Try a Pilates session today.

Thursday, June 23, 2011

My Hip resurfacing -2-3 weeks Post Op

Day 8-Home PT has been great. We are walking around the yard and gardens with the cane. I have a bit of psoas tenderness as I am using the hip a bit more. We have been gently stretching it and strengthenin it by doing a few knee folds  (precursor to Marching exercise).

Day 14
2 weeks post-op
I got my stitches out today. I am off to wash my hair in the shower and start aqua therapy tomorrow. I remember most of the water movements from my prior PT sessions in 2007.

Home Pt has challenged me to be walking with only the cane by the end of this week. I love a challenge! So today I walked around the house, Pilates studio and gardens with the cane. It really takes all my focus to think about how I am walking and keeping the pelvis neutral and move from my hip, not my back muscles- as I was so used to doing. It feels good, and I can get a sense of the strength, but it is tiring. When I get too tired I am relying on the walker as a back up. I feel the inner hamstring group & adductors as a weak link, mainly because I have avoided the whole inseam of the right leg for a number of years.  I will working on those in next PT session.

Day 20-post op
Went to the Petaluma City pool today and did my aqua therapy in the 90 degree heat. It felt great. I did a total of about 50 minutes including; 10 minutes of water walking in about 4.5ft; working on hip extension, straight leg kicks, adduction/abduction (side stepping), easy crawl swimming with flutter kicks, and bicycling in the deep end. We went to run 2 errands before and after the pool, and I was wiped out! , but I came home took a rest and then watered the veggies in our yard. I rested and iced my hip as I watched TV and rested.

Thursday, June 16, 2011

2011-The other hip-PT

Day 4 Post-op
Home PT came today to asses my hip. There was a bunch more lymph swelling than with the left surgery. My P.T.- Maria, was great, she showed my lymphatic drainage massage that helped decrease the swelling. She also addressed the large bruises I developed down my surgery leg. It is a common condition; blood thinners can contribute to post-surgical bruising.  Dr. Vail encouraged me to walk as much as tolerated, the muscle contractions in the leg, circulate blood flow & will massage the bruises away. Maria, the PT did her Pilates training with my mentor, Madeline Black. Maria was also a Feldenkrais teacher and was a great person for me to work on getting out of my previous bad movement patterns. We worked on hip and pelvis differentiation; single leg marching, neutral pelvis stabilization and good ole abduction. I am able to over in bed to sleep on my side or belly. I use a foam pillow and squeeze the inner legs as I roll over. This isometric squeeze also is strengthening my side hip muscles at the same time. Can start to feel stronger in the hip.

Day 5 Post-op
I am working on walking heel to toe with the walker and lifting up off my new femur bone and stretching up tall as I walk. PT-Maria made my walker taller so I wasn’t so hunched over, this helped better my gait &  posture. I started doing more and more lateral hip work in flexion (and attempted extension). The leg becomes more of a lever and is a whole lot heavier in extension. I will be working up to this.

Just laying on my side feels so good on the side hip area, not only cause it was so stiff, tight and sensitive, but also cause the fascia is getting stretched too. I also really feel the posterior aspect of the hip socket. Lying down with my knees bent feels so great on the back of that hip.

The bruising has resulted in Dr. Vail discontinuing the daily blood thinner injections that I had to administer to myself. YEA! I guess the blood thinning was working too well. I am taking about 6 painkillers a day, trying to space them out as much as possible. The pain is more of a dull ache and sitting on the sitzbone area/hip joint is sensitive. I tend to shift to various positions every 2 hrs or so, sitting, laying down, walking/standing, etc.

feeling good, moving well. 

2011-Leaving the Hospital

Day 3- Discharge today!..Yikees
PT came back today and I walked the entire orthopedic floor at UCSF and practiced on the faux staircase. Much better day for movement and regaining all feeling back in my leg. P.T.-Chris guided me through all the in-bed exercises to do. Very similar to foundation moves in Pilates! Heel sides, quad isometrics with glutes, ankle pumps, ankle stirs, adduction and abduction. These last 2 were Believe me I felt them all!! Doing isometrics is great to get those muscles woken up.

I dressed myself in my street clothes and organized my belongings. Lots of instruction on going home and home care. I little nervous about how I will be able to move and feel at home.  My friend Dallas drove me home and was very careful. Everything was a bit harder at home. My bed was lower than hospital bed, sitting on hard edge of toilet bowl is sensitive! Ouch! more moving of leg and lifting onto/off of the bed. I bought a handbag on QVC to make myself feel better. I am planning on returning it. (i did)

June 2011- I decide to have the other hip resurfaced

At about 2.5 years later (2009) and probably because of the increase mobility of the new hip, the right side started to give me similar arthritic symptoms as the left. Joint space decreased, I started to feel my gait compensate, my back muscles got tighter, knee discomfort, tight/weak psoas, gluetal amnesia, significant pelvic rotation, etc. However, only on this side, most of the symptoms were on the lateral/posterior side. That is were the bone spurs were forming. On palpation, you could feel them. I decided to act, instead of waiting, cause I didn’t want to risk my otherwise healthy spine and lower extremities, not to mention my psyche, emotions and attitude. And thank god we have options that we can help ourselves out of a pain spiral of immobility. We have a choice.

Katrina’s right hip resurfacing
Pre-op 5/31/11

Surgery day (kind of graphic for those who may be sqweamish)

My mom and friend Kathy came with me to the hospital. I had a lumbar plexus nerve block that was inserted in the pre-op area. This flexible thread of a needle will stay in my back for about 3 days to keep the post op pain to a minimum. A little stick and it was in, didn’t feel much obvious effect. After adding a bit of "relaxing medicine" I was brought into the OR and then was administered a full nerve block that numbs the whole lower body, from the chest down. This was administered by a trainee (UCSF is a teaching hospital) under the instruction of the anthestiologist. He was having a bit of trouble so it was a bit painful. After 2 or 3 tries and a few “don’t moves” they were in. In a moment or 2 the medicine took effect and the numbing was full and quick. I believe that is the same medicine as an epidural for baby deliveries. I was turned onto my side and was prepped for the surgery. It was weird to feel your lower body numb and have no control of it. I was very cold, shaking deep throughout  my body. There was a lot of clanking around of operating table parts, tools, what have you. Dr. Vail’s eyes had a look of “sorry for all the noise”. They drape your upper body and put you into a heated tent so you are more comfortable. The anethstiologist asked if I felt anything? I said like what? They said, “Did you feel the bladder catheter?” I said no. The lady who put in the catheter smiled thru her mask and her eyes said, “Good I am glad”.  I felt the pressure of Dr.Vail's hands on my hip. That’s the last thing I was aware of. Next I was in post op feeling thirsty.

No discomfort from post-op. I was wheeled into my room. Yea! It was a private room. With a killer view of a mountain of waving Euclucptus trees and sky. (UCSF ortho ward has killer views from all the rooms). Was hooked up to the morphine drip and checked by nurses on a regular schedule.  At 7pm my husband Sean came into the room to visit I was asleep. He said I was kind of out of it. I was on a PCA (patient controlled anthestic) i.e. a morphine drip that helps keep the pain low and I had the nerve block in for a day or so more.

Day One- all the nurses at UCSF were great. The resident ortho Dr. Yamamoto who works under Dr Vail had a great bedside manner, was gentle, listened well, explained the muscular anatomy that was effected in the surgery…because I asked I wanted to understand the process. Physical therapy and occupational therapy came by today to get me to feel what its like sitting up, swinging my legs over the bed a standing up. My blood pressue went way down (91/50) and I felt lightheaded and nauseous.   I was shown how to use the tools to put on/take off socks and clothes, my “grabber”-best device for picking things up out of reach, how to sit on the toilet and what it feels to walk on the new hip! That was enough for the day. I still had the numbness in the leg, and it was a bit worrisome, cause I wanted to move it, but couldn’t. I was told that I would be weaned off of it slowly, as so not to have pain. Because I had the numbness, and no control of my new hip, I wanted to get that nerve block out.  I was still on the drip. My friend Blanche came and visited me in the afternoon, that was nice.

Day 2- Dr Vail came by early in the am and felt I was doing great. I am feeling minimum discomfort still. Nerve block was finished and I had tingling, then full sensation back in my leg. It was still very weak in psoas area and tender posterior /lateral side glutes. I started doing basic PT/Pilates therapy for strengthening…isometrics & Heel slides, quad/glute contractions ankle pumps and circles…all good. I noticed that since the hip joint has been so stiff, tight and dysfunctional that I really feel “loose” in the beginning and the muscles have been stretched during the process, so there is the sensation of instability. You can feel deep in the joint and surrounding muscles a sense of tugging and stretching and dull ache. BUT nothing like the OA.This is quite a remarkable awareness the day after surgery.

Started to gain appetite back (darn) but made sure that I ate, steamed veggies, chicken, yogurts, fruit. Things that were nutritious and fibrous. The pain meds make you constipated, and I was given stool softeners daily, which continue while on painkillers. My friend Rhonda came to visit. The morphine drip ended today. The pain now is managed on Percocet. Dr. Yamamoto changed the dressing and I got a peek at the 8 inch scar. NICE!  Clean, dry, no redness. He said Dr. Vail’s work always looks like this (my 1st surgery looked perfect too). I told him that Vail should have been a “seamstress”…I must have been pretty out of it.

2007-My 1st hip Resurfacing

 In 2002, I had left hip arthroscopy by Dr. François Antounian at CPMC, S.F. The torn cartilage was removed and the femur was shaved a bit to attempt a better fit. It lasted for about 5 years, but after the cartilage was removed, then basically you are left with bone-on-bone, which advances the OA & the gait compensation patterns and the pain.

I had that same left hip resurfaced by Dr. Thomas Vail who had just joined UCSF to chair the orthopedic department in 2007. He had tremendous experience with hip resurfacings (one of the few docs in the US at the time) and had even developed a couple of the latest FDA approved devices. I did 5 years of research prior to having my 1st hip resurfaced. I interviewed 4 surgeons prior to selecting the resurfacing surgery and the surgeon. I wanted a surgeon who had done MANY procedures and was well respected in the field…and of course was in my insurance group. I was lucky that Dr Vail came to San Francisco!

The left hip surgery was great. Recovery was easy but focused and I was diligent on my PT and Pilates strengthening regime. I regained full range of motion, strength, functionality, etc. From the beginning, this hip was worse, but in x-rays you could see a little bit of joint space narrowing starting on the right side. But by comparison to the left, it was fine. I continue to do private Pilates, hike, swim, ride horses, bike, walk, stretch, myofacial release work, take occasional yoga and gyrokensis classes…all great, prescribed non-surgical treatments. 

What is Hip Resurfacing?

Hip resurfacing is new type of hip surgery that was FDA approved in 2006. It has been done in Europe, Asia and India since the 1980's. Hip resurfacings are done to younger patients who want to conserve as much bone (socket and femur), while shaving away all the OA bone spurs that have grown in the joint. 

It is the same process of when the dentist whittles down the tooth, and fits it with a "crown". And  they clean out the acetabulum or hip socket as well. The result is a non-impinged, free-moving fluid hip joint! 

They use metal ball over your own femur and they reline the acetabulum with the same metal. Unlike a total hip replacement, you keep more of your bone and there isn't a giant metal stem implanted into your femur shaft, plus your anatomy is the same, less to no precautions, faster recovery. And if you should need to have a total hip replacement in the future (resurfacings last about the same as total hips- 20-30 yrs- ideally) you will have enough bone to have that procedure done later.

Here is a great resource for everything you want to know about hip resurfacings, it is

Baby Boomer's living with Osteoarthritis

From early in my 20's I had issues with my hips. taking years of high-impact aerobics, competitive horse riding and jazz dance classes, might have made them a bit more worse for wear. I remember getting massage sessions and my illiac crest was always very tender. But really around 2000, i felt the need to reach out to the medical profession. I was told that I have Osteoarthritis in the hip joints. i could not believe it. I was only 40!! 

One of the things that made me feel stronger, stable and flexible in the joint and my entire body was Pilates. At that point, I changed my 25 year broadcast TV career  into "plan B" and became a certified Pilates trainer. I change of career was personally inspired, but I also realized that there were probably many other baby-boomers like me who have had the same issues of OA or other impingement syndromes in their joints. And with so much of my own personal work in the area of hip anatomy, biomechanics, gait, posture, strengthening, stretching, stabilization for the joint and the surrounding muscles and tissue, I feel like I can really offer  help to those interested in helping themselves.

Coming up next, is my story of my 2 hip resurfacing surgeries.....