FAI (Femoro-acetabular Impingement) & Karate

I am really feeling like my right hip is healing so much faster than the left did the first week.  I am trying to put only minimal weight on my right leg.  But it is frustrating.  I am now up to 100 degrees flexion on the CPM (the automatic leg bender/stretcher device), which I am running for most of the night.  At that angle, the “Game Ready” ice-water leg-wrap gets uncomfortable, as it tends to bind at my hip.  So I am now putting more time into icing at times other than while in bed strapped to that machine.  I think this is a much better strategy.  The only way I could really improve on my current arrangement, I feel, is if I had the icing machine at my office… I had my kids here all weekend.  My mother flew back to NY last night. Chasing after them was not bad at all.  Of course my kids are awesome most of the time anyway. But they really seem to show concern these days, making sure they don’t run into me from a full run like they often have, for example.   Dr appointment will be in a couple days.  At that time, we will discuss the physical therapy plan.

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Day 5 of hip surgery 2: I feel fine, physically.  I really feel like I should be doing physical therapy.  But the doctor told me to hold off for at least another week.  So I am biting my lip, so to speak, trying to move as slowly and carefully as I can, planning to keep these crutches attached to me for many weeks.  I regained my appetite within a couple days of the surgery.  So since I am not able to do almost any exercise yet (I plan to start upper-body workouts this weekend, but many of those can irritate my hip region) I am hoping that I can at least finally push to a new weight record during this rest period.  The most I have ever managed to weigh has been 153lbs.  I am within a pound of that now.  So this may be my chance…

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What I wrote a couple days ago, the night after the surgery, about not being in pain… You can forget that.  I couldn’t sleep almost at all Monday night; less than 2 hours in total.  It was quite bad.  I took 3 of the pain-killers between 3am and 11am and the pain continued through to the late afternoon yesterday.  The good news? I’m feeling MUCH better now.  In fact, it is very hard to believe what they told me at the post-op Dr’s visit today…

I had a microfracture.  That means I am supposed to be on crutches (20 lbs max weight on right leg) for 8 weeks.  I am also supposed to continue to use the leg exerciser and ice for 8 weeks.  And they suggested that I hold off on going back to physical therapy for a couple weeks.  This is obviously going to frustrate me considerably. I am cancelling a family trip, a trip to Japan for Karate and will have to make a few changes  in my plans for my hectic March seminar schedule. Better safe than sorry, though…

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Left hip: 7 weeks
Right hip: 1 day

Got up early this morning (actually later than my normal work day, but 5:40am may seem early to some people) to take a shower with special cleaning sponge supplied by the hospital. Patients going into surgery are required to shower this way the prior night and again in the morning.  The goal is to keep the patient’s bacteria to a minimum, as much for the sake of the other people in the hospital as for the patients themselves.<>  I arrived at the hospital, with my mother who is here yet again to help with driving and various things around the house for a week, by 6:30am.  As last time, various people came to see me to explain the machines I would/might need to use for the next few weeks.  The anesthesiologist gave me  a “special cocktail” on the way to the operating room and I was completely out before I got there.  As last time, I was again very slow to recover.  I did not leave the hospital until almost 5pm.  I did not throw up this time.  But I definitely did not feel great, either.  Last time, I couldn’t manage to eat anything the day of the surgery.  This time, I ate some soup and oatmeal.  I don’t feel the need for any painkillers (yet?).  But they are next to my bed, just in case.  I have already gone a couple rounds with the special wraparound icepack/machine.  In a few minutes, I will strap myself into the leg-exerciser to run it all night, while I go through some more icing for as long as I can take it (it’s really cold in this house so I don’t want to get myself sick).

The good news: this hip actually feels like it is in better shape than the other one was immediately following the operation. The bad news, however, is pretty bad for me.  Anyone who knows me will understand how frustrating this is for me. Before the first operation, they told me that there was a high chance I would need to be on crutches for 6-8 weeks.  But it turned out to be just 2.  This time, the probability seemed to be for just 2 weeks again. But my mother told me that the doctor spoke with her while I was recovering and told her that I will be on crutches for 8 weeks.

Of course I will do what the doctor tells me.  I will be going in for my post-op visit in 2 days and will discuss the recover plans then.  I am confident that I will be able to recover as quickly as possible.  But I am realistic about not pushing so hard that I risk ruining the operation, as I did with my ankle almost 20 years ago.

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My right hip surgery will be performed tomorrow morning. It will also mark 7 weeks since the 1st surgery. I am still feeling some pain and limits in flexibility. But, overall, I feel that I am continuing to improve; just not as noticeably from day to day anymore. Taught Karate in the morning at my dojo yesterday and then at another dojo 2+ hours away in the afternoon. I probably will not be back to the dojo for over a week.

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I am now definitely at a pain level better than I had been since well before my surgery. I may never be rid of my hip pain completely, due to the irreversable deterioration of the cartilage. My strength and stability continue to improve. I am sometimes frustrated with my recovery rate. But my physical therapists tell me that I am way ahead of the curve. I have been doing 90-minute sessions with them twice/week, working up to slow jogging this week that involved the therapist tugging at me from behind while holding onto a cord.  In addition, I am training/teaching twice/week at the dojo, spending about one hour at workouts at the gym once or twice per week, and doing plenty of extra exercises in between at home.  I am not neglecting my upper-body in workouts at the gym and dojo.   6 sets of 20 pushups on Thursday, for example, and an assortment of exercises at the gym.

<>Surgery on my right hip is a week from tomorrow. I would think that I should recover from that one even faster, since the condition of my right hip has never been quite as bad as my left. But what worries me and the therapists the most is that my left leg/hip may not be completely ready to support all my weight immediately following my 2nd surgery. I suppose that really shouldn’t be such a problem, however, since I will have crutches to help. Major Karate activities to take place 5 weeks after the 2nd surgery. So I will need to recovery quickly…

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I have been feeling grinding in my hip since a few days after the surgery.  As my range-of-motion increases further, I have been getting a little more of that.  But it doesn’t hurt and I am told by the professionals that this is nothing to be alarmed about and is not necessarily unhealthy.  I have also felt some other sensations recently in my left hip; some good and some not-so-good.  Only a few times have I felt sharp pain.  One thing that feels good, both physically and emotionally, is the occasional “pop” of my hip.  I hadn’t had a pop in my hip for years, since the arthritis started taking its toll on me.  I went for the MRI on my right hip today.  Man, that machine was even louder than the previous two MRI machines I’ve been in!  At least they gave me earplugs AND earphones (not connected to anything) to help reduce the noise.  I ended up falling asleep about 20 minutes into the 30-minute sequence.  I worked out at the gym tonight.  I had physical therapy two days ago and will have another session tomorrow.  I need to get my left hip strong enough to support all my weight and be able to do all the maneuvering following the surgery on my right hip in a few weeks.

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To better prepare for having all the weight off my right leg for a while post-surgery 3 weeks from today, the physical therapists are pushing me harder in my exercises.  I feel a little ashamed to admit that I couldn’t last the full minute on the last couple sets on the leg-press.  But that was following an hour+ of various other exercises.  They know that I like to be pushed by them and that I push myself really hard.  They seem to enjoy torturing me almost as much as I do… 🙂

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Today, I set up the surgery schedule for my right hip.  It will be Feb 4.  Might as well get it all done…

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Day 23: I continue to get better every day.  I taught Karate again this evening.  I didn’t do much of it myself.  But I was able to do some punches and blocks from a relatively high stance (I realize, however, that my “high” stance is considered by many people to be “normal”).  I have only a slight limp left and even that is probably not obvious to some people.  I plan to go to the gym tomorrow for more stationary biking and on Thursday will visit the physical therapist again.  I called the doctor’s office yesterday and today, asking if I could get scheduled for early Feb surgery on the other hip.  I hope they get back to me soon.  If he cannot do it until mid-February, I will probably have to postpone it until at least May, since I have some very major Karate activities planned for March (I am organizing the biggest gathering of Japan-trained westerners ever) and April (trip to Japan where I will bring up to 15 people with me).

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