Hip Surgery

 Wow I am way overdue on an update on my hip! It has been a crazy month, that is for sure! My husband and I moved into our new fixer upper house here in Cincinnati. It is not our first home we have owned, but it is our first fixer upper! It has been so much fun to work on the house, but also extremely time consuming! Then my brother moved in with us! I am so excited to have him with us and get to spend so much time together! We haven’t lived together, or even in the same city, for about 8 years so I am beyond thrilled he is here! I also started my summer semester for grad school. I am taking a 5-week intensive neuroscience class, so that has been tons of work on top of my other two classes! All that to say that I have been incredibly busy since my hip surgery!

The surgery itself went extremely well! It was done at a Children’s hospital and they were just exceptional! It was a relatively quick procedure, about 2.5 hours, and they did not find anything that they did not expect to find. They were so accommodating for my service dog Reilly as well!

The surgeon did not end up needing to remove any bone from my femur or pelvis bone, which is wonderful. He did not expect to need to, but we were not 100% sure until he opened me up. If he would have had to take of bone it would have been a longer and harder recovery. He did have to anchor down the cartilage, but we expected that. The cartilage was torn away from the bone, so he basically pinned it down. In addition to anchoring the cartilage he trimmed off the dead pieces of the cartilage. When a tear happens the edges of the cartilage get ragged and began to die. Overall it was a very straightforward surgery and the doctor was very pleased with how it went!

I woke up in recovery and got to my room with no issues. The pain was very minimal and I was feeling pretty good! My hip was more sore and stiff than painful. I did not take any of the strong pain medications that they offered me. I was instructed to take muscle relaxers for 5 days after the surgery and Tylenol for a week. I did this as instructed, but I did not take anything stronger than that! It was a huge relief to not be in a significant amount of pain.

I, unfortunately, have to be on crutches. Even though there is no pain the surgeon wants to give the joint capsule a chance to heal. He had to open the join capsule, which is a sack that contains all of the cartilage and fluids that make up the hip joint, so there is always a chance that this capsule could become damaged if you do not let it heal for an adequate amount of time. I thought it would be two weeks that I would have to be on crutches, but it turns out it will be almost 6 weeks. There was a slight miscommunication with the surgeon’s office regarding the amount of time I would be on crutches, so I was disappointed by that. I still have another 1.5 weeks left on crutches and I am so ready to be done with them!!!! I am looking forward to the day that I can be rid of them for good! I was on them for about 3 months about 6 years ago, so it was very much like riding a bike in the sense that I got back in the swing of using them very quickly.

I go back to the orthopedic surgeon next Friday, so he will do an evaluation then and hopefully clear me to wean off the crutches and start physical therapy back up. I will let you all know how that appointment goes and will be updating about another surgery I have coming up as well!

I leave you with an adorable photo of my service dog Reilly and I in recovery after the surgery

 

Mobility Service Dog Harness

As most of you know I have a mobility service dog name Reilly. He is a 3-year-old golden retriever that I have had since December of 2014. Service dogs are not required to wear any kind of gear stating that they are service dogs, but many handlers choose to mark their service dogs as such in some way because it causes less questions, fewer accesses issues, and makes life easier. I have always chosen to have Reilly marked in some way for these reasons.

I have always used a vest for Reilly in order to identify him as a service dog, but I chose to get a mobility harness for him so that he can provide more support for me. I got his harness from DD Photo and Design who sells on Facebook. The woman who runs the site and makes the harnesses is named Amanda and she has fantastic customer service! She offers many different options and colors, so there is something to fit everyone’s needs!

I am going to take a quick moment to put a disclaimer out there! These numbers are not concrete and ultimately you and your vet should decide if you dog is large enough, healthy enough, and old enough to do mobility work, but these numbers are a rough estimate to go by. A dog who is expected to do light mobility work, such as counter balance and momentum pulling, needs to be at MINIMUM 30% of you weight and 30% of your height (at the shoulders). For heavy mobility work, such as bracing, your dog should be at MINIMUM 50% of your weight and 40% of your height. This would mean if you weigh 150 pounds and are 5 foot 6 inches tall your dog should be at least 75 pounds and be 26.5 inches tall to the the shoulder. That being said I would not use a small dog for mobility work even if you do weigh only 100 pounds! Additionally, your dog needs to be cleared by a vet to do mobility work and is not normally physically ready for mobility work until around their second birthday.

That being said Reilly is tall enough, old enough, and weighs enough to do heavy mobility work for me. This harness will allow him to do more momentum pulling and be more comfortable while doing his job. 

Here is what Reilly's new harness looks like on him. 

 

And here are a couple of photos of the harness off of him.

 

There are numerous features that you can choose from on these harnesses. First, his harness has a Y-front which provides more stability and greater comfort for him as it distributes the weight better than a straight front harness does. I also chose to get a detachable handle. The handle is fed through a couple of rings and clips onto the harness itself. This allows me to remove the handle if he needs to fit  into a tight space, if he will be laying down for an extended period of time, or if I am using my wheelchair and won't needing the handle for a while. It is just convent to have the option to remove the handle if I want to.  I also chose to get a padded handle. The handle has handle, and all of the harness actually, is lined with teal fleece. This just makes the handle all the more comfortable! The next upgrade I made was to have a double buckle put on. This means that I don't have to try to have him step into one side and pull on the other. It has buckles on either side, which means that I just put the front piece between his legs and buckle it on either side of his belly. The harness does have velcro on these straps as well to adjust them. 

The final upgrade I decided to make was cosmetic. I chose to have SERVICE DOG embroidered on either side of the harness itself. This is just one more way to make sure that people know he is a service dog and hopefully prevent people from coming up and trying to pet him! I also chose the teal color, but Amanda has a bunch of colors to choose from! I thought the teal looked nice on him though!

I chose to get a cape that snaps onto the back of his harness. The cape has zippered pockets which is incredibly useful to store things in! The red patches on either side of the cape say "Mobility Service Dog" and above that it says "DO NOT PET". On the top of the cape There is a large black patch that says "Not all disabilities are visible" along with a small "DO NOT PET" patch. I really wanted the not all disabilities are visible patch because I am constantly questioned as to why I have a service dog since I do not visibly have a disability and people always think that I am training him because, again, I don't look disabled. On the handle of the harness itself I have two patches Velcroed together that have stop signs on them and say "Service Dog Do Not Pet". I wanted to have something on the harness itself that said do not pet so that if I chose not to put the cape on him that message was still clearly displayed. All of his patches came from an Etsy shop called DannyLuannEmbroidery and the woman who made the harness sewed the patches onto the cape for me!

This harness was definitely an investment, but will last Reilly the rest of his working career and I may be able to use it on my next service dog if he/she is of a similar size to Reilly and since it is adjustable there is a degree of flexibility to the sizing of the harness. The harness itself was $90 with all of the upgrades, the cape was $30, and all of the patches were $50. Like I said it was an investment, but one that will be well worth it! If you are looking for a mobility harness I would definitely recommend you check out DD Photo and Design on Facebook!

Botox Injection for Gastroperesis

I was able to get my botox injection done today to see if it helps my gastroparesis. The botox is injected into the pylorus muscle, which is the muscle that acts as a valve to let food out of the stomach into the intestines. The goal is that by injecting the botox into this muscle it relaxes and allows the food to pass faster through my stomach. This will hopefully mean that  I will have less nausea, abdominal pain, and feeling full very quickly. We will not know if this worked for another few days because there is swelling of the muscle from the injections before it ultimately relaxes.

This procedure is done through a scope. The scope is passed through your mouth, down your throat, and into you stomach. The needle is then passed through your stomach into the pylorus muscle. Thankfully this procedure is able to be done under twilight sedation, so you continue breathing on your own and do not need a breathing tube. There are virtually no risk to this procedure, so that was very reassuring!

The procedure went very well and I only had a bit of low blood pressure, which is completely normal for me! I have been able to eat a small meal and am feeling pretty good! My stomach is sore on the left hand side, which is where they did the injection. I am going to take some anti-inflammatory medication (a prescription that is similar to Aleve) to help decrease the swelling a little bit because as the night goes I am becoming more and more sore.

Like I said we will know in a few days if this procedure worked and if it does I will be contacting Cleveland Clinic to hopefully procedure with surgery to permanently open the pylorus muscle up since the botox is only a temporary solution (it last about 6-12 weeks typically). They also took some biopsies from my stomach to test for another condition, so I will get the results back from that by the end of the week and provide more information on that!

My hip surgery is still set for next Tuesday (5/17), so I am excited for that so that I can get my hip feeling better again!

Hip MRI Results and Surgery Date

I saw the hip specialist here in Cincinnati about a week ago in order to get the results of my MRI. It shows that I have a complete acetabular labral tear with detachment in my left hip. The acetabular labrum is the ring of cartilage that is between the head of the femur (thigh bone) and the pelvis. This is what we thought was the issue with my left hip and the MRI confirmed this.

I will have to have surgery to fix the labral tear and detachment. He will go into the hip arthroscopically, meaning through multiple small incisions, and fix the tear. The surgeon will remove any of the tissue that is dead or beyond repair and repair any of the tears that are able to be stitched back together. This is a relatively minor surgery and is the same type of procedure I have had done on my wrist and knee. I have done very well with both of those procedures, so I am not too concerned about this one!

The one other concern that he did note on my MRI is that I have a moderate degree of anteversion. Anteversion is another way to say that my hip is turning inward toward my other leg. This is perfectly normal in young children, but disappears in 99% of children by adolescence. While I am not that old (22) I am past adolescence, so it is not considered normal for me at my age! This is a condition that is not uncommon in people with EDS and I only seem to have it on the left leg. Since the degree of anteversion is moderate and the surgery to correct the anteversion is very involved (it involves shaving down bone in the femur and pelvis) we have decided to not treat the anteversion at this point. If after the labral tear repair I am still having hip pain then we will discuss if we need to address the anteversion at that point, but the surgeon is fairly confident that once we fix the labral tear I will have relief!

I have already been to see my primary care doctor and have been declared “medically optimized” for surgery. This just means that he does not see any reason why my health should cause complications during or following the surgery. I have had a number of surgeries in the past (six under general anesthesia and multiple under twilight sedation) and have always done really well. I need medication to prevent vomiting after surgery because that is one negative reaction I have to anesthesia, but we know this ahead of time so we can medicate for it before the vomiting starts (about 4 hours after surgery)! There are a few other minor things that we need to watch out for like making sure I stay well hydrated, ensuring the anesthesiologist des not dislocate my jaw when they put the breathing tube in, and making sure that my neck does not get bent too far backwards because of my cranial cervical fusion, but in general I do really well with surgeries!

This surgery will be in about 3 weeks on Tuesday May 17 at 11:45 a.m. Of course this date and time may change, but as of right now that is the big day. I will let you guys know if anything changes, but prayers that everything goes smoothly would be greatly appreciated!