Kathryn Cardy: Kathy Writes about the Hip
Kathryn Cardy, former dancer/teacher/choreographer (ballet, jazz, musical theatre), retired from performing in 1991, but continued to teach for 10 years after that, and to choreograph up until May 2008. Since 1999 she has worked as an artist-manager for a roster of classical musicians. Below is her introduction to the diary of her hip journey - which follows directly. - NR
I am a 53-year old former dancer/teacher/choreographer turned artist manager, who, on Dec 8, 2008, had a titanium total hip replacement done by Dr. Joseph McCarthy at Massachusetts General Hospital in Boston. If you are lucky enough to get an appointment with this doctor and his fine staff, either at Mass General or at his clinic in Newton, MA, then you are in the very best hands. I found him by sheer luck - my orthopedist at home had done a fellowship with him; he sent me and my shallow hip sockets "to his teacher."
If you are a dancer or an athlete facing a hip replacement, you've probably been all over the internet looking for somebody, anybody, with whom you can identify. What I can tell you is that the discomfort and limitations that led me to hip surgery crept up on me so slowly that I can't remember a specific "straw-that-broke-the-camel's-back" injury. I just realized that more and more, I was choosing not to do things - my world was becoming smaller and smaller. I went into this whole thing sure that all I needed was a "shot of something" into the hip, and I'd be fine; it was the biggest shock of my life when the doctor said "Oh, you need a total hip." As if it was the most normal thing in the world.
If you are a dancer or an athlete, you are used to living with a certain amount of discomfort, and you're liable to continue to try to tolerate the pain. You may have decided that that's the way life is going to be -that it's the price we pay for the joy of what we used to do. Or you may have decided that "It doesn't hurt enough yet." Understand that we have a much higher tolerance for pain than the average person, and living with this level of pain that you think is tolerable is not normal and not the way you have to live the rest of your life. Do not be fooled and do not be scared: they can fix this. You are not going to believe the wonder of medical science. These people are amazing; they are gifted and very good at what they do. You go for it. Two years later, I continue to have the experience of getting my life back: of thinking "Wow - It used to really hurt when I tried to do this, but just now, I didn't give it a second thought!"
Here's my journal:
Oct 31, 2008
So I went to Boston to see Dr. McCarthy. Apparently, I have massive osteoarthritis on the right side plus cartilage that looks like "mashed up crabmeat." Lovely. I am getting a titanium hip on Dec 8. I have been freaking out, but I am determined to find a way to micro-manage this. It will calm me down if I think I am controlling it...
The therapist says that we dancers are a textbook on how not to bend, reach, sit, etc., so that I will have a lot to learn post-op. Which means they'll probably torture me the whole time I am there. They say I could be 6 weeks on the walker before they'll let me use a cane or crutches or drive or even bend at the hip past 90 degrees. I am choosing to believe it will take less time than that, but I guess it will be what it will be. I have done with freaking out now, and am determined to move ahead and be in great shape for Emily's graduation from law school in May.
I had a major meltdown 2 nights ago, but now that that's out of the way, I am going to move forward with my usual optimism and just get it done. No more crying or trying to talk myself out of it.
...I figure that, when you're in hospital, you are improving every day -- every day you achieve a little toward going home. But when you get home and are actually faced with all the things you used to do that you can't do now, that probably brings on a downer. Someone will have to remind me to give myself enough rest - I am notorious for "pushing through" until I'm sleep-deprived and exhausted.
Nov 3, 2008
I am tired of pain and constantly feel drained; but I am determined that today is the beginning of the path to "better." I have got to turn my attention to being as rested and healthy and strong and positive as I can, so I will get through this surgery in the best way possible, come out stronger and pain-free and ready to get back to life the way I like it. That's the goal, starting today.
I am really scared about this surgery; I've heard and read that once you've had a big operation, you never regain your full self - that you age faster and things just start all going wrong after that. I am determined to not let that happen, and the doctor reminds me that health-wise I am a perfect candidate for this operation. But I hate not being in control, and I know that I am going to have no control at all once I hand myself over to the scalpel. It scares me to death.
So this will be a period of re-education, I think, both mental and physical. It will be an exercise in humility. If I think about it too much, I will talk myself into putting up with the pain for a few years longer.
Nov 11, 2008
I've been bitten by a tick and need to be tested for Lyme disease. Between that and the impending hip replacement, I am not livin' it up.
Let's start with the hip replacement. I mean, we knew it was coming, right, the way I was limping around, but the whole thing still just freaks me out. So, they're slicing open my leg and taking out a big hunk and putting in some metal? Right. Gross!
And to make it more complicated, the surgery is in Boston, not here at home. I can't imagine getting on a plane 4 days after major surgery, even with my husband with me, but the doctor says they do it all the time and I'll be fine. They say they will not release me until I can walk easily from the wheelchair to the plane seat. And they have an occupational therapist who will give me plane lessons, just like they'll give me car lessons. (How 'bout it?). They tell me I'll probably have to use a walker for 6 weeks, then crutches, then a cane. (Watch me lose that walker sooner. And then watch me fall right on my nose trying to use crutches. OMG, I am so uncoordinated with stuff like that!)
The upside is that, for the holidays, I will get to sit around and have everyone wait on me. I'll probably lose my mind.
Can you tell that I am rocked by this whole thing? I swear, I never really thought I'd have to lose the whole joint. I really thought the specialist would be able to do some kind of quick fix. Aaaarrrgggghhhhh!!!!!!
My husband is beginning to dread Christmas as he realizes all that he will have to do if he wants it to be as it always is. It'll be very interesting to watch from a chair as it unfolds.
I think I know what people mean when they say right after surgery that they're not one of those people saying, "Oh, why did I wait?!?" I keep hearing tales of a people who are "so happy and wish I'd done it sooner." I suppose that is especially the case for people who were only moderately active to begin with, or for people who waited until long after they were completely debilitated. But since I am moving around the house OK most days, with no outward signs of discomfort unless I try to do "too much" in a day (like go to the grocery store or walk the dog, or God forbid, go to the gym) it's kind of hard. Tolerating the constant low level pain, pulling back on daily activities and cancelling stuff that never would have fazed me before - the trip to New York, the trip to the Gallery, errands with the girls in Boston, Christmas shopping at the mall, yoga class and the gym, a walk around the lake. All those capitulations add up. But still, people would look at me most days and say - "It's way too early to be thinking about a hip replacement. Take some Advil and rest."
I can't wait to have all those things back. Even so, I can't help seeing the hip replacement as confirmation of a whole list of things I will never do again. Will I ever be able to sit on the floor again without thinking about it, or do a whole yoga class? Move fast and easily without thinking about it? Shave my legs standing in the shower? Run around the yard with the dog? Haul stuff in and out of the attic? Unload a car full of mulch and birdseed and dog food? Pull the spaghetti pot out from under the sink? Carry the laundry outside? Carry wood? Pick up my granddaughter when she's 3 or 4 or 5? Choreograph a show? Will I be able to spoon up next to my husband in bed at night in the same way we've done every night for 35 years?
The answer to all these questions might be "probably not." I don't know. So, for me, the surgery seems like a stopping point; the finish of one kind of life and the start of another slower, more careful, less energetic existence. A fifty-something, arthritic, non-dancer, regular-person life. With a really restricted caloric intake so I don't gain 10 pounds a year. Mind you, I am very aware of all that I will get back, and I will be grateful for all of it. I will get back that walk around the lake with the dog, and the grocery store and the mall, and Em's graduation in Boston and probably many more trips to Europe - all pain free. But in my head right now, the list of things to let go of is awfully long and discouraging.
But -It was lots of fun wearing the old body out; time to find a new kind of fun. I think I am on the way to a re-education gulag to learn a new normal.
About exercise: I have long used the following as my judgment on whether or not to engage in a certain kind of exercise: Look at the faces if the people doing the exercise. Do they look happy? If they don't, then that is not an exercise for me. Over the years, this method has worked like a charm to eliminate many options that seem like too much work. I am going to remember to employ it regularly.
Well. I made a big mistake the other day and weirded myself out by looking at photos of hip replacement scars on the internet. Bad, bad mistake. They were 12-14inches long and full of staples, and so gross that I was nauseous for four hours and all tied up in knots. That was Saturday, so first thing Monday, I called my surgeon's office and spoke to his nurse, who gave me a big lecture. She said (kindly but firmly) that I need to get off the internet and only read the stuff that their office sent me and stop reading garbage that might be 20 years old. The nurse told me to get my butt back into the gym and work up some endorphins, then go have a great Thanksgiving holiday, and then come up there with a healthy "let's do it" attitude. She says attitude directly affects your body's ability to heal...so I am following her advice and have become this tornado of energy.
...I really have no wish to go back to dancing past an occasional jitterbug - the stage stuff feels too much like work now. It would be fun to choreograph again, but the fact is, even after the hip is replaced, I'll be fairly limited compared to what I've been used to. I won't be able to demonstrate as I did before - not for high school people with no dance training. West Side Story only worked because I danced every step with them for months and months - they had pictures in their minds. Anyway, when the surgeon asked me what I expected from the new joint, I told him I wanted to walk all over Paris, and I didn't want to have to sit like a lady for the rest of my life.... It's the new normal.
SURGERY was Dec 8 2008
Dec 18 2008
Thank you so very very much for all your support and good wishes while I was in Boston for surgery. Many of you know that I was fairly freaked about the hip replacement - I had way too long to think about it. Your cards and letters and calls and emails propped me up before the surgery, while I was in the hospital, and they continue to do so now that I'm home, repaired, and can see that everything is going to turn out just super. Here is a long and entertaining account of what has happened to me in the last 2 weeks. Some of this stuff you are not going to believe, but I swear to God it's all true.
To start, you have to know that, being "Type A," I made thorough advance preparations for this surgery. There was all this doctor stuff to do: blood tests, x-rays, EKG and stress test (Really? We need a test for that?) and all these forms to sign, including a living will (Great. Excellent. Now I'm feeling confident.) Then there were the other, even more important preparations: manicure, pedicure, hair cut (I mean, I can't go anywhere for weeks, right?) Hit the gym to get strong. Went on a diet. We did all the Christmas shopping, wrapping & mailing; and most of the decorating so I could come home to a festive Christmas house. We got all of it done except the Christmas baking, and well, the ingredients for chocolate chip cookies are here if someone else wants to make them. I made an obsessive-compulsive-control-freak's 8-page "itinerary" for the trip, like I do for my musicians when they go on tour, outlining what was happening every single day, and especially, outlining how my poor husband and daughters were supposed to make arrangements to get me onto a plane for home 4 days after surgery. I did everything I could think of to prepare, then packed and went to Boston early, figuring I'd spend 4 days playing with my baby granddaughter. I got lots of playtime, plus DID MORE TESTS and FILLED OUT even MORE FORMS. No kidding. Unbelievable. I finally got to wondering who would have done all this stuff if I'd been hit by a bus and just ended up at the hospital. I mean REALLY. But Massachusetts General Hospital is connected to Harvard, ya know, so they probably specialize in forms and procedures.
So for 4 days in Boston, the goal was to wear out what was left of my right hip by going up and down the many flights of stairs to the girl's apartments, and to help with errands and shopping and baby care. All without Advil, which was now banned. Of course, we had to stop at TJ Maxx for soft and stylish sweatpants for me - a girl's gotta look good when she recovers. (A really neat dress also ended up in the bottom of my suitcase - I don't really know how that got there, but it sure is a beauty...) ANYWAY. My husband flies up the night before my surgery, and we have a great family dinner at our daughter's house, then we check into a lovely B&B across the street from the hospital. Now is the time for romance, right? Wrong. We are both edgy. My brain is working overtime. And now I am fasting. I hate fasting. I'm bad at fasting. The surgery isn't scheduled until 2pm the next day, so I am pretty sure that by then I will be so dizzy and miserable that I won't be able to cross the street to get over to Same Day Surgery Admitting.
Let's talk about that. Surgery is to be at 2:00, so when my wristwatch says noon, I put a few things in a baggie: eyeglasses case, chapstick, tweezers (you ladies know what I am talkin' about), bundle up against the cold, and we literally walk across the street for a hip replacement. In what kind of a sick world do you voluntarily walk into a building, let someone you barely know cut into you and take out parts and put metal parts in, and pay lots of money for the privilege of waking up feeling like crap? This can't be real. So when I get to the front door, this is the first time I am feeling like I could probably still run fast enough to escape down the street. It could be like an episode of ER where the patient goes missing. Luckily, I am actually limping pretty badly, and dizzy from no food, and my husband has got a good hold of me. So we go in the door, fill out more papers (MORE?), they give me the funny outfit, I say good bye to my family (not good) and get on the rolly-bed. This is not a good point in the day. I am emotional, hungry, all by myself, and no one has given me any happy pills yet. They wheel me to the OR (the swinging doors look just like they do on TV); the guy parks my rolly-bed outside the scary swinging doors and he LEAVES. For what? To take a smoke? Where is he? Why am I all by myself? No happy pills yet, and trust me, I am Not Happy.
I am also beginning to think hard about what a really bad idea this is. Maybe I can just take 20 Advils a day and make it through another whole year before I do this, or get liver disease, whichever comes first. Just then someone comes out of the OR. He explains with a cheery voice that there is a bit of a "traffic jam" and that I am next up. I am feeling oh, so much better now. I am next up. Then someone else comes running out dressed up like she's on ER. I see blood on her. "Please forgive me" she mumbles as she runs by. Super. This is the second time I am feeling like I could probably still run. Remember, no happy pills yet, so I actually sit up and decide to put my escape into motion. I am officially freaking out.
But just then, my surgeon shows up. He has his costume on, but he is not scrubbed up yet. He sits down and says "We haven't had a whole lot of time to talk together lately, so let's just hang out." What a nice man. He sat with me for 20 minutes while they finished up whatever bad thing was going on in the OR, and he blocked my view of the scary swinging doors. I was really glad to see the surgeon for another reason: I had a lot of last-minute questions for him. I asked him if he was having a nice day. "Did you get a good night's sleep? Did you eat a good breakfast? Do you need a nap before we go in there?" He gives all the right answers, tells me he's really good at this and that he only has "A" days. I like confidence. I make him promise that he is doing the surgery, not one of the million of students that are hanging around this hospital. He promises; he goes to scrub up, and then, thank God, they give me the happy medicine.
As expected, I wake up feeling like crap. But it's OK because I am alive, and my expectations are pretty low at this point. They tell me it's 9pm. Whoa! The relieved faces of my husband and daughters float by in the morphine haze; then I guess I went to sleep. I wake up again at 4am, when Rhoda the Roommate arrives in a clatter of noise and beeping machinery. Rhoda turns on the TV first thing. Rhoda likes to watch TV 24/7, and Rhoda likes Judge Judy. The hospital seems to have a whole channel that plays nothing but Judge Judy, but maybe that was the morphine. Morphine is tough stuff. It works really well for pain, but it is a powerful narcotic. I barfed it up. They tried Percocet. Also a powerful narcotic. I barfed that up too. Now I know why drug addicts look like they are wasting away - they can't keep their food down. It's the Narcotics Diet, which will not be on Dr. Phil anytime soon. Don't take narcotics, people. They make you really sick. They finally tried a 3rd drug, tiny little pills of what I hear is a scary controlled substance (oxycodone), which worked for great pain and did not come back up, but unfortunately did not take away Judge Judy or Rhoda the Roommate.
24 hours after surgery, the nurses decide I should sit up (now that I have stopped barfing), but the room spins, so I get to lie back down. My blood pressure drops down to the "she-might-be-dead" range, and everyone gets very excited. That's it for the day insofar as activity is concerned. They next day they decide to try again. I sit up. The rooms spins. OK. Fine. I can spin - after all, I practiced spinning for years, so what the hell? So I stay sitting up, watching the world spin. Then they decide I should try to stand up. No luck. Blood pressure takes another scary dive. Apparently seated spinning is way different from standing spinning, and way way different from anything I'd rehearsed in the last 50 years. They decide I'd better find a way to eat, and that I'd also better have a blood transfusion right away, or I will still be there for the New Year's party. The transfusion itself is a nightmare (Whose blood is this? Oh, CREEPY! Why do I have the shakes?) But it works, and I very rapidly improve to "hungry and energetic." My family has apparently warned them about what happens when I get energetic, and nurse Holly (note the seasonal name, which was festive) threatens to hurt me if I break even one of her rules: No bending over. No lifting anything. No reaching, no twisting, no sitting up straight, no getting out of bed or into bed or going to the bathroom by myself, no doing anything much except reading a book. Great, except who can read about Eleanor of Aquitaine with Judge Judy on TV 24/7?
At least I can start eating anything I want, which is exciting stuff when you normally live on a diet. I order real food: fruit plate and salmon. The salmon comes and it is hard like a bone -- you can pick it up and gnaw on it. Oh, man. I order bacon and eggs. Whoa - the eggs might be made of plastic. The bacon looks like a dead thing. I realize that, for a week, I am going to have to live on fruit plate and tea. That's OK. My expectations are, as I said, quite low. I eat a lot of fruit in "real life." I am not doing much but sleeping a lot right now anyway, and in between, I am wishing I am asleep because Rhoda the roommate turns out to be a bona fide nutter.
Rhoda has every disease, and she has spent way too much time reading medical books. Turns out this is her 3rd trip in here in the last 2 weeks. Rhoda spends hours on the phone to her friends and family, describing every symptom, and what it might be. Doctors and nurses parade in and out, and Rhoda tells her stories over and over, non-stop, like this horrible rap that's on a loop with Judge Judy. I beg my nurse, Holly, to let me get up and walk. I accuse her of putting me with Rhoda so I will want to work harder at the in-bed exercises, so I can get up and get out of the room faster. Holly laughs this "nyuck - nyuck - nyuck" sort of chuckle, but later, she tells me that she has scored me a change of rooms, and that they've called in a psychiatrist for Rhoda. Holly wheels me and my rolly-bed out of there and down the hall, where I can watch MSNBC or read my book in peace. I love Holly the nurse, and now, I feel kind of bad for Rhoda.
What I cannot get Holly to do is to let me take a shower. It is now day 3 and I really want one. But, no. I try to bribe her into at least washing my hair. She asks if I'm going somewhere. No, but, people are parading in and out now, and they are all looking really dismayed at first, before their faces smooth over and they say "Boy, Mom, you really look good." C'mon, people! Was I born yesterday? I finally grab the wet washrag and scrub my hair with it and slick it back ballet-style with a headband and a pony-tail holder. This is ugly, but at least my family has seen this hairdo before and they are not scared of it. Holly the nurse says I look gorgeous. Well, OK, but only compared to the only other look she's seen so far. I will never ever again underestimate the value of a hot shower.
Day 4. It's Thursday, and I am supposed to fly home on a airplane on Friday. They decide that they'd better put me on the accelerated PT program, since I am a day behind because I spent so much time spinning and barfing. The PT invites me to stand up and take a walk. With great surprise, I find that I can do this. My legs feel the same - one doesn't feel full of metal - it feels just like the other one! How about this? Pretty cool! I take my new walker and clump about 40 feet. They all tell me I am fabulous, and I, with my very low expectations, believe them. Then I realize that I am in the hallway and I have to go back to the bed. Hmmm... Well, OK, since there's no choice, I go back. More celebrating. Ginger ale and ice cream appears (which I haven't gotten to eat since maybe 1991). And I get a well-earned nap. By Day 4 afternoon, I have lost the clumping walker and am walking slowly down the hall on crutches, showing off to anyone who will notice me. A fun occupational therapist lady comes to visit me with "dressing aids" - a stick to help you pull up socks and underwear when you can't bend over, and a grabber thing to help pick up all the stuff that I am dropping and then can't get. I find that I can use the props without too much instruction - all that theatre training came in handy. Good thing, because some of the stuff on that list of "no's" is apparently in effect for at least 3 months. And then, Dick tells me that we are going home tomorrow night; he and the girls have miraculously made all the arrangements. Holly the Nurse says that, first thing tomorrow morning, I will get to take a shower! Woo-Hoo!
Day 5. I wake up and cannot imagine that, in the next 12 hours, I will be able to take a shower, dress all by myself, walk twice around the ward, and do stairs on crutches; but they tell me that all this has to happen if I want to go home tonight. Clearly someone has told them that I am goal-oriented, so I get to work. I do everything in order, with a nap in between each thing. Breakfast. Take a nap. Shower. Take a nap. Dry my hair (Holly scored me a hairdryer). Take a nap. Dress myself. Take a loooooong nap. Lunch. Take a nap. Do the stairs with the encouraging young PT who is sure I will not fall down them face first. (Clearly, she doesn't know that I have done that in "real life," without crutches.) Nap. Finally, it is nighttime, and we are ready to go to the airport. The guy comes with the wheelchair; I hug Holly the nurse and climb in. My husband and the wheelchair guy load me into a taxi. It is a clear cold night after one of Massachusetts' worst ice storms. Thousands of people are without power, but the storm has missed Boston, and all over town, the night is lighted up like a Christmas tree. I'd forgotten it was cold. I'd forgotten that it is December, and 2 weeks until Christmas. I feel profoundly grateful, like Scrooge when he wakes up and realizes that he hasn't missed it. We're going home.
I made it through the indignity of airport security, where, because I couldn't stand unaided, the kind TSA lady had to pat me down as I sobbed. (It wasn't that bad, really it wasn't, but drugs make you weirdly unable to cope.) Survived the plane ride in business class, which, by the way, is great: they have shortbread instead of pretzels and everyone was so nice and no one could believe I'd had surgery only a few days before. Got home and was tucked in by my own Mom (wow) who fed me soup and then Mom & Dad stayed overnight to make sure we'd be all right. How do you thank your parents and your husband and your daughters, and people like Holly the nurse, for taking care of you? How do you thank friends who listened when I was freaking out, and who keep sending cards and letters and presents and food to cheer me on? How do you thank the surgeon, who is a genius, because now, just 10 days post-op, I am walking slowly & stiffly, but without hip pain, on nothing stronger than regular old Tylenol? Who do you thank for the good fortune of medical insurance that covers surgery like this and you get a bill for only a couple of hundred dollars?
Listen, you guys: Lots of people are down and depressed right now, with good reason. The economy is in the tank. People are losing their jobs. There are wars and terrible things are happening to people all over the place. It would be really easy to wake up every day and see only the bad out there. But you guys should remember that miracles also happen every single day. Lots of people are studying hard and working hard every day so that people like me who were hurting can look forward to a normal life. Maybe not the crazy life of a dancer, but definitely the normal life of someone who will be able to exercise, travel, play with her grandchildren, work at a job she loves, train her puppy (I hope he is still train-able) and have a little fun once in a while over at the local high school drama department. I am still massively bruised up, tired, and slow, and my butt feels like I am sitting on a tennis ball, but because of God's blessings, good fortune, and the love and hard work of a great many good people, I have to tell you - the world looks pretty good to me right now.
Merry Christmas, everybody. Happy Hanukkah. Happy New Year.
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Dec 17, 2008
Recovery is going well- in fact, I never expected to be moving around so well at 1 week post-op. The PT has just given me a new assignment - "toe raises" (think relevés) and marching (think Nutcracker Act One Children's March) The relevés are a piece of cake; but who knew I wouldn't be able to march! Talk about going back to Square One... "And now we're going to kick our leg," she says. "What do you mean by that?" I ask. I mean -- I'm pretty sure she doesn't mean what I think she means, and I am right - she means hold my leg out to 45 degrees. OK. That I can do, but it's a shock that some things are still so weak. You tell the muscle to do something and it just sits there like, "Are you kidding me?" But all in all it's great - I am off the walker, and off the crutches unless I am going to be away from home. At home I am using a cane, or nothing, for the really short walks, like around the bathroom. The surgeon says that this was the plan all along, and that that other "careful" plan is for older people who didn't get to prepare at the gym as I did.
Some days are really slow, of course -- my friend Caryl calls those days "First Gear Days" (Do one small task, take a nap, do some PT, take a nap, do one more small thing, take another nap - you know.) Most of you can imagine how well that kind of schedule goes down with my Type A speed-of-light personality. But I'm discovering (yes - the hard way) that if I allow myself those First Gear Days, I actually do much better overall, so I am trying to behave. I am learning to love relaxing in bed until noon -- sitting on my heating pad, making phone calls in my pjs, reading a novel. I like it! I am also learning to take a long afternoon nap.
But, God, it's good that my husband loves me. Those rose-colored glasses of his sure are coming in handy lately, becasuse this hip is not a pretty thing to look at. My family has been taking good care of me, as is the nurse and the PT - everything is going so well, and the surgeon has taken me off the narcotic pain meds.
I still feel like there's this big golf ball under my right butt muscle. The surgeon says that's a hematoma caused when they had to split the muscle. She said (no lie) that I was all muscle back there, and that tried to get that muscle to relax and let them do what they needed to do, but it wouldn't, so they finally had to split it. They say it might feel like there's a golf ball in there for 6 whole months. That's what's hurting - not the fabulous bruises that are showing up, and certainly not the hip itself.
Dec 20, 2008
...It hasn't been so bad, once I got the morbid notion out of my head that a dancer died on the day of the surgery...
Recovery is going well -- the new normal is strangely satisfying to work toward, and I know the time is right. PT is really interesting; I tell you, it is fascinating to ponder the things I cannot now do that I used to take for granted - it really makes one humble. I have a new appreciation of all those former students who used to wail "But I just can't..." For instance, The PT tells me to march. "March? You're kidding, right?", I think. Then I try it. One knee goes up, and the other knee slowly draws only about halfway. He asks me to "kick" out from the knee and hold at 45 degrees. One leg goes "Oh for God's sake..." The other leg goes "Are you kidding me?" And weirdest of all, I sit with my legs straight out in front of me, and the PT says "Lift your leg up with a straight knee." One leg goes up to my forehead. The other leg doesn't even react. It's like it's deaf or something, and, trying too hard to do it, I've now strained my hip flexor! Apparently, the nerves have to learn to lift all over again, and they are not ready. It's all fascinating.
Dec 23, 2008
Luckily, we had some cut-up pieces of memory foam from a mattress topper, and Dick's fashioned me an enormous and wonderful cushion, because I was having a devil of a time sitting on any chair, hard or not. Slowly but surely, the PT and I are working the kinks out of my poor behind; gradually stretching it. Every day is better - but the prize will be when I can finally sleep on my side instead of flat on my back. I still have to wear the damned anti-thrombosis stockings. I hate them. But I also have to admit that my leg feels better with it on.
My family has been amazing. Everyone is waiting on me hand and foot. Food miraculously appears, and there is always someone to help me put on my socks.
Christmas Eve, and I am going to lose my mind. The furnace won't come on, and the world has run out of Christmas trees. It is 9pm; no one has had dinner, and I am have to just hide here in my office while everyone tries to fix things.
Today is my first day with no one to "mind" me, and it's been really kind of wonderful - everyone is gone, the house is quiet, and I am actually getting a few things done. And today I got permission to get into a bubble bath!
Today is my first day in sweats instead of pjs. The leg is still weak, but I've got home physical therapy until Jan 6; then I'll go to a rehab place 4 miles down the road, where we'll get working on getting strong enough to drive. It's weird is that the leg with all the metal in it doesn't feel any different from the other leg at all, except that it's sore - you can't tell there's metal in there. I'm still massively bruised up, and with that 5 inch scar on my hip, my bathing suit days are definitely over (but that's no great loss to anyone). The great thing is that I'm standing up straighter than I have in years, and there's no pain in my hip. So, Happy New Year !
Jan 2, 2009
They tell me to add one new thing a day, and I just got permission to take short walks around the neighborhood (flat surfaces only - no hills), so today I walked carefully down the driveway and back, then came home and fell right asleep on the sofa. My daughter says that tomorrow's walk is going to be inside DSW - she says it's a lot warmer in there, and they have lots of little benches I can sit down on while she tries on shoes. (Sounds good to me.)
It looks like I have passed the choreography torch to a brand new dance teacher at the High School. She is young and enthusiastic, and the timing could not have been better. I'll miss working with the kids, but I probably won't be much good at demonstrating after this. Besides, I have to confess that hauling myself to rehearsal in the frigid January weather sounds like way too much work right about now. I'm really grateful to have a cozy home office, and a super-good job that I can do in between naps. Life goes on, and soon the drama kids won't even remember who I am.
I feel great; did 2 circuits around the perimeter of the yard yesterday with the dog. I've been discharged from home PT and the scar is really healing nicely. I have my first followup appt with my local ortho in an hour, which will be creepy, because they'll take x-rays and I'll actually get to see what's in there. He'll also write the script for rehab. I hope they let me drive. It would be nice not to have to depend on anyone else to get to rehab.
Jan 6 - The 4-Week Update
Today I went to the doctor for my first post-surgery followup (Monday was the 4 week mark). They took x-rays and I got to see the new hip. It was so weird to look at it -- I can't really wrap my brain around the fact that it's in my leg. My doctor says I'm Wonder Woman, told me I was cleared to drive, but only to rehab and back and to social things - no doing chores. I am allowed to walk at the mall if the weather is too bad to walk in the neighborhood, but only if I take a snack-or-drink rest every once in a while; and I also had to promise not to buy all kinds of stuff that I would have to carry. (Are he and Dick talking?) Then he reminded me that most people are still on a walker at 4 weeks and to remember to slow down and sleep whenever I am tired (...like I have a choice-I practically just fall over) What I still don't have permission to do is bend beyond 90 degrees, roll up in a ball to sleep, carry things, do housework, or climb. And I still can't put on my own socks, which is getting annoying.
The doctor "graduated" me from home PT and put me in outpatient rehab starting Thursday. I definitely want to get some more leg strength back. I still can't lift the leg straight up without straining, and I still feel like I am sitting on a golf ball by the end of the day. All the muscles in my upper leg are aching now, too, which he tells me is a good thing because it means they are working, but I think I liked it better when they were weak and happy. And, to make matters worse, I now I have to do leg lifts lying on my side, which is really hard (When I think of how easy it used to be I could just die).
A bubble bath seems to make everything a whole lot easier, so I'm hoping for some lovely outpatient hydrotherapy in a zen-like setting instead of a big beefy woman in spandex counting leg-lift reps. Hydrotherapy, massage, you know... spa rehab. Maybe with a manicure and pedicure on the side... Truth is, though, that they'll probably get down to some real business and I'll be sorry I "graduated." Plus, the rest of my body is beginning to feel creaky, especially my back (which is getting used to new and improved posture), so the doctor says that if rehab is only allowed to deal with the hip, I have his permission to head back to the regular gym on the "off" days to do light weights and stretching for upper body only - nothing below the waist. If I do that, my home PT said she would meet me at the gym and show me which machines I can use and which are off limits, and she'll set the weights so I won't do anything stupid. That's definitely worth paying her for.
So, it sounds like reconditioning is going to be my new full-time job. I'll probably need a nap and a trip to Starbucks before I can even drive back home from these lovely rehab sessions. Good thing I work from home and no one will know if I fall asleep in my rolly-chair. I'm probably going to have to spend the whole winter in sweatpants. Good thing you can buy them online. I hear Victoria's Secret is having a 70% of sale on "loungewear."
Jan 8 Rehab Report:
Driving: Check. Rehab: Check. No spa tub. No massage. Only lots of hard exercises and nasty old ice packs. Ice. I hate ice. I hate being cold.
The Dr. says I should not gain any weight. He says that, for every pound I gain, I put 3 additional pounds of pressure on the new hip. In addition, I can never lift more than 30 pounds ever again. And if I gain 5 pounds, I have to subtract that from what I can lift. I am already in trouble, because I have gained 2.5 pounds since the surgery, because of all the good stuff people are bringing over here to eat. So I have had to start watching it already.
On the other hand, there should be some reward for the first day of rehab. My thigh hurts. Hmmmm... Wine: 2 points a glass. Ice Cream: 5 points a scoop. I guess it'll have to be wine...
I have recovered my spirit, I am recovering my energy, and am working hard on getting moving. I am doing really well - walking without "assistive devices" and doing my exercises like it's a job. I ditched the cane over the holidays, when the home PT said I was doing too much leaning on it & that I walked straighter w/o it. I'm still stiff, and it still feels like I am sitting on a friggin' tennis ball (maybe a golf ball, actually), but at least the bruising is almost gone.
The leg is still weak - Going up steps one over one is do-able but not great, and I still can't lift the leg past 4 inches sitting with both legs straight out in front of me. My hip flexor is still really sore. It's a huge bummer -- they've taken me off anything that challenges it until it is completely without discomfort. But I make a little progress every day. I now can march to 90 degrees (carefully) and I can adduct my leg (or is it abduct?) about 50 degrees to the side (no rotation, of course - my poor piriformis muscle is wildly unhappy and refuses to rotate more than 1/4 inch.) I have only about 45 degrees extension to the back (no turnout) but actually, that's all I have on the other leg anyway if I keep my pelvis straight, so whatever. I freaked the PT out yesterday by balancing in relevés on the operated leg. It's fascinating to see what the leg can and can't do - which muscles are awake and firing, and which are still retarded and just sit there no matter what you try to tell it to do. Some days I get weird tingling sensations, and then, it seems like a muscle will respond better the next day - do nerves actually reconnect and start communicating? All the muscles in my upper leg are aching to the touch now, too, which the doctor tells me is a good thing, and I now have been asked to try leg lifts lying on my side, which is really hard (When I think of how easy battements used to be I could just die). The bubble bath seems to make everything a whole lot easier.
I expected to be tortured at PT, but maybe not - apparently, the goal is to "normalize" me - to get both sides to normal rather than to try to get the operated side up to where the dancer-limber side is. Unfortunately, I don't think I actually know what a normal range of motion is. The reason for the "normal" goal is to protect the new hip, but also the other hip and my back, so that I don't need more surgery 10 or 20 years down the road. With all the arthritis, it's really important to treat myself with kid gloves if I want a normally active life. This might mean I can lose the treadmill for good!
There is still a golf ball inside my poor butt muscle. Every time we get the cramp massaged out, it comes right back. Maddening.
My friend Lock is the first person to acknowledge that all of this is extra hard for a dancer. I really freaked out when I first heard that I had to have the surgery, and couldn't just get a cortisone shot or arthroscopy and be done with it. Then I went through the whole "a dancer is dying" thing. But after I got my head screwed on straight, I realized that actually, at age 53, dancing seems like way too much work; and really I don't care if I ever see another treadmill or aerobics class, either. I am lucky to have my wonderful job and my home office.
I am recovering way faster than anyone expected me to -- I'll be in good shape to see Emily graduate from law school in Boston in May, and soon I'll be able to get back to training the dog (in dire need of more training!) and get on the floor to play with my baby granddaughter.
I'm not ready for a long car ride quite yet; I tend to cramp up when I sit too long, and I tire easily. My friend just had his hip done. He didn't have a hip replacement - he had a resurfacing. But his scar is 3 times as long as mine, and he had staples. My 5 inch scar was done with a "plastic surgery closure" and is considered "gorgeous" by every professional who sees it. (I hadn't asked for one - I just got lucky). All you see is a red line about the size of an earthworm. It is already smoothing out and they tell me it will fade away over time.
I did too much today, so it's 9:30am and already I am exhausted and have a twinge -- not in the leg muscles, but right in the hip where I shouldn't. I am in big trouble if I don't shut it down for the rest of the day. Dammit. I get so exhausted after I do the exercises - my stamina just sucks. Right now, we are concentrating on strength, not flexibility, because the PT says I am already flexible way past a normal range. I am not sure we ever get to touch our knees to our chest again, but I know that we DO get to be able to put on our own socks. So I spend time in the bathtub sliding my knee towards my chest, but the leg absolutely stops at a little inside 90 degrees, as if it hits a wall. I'm not used to anything being in the way to touching my chest, but now, I guess that's titanium in the way. The bath really helps relax the muscle stiffness, so I know the muscles/tendons are OK to go further, but if the new joint's range of motion is going to remain that limited, I feel like I will never get my right sock on. So I am going to ask for some specific flexibility exercises, aimed at putting on socks, at tomorrow's session.
Today I put on real pants instead of sweatpants. Woo-Hoo! Conquering the planet, one pair of pants at a time!
Sex: Finding new ways, since some of the old positions are now on the 'No-no' list. All those fun dancer-ish positions are now gone from the repertoire. It's probably the saddest thing about this whole hip-replacement thing.
The hip is all good. Rehab is tough but very productive. I am going to be awesome.
They assigned me a new PT at rehab. We did all kinds of new and unusual exercises and really feel like I am making progress now. I am using props: balls and therabands and balance boards and steps. And we have that new flexibility goal - to be able to put on my own socks. You can't believe how hard it is to get my foot into a position even close to that. It's going to take a while - they put everything in there really tight. I guess that's good in a way - I mean, we don't want anything to fall out or loosen up in 10 years; but boy, I am not used to this way-smaller range of motion. I am so used to being really limber that "normal" seems way restricted to me. Ah, well. Normal & pain-free is a good trade-off from limber and crippled. I'll take it.
The new PT also says we have to keep checking my gait - that if the muscles don't strengthen evenly, I will throw my foot in a semi-circular pattern when I step forward. He put me on a slow treadmill and got down to stare at my feet while I walked; that was already happening, apparently, so I got a bunch of new stuff to do aimed at even-ing that up. The PT also showed me in a mirror me how, when I am doing squats (mini-squats, trust me) I am loading the left (stronger) leg. Apparently, right now I have to feel uneven to be doing it evenly.
Best of all, he went after that terribly cramped butt muscle with some heavy duty massage and finally worked that knot out. It feels much better this morning. And nothing we did made me hurt so much that I needed medication. A warm bathtub was all I needed to relax the stiffness. The guy is good. Meanwhile, I am working a full day now, driving, cooking a little, and getting out to meet friends for lunch or coffee (but not grocery shopping, cleaning up, or doing laundry). And I am down to 1 nap a day instead of 3 or 4. I think we've turned a corner.
3 weeks post-op, I am walking unaided and getting stronger every day. I think the most important thing I did for myself was to go the gym before the surgery & work those quadriceps and calf muscles even if it hurt. I mean, they were going to replace the hurting part anyway, right? Strength really has made a huge difference in the speed of my recovery. I get tired quickly, but it is really good to be moving again.
I would say that, for normal living, I have recovered completely. I can touch my toes, put on my own shoes and socks (stiffly, but I can do it) and am driving, doing stairs... Really and truly, I move around the house like my old self, except I'm just not allowed to carry and lift the way I used to. My daughter was just here and says if she hadn't seen me in the hospital with her own eyes, she would not believe I'd had a hip replacement at all, let alone 2 months ago. And the other day when I was out somewhere and told someone, their response was "Who was your surgeon? He must be a genius!" I don't leave the house yet when there is ice & snow for fear of falling, so I am grateful to work from home where I can just hole up during February and probably a lot of March. The only time I am aware of limitations is when I am at PT, where some of the stupidest things are still difficult to do for lack of strength.
I am out and about. Concerts, Starbucks, shopping, anything I want to do. And I've driven to the airport, train station & metro countless times.
I had a followup appointment today. The scans show that I have lots of bone grown into my hip prosthesis, and except for the 30 lb. weight-lifting limit, my only restriction is "If it doesn't feel good, don't do it."
Really - in the grand scheme of operations and bad stuff that can happen to you, this was a walk in the park. I truly mean that. The worst part was the worry and anticipation. If the other hip starts up, I am there again in a heartbeat. But I really think the success of my recovery has a lot has to do with who did the surgery, of course, and that I was fit when I went in.
Someone asked me if I can "tell" that I have had a hip replacement. Well, it doesn't feel like there's metal in it - not at all. In fact, that's the weirdest part. Except for the scar, you just can't tell from the outside. People are going to think I am lying.
Here's how it feels different:
It's a little stiff in the morning and if I go out in the cold. (But so is my back, so that's nothing new.)
There's a nerve that runs down the side of the leg that burns when I roll onto it in bed, but that stops after a second or two, and they say that will gradually fade.
The new joint doesn't like that stretch where you cross one foot over the knee of the other leg and pull toward your chest.
The hip flexor is still a little tender and I have still got some weakness in the quad.
BUT here are the surprises, all with no pain, and all were excruciating before:
I can do flights of stairs, and forever on the elliptical bike.
I can do a full squat down to my heels and back up without holding on.
I can balance on the operated leg, on flat and on releve, without holding on. (Boy, does that freak out the PTs!)
I can sit with my knees crossed, touch my fingers to the floor with straight knees, do a seated straight-leg lift, and shake dog poop off my shoe when I am out in the yard.
I can walk as far and as long as I want to on the flat - working on those hills (no pain, but I get tired)
I can wear my skinny jeans.
It only gets better as I gain strength. It really is unbelievable.
I have been released from rehab, and am, as of today, working on my own - either at the gym or walking the neighborhood. I am timid at the gym, careful to avoid any stress on the joint, which means not doing a lot of the stuff I used to do, but that's really OK with me. Now it's all about preservation and enjoyment and health, not about Progress.
This Thursday I have been invited to watch rehearsal at the high school where I used to choreograph. It'll be bittersweet, but I think it will be OK, too. I loved the work & miss the kids, but I was getting really lazy about the preparation and too often creating off the top of my head at the last minute - they deserve better. And I'd really rather be having an espresso with my husband at the end of the day instead of hauling myself out to rehearsal. Strange how life changes.
Someone (a painter) asked me yesterday what my new creative outlet will be, and I had no answer. I would like to add some things back into my life that being creative had sucked the time away from: I want to read more, and continue to study languages (expand the French and Spanish, and start learning Italian). I want to travel once the stock market recovers (make that if the stock market recovers) Wouldn't it be cool to do an immersion trip and live in France for about a month?)
My husband says I am uncontrollable, and if I don't behave, he will sell me for my titanium parts.
I am jealous of my friends, who are off to London; but truth is, I am not ready yet. Yesterday I walked the neighborhood & then the mall, and that was too much - went to bed hurting and got up hurting today. So, I will save my money and my miles and just wait it out, I guess. Maybe September or October, which is a super time to go to Paris...
It was good to go to rehearsal yesterday. It confirmed for me that I don't want to do that anymore. Shocking, but there it is: In the blink of an eye it's over, and I am okay with that. Funny how things change...
Well, it is 10 weeks since I had the hip replaced, and at this point I am moving so well that it's hard to remember now how much pain I had been in and for how long - I guess it just sort of crept up on me. I am in much better shape than I am supposed to be at this point -- still comparatively weak on that side, and I'll never have my hyper-normal range of motion back, but I do have a completely normal range, so I guess I'll have to get used to that - it sometimes feels a little lopsided. At the gym I've subtracted some exercises on machines that I am not ever allowed to use again, but added a bunch of new challenges from the physical therapist; I am gaining strength fast now. I've noticed over the last few days that I can move more quickly and more freely; I guess that's part of really feeling recovered. It also presents a new danger that I will over-do and knock something out of whack, so it pays to be mindful.
At first, they asked me not to go back to yoga until summer. Now, the doctor says I have no restrictions except "If it doesn't feel good, don't do it." That, and to remember I'm not supposed to lift more than 30 pounds, or to gain any weight (which I suppose means a lifetime membership in Weight Watchers...) Those proscriptions are more about preservation of the other hip than they are about babying the new one, though they've asked me to "watch it" because this new hip has to last a lot longer than hips that are put into the typical 70 or 80 year-old patient. So, now's not the time to learn to ski or snowboard; and I probably won't dance or choreograph again, because I know I'll get carried away when the music starts and forget all about what I am supposed to be "not doing." So, back to yoga: I can go to class, but I have been admonished to pay attention only to what is happening on my own mat, to listen to my body, and to leave my ego and my expectations at the door. So I am going to go next Tuesday and put my mat in the back of the room so I won't throw off someone's pace if I have to move more slowly, or stop and rest. And I am going to use a boatload of blocks and blankets.
So far, the thing that gives me the most trouble is that hip-opener stretch where you lie on your back, cross the ankle over the other bent knee and pull up on the thigh. The PT says I should be able to do that stretch better than I can do it, and the only thing he can figure is that they put me back together really tight so that I wouldn't dislocate when I began to misbehave. When I do that stretch, it feels like the whole metal hip is going to push right through the place where they split my butt muscle - NOT GOOD. And, they are the ones that told me "If it doesn't feel good, don't do it." So... Even though it's most certainly NOT my new hip trying to push its way out of my body, but only a really really tight muscle, I guess I just don't have to do it if it doesn't feel good.?
I feel SO good now at 10 weeks - no pain, not even a twinge, and I can do anything I want except dance onstage (which was over anyway - hell, no one wants to see that at age 53!)
Here's the list of stuff I did in the last 2 weeks, all of which I had stopped doing because it hurt too much. Everywhere I went I kept thinking, "God, last time I did this I was in so much pain." Or "Last time I did this I had to take 20 Advils to get through it."
Here's what's been going on, besides working, keeping house (not cleaning; just the everyday stuff), and walks/outdoor playtimes with the dog:
Sun -- Concert in Baltimore (walking a couple of blocks from parking, and flights of steps in heels, no problem)
Mon -- Lunch out with friends; long walk with the dog.
Tue -- Gym workout (regular upper body workout plus the new leg stuff from the PT)
Wed -- Helped my parents move stuff into their new house.
Thu -- Concert in Bethesda (more walking from parking, more flights of steps in heels, no problem)
Fri -- Dance rehearsal at the high school (cleanup and fine tuning, not new choreography, but hey, I was moving...)
Sat -- Dinner out with friends; long walk with the dog.
Sun -- Stage-managed a concert in Washington (6 solid hours of running around backstage, up and down steps, which left me exhausted but not hurting at all.)
Mon -- Breakfast meeting - lots of steps; no problem. Then walked the shopping mall, both floors. Tue -- First try at yoga class is tomorrow
This coming weekend, a houseful of company coming: cooking, cleaning, sightseeing.... Let's do it!
March 27 2009
The only thing still hurting is that hip flexor. I must have really done a number on it.
On Nov 3rd I asked myself these questions. Here are the answers:
Will I ever be able to sit on the floor again without thinking about it?
or do a whole yoga class?
Yes, slowly and carefully, with props.
Move fast and easily without thinking about it?
Shave my legs standing in the shower?
Run around the yard with the dog?
Awkwardly, but yes.
Haul stuff in and out of the attic?
Yes, but not like before: It's do-able so long as it's not heavier than 30 pounds, and so long as I have a spotter for climbing up and& down the attic ladder. . (I really shouldn't do this, but I have...)
Unload a car full of mulch and birdseed and dog food?
I think I could, but I don't. I get help.
Pull the spaghetti pot out from under the sink? Yes
Carry the laundry outside?
One log at the time
Pick up my granddaughter when she's 3 or 4 or 5?
Choreograph a show?
Not in the same way; not a whole show, I can't demonstrate the dancing, but I can stage songs and movement for street scenes etc., and was really happy to go and do that when I was asked to. It was fun!
Will I be able to spoon up next to my husband in bed at night in the same way we've done every night for 34 years?
Yes I can.
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Apr 6 2009
First followup with Dr. McCarthy in Boston (4 months, almost to the day). X-rays show everything looks super, and everyone is really really pleased with the result. The doctor asked me to stay careful about turning in the knee to an extreme - turning out is fine - and to continue not to lift more than 30 pounds. He asked me to stay away from the Stairmaster and the leg press machines at the gym (no problem!), all to preserve the life of the prosthesis, which he intends to be there and working perfectly for the rest of my days. And to always and forever take antibiotics before anything invasive, including dental work, so as to never risk a bone infection.
I wonder if the man ever gets tired of hearing how gifted he is? I got really emotional and could not thank him enough.
Later that day, I walked the 2 miles from my hotel to my daughter's place. Afterwards, my leg was tired, but it was muscles-out-of-shape tired, not bone-and-joint tired.
Apr 12 2009
Today I made reservations to take my daughter to Paris at the end of May (her law-school graduation gift). Found a hotel with an elevator, and I'll be sure to rest often (before I need to, I promise!) The trip will be at about the 6-month mark, so I'll let you know how I do. Hmmm... I can only pack 30 pounds of stuff...
Apr 13 2009
So funny to read through my posting on Nov 20, where I say that basically I was "moving around the house OK most days." I was lying to myself. Really. At that point, I could not get out of a chair without getting stuck halfway up, and was doing everything carefully - thinking hard about every move. I continue to realize how wonderful it is to have my life back to its normal speed.
FINAL UPDATE (6/16/2009): This'll be the last post, because I am totally fixed up!
5 months and 10 days post-surgery, my daughter Emily graduated from law school. I hoofed it all over Boston, even around Agganis Arena, and wore cute new flats all day long, not my usual Dansko clogs.
Right after the graduation festivities, Emily and I flew to Paris. For 10 days we walked everywhere. We started early in the morning, and didn't stop most days until around midnight. I wish I had started counting stairs when I left home, because there were thousands of them. We had the most wonderful time, and I never once had to sit down and rest because my hip hurt. In fact, come to think of it, my back doesn't hurt anymore, either, and neither do my feet. I actually think I haven't been this strong since I was dancing. The pictures tell the tale...
Thank you all for taking this journey with me; and to those of you who are reading this before your surgery: Remember my story, and plan that trip!
Love to everyone,
If anyone has any questions at all, please feel to contact me:
Kathryn Cardy, Artist Liaison
Jonathan Wentworth Associates
Wandering Dancer Arts Consulting
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