Thursday, April 29, 2021

Difficult Health Decision

 I have some very disappointing news. I'm still broken.

After three months of wearing the hip brace, I was excited to finally get out of it and get back to my activities. I went to 2 pool exercise classes and one physiotherapy appointment. I was going to get a form filled so that I could get back to work with modified duties and eventually be back to normal hours. I was just starting to get a few things done around here that have needed doing, we went for a few car rides and a little walk in the park, and I was wearing pants other than leggings! Then it happened.

Last week, while I was seated, my hip had a partial dislocation. It popped out when I twisted sideways and kind of reached forward. I screamed, and my daughter called her dad and tried to figure out what to do. She was just starting to call 911, and I kind of arched my back with the pain and tada it clunked back in. Yes, I actually could hear the thunk as it relocated itself, and immediately the sharp, severe pain stopped. I cried and cried because, beyond the pain, I knew what this means. I put the miserable brace back on until I could check in with the doctor.

I called my surgeon's office and got an appointment for his next office day. He believes that we should do a revision surgery as soon as possible to go back in and change the style of the liner in the artificial socket and check things out. The protocol, if it had fully dislocated, would absolutely have been to do the surgery. There is no good guide for what to do with a partial dislocation, so the choice was up to me. I questioned why this dislocated at 2 and a half years out. It is very, very unusual - dislocations are usually very early in the game or after many, many years of wear. There is no answer to that one.

 I was supposed to have that cancelled knee replacement finally happen in July. He is highly concerned that if we don't have my hip stable at the time of the knee surgery and it dislocated again, it would be catastrophic for the recovery of both joints. He suggested that if the hip wasn't 100 % by then, we should do the hip instead of the knee at that time or just cancel the knee surgery.

 I asked if serious strengthening exercises would be a possibility instead. Our decision was that since I already had an appointment in a couple days with the physiotherapist, I should get her opinion. 

I saw the physiotherapist three days later. She really didn't think it was likely that we could get it strong enough once I was having repeat injuries like this, and the unfixed knee was not helping the situation. She said she would just go with the surgery rather than waiting in fear for another dislocation. Don't put so much work into strengthening that hip just to have the muscle cut in an emergency situation. Made sense. 

I called the doctor's office, and now I have surgery scheduled for May 19th.

Three weeks is actually a nice amount of time to get organized for life after surgery and to talk myself into accepting that this is really happening. On May 25th, it will be 3 years since I was in the hospital having the replacement and 13 years since I was in the hospital due to the pulmonary embolism and the subsequent brain injury. May is apparently not an easy month for my health. I am pretty discouraged at this point. I feel like I have done all I can, but then I question what I might have done wrong that I am having trouble with my hip like this. Unwarranted Self-blame is an issue for me sometimes.

The new Physiotherapist, Janine, said something helpful. I hadn't actually said anything about blaming myself out loud, but I guess she picked up on my emotional state. She looked at me kind of sharply and said, "You do know this isn't your fault, don't you?  This isn't you, failing here... it's your hip. No, actually, it is not your hip .. it is the prosthesis (artificial hip) that is failing. Maybe a problem with it. Maybe not the right fit or orientation for you and your life, but for sure, it is NOT you!" I didn't realize how upset I was feeling about that until I felt such a wave of relief go over me with her words.

I'm going to try and get some fun into the next 3 weeks while I still can. Life has already been so restrictive in this Covid Time. Unfortunately, we are in another wave in Winnipeg and experiencing increasing restrictions related to rapidly increasing case numbers. Another bunch of limitations because of the hip and now continuing for 4 more months is just adding to the isolation and feelings of being restricted. Even though I am in quite a bit of discomfort and pain, I want to go for some car ride adventures, take some photos, have a picnic, get some takeout food and enjoy our yard. I don't want to miss this lovely warm spring weather.


oc1dean said...

Sorry about your difficulties Linda. You talk about having to cut muscles which means the surgeon is not doing the surgery where the muscle fibers are separated rather than cut to replace the hip. A friend had it done that way and was climbing steps in three days. His dad had it done the old way by cutting thru the muscles and always had to worry about dislocation.

Linda said...

Good to hear from you Dean!!
I am not sure what all they will have to do in terms of the muscles frankly. I know they will switch the socket liner for a constriction-style socket which will act as more of a lock. I think it really depends on what they find.
There could be a flaw in the actual prostheses, could be something shifted.
I had some swelling after the initial hip replacement almost 3 years ago. A week after I got home there was massive swelling. I wound up rushed back to the hospital and a grapefruit-sized hematoma developed. It turns out that the swelling caused the muscle to rupture/ tear in 2 places. I wound up on a month's worth of bed rest rather than doing the initial exercise that is so important post hip replacement. There is a possibility that the muscles have scar tissue and may need reconstruction. The dislocation in December was also very serious but was reduced after many tries with no surgery. The Physiotherapist figures there is probably some ligament or tendon damage from then that will need repairs too. We don't want me to have another trauma situation but better to take care of this as a planned repair.

Rebecca Dutton said...

I am so sorry this is happening to you. If I were there I would hug you - gently.

Linda said...

Thank you, Rebecca! I especially appreciate the gentle part. I must admit that I am feeling very breakable lately.

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