It's the End of the Road

 Tomorrow is the big day.  What feels like a finish line will really only be the start of the climb back to being me.  Bring.  It.  On.

If the four months between scheduling surgery and actually going under the knife were a marathon training cycle, then I definitely experienced some taper crazies this week.  I've been holding on for dear life, hoping nothing would come up that would cause my surgery to be postponed.  I walked a fine line between trying to work as much as possible before the big day and trying not to get sick doing it.  I was eating really well,  drinking tons of water, going to bed early, and my hands were raw thanks to the gallon of hand sanitizer I used each day.  Last Monday (9 days out), I worked in PE on a beautiful sunny day.  I was outside more than I was in, which helped ease my germophobic mind a little bit.  Working PE is by far the toughest on me physically (it's no joke mentally either, TBH!), and by the end of the day, I felt like I got hit by a truck.  My whole body hurt, and I could feel my face was warm with sunshine from all the time spent outside.  Par for the PE course.  Until later that night I started having chills.  I hobbled upstairs to where I keep my thermometer and popped it in my mouth.  

99.7. 

I didn't take any meds because this happened to me a few months ago and the little baby fever was gone by morning.  I was in bed by 7:30 and asleep before 8, and I'm thrilled to report it worked like a charm.  All I had to do was survive two more days with little booger eaters and my last two days of work would be with high schoolers, who are far more skilled at keeping their germs to themselves.

I made it through the week (thank you, immune system!), and we headed out of town Friday afternoon for a college visit at Virginia Tech.  It was a quick trip - up Friday, tour stuff all day Saturday, home Saturday night - but it was just what I needed to distract me.

Right outside our Airbnb window

Go Hokies!

Determined to squeeze every bit of movement into my last few days before my journey into the great unknown, Ryan and I threw the bikes in the car on Sunday and did a Sandbridge loop.  

While we were riding, some friends mentioned going to New Realm to enjoy Jesse Chong and some obligatory beer on St. Patrick's Day, and I certainly couldn't turn any of that down.  As is tradition, we ended up staying longer (and drinking more) than we originally planned, but it was too beautiful a day to call it quits early.

 

Monday was spent controlling the controllable.  Cooking, cleaning, laundry, errands. Procuring my durable medical equipment.  Clipping my toenails while I can still reach them.  A good long bike ride.  Collecting a few more holds from the library.  And when I realized March Madness starts on Thursday, I printed out a bracket to fill out.  Yay for having something fun to "do" while I'm stuck doing very little.

Today has been more of the same.  Grocery shopping, chopping veggies for quick healthy snacks, more laundry, more errands.  Waiting for the phone call telling me what time I need to be at the hospital tomorrow (8:30am check-in, surgery at 11:30).  Spending some time sitting in my feelings, appreciating all the incredible things this little hip joint has done for me over the past 45 years...all the cartwheels and handsprings, all the miles run and finish lines crossed, easy waves caught and tough spills learning to snowboard, carrying the weight of my two girls (both inside and out).  That little ball and socket have served me oh so well, but it's time to let them go and get back to go-getting.  See ya on the flip side.

Back to Good

 10 days out.  Holding it together by keeping busy with work, housekeeping, and meal prepping, and reading is and always has been a wonderful distraction from reality.  Obviously the world doesn't stop turning because my world is about to be turned upside down, and hearing people talk about plans they have in the very near future scatters my brain a little.  I can't commit to a thing past March 20th, and while I'm told I'll be getting around pretty well after that first month, it all still feels like a big question mark.  Trying that whole patience thing and letting whatever happens happen.

I had myself a moment today after seeing this photo come up in my Facebook memories:

It was after my last long run before the Shamrock half marathon in 2017, and I was probably as fit as I've ever been in my life.  I look at that photo now and feel a sense of mourning over not feeling like that person anymore.  Strong.  Athletic.  Limber.  Joyful.  Of course I have plenty of things in my life that bring me joy on a daily basis, but for the past 18 months or so, I have felt like a watered down version of myself.  And also like the tin man.  I'm so ready for Psimas to get her groove back.

Do You Get Deja Vu?

14 days out.  Feeling lots of feels, with anxiety emerging from the deep, dark place I've shoved it down into since I scheduled surgery back in the fall.   The fear of the unknown is occupying a lot of real estate in my mind right now, yet what's funny is that it kinda feels strangely familiar.  I keep finding ways this process reminds me of training for a marathon.  And when I was training for marathons, that process kept reminding me of pregnancy and childbirth.  There's an important date circled on my calendar.  It's all I've been thinking about for months.  I know something big is going to happen on that day, but I don't know how it will all go down or what I'll feel like after that big thing happens.  I've been preparing my brain and my body and my family for the challenges we'll face after that day.  I'm terrified of getting sick right now and having all that hard work not even matter.  See, just like training for a marathon or preparing for childbirth.  I've done both of those things multiple times, on every occasion coming out on the other side feeling exhausted and in pain but in awe of what my body was capable of.  I am hopeful this experience will be no different in that sense.

I had my first pre-op visit last week, where I went to Sentara Leigh's PASS clinic to have my bloodwork and EKG done.  Being in the hospital where I'll have the surgery made things sink in a little more, and seeing dozens of people roaming around with walkers was a gut punch.  I'll be one of those people soon.  Yikes.  As much as I try to quiet my mind about this whole thing, my elevated blood pressure didn't lie.  As far as I know, the bloodwork and EKG looked good and we're all systems go.

Today was my last pre-op visit, this time with the surgeon's PA, although hype man might be a more accurate description of this guy.  He was pleasant, upbeat, and reassuring that I'll be back to doing everything I used to do...eventually.  He answered all my questions - and I had a bunch - such as:

- In addition to stopping supplements, do I have to stop taking my fiber powder a week before surgery too (the fear of constipation is real, y'all)?  No, just don't take it the morning of surgery.

- How big is the incision?  About 4 inches long

- Will there be stitches or staples that need to be removed?  Neither...the incision will be glued and taped.

- Do you recommend a walker or crutches?  Walker (less of a trip hazard).

- When can I shower?  3 days after surgery.

- When can I drive?  Definitely not while still using narcotics for pain, try to hold off until after the first post-op visit (4 weeks).

- When can I sleep on my stomach (fun fact: I snore like a chainsaw when I sleep on my back)?  Possibly after a week or so, as long as leg doesn't cross midline.

- When can I ride a stationary bike?  PT will decide.

- When can I ride a bike outdoors?  PT will also decide.

- When can I swim?  Depends on how incision heals, not before first post-op visit.

- When can I donate blood?  Give it at least 3 months.

- Will I be able to surf again?  Definitely.  Eventually.

- Will I be able to snowboard again?  Eventually.  Even if I fall a lot?  Yes.

Then things got real nerdy:

- Is there an increased chance of revision because of the hip dysplasia?  No.

- What's up with Kelly Slater?  At his age, why did he have his labrum replaced with a cadaver's and his femur cleaned up instead of going full send on hip replacement?  I haven't read about that but now I'll have to.

You can read about it here.

Having those two appointments under my belt have settled my nerves somewhat, and now we wait.  And continue to stock the freezer.  And take a good, hard look at my calendar if I'm not driving until the end of April.  And keep riding that bike to spin the crazies away.

Get Ready

We're in the 30 day window of the big day, and shit's starting to get reeeeeeal real.  All of my pre-op appointments are scheduled, as well as my first post-op appointment.  I got a good chuckle out of the scheduling process because there was no phone call to see what works with my schedule, they just emailed me and said this is when you're coming.  Sir, yes sir!  By some stroke of luck, I'm not scheduled to work on any of the assigned appointment days.  I've watched all the videos Sentara sent about how to prepare the night before and what to expect from the time you walk through the hospital doors until a few days after surgery, and I'll probably have Ryan do the same to help him wrap his brain around what his role will be.

Over the next several weeks, I plan to chip away at making some meals I can put in the freezer.  I know my family can throw a meal together when needed, but they don't quite have the ummm...stamina to cook night after night...after night, after night, after night.

This past week has been about dialing in my nutrition.  I've been dealing with tummy troubles for a while now and haven't worked all that hard to find a cause or solution, but with a major surgery looming, I've found new motivation to get to the bottom (haha) of it.  Getting my gut right has become a top priority, in the hopes it will help me recover quickly from surgery and continue to benefit me as get up into those late 40s. 

I've also leveled up my pre-hab game over the past couple of weeks, and will continue over the next month.  I discovered an entire library of stationary bike workouts on the Bodi app, and it's been so good for the body and brain to knock out a 30 minute video or two at the rec center.  My cardio has really taken a blow over the past year and a half, so feeling that heartrate get up has felt amazing.  

It's not lost on me that I find myself in the middle of a countdown this time of year.  For years, I was counting down to one Shamrock race or another, and my surgery just happens to be a few days after Shamrock weekend.  I'm quite familiar with having a date on the calendar and putting in the work required to set me up for a good outcome, but now I'm working hard only to be totally out of commission for a bit.  I have to keep reminding myself that I'm playing the long game here.  The hard work isn't for nothing...putting in the time and effort now will get me back to the things I love faster.  March 20th may feel like a finish line, but it's really more of a reset button, and I'm doing everything in my power to reset to maybe like Level 3 instead of Level 0.

I Don't Want to Wait

The cortisone injection I had the day before Thanksgiving only brought me only a month of relief.  It's like I never even had the injection in the first place.  The upside is that it removes all doubt that I could kick this can down the road for a while and subsist on daily PT and cortisone injections two or three times a year for a few more years.  Right now, my mind is singularly focused on

 So now we wait.  In pain.  All day.  Every day.  Some days I move better than others, and I take advantage of those days by being as physical as possible.  Even if I suffer for it later, the mental lift I get from moving my body is worth it.  I keep reminding myself that while this sucks right now, there is an end in sight.  I may be missing out on stuff with my friends and family right now, but I'll be back at it eventually.  It comes down to being grateful it's just a hip.  

While I count down the days until surgery (62), I'm doing everything in my power to set myself up for the quickest and most successful recovery possible.  I'm keeping up my daily strength workouts to make sure the rest of this body doesn't fall apart.  I'm diligent with the homework from my physical therapist, and I've added some basic hip strengthening and balance exercises in an attempt to be as strong and steady as possible going into surgery.  I get on my beach cruiser a few times a week for gentle motion and fresh air.  Correction, I get on Camryn's beach cruiser now because hers is aluminum and much lighter than mine.  Yeah, that's how far we've fallen.  Swimming once a week is good for the soul as well.  I ice my hip daily, using this ice pack that was sent from heaven.  I try to take ibuprofen only if I know the pain will keep me up at night.  Or if it's been brought to my attention that I'm being a raging bitch to my family (but if one of them asks "What's WRONG with you?" one more time...)

I'm also 18 days into what I've dubbed Joyless January.  It's kinda like Dry January where I've cut out all alcohol consumption, only with the bonus suckage of cutting out all sweets as well. The L-B's were creeping back on with all the holiday indulgences without the hardcore cardio to counteract them, and I'm hoping to create an optimal healing environment from the inside out.  It hasn't been as joyless as I imagined it would be, but I'd be lying if I said I wasn't curious how Ryan's birthday cake turned out (homemade Nutella frosting!), and that bowling alley pitcher of beer looked reeeeeeeally refreshing.  

62 more days is a long time, but sticking to the things I know will help me from the day of surgery and beyond is keeping from totally losing it.  

Hit Me with Your Best Shot

So how am I feeling after scheduling a hip replacement?  I'm feeling lots of things, but initially I simply felt relieved to have actually made a decision.  The should I/shouldn't I/if I do then when back and forth was agonizing, and I'm glad it's out of the way.  

Speaking of agonizing, pain in my hip is another feeling I'm (still) having, so yeah, I probably made the right decision.  But it doesn't come without a twinge of doubt.  What if I go through the hell that is surgery and recovery, only to be no better than I am right now?  It's certainly possible, but to stay off that ledge, I remind myself it's not likely.  I'm "young" (relatively speaking), healthy, strong, and motivated.  All factors that set me up for a successful outcome.  I'd also be going against my physical therapist's recommendation of putting off surgery for a few more years.  What if I need a revision down the road?  But I always circle back to my pain and loss of function, and all signs point to 

Another feeling in my quiver is dread.  March 20th seems like an eternity to continue feeling like this.  The toll being in constant pain takes on one's mental state is costly.  I'm irritable and incredibly short on patience, which isn't great when working with young children all day, and parenting teenage daughters at night.  It felt like my face always looked like this:

I don't like being pissy all the time.  I'm not that kind of Karen.  

But the universe helped me take care of that with a Thanksgiving miracle in the form of a cancellation that allowed me to get my cortisone injection a month early. 

I had the injection the Wednesday before Thanksgiving, and by Small Business Saturday, I was a new woman.  Just about the only time I felt true pain was when my hip was in nearly full flexion, which I've been avoiding for well over a year anyway, so no biggie there.  I could walk faster and without a limp, and was able to start going for actual walks again (I hadn't done that in several months).  I rode my mountain bike on some easy trails with Ryan and some friends.  I could lift a little heavier and squat a little lower during my strength training workouts.  I could come home from work and remain upright instead of needing to lie flat to alleviate the pain.  I could sleep without turning like a rotisserie chicken all night long. I started feeling hopeful that I could make it to March without murdering someone or at the very least, sawing off my leg.

I checked in with my physical therapist, who was thrilled with how my body was moving.  She gave me some new homework and told me to come back in 2-3 months as long as I continue to feel good and consistently do said homework.  I can do that.  

But then that pesky doubt comes creeping in again.  That bastard.  Feeling good makes one question if one needs the surgery after all.  Decreasing pain and increasing activity has always been the goal, right?  If my pain is all but gone and I'm slowly getting back to some - albeit modified - activity, why have surgery now?

Because cortisone wears off and your hip is still wrecked, my friends.  I'm four weeks post-injection, and while I'm not in agony like I was pre-injection, those little niggles of discomfort are slowly seeping in again.  So once again, I'll back off on the walks I've started to enjoy again.  I'll keep the weights a little lower and the squats a little higher.  I'll hit it with all the conservative modalities I have on hand and hope I can keep the resting bitch face at bay until March.

 

Slow down, you move too fast

 Since my appointments with both the orthopedic surgeon and my physical therapist, I've been weighing the pros and cons of both putting off surgery for as long as possible and pulling the trigger and just scheduling it.  Surgery sucks.  It hurts.  You're out of commission for a while.  It's expensive.  There's always a chance it won't actually solve the problem.  So if my pain is manageable with a cortisone injection and being consistent with my PT homework, maybe postponing it a year, two years, five years is possible.  I can be on board with that, right?

Picture it.  Brooklyn.  2023.  

My girls and I are visiting Dayna and her family in New York for a long weekend in November.  We're running late walking Dayna's kids to their gymnastics class, so we have to hustle.  I love to hustle.  Hustling is my favorite.  

Except I can't keep up.  I'm straggling farther behind with every block.  I'm getting outhustled by an 8 and 6 year old.  The only one whose pace I can match all weekend belongs to the 16 year old dog (I'll save you the math...that's 112 in dog years).  While I've known I've lost the pep in my step over the past year, that weekend in New York was eye-opening.  And heartbreaking.

But I still wasn't quite ready to schedule surgery.  I opted for scheduling a cortisone injection.  It seemed to provide some relief when I had one in January, so having another would allow me to avoid making a decision about surgery for a little while longer.  

Except it took two weeks of phone tag to finally schedule the procedure, and the appointment wouldn't be for another five weeks.  At least I'm outhustling the pace of healthcare in America, am I right?

The universe must know I need help when it comes to making big decisions, so it bestowed upon us the open enrollment period for our health insurance.  With our current plan, our out of pocket max will double starting January 1, 2024.  DOUBLE.  Changing to the bomb diggity plan would cost a little bit more per month but would "only" increase our out of pocket max by $1000.  So I basically have a week to decide if I'm having surgery in 2024 so we can make the best choice for our insurance plan.  Greeeeeat.

Feeling paralyzed with indecision, I used the phone-a-friend lifeline.

My friend Anne is one of the fittest people I know and lives a lifestyle similar to my own.  She had her hip replaced a few years ago, so I called her to pick her brain a bit about her timeline leading up to surgery (did she try to put it off and if so for how long?), her recovery, and her post-surgery level of activity.  Chatting with her shoved me off the fence, and today I scheduled my total hip replacement surgery for Wednesday, March 20th.  

Whoa. Ages that end in 5 have always been significant for me, and it looks like 45 will be no exception.

More feelings to come.