Saturday, September 22, 2012

My Physical Therapy Experience

At this point I've been to a variety of physical therapy offices and I now understand the importance of doing your research.  But when my pain first started, I picked a sports med doctor purely because it was closest to my office. They referred me to their own PT practice which I hated. Sessions were short - 30 min including ice, and didn't incorporate any exercises for strength. My therapist was strange and very negative.  She was extremely anti-surgery and told me that she herself has hip pain but is not interested in having diagnostic testing because she "doesn't want to know." That puzzled me and turned me off.  I didn't want to continue seeing this therapist, but I didn't know how to 'break up' with her so I just kept going.

After my MRI-arthrogram results confirmed a labral tear I decided I needed to take more serious action, so I stopped going.  My best friend Amy, who works as a physical therapist, had just completed a course earlier in 2011 to become a certified hip specialist with Hospital for Special Surgery (HSS). Her office was all the way out in Forest Hills, but I wanted to go to someone I trusted so I decided to tough it out and make the trek.

Best. Decision. Ever. 

I admit, I might be biased, but I do think that Amy is a fantastic therapist who really knows her stuff. Sessions with her were 1.5 hours most of the time, including hands on manual time as well as a bunch of strength training exercises which really helped me get ready for surgery. I saw her from January - March 2012. After my first surgery, I wanted to continue to see Amy, but I knew I wasn't going to be able to manage a trip to Queens twice a week on crutches. I decided to find a place near my house (Nassau County, LI). 

Hospital for Special Surgery provides a list of preferred therapists depending on your type of injury or condition. For hips, this is essentially a list of practices that have a therapist that has completed the hip specialist course (like Amy). I checked out the local list and found one that included a pool for water therapy. I figured that would be awesome, and decided this was the place.

Reading about other people who have gone through these surgeries online, its interesting to see the differences in when PT is prescribed by their surgeons. My doctor prescribes PT immediately, to begin on Day 3. I've seen some people say their doctor held off on PT until 2 weeks out, and even some people who wait until they are 6 weeks out and done with crutches before beginning PT.

At first I was horrified at the idea of PT so early on. At the time of round 1, I thought it would be at least a week before I was supposed to leave the house. My surgeon surprised me on the morning of the surgery by giving me a script for PT and telling me I should schedule it for Wednesday - 2 days later.
I was nervous I wouldn't be able to book an appointment on such short notice (I hadn't thought to plan ahead). Luckily, the place I had in mind had space for me with 'hip specialist' PT.

If I had to grade my first post-surgical PT experience I would give it a B. The facility was large, and well stocked with equipment. There were a lot of assistant therapists to help out and everyone was very nice. There was the pool, which was really a big hot tub, but still allowed for water exercise. 

However, the therapists were not aggressive. I think that they worked mainly with older people, hip replacements, that kind of thing. Not young athletic women who want to be aggressively rehabbed back to shape. I did not get the impression that my therapist was a 'hip specialist'. I don't think he ever saw anyone who had impingement before or a labral tear. The worst part was that nobody there was a runner. One assistant told me he actually hated running and didn't understand why people like to run. What?!

I went dutifully and made progress, but whenever I discussed my therapy with Amy it was clear there was a lot I wasn't doing and I should have been further along that I was.  So, when they told me in early June that my insurance company was trying to shut me down I wasn't that bummed.  

Instead of fighting my insurance company for more, I thought I would try rehabbing myself. Not my best plan. It was tough to carve out the time I needed, when I wasn't actually going to an appointment. It also didn't help that my right hip was bothering me more and more.

Mid July I began seeing Amy again. First it was to try to get my right hip feeling good enough to begin running again, but when it became clear I was bound for surgery #2 the focus switched to getting the left ready to do primary duty.

With surgery #2 on the horizon, I knew I needed to find on new place on LI. So what lessons did I learn from my previous experiences? Research the places! Call around, speak to the therapist you would work with, ask them how often they have people come in with FAI/labral tears? what are the outcomes? how are they qualified? do they treat young people? It seems so obvious, I know, but until this round, I hadn't bothered to do any of that.

I ended up choosing a PT that is both a gym and a sports therapy office. The owners are the therapists and they are both athletes. They have a pilates focus which is something that I want to explore when I am well. I was also able to speak with my PT before hand and was really confident that I would be in knowledgable hands. Its not the closest office to my home but I think it will end up being a good fit. Only time will tell.

Thursday, September 20, 2012

Post Surgery - Day 1

Today is Day 1 post surgery (right hip arthroscopy with labral repair). I woke up early and was actually pleasantly surprised by my pain level. I was in so much pain yesterday after the epic cab ride home that I thought I was in for it today. But I would rate the pain at a 6. The cold was actually bothering me more than the leg. I woke up in the middle of the night around 3, maneuvered my way to the bathroom pretty easily and then took some drugs. Went back to sleep after that pretty easily.

I was eager to get on the CPM machine to get some movement going. Derek set me up, I ate some omelet while I watched Breaking Bad on Netflix and then passed out. Napped through most of the 2 hour session, then had Derek switch me to ice machine.

The rest of the day was filled with frustrations.
Feeling great, I was eager to get some work done. But, when i went to start up my work laptop, it wouldn't start. I tried multiple outlets, but nothing. Huge bummer.
I also discovered that my antibiotics didn't make it home from the hospital with me. Not sure how that happened. I called the emergent care clinic that prescribed them and they blew me off.
Called GameReady to find out how to program my machine to cycle on and off and found out I didn't get that type of machine. Apparently its random which one they give you. They did offer to ship me the programmable though so I can switch.
Derek had a lot of work stuff scheduled today so he was swamped and not able to focus on me. So of course I dropped, and spilled and got stuck. I even knocked two full toilet paper rolls into the toilet. I had a few pity parties/tantrums over the afternoon.

CPM round 2 around 2pm for 2 hours. Followed that up with several rounds of ice machine.

Took a round of medication at 11.
Felt really nauseous  and thought that i might actually throw up. Took some Zofran and it passed.
Took another round of meds at 5.

Its 10 now, and I'm definitely ready for pain killers. Holding off so that I can take it right before bed. The pain is at a 7.5. Its on the outside of the leg.
First day of physical therapy is tomorrow. New place - I'm nervous!

A few observations so far:
-the raised toilet seat was THE BEST thing i have ever purchased. It has made going to the bathroom so much easier.
-its much more difficult to maneuver my right (freshly operated) leg with my left, than it was last time around. I have a lot of weakness in my left. I am going to have A LOT of work to do in physical therapy.