Back to work! 

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!

  

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A change of pace

I’ve been in London a week now and things have been pretty good. I think the cooler climate has been good for my joints and trading sandals for proper shoes (with orthotics) has made a huge difference to my ankles, knees and hips. I’m in generally in a lot less pain and have been able to stop taking paracetamol (teylenol) regularly. My liver will be pleased! My neck has also improved but that might be due to the better ergonomics of my laptop setup. 

I’ve increased my walking considerably, and while I’ve been sore the hip has coped really well. I’m living in a household with a dog so have been walking at least 60min a day. Yesterday I walked 7km (approx 2hrs) and it’s amazing how different the hip is now that I’m almost 9 months after the surgery. It really does feel like I’m a new person! Before I was in pain all the time, took a lot of medication and was unable to walk for more than 10min without the pain getting unpleasant. 

My fitness is still terrible though and my legs are very weak, but I’m sure that will improve with time. I can feel the muscles in my feet are getting stronger and my inner thighs are doing some work. I’m not 100% sure my biomechanics are quite right so I’ll see a physio this week to fine tune my rehab and help me get back to yoga classes. I’m quite keen to give barre classes a go too , and when I’m feeling more confident in my recovery I’d like to return to the gym. 

Things aren’t perfect though and I’m often reminded of “what was”. I get tired easily and need to sit down to rest fatigued muscles. I was in the supermarket on Friday and the hip got stuck and clicked very painfully for the first time in months. I’m pretty good about not panicking when this happens, but it does make me a little uneasy. But as things continue to improve week by week, I’ll stay positive. I believe having a positive mindset is a key ingredient to a successful recovery.

  

Significant progress

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.

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Will I ever be ok? 

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.

Expectations, a recipe for disappointment

Latest update from India. It’s been a rough couple of weeks. I’m feeling a bit disappointed, for some reason I thought if I stayed here long enough I’d get a piece of my “old life” back. I think this was a mistake, there is no going back and I’ll never be the person I was before CRPS & my hip problems. I’m a lot healthier though, I’m sleeping better and I can walk. Surely that’s enough? I can’t believe that being able to walk is an accomplishment after 4 months of yoga therapy. But I’m feeling I can leave my crutches behind and that’s a HUGE deal! Something to be very happy and proud of, so why do I feel sad? 

I guess I’m on the slow and steady path, my instinct is telling me to get back in the pool as my body is actually quite sore and I’m not enjoying the yoga anymore. I feel sad to leave Mysore as I don’t know if I’ll come back, things are different here – but everything changes and evolves, this is life. One door closes and another opens. I don’t feel I fit in with all these super-yogis, I look at them doing the crazy stuff I used to do and wonder… what’s the point? Why do I want this? Prana Vashya is a beautiful practice, but it’s been out of reach for a long time… I think it’s time to just let it go.

I need to start writing again!

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.

Hip FAI Surgery

On Wednesday 13th August I finally had my surgery to remove the impingement in my hip (FAI). I had to call the booking office the night before surgery and was told to arrive at the hospital for a 7am checkin. At this stage I was still pretending that it was a holiday and I don’t think reality hit me until I woke up the next morning. This was good, less of a chance for the nerves to get the better of me.

I live so close to the hospital that I was able to walk there which I thought was amusing given I was going in for a hip operation. There was a handful of families also waiting to be first in line for surgery on that day. I was alone but this  didn’t really bother me, surgery is less scary the second time around.

I was one of the first patents called in; I chatted with the nurses and anaesthetist, got changed into a hospital gown and given a warm dressing gown to wear.  I had to wear a hair net and silly smurf slippers over my feet which cracked me up.  The surgeon was late, so I spoke with his registrar and waited in the pre-op area for ages.  The anaesthetist and I decided against the spinal in the end, so went for general anaesthetic and an infusion of something that would to help prevent pain complications (ketimine or licocane – not sure).  I wasn’t as nervous or scared as I expected to be, but I was grateful I got knocked out AFTER speaking to my surgeon and BEFORE going into the operating room.

Before I knew it I was in post-op recovery area and waiting to go up to the ward. I think I got up to the ward by noon and don’t really remember much of that afternoon.  I was in a fair amount of pain, but it was well managed.  I was given pain relief by IV and was able to control when I got it by pressing a button. The best part was turning my phone on and getting so many text messages from friends, workmates and family, including some lovely photos from my family in the UK. The worst part was getting up to go to the toilet numerous times that first night, I had to use a zimmer frame and every time my body would shake uncontrollably which made peeing very challenging. My body has a thing when it is in an excessive amount of pain that it shakes uncontrollably and I get really cold.

I was in hospital for 4 days and the time on the ward wasn’t overly restful as I was sharing with three very noisy old ladies. This was especially challenging when we changed the pain medication and the central sensitisation went a bit haywire.  Bright lights and noises are a problem for me, especially when I’m in pain or stressed. Hospitals are very bright and noisy places,  my ward was chaotic and the old ladies had a lot of visitors who ignored visiting hours.  Thankfully, the pain team  did a good job and got my pain back under control fairly quickly and I was able to go home just in time for my birthday.

The surgeon was light on details but he said the operation went well. When I asked about the number of holes in my leg (more than I was expecting) he said that he wanted to be sure they got all of the impingement so that gives me confidence. I noticed the feeling come back in my foot almost immediately and the pain in my hip feels different. It is still early days, but I am feeling really hopeful about the surgery.  I know I’ve got a lot of work to do to make a full recovery, and I know its not going to be easy (or happen very quickly), but I’m feeling really hopeful and am ready to put all this behind me. I’m very relieved the worst is over now and I am on the road to recovery.

I am partial weight bearing on crutches (allowed to put a little bit of weight on my foot, but not much) and am resting at home for at least 2 weeks. At the 2 week mark I will see the surgeon for a follow up and to get my stitches out.  I’ve got some very basic physiotherapy exercises to do and will start the rehabilitation when the surgeon gives the all clear to get started.  I’ve also got an appointment with the pain specialist in October to discuss the plan forward from a pain management perspective, the pain clinic have been very clear the expectation is that surgery will improve my function but is very unlikely to make me pain free.  Regardless, I’m excited about the future and looking forward to getting on with the rehabilitation. Its going to be an interesting few months.