Tag Archives: periacetabular osteotomy

Still Screwed…2 Year Post Op Right PAO

You are reading this title thinking, “Oh no, what happened?”  It’s not so bad.  My official two year anniversary of my right PAO is fast approaching: December 16.  I did, however, have my two year follow-up last month when I was in California helping my sister recover from arthroscopic surgery to repair her torn labrum.  We have the same surgeon, so it was nice to be able to talk with him about her surgery and recovery.  Anyway, I snuck in an appointment since I was in town.  Here is my X-ray from my appointment. As you will see, I have most excellent bone healing and nice joint space (read: no arthritis):

2 year post op xray

Another reason why I scheduled to see Dr. Bellino was to see if my right screws needed to come out.  I was having pain (aching in cold weather) and when I wore jeans.  After a few minutes of him trying to feel them (I guess he countersinks them pretty good), we concluded I need new jeans and I need to move to a warmer climate (haha) because he couldn’t feel them coming out.

Some PAO surgeons take out the screws around 6-9 months post op, other surgeons only take them out if they cause problems. Its a matter of philosophy, there are pros and cons to each school of thought.  My surgeon does the latter.  I trust his suggestion in leaving them in for now.  I am back spinning, running, hiking, and strength training like I did before this whole hip saga, when I was a lean, mean, triathlon racing machine.  And you know what?  That pain has not recurred with increased activity and in the recent cold weather, so who knows why I was having issues earlier this fall.   While it would be fun to make some badass jewelry from my hardware, I am happy to stay screwed for now.

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What A Difference Three Years Make…

If you are on Facebook, then you are familiar that this lovely social media platform likes to remind you of anniversaries of your past posts (i.e. 1 year ago…).  This can be a good thing or a bad thing.  For example, I cried last week when I saw a post with a picture of my beloved fur baby Evie (who crossed the Rainbow Bridge) from last year.  Two days ago I was reminded of a post I wrote on October 22, 2013; it read:

“So very thankful to be going to CA today to FINALLY see these two surgeons at UCSF and Stanford about my hip surgery ordeal. I am READY to put a plan in place once and for all!…” 

“Hip surgery ordeal,” HAHA!  Ain’t that the truth!  I had no idea what PAO surgery and recovery entailed.  I had completely forgot I wrote that post!  At that time, I couldn’t walk more than 12 steps without limping. I had gained weight from inactivity. My identity as a Personal Trainer and athlete was lost.  I was trying to find my way in a new career.  I was in pain 24/7 and I was depressed.

Well, fast forward to today (and if you want the whole story, read all my blog posts): my butt muscles are still sore from helping paint my new metal-smithing studio but the hip pain – oh that hip pain that rocked my world – is gone. Yesterday I went for a run on a perfect fall day, and guess what? No hip pain.  My plan worked.  I am so incredibly grateful: I wake up every morning and have gratitude I am without chronic pain.

The pain doesn’t define me anymore.  What defines me are the lessons and the strength that I have learned in the past three years.  I found a new passion: increasing awareness of hip dysplasia; I now have The PAO Project linked to the International Hip Dysplasia Institute.  I try to help out local PAO Warriors in any way I can (last week I was getting raised toilet seat handles from a senior center and dropping them off to a PAO Warrior at Boulder Foothills Hospital) and provide support on the PAO Facebook group, because I know how rough the early weeks are in recovery.  This journey has not only made me more grateful, but it has also made me more emphathetic.

Ironically, I fly out to CA on Wednesday because my sister is having labral repair arthroscopic surgery with my surgeon, Dr. Bellino at Stanford on Friday.  She does not have dysplasia; labral tears can happen in normal hips (imagine that!), and in her case it was most likely speed training with running.  I will return the favor of her being my caretaker and will be hers in the early days of recovery.  I feel well equipped emotionally and I am happy that I am able to be there for her.

Its all good.  What a difference three years make….

To All The Naysayers….

In December, I saw a Facebook post from my fellow local PAO friend that she was forming a PAO team to do the 2016 Ragnar Trail Relay in Snowmass, Colorado; which is held over the first weekend in June.  Now, I have not ran steadily since I started having some pretty gnarly pain in my hip flexor area, which was in 2012.  I was forced to quit running on a regular basis as the pain was debilitating.   Since 2012,  I gained 34 pounds due to inability to exercise and I had my pelvis sawed apart in to 6 pieces (3 pieces for each surgery) and screwed back together, a surgery called a periacetabular osteotomy (PAO), all with the hopes that I could have a better aligned hip joint and be able to 1) not live in chronic pain and 2) be able to do the physical activities I love, one of them being running.  That is a big selling point of PAO surgery: it has no activity restrictions compared to a hip replacement.

So, when I saw this post about being part of a team with fellow PAO Warriors to complete three loops of 3.8, 4, and 6.7 miles on mostly single track trail in the Rocky Mountains over 36 hours, I was intrigued.  I posted on my personal Facebook page asking opinions of those who have run this race if it was doable for me with six months of training and most people said “yes!” but there were a few naysayers.  For those who know me know its the naysayers that are the most motivating  for me as I am very stubborn and determined to prove naysayers wrong.  Plus, I needed a goal.  At the time, I was one year post-RPAO and I was struggling with losing weight, and I was depressed since losing my fur baby of 14 years and losing a contract on a new home.  Something needed to change, I was in a funk!  I told the team captain, “give me three months to see if my hips can handle running.”  I started running, well – more like walk with some short jogging intervals – several times a week.  I was happy to complete a 20 minute walk/jog session!  My hips did fine.  My lungs burned, my muscles ached, but my hips – those newly aligned hips – were fine.

From December to March, I progressed my mileage carefully, gradually increasing the run time and decreasing the walk time.  What I was consistent in was doing my sessions: I ran 3 times a week: rain, shine, wind, snow.  I remember bundling up in 10 degree weather and putting on my YakTrax (devices that go on the bottom of running shoes that have metal spikes to provide better traction on snowpack/ice) to do a 30 min run.  By mid-March, I committed to our Ragnar team, which is aptly called “All Screwed Up.”

Fast forward to now:  yesterday I completed a 10 mile run in the wind, cold, and GI distress (note to fellow runners: do NOT eat Mexican food for dinner the night before a long run! Another piece of advice: know where your toilets are along your route!).  I had to tough talk myself through miles 5-9: “Jen, you are doing this because you CAN!”  “Jen, you would have no problem running this if it wasn’t for your stomach ache!” “Jen, this is a piece of cake compared to PAO surgery, remember how much pain you were in at the hospital?”  In under 2 hours and 15 minutes (which included about 40 minutes walking due to my poor nutritional choices) I got the 10 miles in and my hips were fine!  It was the first time since 2006 that I ran 10 miles, 15 miles in a 25 hour period, and 28 miles for the week.  And as far as my last weigh in, I have lost 14 pounds.

So, my advice is: do not let the naysayers keep you down.  Rise above negativity, work hard, and prove them wrong!

My next post will most likely be a race report of Ragnar: the ULTIMATE PAO WARRIOR GATHERING!!!  Its going to be a hell of a party!  Onward!

Dec. 16 2015: 1 Year Post RPAO

Last night marked my one-year anniversary of my right PAO surgery.  I’ve come a long way, baby!  This year has not been without its challenges,  most recently being the loss of my fur baby of 14 years, Evie (she crossed the Rainbow Bridge on 11/10/15).  Evie was with me for a large part of my recoveries, laying and purring right next to each operated hip. The void is immense, but I am eternally grateful  for her company while I was at my weakest, saddest, and loneliest.  I joke and say she was the love of my life, and in a way, she was.  Here is a picture of us when I was eight weeks post op from my first (left) PAO:

Evie and me, June 2014
Evie and me, June 2014

Despite my loss, I have so much to celebrate. I FINALLY feel normal. My “new normal” feels good, though I still have stiffness and soreness.  I ignore it as I know I am bad about stretching and its different than the 24/7 pain that I used to have.  I don’t have to think about proper gait when I walk. I can run. Last month, I started kickboxing (with heavy bags and speed bags, this is the real deal!) three times a week and I feel great. I am entertaining being on a relay team of fellow PAO Warriors for the 2016 Colorado Trail Ragnar in Snowmass in early June (I would run 3×5 miles).   I started The PAO Project, so those diagnosed with hip dysplasia, considering PAO surgery or recovering from surgery can find a source of information and inspiration.  This led to the recent publication of my anthology, “Onward! Navigating Hip Dysplasia, PAO Surgery, and Beyond.” I hope that this is the beginning of bigger and better things regarding increasing awareness of hip dysplasia, and I want to be instrumental in making that happen.

If you are interested in purchasing the anthology, here are the links:

United States:

CreateSpace: https://www.createspace.com/5928858

Amazon: http://www.amazon.com/Onward-Navigating-Dysplasia-Surgery-Project/dp/0692585206/ref=sr_1_1?ie=UTF8&qid=1450393928&sr=8-1&keywords=onward+navigating+hip+dysplasia

Worldwide: Order through my Etsy Shop: https://www.etsy.com/listing/260688343/onward-navigating-hip-dysplasia-pao?ref=shop_home_active_2

United Kingdom, Amazon UK:  http://www.amazon.co.uk/s/ref=nb_sb_ss_i_3_7?url=search-alias%3Daps&field-keywords=onward+navigating+hip+dysplasia&sprefix=onward+navigating+hip+dysplasia%2Caps%2C248

My final post op appointment is February 19, 2016.  I am sure things will change a lot by then for the better; I am planning on it!

ONWARD!

 

 

A New Chapter

Its days like today that I really miss my dad.  (He passed away in 2004 from a 3  week battle of liver & pancreatic cancer). Today as I headed west on Woodside Road towards Stanford Medical Center for my nine-month post op, I approach Alameda de las Pulgas Road. Suddenly I time-warped to another time, another life.  “Do you know what ‘Alameda de las Pulgas’ means?” my father asks my sister and me. How would we know? We were five and nine years old, respectively.  Before we could even squeak a noise from our tiny mouths, he answers his own question in a booming voice “THE LAND OF THE FLEAS! HAR HAR HAR HAR!”   Only those that knew my father will appreciate  this.

After waiting a while to see Dr. Bellino, he finally came into the exam room.  He told me I am “pretty much healed” and he is confident that the gaps near the ischium (aka “butt bone”) will heal by the next time I see him in the Spring.

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But this post-op visit was so much more than wondering what my x-ray would show in terms of bone growth.  I was anxious, like a kid on Christmas morning, to tell my surgeon about the ultimate PAO win: being physically capable to save someone’s life, which occurred two weeks ago.  And to tell him about my labor of love, thePAOproject.com. And last but not least, to give him the thank you present I made him, a photo book of all my “firsts” post PAO: first bike ride, first hike, first rafting, etc.  He read the whole thing and was truly touched. At the end of the appointment, I reached out to shake his hand and  he opened his arms to give me a hug, which meant a lot to me.

As I headed back towards Highway 280 (a much prettier drive than 101, so I take the scenic route), I saw a sign that said “Emerald Hills.”  My dad lived in Emerald Hills, an upscale neighborhood in Redwood City.  My heart ached to be able to share with him my successes.  I have been through SO MUCH in the past two years: the dust is finally settling and I am emerging from the ashes.  I am a better version of me.  Life after PAO: a new chapter begins.

Nothing is Sacred in the PAO Life

My diagnosis of bilateral hip dysplasia in 2013 at the age of 39 was a shock.  Almost 2 years later, I can say without a doubt, that it was certainly life changing.  Two periacetabular osteotomy (PAO) surgeries within 9 months has also been life altering.  Looking back, I never would have predicted I would have had 6 screws in my pelvis, live with my sister in California for a total of 2 months, spend 7 of the past 11 months on a walker and/or crutches, not drive for a total of 5 months, own not one, but TWO sets of surgery recovery equipment fit for a nursing home, and learn how to be a patient person.  I have grown in ways that is hard to explain, so I will just say I am not the same person I was when I got diagnosed; I am a better person for it.

The other day I was thinking about my first surgery recovery and what is different (do not equate “different” with “easier”) this go around, and this story came to mind. I  was horrified when it happened, but now I can look back and laugh.  Nothing is sacred in the PAO life:

I was 7 days post-op PAO #1 (April 2014) and I was staying at my sister’s house for awhile post-op before I flew home to Colorado. I had to pee BAD (like the kind that you wait forever in bed holding it until you absolutely have to get out of bed because, on a walker, it takes forever and a day to make it to the bathroom.) The non-master bathroom was my bathroom and I had my raised toilet seat.  The raised toilet seat fits over a regular commode but is 6 inches higher, making it so much easier to passively flex at the hip to sit.

It was at night and I walkered gingerly to the bathroom, and sat on my trustworthy raised toilet seat and I started peeing something fierce. Relief! Then I felt that my bare foot was wet, I was perplexed, thinking, “WTF? Is the toilet leaking?”  So I look down. Much to my dismay, I realize I was peeing on myself and all over the floor because the toilet lid was DOWN!!! Prior to my little bathroom excursion, my 7 year old nephew went to the bathroom, put the lid down and then he was trying to be helpful so he put the raised toilet seat over the closed lid. I screamed in horror and my sister rushed in and I had a total freaking meltdown; bawling my head off, saying I was sorry. Being a mother of a 3 yr old and 7 year old, she didn’t care, she was just mopping it up with anything handy saying “At least it isn’t explosive diarrhea!” I just could not let it go, I was melting down like a toddler, bawling saying “I’mmmmm sooooorrrrrrryyyyyy….I caaaaaaaan’t doooooo thiiiiiiiis! Its only been a weeeeeeek”.   At the time, I really thought I could not survive.  Of course, we laugh about it now and that did not happen again!

Purpose

I think its human nature that we are quick to label circumstances as “good” or “bad.”  My earlier posts about being diagnosed with bilateral hip dysplasia at the age of 39 and navigating my way to treatment showed that it certainly rocked my world, and shook me to the depths of my core.  At that time, my diagnosis was BAD and the inevitable surgeries were BAD!  For the past two years, hip dysplasia and PAO surgeries forced me to ponder the “why?”, the “how?” and the “when?”  of all aspects of my life.

Two days ago I had my second  Physical Therapy appointment,  my first real workout since surgery (the first PT session was mainly an evaluation).  I came home and my right glute  was on fire (in a good way; look out “bun of steel!”).  Tired and bored, I decided it was a fine time for an afternoon nap.  I awoke suddenly to realize the sun was setting.  I was perplexed that I slept that long: two hours!  I managed to get myself out of the groggy slumber and once I did, my phone rang.  I glanced at the caller ID, and it showed “Stanford Ortho.”  I scrambled to reach the phone and I quickly answered with a cautious “Hello?”

“Hi Jen! This is Rachael at Dr. Bellino’s office,” Rachael greeted cheerfully.

“You are not calling to reschedule my post op appointment, are you?” I questioned. (This is kinda a joke between us as I am a long distance patient and once my travel plans are set, they are set in stone.)

With a laugh, she replied “Oh, no.  Dr. Bellino and I were talking about you today and we were wondering if you wouldn’t mind being a reference for a patient.” [Long story short, this poor woman got the news about hip dysplasia and PAO surgery and is terrified.]

“Of course.  I’d be happy to be talk to her.  Yes, the news about PAO surgery IS terrifying!”  I replied.

We chatted for a bit and when I hung up, I smiled.  I was touched that they thought of me to be a reference.

The next day, (yesterday) my PAO buddy that Jessica and I visited in the hospital, Jenni, had her follow-up with Dr. Bellino.  I messaged to ask how it went, and she responded that it went well. She then proceeded to share that she mentioned Jessica and me to Dr. Bellino, and mentioned that he responded  “how rare it is that a patient would extend herself in that way” [to visit a fellow PAO patient in the hospital].   I was blown away.  First of all, its my nature to go beyond the expected, especially if it means helping someone who is have a tough time.  I don’t think anything of it….then I started thinking more about PAO surgery and recovery (what I call the “PAO life”), and I had an epiphany:

I felt the threads in connectivity come alive.  The crazy journey of getting diagnosed in Colorado, researching adult hip dysplasia on the internet and found Kelly Ariagno’s website (a PT in SF who had her PAO with Dr. Diab) which led me to fly out and meet Kelly for a session, who encouraged me to consult with Dr. Diab and Dr. Bellino, which led to another trip out to CA to consult with said surgeons, to researching “Diab Bellino PAO” on the Internet and finding Jessica’s blog, which led us to becoming pen pals and fast friends, to her recommending the PAO Facebook support group, to the cancellation of surgery with Dr. Diab and reschedule with Dr. Bellino….well, I can go on and on, but I realize it was all for  a reason.  In addition to learning some life lessons that PAO surgery and recovery has taught me (patience, process),  I sit here in bed and feel so incredibly blessed to have a whole new circle of friends through the PAO Facebook support group, most of which I have never met.  We cheer each other on and share our experiences as needed.

Helping and empowering people to see the light in their darkest of times, that is my purpose.  Having my surgeon recognize that just reinforces my purpose.  I am such a better person after going through such a brutal elective surgery on both hips, it truly has transformed my body, mind and spirit.  In the end, the hip dysplasia diagnosis and PAO surgery recoveries have been GOOD, not bad!  Its probably been one of the best things to happen to me.  I have Dr. Bellino, the team at Stanford Hospital and Clinics, my Physical Therapist, my PT Aide, my support team at home and my fellow group of PAO warriors to thank for enabling me to have a purpose to Shine.  And as I type this, I realized my blog theme is “Shine On.”  Yes, Shine On…everything comes around full circle.

 

 

On My Way….

Time is a flyin’!  I am well on my way on this road to recovery.  Yesterday was my 5 week post-op anniversary.  In 2 weeks I start Physical Therapy, 3 weeks get cleared to weight bear as tolerated, and hopefully 4 weeks until I can drive again (fingers crossed on that one!)  but who’s counting? THIS GIRL is counting!  It motivates me to have time goals so I have something to look forward to.

Overall, I am doing well.  Mentally and emotionally, this go-around is easier for me.  Physically, however, I have had some pretty intense groin pain and I discovered that I was accidentally putting too much weight on my op leg, straining the pubic cut area.  Below is my X-ray taken at 3 weeks post op and you can see that gnarly gap in my pubic bone:

xray rpao
Bionic Woman! 3 Weeks Post Op, Stanford, CA

I am behaving now: being more mindful of truly practicing “toe touch” weight bearing.   Now that the groin pain is gone, my hip flexor on my “good” leg is ON FIRE!  So I guess I need to rest more.  I have learned when your body nags at you via physical pain, its trying to tell you something. I only have one go-around to rehab correctly so I am listening!

In the meantime, I am reading the latest book of the “Fever” series (total guilty pleasure), starting to work a bit at my desk, and look forward to my friends’ visits via my Meal Train.  Each day I get stronger, and I cannot wait to have this all behind me!

 

On the other side, again: 2.5 weeks post-op

Leading up to my second PAO surgery, everyone told me that this go around would be easier than PAO #1.  They were wrong and they were right…its never black and white.  Let me explain:

day 1 post op
Doing “the pose”

I had my RPAO on December 16.  It was 5 hours and deemed a success, as Dr. Bellino said I was “rock solid.” The MRI showed the possibility of labral ligament damage needing repair, but once he got in there, the labrum was intact and so he left it alone. Instead, he reshaped my femoral head (femoral osteochondroplasty) so that it had better tracking within the newly aligned hip socket.  The PAO corrected a center edge angle of 19 to about 37 (educated guess, I will get this confirmed at my post-op appointment on Monday).

The hospital stay was more difficult this time, as I had a pretty bad pain episode day 2 post-op (they did not have my dosages right on my non-narcotic pain meds and my body went into shock as I tried to sit in a chair for my P.T. session). Also, throughout my hospital stay,  I suffered from severe light headedness, and while I lost a fair amount of blood during surgery, I was not a candidate for a blood transfusion.  The silver lining, however, was my PAO buddy who had her surgery the same time as me, ended up being my roommate.  We laughed and groaned together, and cheered each other on when we needed it.  Dr. Bellino visited me almost every day and I sensed he truly cared about my well-being.

Discharged
Discharged! Walker hug with my PAO roomie, Jolene

Since I have been discharged, I have been recovering at my sister’s house in sunny California until I get cleared to fly home (this can vary per patient, but I decided to stay longer though the holidays and see my surgeon once he was back in the office).   My recovery so far at “home” has been easier this time. I feel more confident using the walker, as well as using the leg lift assist device to get my leg in and out of bed (I cannot actively raise my operated leg for 8 weeks).  I know how to better position myself in bed so that I am comfortable sitting and sleeping.  I know what the mental challenges surgery recovery entails, and I am better prepared with tools to keep myself from dying of boredom (or depression).  My laptop has been a life saver, and I spend most of my time working on my Etsy store,  Netflix streaming (Californication is currently my guilty pleasure), Facebook-ing (especially the PAO support group), and I also signed up for my next gemology class online.   Its been fun to have my 5 year old niece and 8 year old nephew at home over winter break; they are very eager to help their “Tatie Jen” (Tatie is French for “auntie”).  The ease and comfort of my recovery would not have been possible without my sister and brother in law.

at the beach
Half Moon Bay, 1.5 weeks post op

Another big difference is that I do feel like I have more stamina.  My friend Jessica took me to see the ocean at Half Moon Bay last Sunday.  What a treat! I was pretty sore after the outing, but it was so worth it!

Today is New Year’s Day and while 2014 was very challenging, I am happy to have these two major surgeries behind me. I am dedicated to spending the first part of 2015 fully recovering from my surgery.  I want to get my fitness level back, and also grow my jewelry business to its fullest potential.  I want to travel more, and be as active as possible. I want to see what my newly aligned hips are capable of!

2015 is my year to go with the flow and embrace opportunity.   Onward!

 

Beauty in Chaos

PAO Support Charms I made by hand.
PAO Support Charms I made by hand.

I am not even sure where to begin…time has literally flown by and here I am, in California, four days before my second PAO surgery.  Life has been chaotic to say the least, between work, year-end accounting on my businesses, holidays and preparing to be away from home for a month.    In fact, to add to the stress of leaving town and preparing for a  major surgery, I decide 48 hours before my flight to reschedule to leave a day early (on my birthday) to avoid flying into the storm that hit the Bay Area yesterday.

That said, just when I feel like I am losing my footing, I find ground to stand on.  The day after I flew into town (yesterday) my exhaustion finally caught up with me.  I watched the rain pour down, seeing water starting to rise against my sister’s house foundation and then recede.  In the midst of the storm, I start to feel a sense of peace: letting go of control, going with the flow, riding the storm.

Today was my pre-op appointment.  Reflecting on the day, I connect the dots and I realize the day I was dreading turned out to be fantastic.  I was happy to have unexpectedly meet a fellow hippie in the parking lot before my appointment.  We have the same surgeon, Dr. Bellino, and she was there for her 5 week post op appointment.  I hope I instilled a little spark that there is light at the end of recovery.  Pre-op with Lisa the P.A. went smooth.  Then another unexpected gift occurred: Dr. Bellino stopped by to where I was in the clinic and we chatted about 5 minutes, which I know is rare as his time is very limited.  It certainly lifted my spirits and I was pumped to finish my pre-op labs and meet my fellow PAO soul-sista, Jessica, at Stanford Hospital to visit another hippie who had her PAO with Dr. Bellino on Tuesday.

Jessica and I made sure we shined our light and spread our Unicorn Rainbow Pixie Dust to our fellow PAO warrior, who has had a tough go the past couple of days.  It made my day to see her smile and see hope in her face.  Yes, PAO surgery sucks, but its worth it and it gets better.  Her thank you note later this afternoon on the PAO FB group warmed my heart.

As I was leaving the hospital, I thought about how in the craziest of times, there is beauty in chaos.  Beautiful things happen, we just need to be open to see them.

I will leave you with a picture of what Jessica and I found snooping around Stanford Hospital; good to see the orthotics department has a sense of humor!

Santa hiding in the cast room at Stanford Hospital.
Santa hiding in the cast room at Stanford Hospital.