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FAI:The Great In Between

I’ve read so many horror stories on the Facebook FAI pages that I have a hard time believing how my situation is going to turn out.  You could say that I have accepted that I probably won’t be able to do many of the wilder things I’ve been doing in the last few years.  But, that’s not such a bad situation if that means one can do 90% (aka more normal things) of what they used to do. 

However, this past week, someone from a snowy climate posted that they went skiing for the first time since surgery and indicated that their hips might have even been ready at 5/6 months post-op, if there had been snow.  I was so relieved to read that post.  It means I have hope that when this is all said and done, I will do what I want to do.  

Surgery Day- wake up and take last shower for days where I also shaved my legs for the last time until further notice, arrival at outpatient, get into gown with a plunging back so low it looked like a hospital gown, get super warm and cozy blanket from the warmer, have super sexy thigh high Ted stockings put on, make joke with nurse about eating SPAM, kiss the husband good-bye, talk to anesthesiologist about nerve blocks and good knock-em out drugs, talk to Dr. Komanduri and ask him if he’s had his coffee yet, yes, that’s why he was late, go to OR, transfer to weird looking table then have all memories erased, ask husband three times “how long have I been here?”, finally come to – sort-of, attempt to pee in bed pan, continue to lose memories, fall asleep on drive home, too woozy to use crutches so I used a wheel chair, got into bed, ordered 10 piece chicken McNuggets meal, devour meal, sleep, use ice machine for 6 hours straight, watch This Is Us with K-man, say a cheery hello to my friend who made lasagna for us to eat, go to sleep, again. 

Up to 3 weeks post-op

I don’t have the brain capacity to recount the last three weeks post-op chronologically so I’m going with the main points. 

For me, the pain has been minimal. They said the nerve blocker would only last 12-24 hours. I couldn’t tell you when the nerve blocker wore off.  However, I have malfunctioning nerve endings.  Which means that there are plenty of times when I don’t feel pain properly and sometimes when I can’t feel at all.  I’m not pain free, it’s just very minimal pain. I don’t think I’ve ever been above a 3 on the pain scale this whole time. I also used the ice machine for nearly every minute the first several days. 

On the other hand, when I moved, I had someone help me move my leg so that I wouldn’t cause any pain or cause anything to go wrong, like, when I needed to pee, and that need occurred often in the first day or so.  Over the following few days, I could tell my hip was getting stronger so I slowly transitioned away from needing help to moving it on my own. 

When I was up on my crutches, I moved a little more. My doctor put me on 10 days no weight bearing restriction with a brace that only allowed me to bend my hip joint 70 degrees.  I found that when I was on crutches I could swing my leg, just a little, without any pain or other indicators of illadvised movement.  So, every time I peed, I made sure to swing my thigh back and forth and even in small circles. 

I elevated my feet constantly the first 5-7 days. I did not have any swelling. 

While I was laying about the rest of the time, I read up on blogs of others who have been throughout scopes for FAI.  The post-treatment ranges on what patients are allowed to do.  An example is some doctors saying no crutches are necessary to some saying 4 weeks on crutches.  About the time I hit 5 days post-op, I was ready to move.  I woke up in bed with an aching back. I decided that I would do two things. 1 I would do some of the exercises mentioned in blogs where PT started immediately after surgery. 2. I would make broccoli and cheese soup for dinner.  1. The exercises included things like slides, raise up on elbows, cobra, prone glute raises, etc. 2. The soup included so much cheese it might be better called cheese soup with broccoli.  

When I finally got to start PT, I was so anxious, I called ahead of time to make an appointment for the same day as the doctor’s follow up so there would be no further delay in my active recovery.  The follow up appointment was very interesting. The doctor walked in, asked me how I was doing then opened the door and told me to walk down the hallway.  No brace. No crutches. I was not expecting that but I was excited to try it. I was as graceful as a two minute old foal.  Doc gave me directions to use crutches as needed.  I went directly to Walmart and drove the amigo while I shopped.  Who wants to be a foal in China shop? 


I am now one week pre-surgery #2. My right hip is doing great.  I’m walking around home with no crutches. I’m still icing for hours every day to keep all inflamation at a minimum as I push to get stronger. The therapy isn’t what I expected but, today, my PT added some exercises and stretches.  It feels good to graduate to the next level. I even drove to PT today which was 5 minutes away.  

I’m beginning to think about everything I have learned from the first time around.  I worry and fret that #2 is going to crash and burn or I’ll tear up #1 in the process.  I’ve trusted my doctor thus far, I no reason not to now.  I started working with my pull-up bar at home to strengthen my shoulders, arms and hands for a second go on crutches.  I worry but I am ready. 

At home exercises for PT–Flex/point toes, glute sets, hamstring sets, quad sets, squeeze a pillow between knees, pelvis rockers, bridges, seated leg raises, raise up while on stomach, slow buttkicker while in stomach.  

~2 weeks post op. 3 little holes.

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FAI : The Road To Surgery

I want to share my story with others trying to learn about FAI and arthroscopic surgery.  However, I think there will be some advantage to walking through the steps so that I have the same confidence in my decision that I made in September.  

It started in the chiropractors office.  My chiropractor took x-rays of my lower back and hips.  She decided that she didn’t like something in the x-rays so she sent me over to MK Orthopadics to see the hip specialist. It turns out that whatever she thought she saw in the x-rays was nothing at all. But, I’m glad she sent me because Dr. Komamduri replicated my pain without even thinking hard about it.  He showed me the X-rays and explained what FAI is.  What the X-rays couldn’t show is the state of the labrum. We’d have to do an MRI with contrast dye to find out if the labrum was torn. 

Within a couple of days, Dr. Komanduri’s office had me back for an MRI of my hips.   Each hip was done separately.  So it took about 4 hours total.

 Never having this done before I was naive about the process. The contrast dye is injected into the hip. I don’t know why but I thought that would be done through the fatty part of my hip. Instead, they inject the dye, after a numbing agent, through the groin directly into the hip joint. Duh, I know, but I’ve never thought  much about anatomy.  In the process of getting the dye into the hip, the PA hit a nerve that sent a sharp pain down the front of my thigh. It wasn’t so bad on the right hip but she had trouble finding the mark on the left hip, so,  she went across the nerve several times and caused several tears to fall. She had to pull out the needle and try a second time.  She gave me more numbing agent so the second time I ended up not feeling a thing.  In addition to the dye, they shoot saline into the joint to expand it for better MRI views. 

The injections are done in a sterile room.  After removing the needle, she put a band-aid over it and said, “I just put a hole directly in your joint.  Leave this on for 24 hours.” followed by a direct look that warned me not to screw this up.

Walking over to the MRI with my expanded hip was no problem.  Laying on the MRI table for an hour at a time was a big problem for me. FAI patients commonly have SI joint pain (high buttocks /lower back). I was packed into the MRI machine pretty tightly so there wasn’t anyway to get relief until it was all done. 

When I scheduled the MRI, I asked if I would be able to drive myself home. The boys had a bunch of after school activities, so,  I didn’t have my husband come with me. Yes, technically, I was not drugged. Between the pain of the saline and contrast dye and the stiffness from laying on the table for several hours, I would have preferred to have been able to sit in the car with having to worry about driving. As it was, I stood outside my car for several minutes on the brink of breaking down from the thought of getting into a car. Quite fortunately, my pain receded quickly.  Still in pain, I was able to drive home. Within 2 hours, things felt normal for me again.  

A few days later, Dr. Komanduri reviewed the MRI pictures showing a labrum tear on both sides. We discussed that surgery would be necessary to shave off the extra bone causing the impingement then he would reattach the labrum.  Since I hadn’t attempted any treatment specifically for my groin pain, we decided that I should try physical therapy as conservative treatment to see if it alleviated the pain and for insurance sake.  

I’m a believer and practioner of functional fitness. I have followed programs that incorpate similar activities to physical therapy. At my first appointment, my therapist said I was fairly strong in the hips during my initial evaluation.  I figured that was both good news (the programs that I follow work) and bad news (confirming pain wasn’t caused by poor muscle performance).  We worked for 4 weeks starting at a higher level since I was demonstrating good strength already.  However, the key pain areas never went away. 

I met with Dr. Komanduri again and agreed to the surgery.  I tried to fight it but my husband pointed out that I was unable to drive to visit family just 2.5 hours away without having to stop due to intense pain.  Now, it was just a matter of getting insurance approval. Hip arthroscopy is an out patient surgery. My insurance doesn’t require pre-certification. In these cases, because it is an expensive surgery, the office requires pre-determination from the insurance company. It is essentially the same process as a pre-cert but since it is optional, the insurance company takes 30 days to give an answer.  Just enough time to doubt, double doubt and scare myself senseless about what I was about to do. 

A few days before the surgery, I had my surgical clearance physical then was outfitted for the hardware.  The brace wraps around your waist, hinges at the hip and is set at 70 degrees to protect the hip joint.  The brace is also strapped around my thigh.  They put the brace on you when the surgery is done so that it is under all your clothes. I also purchased an ice machine through the doctor’s office. It is not covered under insurance so it cost me $265.  I easily justified the expense since I have two surgeries to deal with and they promised faster healing.  At this point, I was all about securing the fastest track to normality, whatever that is.  

The hospital called the day before the surgery to confirm a 5:30 arrival time. 

Heavy with doubt and worry, I dressed in my comfy-s and headed to the hospital. 

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FAI: I didn’t know

“I didn’t know you were in pain.”

 I did not know either. 

I know that seems like an improbable statement but it’s true. 

First of all, I’ve been this way for so long that I didn’t know that it wasn’t normal.  I have it in my head that because my FAI is in both hips that there must be a genetic influence. It’s not like one day I went skiing and blew out my hip as I failed to performed a radical trick. I cannot pinpoint a day zero as to when the pain started.  So, either I grew up this way or the condition came on so gradual that the change from day to day was undetectable.  As you might recall from my last post, my original treatment goal had been to recover from chronic achillies tendonitis not to find out why I don’t like to sit down. 

Second, I would describe most of my pain as more like an ache than a pain. I rarely take anything for pain management. I’m almost always just uncomfortable.  I assume it’s similar to how most people feel  feel after a very long car trip, only I feel that way immediately when I sit down. 

I feel pretty lucky.  Many of the FAI blogs and members of FAI groups are in terrible pain and need prescriptions to alleviate their pain.  Because I’m not in that state, there are many days when I question if I really need this surgery. I am often told, however, that the labrum cannot repair itself. If I don’t have it fixed now, I’ll have full hip joint replacement down the road when I can’t take any more pain. That doesn’t sound like a very good option to me.  

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I Dreamed of the Motherland – Riga

From the moment that I became part of the Latvian Community in Kalamazoo, I wanted to experience the place that so many of them love.  My family and friends have such a deep connection to their motherland. I wanted very much to share that experience. So, when word came around that Matiss Kukainis was finally getting married AND holding the wedding in Latvia, there was nothing that would stop me from going to Latvia and taking my family along.  

One of the most beautiful cities I have ever visited is the old part of Riga, called Vecrīga.  I’m not sure why but I have a deep admiration for centuries old cities filled with character and charm. Maastricht, Sienna and Vecrīga round out the top of my list. One of the great things about Vecrīga is that very few to no cars drive through the streets of Vecrīga. It allows you to wander through a maze of cobble stone streets while gazing at amazing architecture.  The only thing you need to be wary is of  bumping into relatives coming out of a corner cafe while your gawking at St. Janis church.  

When you run into a cousin (or two) be prepared to be carried along to the next outdoor cafe residing in the shadow of St. Peter’s church, the tallest church in VecsRiga, where more friends will be gathering.  If you are visiting in July like we did, it will likely be a warm (but not hot) sunny day.  Never fear, however, if it isn’t as warm as you’d like, the cafes keep a blanket on the back of each chair for patrons to be cozy comfortable.  

This was an amazing once in a lifetime trip.  But, to make this easy on myself, because I don’t want to forget a thing from my dream vacation, I will recount everything from the beginning.  It might not be my best writing but this is mostly for me so be it.  

Four months before our arrival, I used Trip Advisor to rent a one bedroom apartment.  I spent hours pouring through pictures of apartments finally settling on good location, reasonable price and ability to sleep 4. PK and I stayed in a large bedroom while the boys slept on a couch with a rumble bed.  It was much better than renting two hotel rooms like we had to do in Munich. The agency renting the apartment to us arranged for strees free transportation from the airport. 

We left Minich that morning before lunch and arrived in Riga with grumbling tummies. Our apartment was located a block down from Vermanes Garden with  City Diner on the corner.  Being hungry and new to the city, we figured the first place we found would be just fine.  We didn’t realize our first restaurant, City Diner, would be an American themed diner! It was a little disappointing to have our first exposure to Riga be American cheeseburgers. Additionally, practicing my Latvian language skills was pointless because the waitress was Russian. 

Still, it was early, I was in Latvia and nothing, not even American food, would ruin my dream.  

The next stop was Riga Galleria.  Renting the apartment meant we had a kitchen and we wanted to fill that kitchen with breakfast and snack items to make vacation a little more convenient when hunger called.  The grocery store is located on the bottom floor of a shopping mall.  We wandered through the aisles looking for unusual candies or other interesting items. We filled our basket with salami, cheese and candy then headed to the bakery section.  By far the best part of grocery shopping was that despite it being mid-afternoon, we were still able to buy warm bread from the bakery to go with our salami and cheese. 

After depositing our grocery goods in our rental kitchen, I texted cousin-in-law and friend, Liene, for a meet up. Liene was with the two rambunctious boys and the “nearly still a baby” at the park by our apartment hanging out at the Latvian culture festival while her husband, Rob was with the groom on a bachelor boat cruise. These kinds of moments in the park make you thankful to have family (with kids) traveling to Latvia at the same time. Mik and Karlis ran off to play with the two older boys so that “nearly still a baby” could nap. PK and I walked through the booths looking over authentic Latvian goods like linens, wooden bowls, and amber jewelry promising myself that I would come back to buy every beautiful thing I saw. I regret that I never went back.  

After a little bit of free time for the boys in the park, Liene took us to see the Freedom monument.  Latvia has a long and determined history. A must see landmark is the Fredom Monument. Unveiled in 1935, it honors the soldiers killed in the Latvian War of Independance (1918-1920).  Fortunately, it later survived the Soviet Occupation (1940-1996) and remained a symbol of national independence during those tough times.  The Latvians have such revenence for this monument that no one is even allowed to sit on the stairs at the base of the monument.  It is permissible to leave a bouquet of flowers at the base. 

For Fatherland and Freedom

 The next must see memorial is the surrounding park, Bastejkalns. A canal winds through beautiful gardens.  You can climb the hill to view Freedom monument through the trees.  The winding sidewalks provide ample opportunity for boys to be boys.  In addition to colorful flowers, this park has 5 memorials dedicated to the journalists, the student and the policemen that lost their lives in 1991 when Russian OMON (Special Forces) attacked the building of Interior Ministry of Latvia.  

With some of the energy burned off, we were ready to try our hand at eating once again. This time, we had our own personal Riga tour guide to keep us on the right edible track. Liene guided us to Lido for economical Latvian food.  At Lido, you walk through a buffet/cafeteria type kitchen selecting genuine Latvian food.  In our excitement, we certainly didn’t hold back on the kotlets (cutlets), kartupeļi (potatoes) and other dishes.  I noticed that we had about three times the  number of plates per person as any Latvian in the restaurant which was just enough for this American family!

Since we were still acclimating to the time zone change, we accompanied Liene back to their apartment to let the younger boys have some down time before bed.  We weren’t sitting there for long when Janis, PK’s uncle, leaned out the apartment window across the courtyard and silently summonded PK to join him in tasting some scotch(es).  

Before too long,  I felt that it was time for us to return to our apartment.  I received protests all around but I insisted that we depart.  The sky, still shining bright at 9:45 pm, had deceived everyone in my family except me, but, then, I had an iPhone to tell me the truth.  Riga sits at Latitude 56° 57′ 0″ N.  In translation, there is little darkness in the summer and little light in the winter.  


This is the view from our apartment window at 10:45 pm three weeks after the summer solstice.  

I allowed one stop on the way to the apartment at a convenience store (or what looked like it might be one) to buy a bag of ice.  Let’s just say that ice is a pretty rare thing in Latvia and it would become a moderate obsession of ours to procure ice over the next 10 days. 

I completed the first day of my dream vacation in the Motherland with such wonders to hold already. We collapsed in bed and fell into a fast dreamless sleep only to be woken by mid-day sunlight streaming through the windows at 5 am.  

…Which is where I will pick up the story in my next blog post… 

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My Retail Therapy

My retail therapy consists of going to the craft store and picking out fist fulls of beads.


Then spending the next half hour wandering around the store convincing myself not to buy them. 

The last step is realizing the ridiculousness of this procedure and blogging about it. 

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Munich – First and Last

I stood on the curb looking around the bustling Marienplatz and could not recall one single detail. When I got back to the hotel with free wi-fi, I texted my sister to ask her if we had gone there during our visit to see my sister’s friend, Julian, in Munich in 1996.  

Yes, we had been to Marienplatz but I didn’t remember it. I felt a little sad.  I hadn’t forgotten all of the trip but how much had I forgotten? The trip to Munich with my sister was right after I graduated from Western Michigan University.  My sister and I were full fledged adults doing things our way and traveling through Europe.  It had felt like we were sophistcated and worldly. At least, if I can’t remember all the details, I remember taking that coming of age step with my sister. 

You would think that I would have learned my lesson since it stared me in the face during another momentous trip.  Yet, here it is 6 months later, I’m just now writing down the details of our trip, and I cannot remember what Mikel ordered to drink at the beer garden on our last day in Munich. 

Edit  
Despite how the picture looks, and I love how it looks, neither kid is drinking beer. Karlis has yet another glass of apple juice, the beverage we consumed the most while in Europe. All I can remember  about Mikel’s drink is that it was a mixture.  So, it could be lemonade and Coke in that mug or apple juice and Coke or some other mixture we thought would be strange but was actually quite delicious.    I am, on the other hand, drinking beer. I’m also holding the glass the way Julian taught my sister and me so that the  heavy mug could be held with just one hand. Hey! I remember something else about 1996 Munich.  

Our time in Munich, in 2015, was short and overcast with exhaustion. On the first day, we hadn’t slept more than about an hour. On the last day, we were worn down from 8 days of authentic Latvian experiences.  I refused to let our exhaustion get in my way.  Between the first day and the last day, we visited two museums, toured two platzs, ate two expensive lunches, shopped and drank at the beer garden.  While shopping is far from my first choice of activities, Birkenstocks are so much cheaper in Munich that I couldn’t resist. Whether they are fashionable or not, they are honestly the best shoes for a  variety of foot issues when you just can’t stay off your feet. (Hello! Touring Europe, folks, there will be no sitting down! Just ask my exhausted family!!) 

Getting around Munich – the train system is so stinking easy there should be no excuse for not seeing the city. 

BMW museum– Since 50% of our family are gear heads, it seemed like the BMW was a must-see site. I was right since Karlis took a picture of every engine, car, boat and motorcycle in the BMW museum. The museum has a very modern style which turns visiting a museum into a whole new experience.  Us non-gear heads even enjoyed walking past shiny vehicles and unique displays of motorcycles. The amount of time it took to walk through the museum was just right for an exhausted quartet. 

Marienplatz/ Karlsplatz  – visiting the platzs had little affect on us other than it provided ridiculously expensive lunches from English language menus.  I think next time I would head directly for the beer garden for pretzels as big as your head. The beer gardens serve other foods but they no longer serve stag parties according to the signs. I’m sure Karlstor (Karls gate) in Karlsplatz is usually an architectural delight but we wouldn’t know because it was under restoration so the picture of Karlis in front of his gate was anti-climatic.  

 

Residenz Munchen – I read a lot of reviews complaining that this museum of the royal palace of former Munich monarchs isn’t worth your money because it is mostly replicas of what existed prior to World War II.  Yes, I suppose it would be nicer for it to be authentic but since I had just one day left to expose my boys to an example of life as a German Royal, I’m not going to complain. I have no regrets about spending my money here.  Note- it was a hot July day, so we opted for the shorter route through the non-air conditioned palace.  

 
En garde! 

  
Gaudy but extrordinary.  This fireplace could put the Rose Bowl Parade to shame.  It is made completely out of seashells. 

 
 I don’t remember the purpose of this hall but I got the feeling it didn’t have much real purpose other than to show off. 

Augustiner-Keller- A trip to drink at a Beer Garden in Munich is a must- do. The only question is what type of experience do you want? I once bought my husband a T-shirt that said, “Do I look like a People Person?” So clearly, Hofbräuhaus and the college beer gardens were out of the question. Not to mention, there is a Hofbräuhaus by O’Hare airport in Chicago now.  By the time we got to the beer garden, we were hot and tired. We found ourselves a nice table with four seats in a shaded location. Unfortunately, we were still stuffed from our lunch so we did not get any food.  Our entertainment included watching the ATV truck shuttle tons (metric tons) of gigantic beer mugs from kitchen to beer stand. The relaxing atmosphere was a fitting place to wind down our extrordinary trip. 

Good night, Munich. Good bye, Europe. 

 

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My signs

I’m Sagittarius. Honestly, I couldn’t tell you what affects being born under the Sagittarius sign has on me.  

On the other hand, I can tell you what these signs mean…

Sign 1. I buy Jack’s special salsa for the fridge at work. – it’s an super easy way to put some type of vegetable in my diet regularly. 

Sign 2. I buy a pull-up bar.  – I always need a new way to motivate me to exercise

 Sign 3. I weighed myself and took measurements.  Despite the horror. 

Sign 4. I bought a new water bottle.  An easy way to stay hydrated is to have a water bottle on hand all the time. 

Sign 5. I bought trail mix for my desk at work.  I want a fulfilling snack in the office for those days when I just need a snack. 

Yes, theses are five clear signs that the Sagittarius is still full on a New Years Crackdown. It’s the small steps that are going to keep my on track for 2016. 

But, the number one sign that I started the 2016 New Years Crackdown….

I BOUGHT A LARGE SPECIAL DARK CHOCOLATE BAR!!!! 

  

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