Preparing for Surgery

After the followup where I talked to the surgeon and he verified that at this point – surgery was the only long term option. I could spend more time in PT and maybe extend my walking time but running, not likely. Since this is preventing me from doing things day-to-day there was really no choice.

He would go in arthroscopicly and shave down the bone, cut off dead labrum tissue, clear out any floating bits, and sew down the live tissue. If he went in and saw really bad arthritis he would likely pull out and schedule me for a new hip. Here is a video (not gross)

We talked about the risks. Mostly standard stuff, but the big one i didn’t know about was possible numbness in the perineum area/groin. During surgery they are going to pull my hip out of the socket so they can get in and work. Holding that position could cause a variety of problems with numbness but in almost all cases it resolves. Sometimes days but it could be weeks or even months.

No weight bearing 4 weeks, no running 3 months, and I would be back to FULL training by 6months (assuming nothing odd happens during surgery). Since he knew my background, I tested him and said I would like to do something “short” like a 5-6hour marathon next fall. He didn’t blink an eye and said for 6months I was HIS and then my coach can take over. 12months should be plenty of time based on my history, so he said he had no concerned. Half distance Tri (70.3) – even less concern. Full distance Aquabike? (2.4mile swim, 112 bike), even less.

He was very clear:

  • those first 4 weeks are extreme-nothingness.
  • 1x/wk PT for 4 then
  • 2x/wk PT for 3-4 months minimum.

The hardest, he warned would be that first 4 weeks. I can confirm this is indeed true. The desire to get back to being independent, being active, and doing too much is extreme.

Since I had to do the surgery at this point I wanted to get the ball rolling. However, it took more time to get a date. Insurance approvals for the 3d CT Scan for the bone shaving, approval for surgery, schedule CT, schedule surgery center, make sure Anesthesiologist is covered by insurance (this was harder to verify than you would think), find a PT place who I could go to AND who would follow Dr B’s very specific PT protocols. 5 weeks more!

Setting up my living space was another challenge. I talked to dozens of people who had the surgery and got some great tips.

Here are some of the big ones:

  1. Raised Toliet Seat – the less you have to lower yourself the better. Go try to sit on a toliet today with ONE leg.
    toiletseat(I took the handles off – they were pretty narrow for our space)
  2. Safety bars in shower – I have two clip on bars. I cannot put my full weight on them but I can use them to stabilize myself. I bought 2 and figured out where to put them in my shower so I could get up.
    bathgrip
  3. Shower Brush – yeah, you have no range of motion at first!
    brush
  4. Shower chair.showerseat
  5. Saran Wrap Press and Seal (specifically). For covering the wound during shower – Cannot get water on it for 2-4 weeks.
  6. Recliner. I have an oversized Lazy Boy recliner, with vibration, which was my bed for a couple weeks during my last surgery (abdominoplasty). WORTH EVERY DOLLAR! will probably spend 3-4 weeks in this it is so comfortable.
  7. Hospital table – an adjustable height table (see below) – the treadmill did a good job holding my crutches when not in use.
    img_1608img_1757
  8. Secondary small tables to put stuff on – I have 3 – one for meds, CPAP, noise machine. One for ice machine. One for cooler for ice to refill ice machine. I am surrounded in tables!
    img_1760
  9. Lots of small pillows.
  10. Small Fan. For me at least, coming off the heavy pain meds I sweat bad.
  11. Socks. Yup, even a polar bear like me needs them. Your feet get COLD!
  12. Lotion. Both my feet were numb, the left for 2-3 days and the right still is at day 10 – but as it heals it BURNS. Lotion helps. Big thanks to one of my sponsors SBR Sports! I used the same lotion I would use for dry skin during the winter (swim team + chicago winter = dry skin!)
    triswim_lotion_2015_grande
  13. No steps. Steps are the worst. I am living downstairs for at least 2 weeks, probably 3. Just not worth the risk.
  14. A wide mouth bottle with a cap (to pee in) – for the ladies, a Lady John. And a towel to clean up. It is not dignified but better than waking your loved ones to detach you from all the crap you are connected to overnight and help you get to the bathroom because lets be honest – if you are like me you will have to pee 3-6x/night for a week. They pump you with fluids and those fluids need to come out. Getting up is a 10-20min adventure that first few days/week. Not worth it. PLUS: If you groin/bladder is numb, you won’t know you have to pee until you REALLY REALLY Have to pee and you cannot wait! Should I thank my sponsor Powerbar for this one?  LOL not exactly the intended use!
  15. Grabber – because otherwise anything on the ground is dead to you!
  16. gripper Leg Lifter -I had big plans for this one, but honestly I am not sure it was terribly useful. It worked getting into bed, but not into the CPM – the angles were all wrong.
    leglifter
  17. Snacks – best to have some so you don’t constantly need someone to get you something! For me it was saltines, peanut butter, small bags of nuts.
  18. Blanket/Sheet – I haven’t used the blanket yet – the sheet + my own heat has kept me plenty warm at night
  19. Cooler – for ice so you can change it yourself.
  20. String bag – hey guess what? you cannot carry anything with crutches
  21. Drink/Coffee mug (sealable) – Put this in your string bag and you are mobile drink carrying patient!
  22. Wheelchair – if you can borrow one, do so. There are lending places all over, for a small donation (based on your ability) they will lend you one.
  23. Laptop/Ipad and LOTS OF CHARGERS – put chargers everywhere you will “land”
  24. More tables for ice machine and cooler.
    img_1758

Medical Equipment

  1. Ice Machine. The GAME READY is the BEST THING EVER! Insurance did not cover the $395 rental (I am fighting them still), but this does compression AND ice and automatically turns on/off so you can sleep on it. Reducing inflammation is huge, you need this! I could not justify the $3,000 purchase price.
    gameready
  2. Calf Compression socks. These suckers inflate and deflate to keep blood flow going in your calves. Feels good actually, especially the first week. They are to prevent clots. You will NOT be using the calf on the bad leg for a while – you need to move them.
  3. Brace – keeps you from 0-90 and is a big red flag to the public- STAY AWAY wounded person! You would think crutches were enough… nope.
  4. Crutches – I ended up getting a normal pair, but also got a pair of Mobileleg Ultras – I LOVE them but the catch on my brace – so until I can figure that out. However, this is another common item you can borrow and return. Or in my case, insurance covered the standard ones but not the special one. I plan to donate mine to someone else (and still keep a pair in the house just in case!)1-pair-of-mobilegs-ultra
  5. Wheelchair – for later in recovery, this is way easier to get around and to get people to STAY AWAY from you. You would be surprised how many people have one you can borrow instead of buying.
  6. Compression Stockings – these are super sexy, but they help prevent blood clots while you are inactive
    img_1750
  7. CPM – Continuous Passive motion machine – you put your leg in there and set the movement range (started at 0-20degrees for me and I increased 3 degrees every time I got in until 90). 4 hours a day… ug! Place in front of a TV!

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STRENGTH

After talking to others, it became clear that strength of the upper body and glutes on the good side were key. So I spent time doing 1 leg squats and practiced standing for about 2 weeks prior to surgery. Luckily, both of these were pretty strong. But ask yourself, how many 1 leg squats can you do? If you cannot do 10+ in a row, you need to work on that!I also got crutch training 1 month (not 1 day before as instructed) before surgery and practiced them daily. Glad I did.

Other stuff I would have practiced (WITHOUT USING BAD LEG) if I had known:

  1. getting in and out of shower
  2. getting on and off toliet
  3. getting up and down from couch
  4. getting up and down from recliner
  5. walking through tight areas with crutches
  6. walking up a single step, tight area, with crutches
  7. walking a flight of steps
  8. drinking some beers and then doing all of the above! Not only do you need to do this stuff with a clear mind, but with a FUZZY ONE!

SUPPORT

You absolutely need someone to take care of you. I am fortunate that my wife has been here and that my boys are old enough (13/16) to lift, carry, haul, clean up, feed, wash, etc. For the first 3 days I was not much better than a giant infant.  If you do not have family, you need to hire a nurse or stay admitted into the hospital. The chances of screwing up the surgery are HIGH for those who do too much. You don’t want to have to do it all over again!

I started stalking some Facebook groups. I am torn on whether this was a good idea. So many folks were complete train wrecks it started to freak me out. I had to really think and look at their situation compared to mine. Once I started getting feedback and responses from Athletes I felt a lot better – without exception they recovered better then the inactive people (no surprise).

Labral Tear Recovery

Hip Impingement Awareness (FAI, PAO, THR)

And of course thanks to my coaches who all have been checking in on me, my social media friends, Team Rev3, and local tri/running clubs. I appreciate it!

FINANCIAL

I have Short and Long Term disability. I got the paperwork and started circulating it EARLY. Employer, Doctor, your portion, etc. It takes them weeks to process this and you do not want to stress over a lost paycheck.  I do qualify for Short and will probably end up on Long term disability as I am unable to fully do my job likely for 4months.Each doctor is different though. If you do not have disability, it is CHEAP and a huge help in times like this. It won’t cover lost billings for me (I am a consultant, so bill hourly) but it will cover my base wages (60% is normal – but remember, you have less expenses and that number may or may not be taxed).

Notify your employer. See if reduced work is possible – hours and/or function. A desk job isn’t going to be easy after this – you cannot sit long periods. Walking is difficult because you are on crutches. Lifting and carrying? Impossible for 4+ weeks. You could be taking 1-3 months off work. This might mean burning your sick, vacation, PTO, and then getting into FMLA (to protect your position). Light duty is, in my opinion a big mistake for the first 4 weeks – just figure out how to take that time off – you will be better for it and your risk of screwing it up will drop dramatically.

I have supplemental (AFLAC). It looks like they will be paying out a minimum of $1,150+ based on all the things I qualify for. Followup visits, surgery, crutches, brace, PT, etc. Review the policy and push for every and anything and just call and talk to them – they are super helpful and not trying to cheap out – the first rep I talked to found $100 that I had missed!

MENTAL

Thankfully, September weekends were amazing. My coach and I talked and the goal was to keep me as fit as possible and to allow my heart to drive my goals for Sept. I spent a lot of time in the pool and doing long bike rides – knowing it would be 6-8months before I would be outside again. I had some WONDERFUL long rides – 3-4 hour rides on the trails, reasonable pace, just felt amazing. I knew going in a strong as possible would help the recovery and mentally allow me to bank some positive thoughts.

No question, it was scary knowing I was INTENTIONALLY hurting myself and knocking myself from training for 6months. But, if you look at it RATIONALLY I was already hurt and would NEVER get better without it. It was the rational thing to do, but still scary. I spoke to everyone on Team Ronbo about it to see what they thought – as I trust them all – and even reached back to some of my prior advisors – and they all agreed I needed to move ahead (and some are vehemently against surgeries – only as a last resort.

Plus, coming from a history of morbid obesity and going to a period of major inactivity terrifies me to the core that my weight is going to explode and I will gain back all the weight. This is a deep fear. When you were as fat as I was, for so long, and you have lost 150+ lbs, gained some back, lost some, this is a big concern.

Well, time flew and suddenly we are ready to roll.

Surgery Day

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