A Doctor as Patient
(Nicole Bullock is a surgeon and doctor from Texas. She is also privileged to be welcoming life on a daily basis. This time around, she is a also a patient. Here is her story of hip hope as well as her recipe for hope and success!)
I'm 43. Gymnast. Dancer. Yogi. CrossFitter.
I have NO arthritis. Surgery confirmed.
That is a result of good genes and healthy eating.
April 10, 2018 – first day towards healing hip pain. 2 anchors and shaving of the femoral neck. Large anterior labral tear with bilateral FAI. Wow!
This was my first surgery.
Looking back, I started having pain about 6 months prior. Maybe sooner. I honestly don't remember how my pain started. I ran my first half marathon in May 2016 and would have some hip /glute pain which I attributed to running. The most significant thing I do remember was not being able to sit "criss cross apple sauce." It hurt. I started to modify activity - lighter weight at CrossFit, props in yoga, less running. I also started seeing my chiropractor regularly. None of that worked, so I started seeing PT through Airrosti. I loved how good traction felt! My chiro and PT did not think it was a labral tear because I did not fit the textbook description of labral tear pain. Even on physical exam, I didn't have labral tear findings. But, after all that and 8 weeks of PT, no improvement, finally a MRI showed a large anterior labral tear of my left hip.
By the date of my surgery, I was having anterior hip pain with walking; going from sitting to standing. Everything was severely limited!
As a physician, I did have some connections about who to see. We have amazing orthopedic surgeons where I work, but none of them do hip arthroscopy! So, I was referred to Dallas. Dr. Joel Wells was the guy I saw. He specializes in hip arthroscopy. Now, that's what I'm talking about!
Dr. Wells ordered MRA and confirmed the MRI findings. He offered more PT and indicated surgery is not always 100% successful. His recommendation was that I should stop sitting "criss cross applesauce"; stop CrossFit; stop yoga and avoid surgery. As that was not an option for me, I asked how soon he could get me scheduled for surgery.
We scheduled a date and I ended up with 2 arthroscopy incisions with an anterior approach, 2 anchors and shaving of the femoral neck for the FAI.
I went home the same day even though I had a 3 hour drive home. We stopped and ate about 45 min into the trip. Got out of the car, threw up, then ate a bowl of Pho. I meant to stop half way home to change positions, but I slept the whole way home, never moving, laying reclined in the front passenger seat.
One of my decisions was to rent the Game Ready Ice machine and I used it a lot (every few hours for the first month). I was on 2 crutches and completely non-weight bearing on my left surgical side. I bought a giant u-shaped maternity pillow to keep from rolling over at night. Ugh, it made me so hot. I was able to start my active healing as I started PT on post op day 2 or 3. I have the best PT in the entire universe!!!!!! Just making sure you know that! She did some manual massage, recumbent bike, upper body strength. I felt like we did a lot and I advanced quickly in PT even while still on crutches.
I am a rule follower. I was super compliant with instructions and with PT at home, ice, taking vitamins, eating healthy, etc. I was given Naproxen (which is an anti-inflammatory NSAID) for a month, but told it was to prevent scarring/bone spurs from forming.
I had NO post op pain. None. Literally none. I was taking the Naproxen, but I never took a narcotic.
One of the most important PT assignments I did immediately post op was flexing quads and glutes. laying, standing, whatever I was doing, I would flex my quads and my glutes. It seemed silly and pointless, but I am pretty sure this is what prevented muscle atrophy. In fact, I had no atrophy of my surgery side.
I kept going to CrossFit. 3-5 days /week as I worked on my upper body and core strength. I have years of experience, am a certified coach, have good coaches AND double checked with PT. I was safe. I think this helped my sanity and my overall recovery. (Listen to your doctor, though)
Because I have been doing a Paleo diet for 10 years, once my surgery date was set I ate super clean /Whole 30. I figured this would decrease any systemic inflammation I might have lingering and could only help with post op recovery. I also continued eating clean post op.
Besides PT and clean eating, I took 2000-4000 mg fish oil; glucosamine/chondroitin; turmeric; and magnesium post op. Ice, ice and more ice. I also did PEMF (pulsed electromagnetic field therapy) 2-3 days / week for the 3 months, then about 1 week or as needed after that.
I was still on crutches when I finished my 200 hour yoga teacher training. My instructor likes for us to teach off our mats , walk around the room; teach with verbal cues, not by demonstrating. There is nothing like being on crutches to get you to teach off your mat.
Besides loving yoga, I am an OB/GYN. I took 4 weeks off from office after surgery. At 2 weeks post op, I did start covering my own labor patients. My husband drove me to the hospital so I could deliver the baby. I'd take the elevators and crutch around. I sounded like a pirate. When I returned to my office, I kept the patient load pretty light, but worked my regular hours. I was still on 2 crutches when I started back to work. Scrubs and a fanny pack. I was on 2 crutches for 8 weeks and 1 crutch another 4 weeks. I was told to not stop using crutches until I could walk without a limp. So, that's what I did. 12 weeks with crutches is a long time. I did not have a limp.
By about 6 months post op, I was no longer restricting any movements or exercises. At 9-10 months out I was working back to heavier weights and not scaling as much. At 9-10 months out I was working back to heavier weights and not scaling as much. I still can't match my 1 rep max for my back squat, but I'm hoping next month I will! Hope!
Now, I am almost 1 year out. I have my follow up appointment with my surgeon next month. I'm anxious to see what he thinks of my recovery. I am still doing PT about 2 days / month. Dr. Wells said he would approve PT for a year, so I took it!!! I see my chiropractor regularly. I still do PEMF about 1 day per month
From a physician stand point, it's good to be the patient sometimes. This was my first surgery. My first IV. My patients loved hearing that. I wanted to remember being in the OR under the OR lights but that Versed kicked in while in pre-op and all I remember is being wheeled out of the pre-op holding area. Kinda bummed about that. I wanted the patient perspective of the OR. As a patient, trust your surgeon (if you don't, find a new one!!!).
Follow the rules. Be compliant with meds, follow up, PT, recommendations/ instructions. They have seen this before. They know what works. They really do have your best interest at heart.
I've had a good recovery, but it was a slow recovery. I'm back to all my usual activity. My left side doesn't feel like my right side. It's not enough to register on the pain scale, but I can't call it normal either. "New normal." I still don't like sitting "criss cross apple sauce" but, I'm hoping that with more time that will still continue to improve.
Take home, it's a slow recovery.
My Recipe: Be patient. Be compliant. Find a surgeon you trust. Find a surgeon who specializes in the surgery you need. Even with a good recovery, you may still have a "new normal."