noun, re·cov·ery \ri-ˈkə-və-rē, -ˈkəv-rē\
- the act or process of becoming healthy after an illness or injury : the act or process of recovering
- the act or process of returning to a normal state after a period of difficulty
- the return of something that has been lost, stolen, etc.
Merriam-Webster. Merriam-Webster, n.d. Web. 02 June 2016.
Stages of Mobility:
10/22/13 Wheelchair / Walker
11/03/13 Crutches – Non-weightbearing
12/20/13 Crutches – 25 to 50 pounds
01/07/14 Crutches – 50 to 75 pounds
01/30/14 Single Crutch
The staples came out and the incision healed. Then the real journey began.
Rehabbing an injury can be an isolating experience. I was “homebound” for three months. I was able to get out of my house, but it took considerable effort to do so. I couldn’t drive. Transportation, seating options, weather conditions, appropriate footwear, and accessibility were all now a part of the planning process.
It was an agonizingly slow experience for me as well. I never would have believed it would take 10 months to walk on my own again. Every time I went to the doctor, I had built up hope that I had made more progress, that the outlook was better, only to have my expectations reset. The difference between expectation and reality is often filled with disappointment. I learned I am not good at Disappointment
One of my first visits back to OI for evaluation, I sat next to a gentleman who observed me waiting for my appointment with my crutches and asked about my injury. After telling him about my surgery and prognosis, he was happy to reassure me having also had hip surgery. He told me how much he valued the care and treatment he had received and how incredible his surgeon and medical team had been. We both agreed we were extraordinarily fortunate to have received the caliber of treatment we received without having to leave our own town. We finished our conversation and he was called to the therapy floor. As he walked away, I could see he had a pronounced limp. My heart sank as I feared for the first time: “What if I walk with a limp for the rest of my life?” I’ve read my medical record so many times now, and the words “very slight trendelenburg gait” haunt me every time I read them.
Every step of this process required “re-learning” how to transfer weight, how to recruit muscles that had been atrophying in the absence of effort. As I re-learned these movements, my brain hurt from the concentration it required. When I took my first unassisted steps 10 months after my injury, it felt like I was walking with my brain, willing myself to walk straight, focusing so as not to limp.
Returning to Normal
I’m not sure the exact moment it occurred, but I eventually came to the realization I would never be “normal” again. I kept trying to anticipate the day I would be fully restored to my original condition. At some point, I had to come to terms with the fact that wasn’t going to happen.
Between my transition from crutch to cane, I went to pool therapy in the Biokenetics Department at OI. I had been growing impatient with my immobility and my weakened state. Dr. Patel said it was safe to start moving my hip again, but it would be safer in the pool where buoyancy would help protect my still-fragile joint. It was late-January/early-February and I remember the mornings of single-digit temperatures after therapy, crutching it across a frozen parking lot with damp hair. Winter is a bad time to be rehabbing an injury for many reasons. Choosing to have this next surgery during the summer months was absolutely intentional.
At every stage of this recovery I asked questions – LOTS of questions – cross-referencing the data I was collecting from my medical professionals with what I had been gathering on my own.
I started going to pool therapy two to three times a week. In addition to giving a status report to the PT in charge of my therapy, I was constantly asking her about other injuries she had seen and what I should expect. I was especially concerned with the amount of swelling and discoloration of my leg, so long after surgery. She would reassure me often that deep tissue swelling was normal and an extended part of the healing process. One day, maybe after the eighth or ninth time I remarked about the new shape of my thigh, she looked at me knowingly and said: “You know, it’s never going to be the same.” I repeated what she said, trying to help it sink in, “It’s never going to be the same.”
Whether it was the lumpy texture of my post-surgical thigh bulging along a 5” scar, or the feeling of walking with one short leg (after having two legs of relatively equal length my entire life to that point), or the near-daily tenderness associated with my bone healing around something foreign in my body, I honestly couldn’t remember what “normal” felt like.
I had no choice but to redefine what normal meant for me.
October 16, 2014 I was released to unrestricted activity. The fracture was completely healed. The ball joint looked perfectly round. Dr. Patel would monitor me for the next year and at the two year mark, if I remained free from signs of avascular necrosis (AVN), I could put this all behind me. He said if I was cautious, this could be the only surgery I would ever have to have. I understood what he meant. Enthusiasm had already proven to be my worst enemy once before. My pace would be measured and cautious.
I felt like I’d been given permission to go conquer the world, so I started searching for a way to physically prepare myself as if I were about to do just that.
I wanted to find a yoga class to attend. Considering the many benefits, learning yoga seemed like a good place to begin. I knew my friend Jason had been practicing for some time, so I asked him whether he thought I could do it given my condition. He told me he had recently been attending a class at Seva Fitness that could be exactly what I was looking for. It had yoga elements, but the class was designed to provide mobility and strength too. He invited me to come check it out.
It took me two weeks to make the space on my calendar to attend Human Fit Class. October is a busy month, but I was also more that a little anxious about starting a new class. It had been more than a year since I had attended a group fitness class. I’d been through a lot physically in the intervening months. I knew what I was allowed to do, but I didn’t know what to expect. How long would it take? How hard could I push? Would it be painful? Could I keep up?
Finally one Thursday night I showed up weak and humble. From that night forward I never stopped showing up. I’ve successfully worked up to attending class, personal training, and individual workouts safely and productively six to seven times a week. I still take rest days, and there are days I am stepping softly battling the aches and pains. But I show up. I started bringing my daughter too. It’s a great way to spend quality time together, and I’m eager for her to hear the guidance and wisdom from the Seva professionals at this formative stage in her development. She loves Seva as much as I do.
Returning what was Lost:
I lost some things: bone, leg length, muscle mass. I lost freedom, confidence, faith. Sometimes in the long stretches of waiting, I even lost hope. Some of those things I eventually regained and some I didn’t.
But I also gained some things I never had. I gained the knowledge and insight required to rebuild myself. I gained clarity on what happened – what physical and emotional factors contributed to my injury. I gained a better understanding of my challenges and a healthy respect for my limitations. I gained strength, flexibility, mobility, endurance. I gained peace and love and acceptance for myself.
I gained a Tribe.
I can’t begin to express the gratitude and love in my heart for everyone who has helped me through this. For the past year-and-a-half I have been working diligently to balance life and recovery, making the most of both. I’ve been making memories. Getting stronger. Growing more and more humbled as I consider every step forward a gift. Every day I wake up thinking about ways to give back, help other people who may be struggling – either temporarily or permanently – through whatever form their Recovery has taken.
The Next Chapter
How does this story end?
In May of 2015, I could tell something didn’t feel quite right. I had been working out three times a week for about a month. Every morning after a workout, I would feel tired and sore, but in the good way you come to associate with an appropriate challenge. At some point in the middle of May, I noticed a growing tenderness in my hip. I called Dr. Patel’s team to relay my concerns, and they asked me to swing by their office for x-rays just to check it out.
My worst fears materialized in the form of a grainy x-ray image. I had an avascular lesion on my ball joint. A complication of hip injuries, AVN occurs when the blood supply to the ball joint is disrupted. If adequate blood flow can’t be fully restored, the bone begins to die and collapse. Over time, the deterioration of the bone creates inflammation in the joint until the pain becomes completely self-limiting. The only solution in my case is a total hip replacement.
I was completely devastated. I had been cleared just six months earlier and had already been dreaming about the things I wanted to do, hikes I wanted to take, places I wanted to see. I was already moving on in my own mind, living my life without limitations. I stood there in shock as those dreams were suddenly erased. I had done the research. I knew the risks. I knew the consequences. I felt my future shifting in front of me. Course correction. Disappointed expectations. What can I say? It’s a recurring theme. I am still learning.
At the urging of Dr. Patel, I got a second opinion. There was a very small chance a salvage surgery could save my hip. While the experts were astonished at what I was able to do, at how well I had rehabilitated my hip through the work I was doing at Seva, there was nothing more to be done. I was in the best hands with Dr. Patel. All I could do now was wait. Every expert I’d visited or read agreed it was in my best interest to keep my own hip as long as I could possibly tolerate it.
Many people have asked: “Why the hell didn’t they just go ahead and replace it in the first place?” Fair question. Why have I gone through all this only to find out two and a half years later it didn’t work?
This approach was thoughtfully and expertly designed to buy me time. The repair was an attempt to give me the best chance to reduce the number of surgeries that will be required, minimize the long-term impact on my mobility, and maximize my quality of life. Broadly speaking, artificial hips being used today have an average 20 year lifespan. There are things you can do to either maximize or reduce that lifespan. Once the artificial hip begins to wear out, it will eventually have to be “revised” in an additional surgery. I try not to think beyond that point, because it’s hard to know how far medical technology will advance, and what outcomes might be available by then. But assuming I live to see 60 or so, that brings the total hip surgery count to four:
In 8 days I will be undergoing the second surgery – removal of the hardware, in order to prep for the total hip replacement at some as-yet-to-be-determined point in the future (six months to three years depending upon the competing effects of recovery and deterioration). I will be taking a break from my current fitness role within my Tribe. I will miss everyone dearly.
But My Seva Story isn’t finished. In reality, I’m simply beginning the next chapter. My hope is that my story somehow helps inspire someone else’s.
Regardless the outcome, I have appreciated the chance to share my story with you.
I can’t wait to see what this next chapter holds!
Other blog posts in this series: