Friday, June 04, 2004
The "Non-recovery" Recovery
All told, I was hospitalized for slightly over four weeks after my surgery. I came home just before Christmas. Of course, I was still not allowed any weight-bearing so I hopped around on my crutches and for the most part stayed upstairs, either in my bedroom or my office. Thank goodness for the Internet.
I live in a city that can get quite cold and snowy in the winter. Up until I came home, we had had very little snow, but shortly after my return home, winter hit with a vengeance. Because I couldn't use my operated leg, I couldn't go outside except when a special transportation service came and picked me up to take me to physiotherapy. As the weeks went by and the snow and ice continued to pile up, I really thought I would go out of my mind. I exercised every day and when I was finally allowed to walk on my operated leg, I paced up and down my tiny upstairs hallway, doing five minutes, then ten, then twenty.
Sleeping was practically impossible. For the first 12 weeks, you have to be extremely careful or your new hip can dislocate. The only totally safe way to sleep was on my back, but grinding groin pain kept me from sleeping more than an hour at a time. Fortunately, my husband is a sound sleeper so the TV and I developed an intimate late-night relationship. At week 10, I couldn't take it anymore and called my surgeon to see if I could safely sleep on my unoperated side with a pillow between my legs to keep me safe. Permission was given and I immediately starting sleeping if not like a baby, then at least passably well.
As the weeks went by, I began to wonder about my recovery. I had been in such pitiful shape immediately after the operation that I couldn't even bend my knee 1 week post-op. Basic movement had come back but I felt that no significant improvement was taking place. My physio kept saying that things were going slowly because of the fracture, but with time I would get better. She went so far as to say that it could take up to 18 months! This was a horrible shock since in my conversations with "hippies" on the Internet, people were starting to get back to normal within about three months.
But I soldiered on, doing my exercises faithfully and crying in frustration every few days.
After about eight weeks seeing the outpatient physiotherapist at the convalescent hospital, I switched to a private clinic and a physio who had been highly recommended to me by a wonderful hippy friend I'd made through the Internet. After examining me, he too said all the problems were related to the fracture and that with time and exercise I would get better. He said my muscles were terribly weak and that was why I was unable to walk at all without a cane. After a few weeks, and seeing no appreciable improvement, I made an appointment with the doctor who ran the clinic. Again, the response was the same. Exercise, build your muscles and you'll be fine.
In February, the knee on my operated side began to hurt. My physio said not to worry, it would get better. In fact, it got worse and worse. At the same time, I became more and more depressed since I felt that now my knee was preventing me from recovering. At times, I even went back to crutches because the pain in my knee was so intense.
In April, I saw my GP who measured my legs and told me that the operated leg was 1 1/2 cm shorter. She suggested orthotics. Though expensive, I had them made and found that they helped with the pain in my knee. At this writing, although not perfect, my knee is much better.
When she examined me, my GP was struck by the extent to which my muscles were atrophied and immediately called my surgeon. The upshot was an appointment ASAP. As usual, I was first met by a fellow (student surgeon) who asked me a few basic questions. I have always found the students to be loathsome, unfeeling creatures. This one was no exception. He started by asking me when my surgery was scheduled for! Obviously, he had not read my file at all. Between gritted teeth, I told him that I had already had surgery. Though this exchange took place almost five weeks ago, it still festers in my mind. If, at my next appointment, I am asked the same stupid question I will send the student packing.
When the surgeon came in, he asked me to walk without my cane. I replied that I wasn't sure that I could. I did manage to take three halting steps and that was it. Immediately, he sent me for x-rays.
After examining the x-rays, my surgeon announced the news. He suspected the stem of the prosthesis was loose--again due to the fracture. The recommended course of action was to cease all physiotherapy and wait and see if the bone would finally grow into the prosthesis. This in itself was devastating news, but it was compounded by the fact that neither the physiotherapists I had dealt with nor the doctor at the clinic had detected this problem. All the physiotherapy I had been doing was in fact making me much worse. How could they have not seen this? I suspect that it's because hip replacements are practically always successful. Only the trained eye of the surgeon is able to see when there is a problem. It's also because NO ONE LISTENS TO THE PATIENT. For months I had been saying that I wasn't improving. I felt as if I was healing into a crippled state--as if someone had slashed my face with a razor and then denied me plastic surgery. Yes, you heal, but without proper care your face will just be a mass of scars.
It's been five weeks since I stopped physiotherapy. I am less stiff in the morning, but the pain continues. My ability to walk unaided is no better than it was in February. In fact, I am walking much shorter distances now than I was before my knee began to hurt. It's not my knee that stops me now, but rather pain in the buttock, below the buttock, on the side and sometimes in the groin area.
I will be seeing my surgeon again in ten days, but he has already told my GP that he wants to wait six months before performing further surgery. That will put me back in the winter and a winter recovery is something I don't think I can handle a second time. Not being able to go out was soul-destroying and I think it also helped to mask my lack of progress. When you go out and put yourself to the test, you can really see what's happening. Also, walking on wooden floors is much easier than on concrete--again, the lack of progress is not so evident.
I live in a city that can get quite cold and snowy in the winter. Up until I came home, we had had very little snow, but shortly after my return home, winter hit with a vengeance. Because I couldn't use my operated leg, I couldn't go outside except when a special transportation service came and picked me up to take me to physiotherapy. As the weeks went by and the snow and ice continued to pile up, I really thought I would go out of my mind. I exercised every day and when I was finally allowed to walk on my operated leg, I paced up and down my tiny upstairs hallway, doing five minutes, then ten, then twenty.
Sleeping was practically impossible. For the first 12 weeks, you have to be extremely careful or your new hip can dislocate. The only totally safe way to sleep was on my back, but grinding groin pain kept me from sleeping more than an hour at a time. Fortunately, my husband is a sound sleeper so the TV and I developed an intimate late-night relationship. At week 10, I couldn't take it anymore and called my surgeon to see if I could safely sleep on my unoperated side with a pillow between my legs to keep me safe. Permission was given and I immediately starting sleeping if not like a baby, then at least passably well.
As the weeks went by, I began to wonder about my recovery. I had been in such pitiful shape immediately after the operation that I couldn't even bend my knee 1 week post-op. Basic movement had come back but I felt that no significant improvement was taking place. My physio kept saying that things were going slowly because of the fracture, but with time I would get better. She went so far as to say that it could take up to 18 months! This was a horrible shock since in my conversations with "hippies" on the Internet, people were starting to get back to normal within about three months.
But I soldiered on, doing my exercises faithfully and crying in frustration every few days.
After about eight weeks seeing the outpatient physiotherapist at the convalescent hospital, I switched to a private clinic and a physio who had been highly recommended to me by a wonderful hippy friend I'd made through the Internet. After examining me, he too said all the problems were related to the fracture and that with time and exercise I would get better. He said my muscles were terribly weak and that was why I was unable to walk at all without a cane. After a few weeks, and seeing no appreciable improvement, I made an appointment with the doctor who ran the clinic. Again, the response was the same. Exercise, build your muscles and you'll be fine.
In February, the knee on my operated side began to hurt. My physio said not to worry, it would get better. In fact, it got worse and worse. At the same time, I became more and more depressed since I felt that now my knee was preventing me from recovering. At times, I even went back to crutches because the pain in my knee was so intense.
In April, I saw my GP who measured my legs and told me that the operated leg was 1 1/2 cm shorter. She suggested orthotics. Though expensive, I had them made and found that they helped with the pain in my knee. At this writing, although not perfect, my knee is much better.
When she examined me, my GP was struck by the extent to which my muscles were atrophied and immediately called my surgeon. The upshot was an appointment ASAP. As usual, I was first met by a fellow (student surgeon) who asked me a few basic questions. I have always found the students to be loathsome, unfeeling creatures. This one was no exception. He started by asking me when my surgery was scheduled for! Obviously, he had not read my file at all. Between gritted teeth, I told him that I had already had surgery. Though this exchange took place almost five weeks ago, it still festers in my mind. If, at my next appointment, I am asked the same stupid question I will send the student packing.
When the surgeon came in, he asked me to walk without my cane. I replied that I wasn't sure that I could. I did manage to take three halting steps and that was it. Immediately, he sent me for x-rays.
After examining the x-rays, my surgeon announced the news. He suspected the stem of the prosthesis was loose--again due to the fracture. The recommended course of action was to cease all physiotherapy and wait and see if the bone would finally grow into the prosthesis. This in itself was devastating news, but it was compounded by the fact that neither the physiotherapists I had dealt with nor the doctor at the clinic had detected this problem. All the physiotherapy I had been doing was in fact making me much worse. How could they have not seen this? I suspect that it's because hip replacements are practically always successful. Only the trained eye of the surgeon is able to see when there is a problem. It's also because NO ONE LISTENS TO THE PATIENT. For months I had been saying that I wasn't improving. I felt as if I was healing into a crippled state--as if someone had slashed my face with a razor and then denied me plastic surgery. Yes, you heal, but without proper care your face will just be a mass of scars.
It's been five weeks since I stopped physiotherapy. I am less stiff in the morning, but the pain continues. My ability to walk unaided is no better than it was in February. In fact, I am walking much shorter distances now than I was before my knee began to hurt. It's not my knee that stops me now, but rather pain in the buttock, below the buttock, on the side and sometimes in the groin area.
I will be seeing my surgeon again in ten days, but he has already told my GP that he wants to wait six months before performing further surgery. That will put me back in the winter and a winter recovery is something I don't think I can handle a second time. Not being able to go out was soul-destroying and I think it also helped to mask my lack of progress. When you go out and put yourself to the test, you can really see what's happening. Also, walking on wooden floors is much easier than on concrete--again, the lack of progress is not so evident.
