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Hip Labrum Postoperative Rehab, Day 6 (Post 4)

Ginger Garner (c)2014.
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Pictured with my three sons, who seem to have a magnetic attraction to anatomy and physiology, ran over when I announced I was going to review photos and video taken of my hip surgery. (c)2014. Ginger Garner.

Hip Labrum Postoperative Rehab, Day 6

This is post #4 in the Hip Labral Post-Operative Series. If you haven’t read them yet, check out:

August 26, 2015 – Day 6

Last night I had horrible restless legs. They kept me awake for hours after everyone in my family had fallen asleep.

And yet, I cannot move my leg actively yet – which my psoas and newly repaired anterior labrum GREATLY appreciate – but my restless legs are contradicting. Anytime my psoas fires (involuntarily or voluntarily) the pain skyrockets over the repaired areas, so having restless legs now, is not only incredibly, tearfully, painful but it is detrimental to my healing and recovery.

Finally, at 2 am, I had to relent and wake my husband – and give in to taking a muscle relaxer. He also obliged to massage my legs and help them settle down, which did calm the involuntary spasms and movement.

CLINICAL PEARL: I should have asked for help earlier, instead of tearfully battling pain in silence for 4 hours. Lesson learned, ask for help BEFORE you are in a critical state of need.

Meanwhile, oxycodone did nothing for sleep or pain last night. I have discovered that, at best, for this situation, pain meds intoxicate my brain to a numb, dull stupor – making perception of pain distant, like a hearing a far-off scream. The pain itself though, my intellectual mind knows and feels, is still there in full force. And since I need a sharp intellect to observe my hip precautions, traverse multiple flights of stairs per day safely, plus negotiate the toys left on the floor by my fast-moving tiny body bodies of my three sons – I resolved to take no more pain medications yesterday.

Today is the first day I have gone with no pain meds during the day. Congratulations to me.

I also went outside for the first time and immediately realized my wrongdoing. I SHOULD have been taking vitamin D or getting daily sunshine to facilitate bone healing.

However, in an altered-mind drug-induced state of post-op pain haze, my health care provider hat is nowhere to be found.

Hence, I completely forgot the advice I always give my patients. Get your vitamin D on a daily basis – it is also a hormone and very important for bone and neuroendocrine and immune health.

CLINICAL PEARL: Please have a family member remind you to get your sunshine vitamin daily OR if sunshine therapy is not feasible, work with your health care provider to see if vitamin D3 supplementation is right for you.

I got a kind email from a friend and fellow physio/PT colleague today. Here is my response to her, which is pretty darn valuable because it is REAL.

Dear Diana,

I read this as I am laying here in bed at day 6 post-op. Weaning off pain meds during the day as of yesterday, but the fog has still not let go of my brain. It is so hard to realize I can’t “hurry up and heal” and this process is going to have to unfold, slowly and organically, over the next 4 months. I can’t believe I have to teach full-time in 2 short weeks, or that I’m also still enrolled in school (and not attending right now) [I was and still am working on my doctorate] and falling behind day by day. 

There are many ways in which I could rightfully press the panic button, but instead, I’m choosing rest. I’m tuning out the outside world and turning inward. I’m spending time with family (about 2 hours each evening) while the rest of my day is spent upstairs tucked away in silence, reclining (sitting over 30 minutes is frowned upon for outcomes) and reading or watching Call the Midwife (a BBC series I’ve been pining to watch, on my own, for months, but knew I couldn’t stand all the crying and angst over poor birth outcomes in the US – that I knew it would bring on). 

So far so good, the acute pain is diminishing, and today I watched the surgical videos for the first time. Jeez, my joint capsule was full of synovitis, very angry, and the labral and neighboring articular cartilage were quite beaten up. The capsule was also repaired, including 2 areas of bony impingement reshaped. So I have my work cut out for me – for sure.  

More rest before I embark on PT (starting tomorrow morning at 8 am) though, because I’ve already made several silly brain “errors” that show me I am definitely not ready for a return to anything that requires mental clarity or even gross proprioception!

Grace and peace, Ginger

Hip Labrum Postsurgical Musings,CLINICAL PEARL: Ask for help, which I did, by finding a second (and eventually third) PT (other than myself) to help me manage my acute rehab. Also, at the time I thought post-op recovery took only 4 months, according to protocol, however, that is not true in the vast majority of cases. Read my post How Long Is Recovery after HL surgery?

CLINICAL PEARL REVIEW

  • Early weaning off pain meds allows you to recognize when you needed help, and also prevents you from unknowingly pushing through pain or hip precautions that could damage the repair.
  • Even if you are a physical therapist who specializes in hip labral rehab, find a another colleague who can assist with your recovery. In my case, recovery was important enough to enlist two physical therapy colleagues. My career and livelihood depends on my ability to move with ease, getting down on the floor to teach colleagues or patients. Also, it is critical to your well-being and stress management to enlist the help of other health care providers, as I could not have managed this early rehab on my own. Heck, I couldn’t even drive a car, put my own shoes on, or manage a well-formed sentence during that time. So ask for help – from your family and colleagues.
  • Make sure to ask for help before you are in critical need of it. Asking for help isn’t a sign of weakness, it is a sign of strength.

Resources

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