag and could not find the discharge orders. After I was dressed we got me in a wheelchair and went out to the nurses station. She gave Logan my prescriptions so we could take them down to the pharmacy and get them filled while we waited. When we came back up the Nurse had my orders ready. The problem had been some sort of lack of communication between staff regarding a blood draw that I had earlier in the day. I am on warfarin, a medication that prevents clots. I will have to have my blood drawn twice a week because of this. Well apparently someone didn't know my INR (blood test used to determine dose of warfarin) had been taken previously and so no one knew what my dosage of warfarin was to be. But now this snag had been taken care of I was given the green light to go home. I asked the nurse about caring for my scar, she said I would have to check with Tess on Monday. I couldn't believe that the doctors hadn't told me in the morning if the nursing staff wouldn't be able to tell me. This made me angry, which pretty much sums up how I felt about staying at the Hospital. I never really felt like I was ever told that much information, thank goodness I am a pharmacist and have a little bit of a medical background. I feel sorry for patients that do not.
A nurse helped Logan and I out to the car with all of my stuff and my walker and crutches. I preferred using the walker over the crutches, but the walker was not mine to keep. Logan stopped at a gas station to get some pretzels and some drinks and we were off. The car ride was not very fun. I wished we had packed pillows for the ride home, we didn't so we never stopped for lunch we just drove home as fast as we could. My pain meds were also wearing off during the drive, so the timing wasn't very good either. Finally we were home and reunited with our son Caleb. It was so good to see him! I had missed him a lot! We had talked on the phone the whole time, but 2 year olds are not so good at talking on the phone. After we got lunch and settled in I was able to shower for the first time since the Wednesday before. It felt really good, I felt human again. Then I took a nap in our bed. I love our bed it is so comfortable, I really missed it!

Hospital Stay - Saturday

2009-05-14T09:46:00.000-07:00

Saturday came and the night before was long, I didn't sleep much due to my roommate. Logan came about 5:30 in the morning and this day the doctors did not round until closer to 7am, so he was frustrated. I didn't blame him. The doctors didn't say much, just changed my dressing and said that I would have more X-rays done today. My appetite continued to get better. My medication regimen included Oxycontin 20mg twice daily, Percocet 2 tabs every 4 hours, Vistaril 50mg every 4 hours, Iron three times daily, Stool Softener three times daily, Senokot twice daily. Saturday morning my parents stopped by to say good bye, they had to make it back to EG for a graduation. Logan and I hung out and I ordered my lunch, we heard a rumor that Physical therapy was going to come for me but the nurses told me to order anyways. Unfortunately right after I did this, they came for me from X-ray. I was wheeled to the dept and was set up in the waiting room. After about 10 minutes, the tech came out and said they didn't realize I needed a special kind of x-ray and the only person available to do it had just gone to the OR. They told me to continue to wait and sent Logan to my room to wait for PT since they were coming any minute. After about 5 minutes Logan came back because my lunch had arrived. So the x-ray tech said I could go back to my room and they would get me later. So I went back to my room had lunch and then went back to x-ray. The x-rays required me to stand on one leg without my walker, it was tough but I was able to do it. I can't wait to see what the pictures look like! After X-Ray I went back to my room and PT was finally ready for me. I got set up with my crutches. I didn't like them at all, I got around pretty good with the walker, but since my home has a lot of steps, I had to use the crutches. It was pretty shaky, and the PT therapist was kind of strange. I didn't like his analogies. When I started with the crutches I kept my left foot up the same way I did with the walker, the therapist said I was doing it wrong and I should try to imagine stepping on a glass, putting enough pressure to touch the ground but not break it. Now, I'm not Jewish and have never stepped on a glass. I would try to ask, if my knee is bent, isn't that a good sign I am not putting too much weight on the left? He would say, what they taught in PT school was to step on a glass and didn't really answer my question. The PT therapist took me into their room where they keep their staircase. I made my way up and down twice. The PT therapist looked pleased, but I wasn't so sure. He said, "you know, now that you passed the steps you can go home." This sounded ok to me, but it was so soon, I didn't know if I was ready. Logan was really excited, he was ready to go home. The nurses had even hinted at the fact that I may go home on sat. I wish I had, sat night was the worst yet. (Due to my roommate and low staffing levels) The way it turned out was that the Dr. was not ready to release me yet and wanted to look at my scar in the morning. So I stayed. I had also tried to take less of my pain medication that day and if finally caught up with me that evening. I hurt really bad and started feeling super hot. The nurses aide came in and took my temp, she held it out for me to see the reading, but it was in Celsius, and I haven't converted Celsius to Fahrenheit since chemistry at Drake. I asked her what it meant, she said she didn't know, then said she thought it was 104. This shocked and scared me, I have had a high temp like that before and it wasn't fun. Luckily we had our laptop in the hospital and Logan googled the conversion and my temp was 100.4. Much better. The nurse's aid had said the nurse would be in to see me in 15 minutes. 1 hour later he came, by this time the pain meds I had taken had eased my pain and i was starting to cool off thanks to my fan. It was getting to be about 9pm, so Logan headed back to the hotel. I really didn't want to see him go, but I knew he wouldn't be comfortable at the hospital. The only good thing was that I would go home the next day.

Hospital Stay - Friday

2009-05-14T09:24:00.000-07:00

My hospital stay was 4 days long, including the day of surgery. It was quite an interesting thing. I wish I could say I slept well, but who can in a hospital? On Friday morning (day after surgery) he doctors came about 5:15 for rounds, Logan had wanted to be there, but just missed them. They didn't say too much, except that I would have a CT scan today. Later that morning my nerve block (epidural) and catheter was removed. My PCA pump was also removed. I wondered how my pain level would be without the nerve block and the PCA pump, but it has always been well controlled with the oral pain medications. Friday morning around 10:30, Dr. Mckinley and his nurse Tess stopped by to check on me. Dr. Mckinley said the surgery went very well and the hip was in a perfect position. Around 11:30 on Friday the physical therapy people came by to get me out of bed and show me how to use the crutches. Unfortunately the nerve block was still causing some numbness so I wasn't really able to put all of my weight on the right leg. Everyone was worried, myself included. If I couldn't put weight on my right, what would I do? Righty had surgery when I was 20 months and I have always tried to be gentle with it. Luckily by Friday afternoon the block had worn off and I could make it to the bathroom really well with the help of my walker. All of the nursing staff was impressed. That made me feel pretty good. I was still battling nausea and I was so HOT! I could not get cooled off, so Logan went to Wal-Mart and got me a small clip on Fan, while my mom wheeled me around the hospital to cool me off. My room was very small and I had to share it with a roommate. I am going to post another entry just about my roommate, stay tuned. After I got the fan set up I was really quite comfortable in my hospital bed. After lunch I got rolled to X-ray for the CT scan, which was pretty uneventful. My appetite improved, but I was still very drowsy. My sister cam by with her kids and Angel that evening. It was really good to see them, but it was late in the day and I was having trouble staying awake. Everyone left about 10:30 and I tried to get some rest.

Day of Surgery

2009-05-12T17:14:00.000-07:00

(It has been 5 days since my LPAO, but I am going to breakdown how everything went. I didn't feel like blogging until today so I apologize for the long delay.)
The morning started at 5am, I had to report to the surgery center at 6am for 8am surgery. First my phone rang, then the room phone rang with our "wake-up" call , and then the alarm on Logan's phone went off, so needless to say we had no chance to oversleep. After another shower with the lovely Betadine solution (this is a special soap that helps prevent skin infections), I was dressed in comfy clothes minus any make-up or hair products. We met my parents downstairs, the hotel was busy, lots of other patients going to surgery as well. I think I was the youngest. We hoped in the car and made our way to the hospital, I was amazingly calm considering what was about to happen to me. We parked the car and then made our way to admissions. I checked in and about 2 seconds later was whisked back to a room by a "no-nonsense" nurse. I think she had been doing the job for awhile. She got my vitals and gave me my hospital bracelet. Then she handed me my gowns and a bag for my own clothes. After I was dressed the another nurse from the anesthesiologist dept. came. He started to talk to me about the epidural and my anesthesia plan, when two nurses came in begged him to let them have the room I was in. The nurse was hesitant, he asked me if I cared if we moved to a TV Lounge that had very few people in it. I being the agreeable person I am said that would be all right and we moved to the lounge with Logan and my parents. Once in the Lounge he went over the risks of anesthesia and told me how the rest of the day would go. I signed some paperwork and then he started my IV, of course this is when other people walked into the lounge. Good thing I don't embarrass easy. I was able to wait with my family for about 10 more minutes and then I had to kiss them goodbye and get on a gurney to go back to surgery. It was an odd feeling being wheeled back when I am used to being very independent. Our first stop was the anesthesia suite, where I was given my epidural which would provide a nerve block and help with pain. Unfortunately I was a test patient for the doctor that did the epidural, he had to poke me three different times and apparently got some spinal fluid, which put me at risk for a spinal headache. That did not make me happy. (My previous experience with an epidural was when I had Caleb and I only had to be poked once.)

(My three pokes and bruise from epidural.)

After that fun time I was wheeled back to surgery where all I remember was the plastic mask and then I went to sleep.
When I woke up I was back in recovery and did not remember having the tube pulled out or anything else. Maybe it was the anesthesia, but I do not remember anyone telling me anything about the surgery. I do remember the new nurse being upset about the new computer system implemented at Iowa and complaining about it a lot. But finally I was wheeled into my new hospital room and after 30 minutes of waiting in my room I was finally reunited with my family. They were a little upset because they did not know I was in my room, they just wandered and found me. It was then that I learned that the surgery had gone well and I had lost very little blood. The rest of the day I dosed on and off. The nurse for my room came in and tried to get me to eat something for dinner but I felt too nauseous. I did order some soup, but was unable to eat it. The rest of the day I got used to my surroundings. I will start a new post about my hospital stay since I feel like this one has gotten too long.

Count down..

2009-05-05T20:40:00.000-07:00

It is Tues night, my wonderful husband is doing the dishes in the kitchen while I check email and unwind from another busy night at the pharmacy. I can't deny the truth anymore. I will be having surgery on Thursday, and I really do have pain, as much as I try to ignore or deny it. Part of me is excited to think that possibly I could feel like my left leg won't go out on me, or that I won't get sharp twinges of pain when I turn wrong, or that it won't lock up on me anymore. Maybe that funny pain in my but will go away too! All is possible. After all, not being able to walk is only temporary. I deal with much more sick patients on a daily basis, who am I to complain? My plans for tomorrow: Finish packing for Caleb and me, Clean the bathroom, go to the bank (i forgot to reorder more checks, argh!), and spend as much time with Caleb and Logan before we have to go to IA City.
Wish me (and the surgeons!) luck! Then next time I blog this will all be over and I will be on the road to recovery.

1 week and counting...

2009-04-30T09:07:00.000-07:00

As I write this I know that at this time next week I will most likely be in surgery. I am feeling a lot different emotions. Denial is always there, but I am trying to be positive and put aside the negative thoughts that keep coming. I am pretty much ready, arrangements for Caleb have been made, there is a ton of frozen meals in my freezer, and I even got some new nightgowns! I have my transfer bench for the shower and some lovely hand rails for our toilet. It is kind of crazy to think that I will be relying on these things very soon. My crutches will come from the hospital, they will be my new best buds! All that is left is to clean the house a final time and pack my bag. This weekend we will go to the farmer's market in the morning and then go to my parent's house to celebrate my Dad's retirement. I am going to try to have a great last weekend utilizing both my legs.

Pre-Op apointment

2009-04-29T14:27:00.000-07:00

My pre-op appointment was last week, I apologize that I do not post as things happen. I will try to do better. The day started very early, Logan and I were up at 5am so we could drop Caleb off at daycare at 6:30am and drive to Iowa City for a 9:30 appointment. Once we arrived at Iowa City I met with Dr. Mckinley's nurse, Tess. She was really nice and patient. I had a lot of questions. I think I might have given her the impression that I was backing out of surgery with some of my questions/comments. I do that quite a bit, I still don't want to believe that I am really going through this. She said I could get a second opinion, I reassured her that I was not backing out. Besides where would I get a second opinion from? There really is no question about how bad my dysplasia is. I am the only one questioning if my "symptoms" warrant surgery. I know that I have to go through with this and the time I waste getting second opinions could be better spent healing from said surgery.
Back to the surgery. I will have to report 1 & 1/2 hours before my surgery time, the actual surgery should take around 4 hours, and then I will spend 1-2 hours in recovery before family can see me. After that I will be transferred to a room and then my hospital stay of 3-5 days begins. I will be on coumadin to prevent blood clots and I will have to wear compression stockings for 8 weeks. Twice a week I will have to have my blood drawn to monitor my INR level from the coumadin. This will also be for 8 weeks. I will not be able to bear weight on my left hip and there will be no driving while on controlled pain medications. Sounds fun right?! All I can do is try to stay positive and know that time will pass and then hopefully I will avoid a total hip replacement before my 60's!
The day ended on a positive note, my CT scan was scheduled at 3:15 pm, but I checked with them when I was done with pre-op around 11am and they were able to get me in early. It was so nice to go home early so we could pick Caleb up from daycare!

CHD+PAO=WTF

2009-04-22T17:55:00.000-07:00

I think now I will explain the name of my blog. CHD stands for Congenital Hip Dysplasia. PAO is for Periacetabular Osteotomy. WTF needs no explanation. I hope I don't offend too many people, but that is truly how I feel. It sums it up quite well. I have often thought that I need a stamp like this one below for the pharmacy that I could use when I got crazy orders from physicians or strange requests from patients.

Back to the hip thing. I am including a very helpful link to explain PAO.

http://www.hipandpelvis.com/patient_education/periace/page1.html

Basically for those unfamiliar with the procedure, my socket will be cut out of my pelvis and realigned and attached with metal pins until the bone grows back together and the pins can be removed. Bone takes a long time to heal and everyone does this differently. I won't be able to put weight on my left leg for 8 weeks or longer, until the bones heal back together. This won't allow me to pick up my son and carry him like he loves so much. I will need help to care for him, which makes me feel useless. I will also have to be on crutches for 8 weeks. This means new ways to learn how to take care of myself and it means no work. (I don't think I could type while on crutches while standing.) Luckily the company I work for has a great short term disability plan so I don't have to worry about not working. Our insurance is also very good and I still have a lot of flex money left to use for the deductibles and copays. Another positive is that my husband is very supportive as is several family members that we will be relying on for help during my recovery. It is hard for me to ask for help from others, but I am so grateful that we have so much support.

And Then...

2009-04-22T17:44:00.000-07:00

So I was sent to an O.S. to evaluate my left hip. I was not very happy about this, I vowed I didn't need surgery. I was sure I would be told nothing was wrong with me and to go back home.
Unfortunately (or fortunately) that is not what happened. The O.S. came into the exam room with his P.A. and then asked me if I had pain and if they could see the scar on my right side. I showed them and they got a funny look on their face and said they would be right back. This kind of freaked me out a bit, I wondered what they thought was wrong and why they were looking at me like I was a sideshow. They came back into the room and said "We can't help you, you need to go to Iowa City. There is only one doctor in all of Iowa that can help you." Well this was a little shocking, but I went along with it. They called and set up the appointment for me, but told me nothing about what kind of surgery I needed or any specifics. I tried to get answers but was told that the doctor in Ia City will be able to answer your questions best. So I waited a week to see the "only doctor in Iowa that could help me." I was still in big time denial and honestly thought he would tell me nothing is wrong, go have another baby and then we will talk. This is not what happened. I was told the brief details about pericacetabular osteotomy and told that I was a perfect candidate. As for waiting, no, I should have my left hip done then have a baby, then think about options for the right hip. If I chose to do nothing, in 5-7 years I will have debiltating arthritis and will need a total hip replacement at age 40. With THR only lasting 10-15 years, that didn't sound like a good option, especially when it is rare to have more than two done on the same side. On the ride home I was shell shocked.

In the Beginning...

2009-04-22T17:08:00.000-07:00

I find it hard to tell my story without going to the very beginning, so bear with me. When I was nearly two years old it was discovered that I had been born with congenital hip dysplasia. At 20 months I underwent an open reduction to repair the dysplasia on my right side. The left side was "fixed" with a closed reduction. (I wore a special harness, apparently I didn't like it) I then wore a body cast for several weeks and then had different braces that I wore I think until around 3 years of age. I don't really remember any of this, I have seen pictures and I remember crawling with a brace on, but that is it.
As a child I was as active as any other and only remember leg pains that my mom called "growing pains." In junior high and high school I went out for almost all the sports, except track. I still hate running. In high school when I was 15 I must have complained about left hip pain because we went to a follow up visit to the physician that had treated me 13 years before. It wasn't too bad though because I never went back and never saw another doctor until I was in college. I decided to see a D.O. because I liked their philosophy of treating the body through manipulations. It seemed to help for a while, but then it didn't so I was referred to a different D.O. who discovered my left leg was shorter than the right and this lead to a rather large muscle hump on my left. He set me up with a heel lift and I did really well for a long time. Then in 2006 I became pregnant with my son, Caleb. The pregnancy was pretty uneventful and I didn't experience too much pain that I can remember. I ended up having a C-section for many reasons none related to my hip, but we both came through just fine.
After Caleb was born and in this past year though my left hip has gotten worse. I don't really have pain so much as it locks up on me. (I like to deny this but I just had to bend down to clean up spilled milk and almost didn't make it back up!) The final straw was in Februrary when I had bent over to tie my shoes to go to the gym, when I stood up I had a sharp pain and my left hip locked up and I couldn't put any weight on it. I toughed it out and went to the gym anyways, as I was working out on the elliptical I had no pain, but when I sat down in my car, sharp pain again. This continued for the next day until it magically went away. This episode lead my D.O. to send me in for an M.R.I. which showed cysts and a possible tear in my left hip. He then sent me to an O.S. in Des Moines for an evaluation.