Well that was unexpected

Today was my last full day at work before surgery.  People funneled into my office all day to say good luck and what not, which was wonderful of them.  But by the 10th person, it really started to HIT ME.  I become ridiculously anxious.  Maybe it was the sheer amount of talking about surgery that triggered it, or all the well-wishes for my health, or maybe the realization that once I'm out of work it's surgery day, but it was really unexpected.  Up to this point I've been nervous but not that pit-in-your-stomach-what-the-hell-is-going-on feeling that I had most of the afternoon.

I applied for FMLA as HR recommended that I do it - and the paperwork came back today.  The notes said that my post-op appointments will be ten days, three weeks, and six weeks after surgery, I will have PT 3xs a week and no driving, no squatting and no kneeling for 6 weeks.  Wait... no driving for 6 weeks?   I am assuming that was a typo or something.  I guess it's a good thing I planned to be working from home!

It's been raining the last few days and my hip has been particularly sore.  I guess I can now add "weather barometer" to my list of many talents.

In other news, I am officially "nesting".  I realize this is something people typically do when they are having a child, but I can confirm it applies to surgery as well.  The house is clean, I have organized everything I can and I even went shopping and bought "new" post-surgery shoes and clothes. I have a closet full of perfectly suitable sweat pants, but I decided that I absolutely needed something new.

If you're curious, I bought these:

Tired

I spent most of this weekend working on school stuff, to get it out of the way before surgery.  Then, because I had spent so much time working, I missed both my workouts... so today I lifted at lunch and then hit the elliptical after work.

I'm exhausted!  But I'm happy that I made it and kept up with my workouts even throughout all the work/school craziness over the last six weeks.

(Keeping with the Futurama memes)

I am in the best shape I have been in several springs, but I hate most of the exercises I am doing - boring PT exercises, elliptical, no impact, blah.

"I love the elliptical" - said no one, ever.

By this time next week....

....I'll be post-surgery!

This week I had my final pre-op PT session and a massage.  I was also bombarded with a bazillion things to do.  It sort of feels like finals week in college - I just hope I don't get the usual "finals cold" to go along with it.

I decided that I wanted to go for a run today.  Why not, right?  Not much can happen to make things that much worse in one running session, one week from surgery.  As a preliminary test, I jogged to my car in parking lot after work (I'm sure this looked silly).  About ten steps in, I gave up.  My hip hurt and it was sort of not fun.  Duh.

Psoas the World Turns

One of the things planned for my surgery is a psoas "lengthening", where the surgeon cuts the muscle partially.  When it heals, it makes the muscle longer in length.   There's are a number of people who have had this done and say that it was the most difficult part of their surgery recovery.  It takes a long time to get that muscle strength back and it's a critical muscle in lifting your leg, like when you go up stairs.  Both of my hips will "crack" or "snap" pretty often, which is the psoas snapping across the hip.

My MRI shows that the psoas is crammed right up against my labrum, and could potentially be part of the reason why my labrum tore.  Like this:

This psoas has caused me a ridiculous amount of trouble over the years.  It's always unhappy and spasming, causing an immense amount of lower back pain.   It also resulted in crappy posture - I would slouch over towards that hip when sitting... you could call me Quasimodo.   Physical therapy worked through a lot of that earlier last year, after yet another bout of back pain.   Interestingly, I've always hated how I slouch in photos, but I've since realized that it was a compensation for that psoas as well.

What happens when one psoas is far too tight:

A few of the millions of photos of me in that same position:

On one hand, I am really hopeful that the psoas release will finally give me more functional motion through that hip, will "straighten" me out a bit, and will resolve many of my back issues.  None of the conservative treatments up to this point have fixed it fully, though routine massages and PT have certainly helped keep things at bay.   Stretching just makes my hip extremely unhappy.

And on the other hand, I am really nervous about the recovery.

Keep on keepin' on

Tomorrow is two weeks until surgery.   It feels strange, like I'm just in limbo until I get past that day.

Keep putting one foot in front of the other, keep marching forward.  I'm checking all the pre-surgery boxes.  I'm exercising as much as I can.  I'm being good about eating.  Preparing the house.  Organizing the things at work.  Right, left, right, left.

I want this whole ordeal to be over already.  I would like to stop thinking about my hip.  I would like to stop being a whining, cranky broad.   I would like my entire groin area to stop being a big pain, literally and figuratively.  

Of course, the surgery is only the start.  But at least it's the start of getting to the end.   Not this prequel baloney.

Nonna's spaghetti sauce

This is the real deal, folks.   My grandmother was your typical Italian nonna - capable of cooking up a delicious meal for a small army. Here's her recipe for spaghetti sauce, it won't do you wrong.  Be forewarned though - this is a full morning of cooking.

Nonna's meatballs
1 lb gr beef (turkey is ok if you want)
2-3 garlic cloves, diced
1 egg
~1c bread crumbs (or if you are gluten-free like me, almond meal)
1/4c chopped fresh parsley
1/2c grated pecorino romano cheese

Mix, form into balls.  You can fry in olive oil or bake in the oven for 40 minutes at 400 - up to you, but frying is definitely the official Nonna way.  Meatballs should be just about done before they go into the sauce.  You can adjust the garlic, parsley and cheese based on your own tastes (more is sometimes better :) )

I tripled the recipe, so hence the three eggs! I used about 3lbs of beef.

Meatballs on a parchment paper-lined baking sheet, ready to go.

Nonna's sauce
1/2 onion, chopped
3 large cans "kitchen ready" (ground, peeled) tomatoes
4 leaves Fresh basil
4 leaves Fresh mint

Saute the onion in a tablespoon of olive oil in a big stock pot/soup pan (I use my Le Creuset for this) until it softens.  Add the three cans of tomatoes (carefully, otherwise it will splatter), and the basil and mint.   Let simmer on low for 1 hour, stirring occasionally.   After 1 hour, add 1/2c water and the meatballs.  Simmer for another hour on low.

If you like a little thicker sauce, you can simmer it for longer.   I usually let it go for longer than the 2 hours because it really helps the flavors.

At the same time as you add the meatballs, you can add braciole and Italian sausages (if you add sausages, boiled them first and then add).

Nonna's braciole
1.5-2 lbs flank steak
maybe 1/2 cup grated pecorino romano cheese, chopped garlic (lots!), chopped mint/parsley, salt and pepper  - I have no exact measurements here, just estimate :)
You can also use fontina cheese instead or in addition to the romano

Take the flank steak and pound thin.

Take the rest of the ingredients and roll it into the thinned out flank steak - I put the mixture on one end, and then roll it up from there.   Tie in three places tightly with some cooking string (or any thin string).  You don't want the good stuff to fall out!

Sear on all sides until browned in a pan with a little olive oil.   Then add to the sauce.  If you are going to add braciole, I would definitely increase the simmer time for the sauce to at least 2 hours.  If you are using a Le Creuset enameled cast iron pan, you can put the pot in an oven at ~300 degrees for a few hours as well.  You want the flank steak to be tender, so the longer it cooks, the better.

Enjoy!

News flash - spring has arrived!

Today we hit 70 degrees.  The last time we hit 70 was wayyyyy back on October 10th.   A long, grueling, miserable 6 months of winter in between.   Tomorrow and Monday are supposed to be just as beautiful out, hooray!

I got out on the bike for 15 miles.  I started off in a jacket but I was down to shorts and a short sleeved jersey by the half way point!  I intended to do 20 but the hip was bothering me enough that I figured I should cut it short.   I have another ride planned tomorrow, a little longer at 25 miles, so there was no need to push it today.   I am pretty sure the deep knee bends I did to get the chain greased and the tires pumped up tweaked things a bit - it's always the little stuff!

My pretty bike!

I hung out on my inversion table after the ride.  I purchased it a few months ago but hadn't gotten around to setting it up - which was a feat with its million pieces and hard to read instructions.   It's supposed to help with disc issues, so I figure getting some traction in before surgery might help alleviate any post-surgery low back pain flare ups (likely some wishful thinking, but it can't hurt).

Today is also day 1 of the freezer stocking cooking!  Spaghetti sauce/meatballs and chili is on the docket.  I'll freeze most of it and save enough for a meal or two during the week.

The mental struggle of chronic pain

This post has been circling in my head for several years now and I've hesitated putting it into words because dealing chronic pain can be a very personal experience, and certainly my experiences may not be anything like someone else's.

WebMD defines chronic pain as a pain that lasts longer than six months. Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating.

It goes on to say: The emotional toll of chronic pain also can make pain worse. Anxiety, stress, depression, anger, and fatigue interact in complex ways with chronic pain and may decrease the body's production of natural painkillers; moreover, such negative feelings may increase the level of substances that amplify sensations of pain, causing a vicious cycle of pain for the person. Even the body's most basic defenses may be compromised: There is considerable evidence that unrelenting pain can suppress the immune system.

Because of the mind-body links associated with chronic pain, effective treatment requires addressing psychological as well as physical aspects of the condition.

It's simplistic to think that chronic pain affects mental state in an "pain = sad" equation, though I have a sense that someone who has never experienced chronic pain might think of it that way.  In fact, I would say that it's not the act of being in pain itself that directly causes depression in any way, but rather what the chronic pain indirectly affects in someone's life.

Chronic pain is different than acute pain in that there is no clear end.    If you cut your arm, you have a good idea that once the bandage is off that your arm is likely going to be fine, even if you are in pain for a few days.   With chronic pain, you have no real idea of when the end will come, if at all.  There's a sense of being put in a situation that you can't quite control for some unknown amount of time, which causes significant anxiety.

Chronic pain also makes you constantly think about it.  Even when you aren't thinking about it, you are.  People in chronic pain make a million decisions every day that are based solely on managing or mitigating their pain.   It starts to consume your thought processes for almost everything in life until it is just second nature.    At times, it feels you are living a parallel life, with an entirely different decision process from those that are around you.  Even little things, like, I recently gave away a lot of my scrapbooking crafts and when asked why, I explained that it bothered my neck too much to look down for any period of time.  Based on their response, I could tell that the answer was not what they were expecting, even though I've had chronic neck pain now for years.

Chronic pain keeps you from doing the things that you really love.   Not doing what you love takes a such a toll on you mentally.  Especially if those close to you are able to continue on without you.  You might be jealous of them in some way, or wish that they understood how hard it is for you to miss out.   The feeling of being left behind as people go on and enjoy their life without restriction hurts.

Chronic pain is incredibly isolating. Unlike an acute injury, people are not always terribly sympathetic to chronic pain.  You aren't in a cast, you don't have stitches, you likely look just like you always have.  But you could be having a really, really bad day.  After a while, you stop talking about it with others because you worry that either people are tired of hearing the same complaints from you or they just don't believe you.  Then it becomes part of your inner monologue only.

I think despite all this, is it possible to deal with ongoing pain and have a positive outlook.  A large part of it is acceptance... acceptance that your life will be different than others, but that it is ok.  It can be a very hard thing to accept and it takes some time to get there, particularly if the chronic pain was the result of an accident or decisions made.  In the end, we each have our individual struggles and you can only walk your path.   You could spend your time wishing for something different, or you can walk the path you have in front of you and enjoy it as best you can.

T-minus three weeks til surgery day!

Green Day's Basket Case was on the radio as I drove home from work.  It pretty much summed up my feelings lately.  I'm constantly in complain and whine mode.

Do you have the time
To listen to me whine
About nothing and everything
All at once
I am one of those
Melodramatic fools
Neurotic to the bone
No doubt about it

My latest complaint is that I'm starting to have symptoms in my OTHER hip.  You know...the good hip.  I noticed it maybe a month ago and dismissed it.  The tightness and achy stuff is starting to happen a little bit more often and last night I had shooting pains as I laid on that side.  Then when I was doing my PT today, I got that sharp zing in the groin that was all too familiar. Son of a _____.

I called my ortho's office today and they said they will do a full work up on the other hip after surgery.  Being the impatient person that I am... I really would like to know what's going on.   I hate being in limbo with a million questions.  Will I need more surgery?  When?  How does this impact my rehab for the first surgery?  Will I ever be able to run again if I have two bad hips?

It all keeps adding up
I think I'm cracking up
Am I just paranoid?

The three-legged dog who inspires

It's sort of cliche and trite to say that my dog inspires me, isn't it?   But he really is an amazing dog.

Before we adopted him, Buster shattered his leg and was surrendered to the adoption group.   The choice for the group was to have it amputated or have him put down.  They opted to amputate and unfortunately, after the surgery he had a series of set backs and complications.  Nearly bled out after an internal suture ripped open, twice.  Had problems eating and keeping food down.    He was at the vet for nearly 6 weeks and was basically wasting away.

His foster home took him in as a last ditch effort to see if home life would help him thrive.  The TLC worked and he put on some much needed weight.   Their goal was now to find him a home - someone without small animals and who would want a three-legged dog.  I just happened to be working with the group president and because I am always the sucker for a dog in need, we adopted him.

Buster has no idea he has three legs and it doesn't impact his life much at all.   He's happy, plays, and loves everyone.  He is very attached to our clan... our other dog, my husband and myself and if someone isn't home, he will whine and stare at the door.  (OK, so the whining is less endearing but I just have to deal with it.)  I can't imagine the mental state I would be in after going through as much as he has.

The canine ability to live in the moment, while I know it's not something they consciously decide to do, is really remarkable.   I try to remember to not worry about what's happened or what may happen in the future and just live in the current moment and enjoy the "now".

Where the *bleep* is spring?

Alrighty, Mother Nature, enough.   It's 40 degrees, overcast and damp.  I suppose I should be happy it's above freezing but c'mon, a little sunshine would be nice.   Ugh.

You know how I was saying that I'd strung together a series of days with minimal pain?  Well, that ended.  My hip has been particularly cranky the last two days now.  Started off with some pins and needles in my hip flexor (not sure what that's about), some locking and feeling tight and now just a general overall ache.   It's my day to aqua run which is good because I'm not sure I could do any full weight bearing exercise comfortably.

I'm working on my list of meals/snacks to pre-make and freeze.  So far I have:
- Spaghetti sauce and meatballs
- Chili
- Shepherd's pie
- Chicken curry
- Beef stew
- Pre-marinated chicken breasts (thaw and throw on the grill, easy!)
- Pizza crusts from Udi's (ok, I'm not making these but they will be handy)
- Banana bread
- Applesauce (homemade applesauce is the BEST!  I make mine with sweet potato for a little added substance. Yum.)

Hmmm, what else?

Tick tock, one month!

Surgery is one month away.   In four weeks, no longer will I be injured...  May 2nd will mark the start of the "getting better" phase.   Hooray!

I have started with the second guessing this week.  I suppose it's completely normal to doubt a big decision.  I have days of no pain at all and wonder why I am going through surgery.  Those days are usually followed by a day where I can't stop complaining about my hip, but I managed to string together a few good days right in a row and really was questioning things, but I have to remember that I'm babying my hip a lot - and not really operating under "normal" circumstances.

I purchased an in-home mounting system for my TRX.   I'm trying to plan out a location on my first floor where I can mount this thing on a ceiling and it doesn't look like hell.  I think it's going to end up mounted in the living room because there's really no other spot for it that won't require me to hobble up and downstairs during rehab.

The nice thing about the TRX is that you don't have to be seated to use it, unlike a lot of other upper body equipment.  I am thinking this will be a nice option to have post-surgery.