After effectively 11 months off work since my surgery I finally went back to work and I’m happy to report it’s been an absolute success!
A bit of background if you are new to my blog, I initially planned 3 weeks off for my surgery (hip arthroscopy). I knew it would be a risk with the CRPS history that a return to work may take longer than expected. While I didn’t have a major flare up of the CRPS my recovery was definitely slower than normal. Due to an inability to sit in a chair for long, the surgeon had to keep extending my sick leave. I could tell work was getting antsy and I was getting worried about money, so I offered to take a period of leave without pay to go overseas and give myself time to recover properly. In the past I have found yoga therapy and a warm climate to be very helpful, so I planned for 6 months in India (to do yoga therapy) and Thailand (to stay with family). At the end of my 6 months I started thinking about leaving New Zealand and moving to London. I was really unsure what to do, but in the end I felt the need for a fresh start, a new adventure and to be closer to my UK based family.
I arrived in London and after some initial job hunting, I had the choice of two jobs. The two jobs very VERY different. One of them looked like it had a very good work/life balance (35hr weeks are the norm), low stress and a very easy commute. Naturally I didn’t take that job, I chose the more interesting and challenging job with a b*tch of a commute! I knew I was taking a risk as I wasn’t sure how the hip would react to sitting all day, but I’m so pleased as it was totally risk worth taking and the hip has been fine! And even better, I’m really enjoying my new job.
I still have a way to go with the physiotherapy and strengthening, and there are few things I need to actively manage, but that’s more around the central sensitisation and other injuries (ankle and knee are still playing up). But the key thing is I’m feeling fully confident that everything is going to be ok and the hip problems are mostly behind me now. Thank goodness!
Since arriving in the UK my right ankle and my right knee have been playing up. I’ve been walking 1-2 hours a day and navigating London’s tube stations which involves a lot of steps. I’ve been spraining the ankle regularly for a long time now but don’t recall actually injuring the knee. Something has happened in the last few weeks and now the knee bothers me when I walk, go up steps and when I get up from sitting. I have a sneaky suspicion it might have been the yoga classes I went to (sigh) and the increased activity levels from having a fixed hip (hooray). As usual I gave it a couple of weeks to settle by itself and as things were getting worse I went back to the physiotherapist I saw when I first arrived in London.
The physiotherapist did a lot of tests on the knee and ankle and has determined that I am lacking in strength in my hamstrings, calves and hips. This combined with the loose ligaments means that my knee joint is getting irritated and she suspects I may have torn my meniscus. She said if it doesn’t get better I may need to go see a surgeon. I told her very firmly that it WILL get better. Hopefully by strengthening around the knee and addressing alignment issues, the injury will heal on its on.
I got a bit tearful during the appointment due to the disappointment of my body letting me down once again, the thought of more surgery and adding another problematic joint to the list of joints that need managing. The cost of private physiotherapy in London is very high, it’s worth every penny but it is an expense that I was hoping to avoid. For some reason I thought if I spent enough time in India doing yoga therapy and got enough distance from New Zealand, then my body would settle and I’d no longer have to deal with these sorts of problems. Apparently not. But I must not forget how far I’ve come and the progress I’ve made since my hip operation. I’m on zero medication, my activity levels have increased significantly, the CRPS symptoms have gone and my hip has almost fully recovered.
How things pan out in London is going to be fully dependent on my attitude. If I choose to make a big deal of this, focus on the negative and get frustrated with the pain – then it will be a problem. If I accept what is happening, listen to my body and follow the advice of the physiotherapist – then in a 6 months or so I should be in a much better place.
The physiotherapist stressed the importance of doing my physio exercises consistently FOR LIFE. I’ve got a pattern of going to physio, doing the exercises and then stopping when I feel better. Then I loose strength and injure myself again. It’s a boom-bust pattern that is painful and expensive. The idea of doing physiotherapy exercises for life is very depressing as I find them incredibly boring. To break the cycle of boom/bust I think I need to do my physiotherapy exercises as told for 6 months (suck it up) and find a way to integrate appropriate exercise into my lifestyle. Then once I have the strength built up and the pain is settled, I should be able to take away the training wheels (of physio) and maintain my condition without help. I was hoping that yoga could do this, but I don’t think yoga is going to be enough. The physiotherapist said I don’t need yoga as I have enough flexibility, she suggested pilates instead. I don’t think she realises that yoga can be strengthening, but I get her point. I think in the short term I’ll do swimming and cycling, then when I’m working I’ll transition to a gym. There is a great gym near my work that has lots of classes (including yoga), a swimming pool, lockers..etc. its expensive but its money well spent in my opinion. I’m not giving up on the yoga as its too important to me, but I appreciate now that yoga alone is not going to help me and is potentially harmful for me right now. So I’ve decided to stop going to classes until I’ve got more strength to protect the joints.
I’m in a bit of a funny place right now. For years because of the chronic pain I’ve felt like I was living life from the sidelines. I felt like the world was going on without me and I was treading water on a daily basis just to function. For a long time I was envious of people who could walk, sit, sleep and stand without thinking about it. Now that I’ve almost fully recovered from hip surgery and from CRPS, I feel like I’m at the sideline and about to rejoin the game of life. It’s a wonderful feeling but its also a little scary. Over the years I’ve lost confidence in myself and I worry more than I used to. This is understandable because I know from experience that bad stuff does happen.
All of this hip malarky happened in one second because of a silly accident at the gym, I remember that moment clearly. I got hospitalised with CRPS twice because of a perfect storm of events. I know that something as minor as going sailing and walking home can trigger the most excruciating chronic pain you can get. Pain worse than unprepared childbirth, cancer and amputation (according to the Mc Gill Pain Index). I know how to avoid another CRPS flare and I am very confident I have the skills to ensure it will never happen again. But fear of CRPS and hip pain is still with me and casts a shadow. As time passes I’m sure that shadow will fade.
I’m very excited to get back to an active life, but I’m more cautious than I used to be because I have a fear of it all happening again. But I can’t live a life in fear, I need to put this behind me and trust that everything will be OK. I’ve moved to London to get away from old associations and make a new life for myself, its not as easy as I expected but it is exciting and full of promise. I’m at the edge of the cave and there is treasure inside, it will be 100% worth facing my fears and working through what I’m feeling.
This image is from Facebook, source unknown.
Oh my goodness, just had the best (and most painful) Thai massage ever. This guy found all the sore spots straight away and was incredibly strong. He has studied massage in Thailand, and Chinese medicine in China and Taiwan. And best of all, he came to our house!
I think my yoga practice tomorrow will be very different than it was today.
I’ve just spent a week on holiday at the beach with family. Its been great to work on my tan before heading back to work, and I’ve been pushing the limits with my hip. I’m now 8months post op and I am doing really well, I’m 100% sure the operation was a success and I’m much much better than I was 8 months after my first surgery.
I feel like I’ve turned a big corner in the last month. Little things I’ve noticed in the last 2 weeks are:
- Travelling from India to Thailand was a breeze this time. It was a long journey that required a lot of sitting and it was almost pain free. I was also very happy to be able to stand in the line for immigration with no issue.
- I was able to run for the plane (oops) and I can walk with a 15-20kg backpack on.
- I’m able to walk for several hours at at time now. Including walking on the beach and in the jungle.
- I can swim in the sea for 45min-1hr at a time (lots of snorkelling), swim 20-30 lengths of freestyle and do some very slow/gentle breaststroke.
- I can lift my 3yr old niece and play with her without too much discomfort.
- I’m walking fluidly with ZERO limp.
As I near the end of my 4 months of yoga therapy, I’m starting to wonder… Will I ever be ok? It’s been a long 4 months of 90min yoga therapy sessions 5-6x a week that has been specifically designed to meet my needs. While everyone else is doing advanced yoga, I’m very much back to basics. It’s so frustrating and a little dull. I’m not even allowed to join the class to do the sun salutations. It’s very humbling to go from having a strong practice to this. While I have significantly improved, I’m still having pain in multiple joints and am struggling somewhat to progress. I’m at the stage where I’m wondering “Will I ever be OK?”. This hip injury has been such a long, painful and tedious journey.
These days hip itself is actually ok (mostly), it’s my ankle, shoulder, neck and wrists that are causing grief and stopping me from progressing with the yoga. I am seriously questioning if yoga is for me but I’m not quite ready to give up. Before surgery I tried a few yoga classes and it always destabilised my pelvis and significantly increased the hip pain. The problem with the classes was that it was hatha style, and I never knew what I was getting until I was in the class. Some classes were better than others. Theoretically now my hip has been fixed and I’ve got a lot more strength, I should be ok but my other joints are playing up. I’m a little fearful of making things worse because of the hypermobility. Some people say yoga is ok and helpful, others say it’s a terrible idea. My instinct is that the right kind of yoga will support my health and joints moving forward, it’s just a case of taking it slowly and not pushing myself. I need to find the right teacher to help me find my way. I am having doubts that my teacher in India is the best person to help me find my way. This is disappointing as I’ve considered myself a student of his since 2008, he was my first ever yoga teacher and to some degree has had a big impact on my life. My yoga practice changed me in so many ways.
Because of these doubts I’ve been reading up on hyper-mobility and I learnt that it takes 6-12 months of exercise 5x a week to build up the necessasary muscle tone to support hyper-mobile joints. Muscle tone is different to muscle strength, muscle tone is how your muscles feel when at rest… a few months ago mine were soft and pudgy. I’m starting to get some muscle tone but I’m really only 3-4months in, so really need to keep up with the exercise despite the pain. Hopefully once I have muscle tone back the joints will be less painful. When I was active (before the hip problems) I had minimal joint pain, and I’ve had a physio tell me it’s very very important to exercise regularly for the rest of my life. I know exercise is very important and while the next 6 months might hurt a little, I need to keep working on it. It’s just a case of working out the best approach.
Soon I’ll no longer be under the guidance of my yoga teacher, the training wheels are coming off and I really do need to trust that “it WILL be ok”. I can do this, I’ve already come so far. I think I’ll probably continue with my yoga sequence, modify it a little to make it more enjoyable and hopefully less painful. My instinct and experience is that my joints like to move, I think starting with basic sun salutations is best for me. I’ll seek my teachers opinion first, then experiment with it. I think I’ll also do less yoga and more swimming/cycling. I’ll be going to Bangkok where I’ll have access to a pool and exercycle so I’ll make the most of that. Hopefully after a few more months I’ll be ready to try a beginners yoga course and can take it from there. When I go back to yoga classes in the west I think it’s very important to start with a beginners mind and make sure my technique is sound. I believe that a strong foundation of strength and knowledge will set the scene for an enjoyable, balancing and safe asana practice. I really hope so.
It will be ok.
I am ok.
It is ok.
I will continue to be ok.
It’s going to be ok.
I will be ok.
Ok, I think its time to start writing again. The blog has been quietly ignored for a few months now for a variety of reasons. Mostly because sitting is still an issue for me after my surgery and computer work isn’t the best thing for me. Also because I’ve been so busy, busy with recovery from my hip surgery and busy with life.
At the moment I’m in India and 5 weeks into my yoga therapy course. I left New Zealand mid October and travelled to Thailand to spend time with my family. After a few weeks in Bangkok I flew to Kolkata and did some travelling with a good friend of mine, this was a challenge on crutches but more about that later! After a week I then made my way to Mysore in Sothern India where I plan to stay for the next few months doing a yoga therapy course. This will be my 5th trip to Mysore to study yoga with my teacher Vinay Kumar (Pranavashya Yoga). My goal for this trip is to get my strength back, wean off my medications and find a way to return to a physical yoga practice.
Since arriving in Mysore I’ve managed to wean off my crutches completely (finally) and have significantly reduced my medications. My strength and range of movement is improving and I’m walking short distances without a limp. I still get some pain and swelling, but its manageable as long as I limit my activities and rest between my classes. The yoga sequence I am doing is designed for me so it doesn’t flare up the pain, my teacher is excellent and clearly knows what he is doing. I feel like I’m in good hands.
My days are quite long here, not because they are full of activity, quite the opposite in fact! At this stage I’m only allowed to attend one yoga class and have been instructed to rest well between. Because I’m still not able to sit in a chair without flaring up the pain my projects are on hold for now. This means I’ve got a lot of time to read and think. The thinking is why I think I need to start writing again!
I hope that writing will help me process what I’m feeling 4 months after surgery as I step on the threshold to a seemingly normal life without severe chronic pain. My accident was in 2009, I had my first surgery in 2010, major CRPS episodes in 2011 & 2012 and my second surgery in 2014 – I’ve forgotten what a normal life without pain is like, the transition from being a patient to a person is more challenging than you’d expect.