Blog

Mind Blown: Pain and the Brain

Yesterday I drove for the first time since my right hip replacement seven weeks ago. Despite being hypervigilant, it felt freeing, if unfamiliar, and I gradually settled in as I drove to my physical therapist.

This past week I also began PRP injections for my left hip and shoulder, areas where I have chronic pain. The doctor said that the pain in my left hip is not coming from the deterioration of the joint and bone spurs, but rather the surrounding soft tissues. Once those tissues heal I’ll likely be pain-free, since the joint is not the cause of the pain I experience when I walk. It’s a total reversal of how I’ve understood what’s happening in my hips and it means that I may be able to avoid having to replace the left hip for a long time!

I’ve been in pain most of my life. I remember being a dancer in high school and being constantly sore, as I was throughout my twenties doing Ashtanga yoga and being a bodyworker. By my thirties I had switched to Anusara yoga to try to heal some chronic issues. My hips began to hurt in my early forties, as I did HIIT and intense strength workouts and got in the best shape of my life. But by my mid-forties I largely stopped exercising and have had a couple of years since in which I barely even walked.

I told my PT yesterday, pain is how I know where I am in space. We talked about how you have to change the brain in order to change chronic pain states. We think pain is located in the tissues that are hurting, but that’s not accurate. The tissues send danger messages to the brain, which sends back the sensation of pain, largely to protect the area so it can heal. We treat the pain locally with massage, acupuncture, surgery, etc., but these treatments don’t cover the whole picture when dealing with pathways grooved into the nervous system by chronic pain.

I’ve noticed that my brain has recreated the sensation of pain in a particular location in my right hip that, before surgery, I thought was associated with the deteriorated joint. But now the joint works fine and that sharp zing has returned. That says to my PT and me that the brain hasn’t caught up to what’s now true for my hip. To retrain my brain, she is having me move my hip toward and into that zingy position for a few seconds at a time, with control, so my brain can learn that it’s safe down there and surrender a little more range.

My PT says many people who come to her don’t really want to get better, that they’re attached to their pain or to the circumstances that create the pain, and therefore are unwilling to do the work to fully allow their bodies to heal. I can relate to that, having focused for years on treating the areas that hurt, but not finding someone to work with who brought the pain issue back to the need to re-pattern my neurology. Nothing I did, whether physical, emotional, or spiritual, held very long and it was frustrating and demoralizing. I’ve resisted and accepted my pain so many times it’s been an exhausting yo-yo in here.

I think that finding the doctor who does PRP injections and says my hip joint is not the source of my pain, undoing fixed thinking that could get in the way of healing, is a sign that I’m ready to shift it now. I think that finding a PT who understands pain and brain science is a sign. I think I’m finally ready to learn a new way of moving through the world and knowing where I am in space, a way based in awareness and connection rather than pain.

pain-brain

Thanksgiving Meditation

On Thanksgiving morning we went to Agape for an intimate morning service. It began with a silent meditation. A woman in our row breathed loudly as it started. I thought she was sighing a couple of times to drop in, but no. She did ujjayi breathing through the whole 20-minute sit. Ujjayi is a breathing used in certain styles of yoga in which you slightly close your throat to create a hissing, audible breath.

She was white, middle-aged with unruly hair, a poncho over her blouse and long skirt, and rings on most of her fingers, which she waved around when she felt moved by the spirit (yes, I peeked). My hackles went up and the litany began in my head:

How inconsiderate and selfish. I can’t stand when people have to display how spiritual they are in public, clueless to their impact on the rest of us trying to sit in silence.

I caught that line of thinking and stopped it. Back to my (silent) breath.

It sounds kind of like the ocean. Maybe I can pretend it’s the sound of waves. She can become a fancy relaxation track to help me relax instead of a disruption.

Back to my breath.

I want to tap her on the shoulder and ask her to stop. But I don’t want to interrupt her meditation the way she’s interrupting mine. I have a right to ask her to stop disturbing the silence. I don’t speak up for myself enough in life. But she has a right to meditate however she meditates. Fuck.

Back to my breath.

I can’t believe my Thanksgiving Day meditation has been co-opted by this selfish bitch. My quiet time has become all about her. How dare she pull for attention that way?

Back to my breath.

WTF. If I can be this derailed by the sound of breathing, what am I going to do when the water cannons are aimed at me? (Standing Rock was on my mind) I’m going to have to get a lot more solid in my focus if I’m to be effectual in the world in the face of people who don’t play by the same rules as me.

Back to my breath.

Shit. Oh, shit. This woman’s my teacher. She sat in my row so I could see how easily I get thrown by conditions not being ideal. I’m grateful she sat here. Ugh. Meditation is not the only time I let the outside affect me this way. Shit. I’ve got work to do.

Back to my breath.

After the meditation, she got up and someone else took her seat. I never got to meet her or thank her. It’s just as well because I’m not sure I could have thanked her without also pointing out what a pain in the ass she was. Clearly, I’ve got work to do.

namaste-bitches

On Working with Scar Tissue in the Body, Mind, and the Country

It’s been hard to write for the last week, glued as I’ve been to the internet, as if watching a 100-car pileup on the 405. I can’t turn away and I feel sick, too sick to eat much more than yogurt for dinner most nights.

The good news: I’m walking well and today is my last dose of antibiotics for the partial incision infection. It is healing. Somehow despite everything my cells march on, stitching together into a thicker version of themselves.

Scar tissue is an odd thing. It heals stronger than normal tissue, but is more inflexible and has to be broken up since it won’t stretch. It has compromised blood flow and won’t grow hair. Instead of the basket weave appearance of normal tissue, scar tissue has a more complex and randomized structure. The chaos makes it stronger but also more inflexible. As a result of trauma, the body favors stability at the expense of flexibility. I start with a new physical therapist tomorrow and we will tackle this exact issue: adhesions that are a form of protection but also cause pain and immobility.

It feels like parts of the country are in a similar place. We’ve have had deep wounds ripped open of racism, sexism, classism, and xenophobia. Just like cells, some people start to clean out and heal the wounds and others harden into scar-tissue-like stances of rightness. That’s great for creating stability in a destabilized land but it also brings inflexibility, pain, and reduced circulation.

I’ve noticed during my recovery that just as the body lays down scar tissue, so does the mind. I’ve dipped into old ways of thinking that have had me down for days. Trauma creates clumps of neurons that translate into habitual thinking and beliefs about the world. Just as it takes exercises and bodywork to break up scar tissue in the body, it takes self-reflection and active choices to shift thoughts in order to build new neural pathways that eventually, if chosen more often, will fire more readily than the old.

I find myself reading article after article, looking for someone who has the magic words, the outlook that can soften and free this lumpy and hardened tissue without further traumatizing the area. How to debride and cleanse the wounds without causing more trauma? I’ve heard some great ideas within the din and I still re-board the fear, grief, and anger train, still find old thoughts firing just as much as the new ones I actively turn toward. While those emotions are important to allow I also want to find a way to be resourceful and of use, and I can’t serve well from that calcified position.

I joked today that I picked the wrong week to come off narcotic painkillers. A part of me wants to take a Percocet, lie down, and call it a day. But the rest of me knows that’s not how healing works after the initial phase right after surgery or injury, that grinding out exercises and moving through pain, without creating further injury, is how optimal healing takes place.

So here it goes. Another day: another set of exercises, another meditation, another prayer. The choice to do practices to create and sustain a strong core-self so that my outer self can be receptive, flexible, soft, undefended, and therefore open to connect with people who think like me and those who don’t. May I have the strength to do the work on my body to walk well, the work on my mind to stay clear, and the work on my heart to love deeply and widely. More than ever, this feels like necessary work.

BNPS.co.uk (01202 558833) Pic: Gary Ellson/BNPS Aerial view of the crash scene - Red Arrow off Flt Lt Jon Egging crashed near Bmth airport on 20/8/11.

Suture Spit and a Peek at my Surgeon

Today I had my first follow-up with my surgeon, three weeks to the day since my total hip replacement. Not a moment too soon, since it turns out that a part of my incision is infected. Luckily it’s superficial, meaning it’s in the skin layers outside the deeper sutures, but important to catch it quickly so that it doesn’t track deeper. This kind of infection has a nickname, suture spit, named after the discharge that gets spit out of this localized spot. Suture spit. My poet likes that phrase.

It turns out that the aching and burning skin pain on my lateral thigh is one of the rare complications that can happen with the anterior placement type of hip surgery. In some people, the cutaneous nerve that runs past the incision and gets stretched and moved during the surgery gets irritated with intense residual effects. I can try to desensitize the skin with massage and pinching (hello TheraGun!) but the surgeon said it takes time to lessen and in many cases goes away eventually.

It hasn’t been the easiest day. I feel powerless in the face of this news about the irritated nerve. Like I can do all these things toward recovering as well as possible (outlined in this post) and be felled by something totally out of my control: a hyper-reactive nerve.

I notice there’s the kind of powerlessness that leads to despondency and wallowing in victim, which I feel myself dipping into at times today. Thoughts like Why me?, or, Of course I’m one of the fewer than 1% of people who get this nerve pain. This always happens to me, are signs that my victim has the floor.

However there’s another kind of powerlessness that leads to surrender, an acceptance of things as they are that breeds resourcefulness and courage. Thoughts like, Even if I don’t like it, I trust what’s happening, or choosing to pray the Serenity Prayer in order to remember to focus what I can change and accept what I can’t, are signs that my inner master has the floor instead of my victim.

There’s a more radical view that I dip into in moments when I’m praying with a friend in the style of affirmative prayer. I feel that place where I’m whole, complete and already healed, regardless of what’s happening with my body. It’s a felt sense awareness that emerges as the prayer unspools. It may last a while afterwards or it may disappear with the amen, but regardless of how long it lasts, I’ve touched that awareness and that’s what matters.

I don’t know what the lesson in this pain is yet, but I have a sense that it has to do with being willing to make a different choice than to dwell in my victim. Perhaps it’s to let go of the ways I try to control outcomes by being good. I don’t mean to stop doing my rehab exercises or stop using the hyperbaric chamber. I mean something more subtle and insidious, like the idea that because I do all this work to help my body heal well I’m entitled to have an easy recovery and to be pain-free. That kind of thinking is self-involved, reward-based, and deeply flawed.

Far more growth-producing is the idea that no matter what happens in my life or body, my job at every moment is to trust life/God/universe/insert-your-favorite-word-here and attune my listening to that deeper, quieter place in me in order to hear its suggestions and act on them instead of letting my victim keep the floor. As long as I can keep my attention on how I show up to meet whatever happens moment by moment, I can stay open to life as it unfolds without trying to manipulate it to prop up my teetering sense of self-worth.

Here’s my talented (and hot!) surgeon at our visit today. He’s the only one of four local Kaiser hip surgeons who’s trained in the anterior approach. I’m grateful for his skill and his no-nonsense explanations. And for the new phrase he taught me today: suture spit.

image1

Entering the Well: the Down Part of Healing

I have to admit it’s been hard to write. Each morning for the last week, I’ve wanted to make a cheery post about how amazing it is to walk, how much stronger I am already, what a difference a week makes, how grateful I am. All of that is true and it’s not the whole picture.

I’m weaning off the pain medication and some hours of the day are really hard to get through. I lie down and grit my teeth until the alarm goes off and I can finally take that pill.

I’ve developed skin sensitivity along my outer thigh and hip. Just the sensation of my pants moving along my leg, or the weight of the comforter, is agony. I emailed my surgeon yesterday to ask about it, and he said to massage the area to start to desensitize the hyped-up nerve endings. I started doing that yesterday. I had some blood come out of a swollen part of my incision this morning as I pressed around it. That scared me.

I’ve been down for a couple of days now, like, really down. I want to think it’s a normal part of the healing process. It’s almost 3 weeks post surgery and the initial excitement to be through it and the willpower to keep moving and be a good patient is turning into fatigue and a waning of joy like water going down a drain. I’m an empty tub.

It’s tempting to fill the tub with thoughts about why this is happening, what I’m doing wrong, fears about my skin and incision, or even platitudes like this too shall pass, or one day at a time, or slow and steady wins the race. There’s something in me that so resists being empty. Gutted. Down.

Part of it is that when I was little and lonely, I made a decision to keep moving because as long as I’m doing something I won’t drown in the well of despair that caused the decision to keep moving in the first place. As a consequence, I’ve kept it moving basically my whole life. Don’t get me wrong, I’ve given myself space to grieve, I’ve loved and felt a whole range of feelings. I haven’t been numb this whole time.

But while moving from one task to another, I piled more on my plate than I would ever be able to complete. This way I would never land in a feeling of completion or fulfillment. I think a part of me has known intuitively that the other side of fulfillment is emptiness, the wide-mouthed well there where it’s always been. To avoid falling in, I’ve largely stayed on this side of fulfillment by keeping myself perpetually in yearning. I love yearning. It’s such a rich place to hang out. It’s good food for poems and creativity in general. But as wonderful as it is, it’s not the whole cycle.

Maybe what I’m feeling is the permission to go into the well and stay there for a while. Maybe it’s the exhaustion of resisting it for so long. Maybe this need for a new hip was a communication from my body that now is the time to slow down, sink in, and fall through the well to a new ground of being where I so feel my connection with God that it fills up the loneliness that almost engulfed me as a child.

For now I don’t know much beyond I’m tired and scared that my incision could be infected. I want to be held. The sun feels good on my shoulder. I’m tired of trying to be good, tired of a life spent running from loneliness, tired of trying to prove myself the right person worthy of love. I don’t have the energy anymore. I’m chest deep and sinking. All I want to do right now is rest.

Surgery Recovery Tips!

I thought you might enjoy a list of most of the things I’m using as I recover from surgery, organized into categories of physical, mental-emotional, and spiritual. If you’ve got surgery coming up, and even if you don’t but you want to feel better, you may want to try some or all of these ideas, whichever of them resonate. I think the main thing to remember is to do what feels good to you and that will have the greatest benefit. I’m not prescribing anything with this post and remember to take responsibility for what you decide to use on yourself. And above all, get advice from medical professionals if you’re going to try something new!

It’s day 11 after surgery and all the steri-strips have come off. I got curious about what other people’s scars look like around this time, since I’ve had very little bruising and my swelling looks pretty good, confirmed by my PT, who has seen lots of post-op hip patients.

It was hard to find a comparable scar, and this one is blurry, but here is a photo comparison of our scars. I’d say I’m doing very well!

image1

HERE’S THE LIST:

Physical

1) Do what the PT says. Studies show that patients who do their exercises several times a day, walk every hour, and ice regularly recover more quickly and with better strength and range of motion than those who don’t. Muscles are not going to turn themselves back on with magic, it takes intentionally activating them to have them respond. Visualizing the muscles working right helps, too.

2) Sleep. I’ve allowed myself to sleep as long and as often as my body wants to, while also setting an alarm for every four hours to take my pain medication. I sleep on the Samina sleep system with a grounding pad. I love my Samina bed and Claus and Denise Pummer are very knowledgeable about everything having to do with sleep. It’s a very expensive system, but to me it was a worthwhile way to spend my money, since I spend a third or more of my day in bed and don’t want to be sore from it.

3) Take the right amount of pain medication. I was originally on a schedule of two pills every six hours but had terrible pain. Two days after surgery I changed to one pill every four hours. It ends up being two fewer pills a day but because the interval is shorter my pain has been better regulated.

4) Hyperbaric chamber. See my prior post here. I’ve been getting in about 5 days a week. I think it has a lot to do with how little bruising I’ve had and how well my swelling is healing. Last week my PT told me it’s rare to see ankle bones so quickly after surgery. In fact, my ankle bones never fully disappeared.

5) TheraGun. See my prior post here. I can’t use it near the hip or the incision yet, but in my calf and down around my knee it has been wonderful for easing the pain of the swelling and increasing circulation to help reabsorb the stangnant fluids. I use it for 10-20 minutes every day.

6) Marc Pro Plus. This is an amazing electric stimulation machine that has a low frequency option that directly addresses recovery and the movement of fluids. I’m using it several days a week for 1-2 hours at a time on my quads, adductors, glutes and piriformis to help flush the leg.

7) Bio N’ Ice. This device uses a combination of ice therapy and LED light therapy to rejuvenate the skin. I’ve been using this on my face for a while. Now that the steri-strips have fallen off, I’ve started circling the incision with the green and the blue lights twice a day when I also treat my face.

8) Infrared Sauna. Once I’m cleared to use it again, I’ll be adding it back in. I have a Sauna Space because it’s easy to put up and take down and it’s compact.

9) High-quality all-natural skincare. I use skin care that’s safe enough to eat. There are two brands that I use: Annemarie Gianni and Alitura Naturals. I use Annemarie Gianni’s Coconut Body Oil in addition to her facial oils and serums. They’re made in small batches and are expensive, so I recommend ordering samples to try it out before committing to the entire line. Andy Hnilo, founder of Alitura Naturals, developed his skin care line after healing himself with minimal scarring from a devastating car accident using natural ingredients and superfoods. I’m using his night cream around (but not touching) the incision right now and will add in using the mask on my incision and thigh once I have permission from my doctor to put things directly on the skin of the incision.

10) Food. I’m not going to go too deeply into food because it’s such an individualized topic. What’s worked well for me has been bone broth and soup. When I didn’t feel like eating I could still usually tolerate bone broth with extra collagen added to it. I’ve also had superfood smoothies to nourish my body deeply while not challenging my digestion too much. When I do consume more solid foods my focus is organic vegetables and grass-fed meat. I loosely follow the Bulletproof Diet, including a high fat intake of healthy fats, and medium amounts of protein and low carbs. I cut out refined sugar before and after surgery due to its inflammatory effects. Every now and then I have a sweet treat, usually sweetened with stevia, coconut sugar, or raw honey.

11) Jing Herbs. A Chinese Medicine herbal company with terrific powdered herbs and formulas. I especially like their Pearl Powder, Awaken the Shen formula, and Coco Qi Latte. I combine the three with warmed unsweetened almond or coconut milk and a few drops of liquid stevia for a healing hot chocolate treat. I have other individual herbs of theirs that I add into smoothies when my stomach is feeling strong. Before going too deeply into Chinese herbs I suggest talking with a professional practitioner of Chinese Medicine to determine what herbs would be good for your specific constitution.

12) Supplements are another area I won’t wade too deeply into because of tremendous diversity of opinion on the topic of what’s best. I use TianChi (adaptogenic tonic), Coromega for Omega 3s, and Natural Calm magnesium powder, to name a few. I’ve heard proteolytic enzymes are great for healing from surgery but don’t have personal experience with them.

13) Rest and cuddle with someone if you can. Get a foot rub. Every day I try to counter messages of pain going to my brain with messages of pleasure and comfort so that I can remind myself that my body is also a source of pleasurable sensations.

Mental-Emotional

1) Let it flow. When I’ve felt tears coming, I’ve let them come. I’ve let fear and frustration yell through my voice. Joy and laughter, too. Recognizing that they’re passing by, and that memories and emotions get released on numerous levels through a surgery like this, I’m giving myself permission to feel the range of feelings as they come.

2) Gratitude journal. If I know I going to be writing down 5-10 gratitudes a day, my mind starts looking for things to be grateful for so that I have something to write. This practice helps keep my mind from focusing on pain or suffering as much as it normally would. Studies have shown that having a gratitude practice creates more overall happiness over time.

3) Connection. It’s important. Make Skype and phone dates with friends. Stay connected and make sure you have help after surgery. If your primary caregiver burns out, ask more friends to help.

4) Visualize your desired outcome. Several times a day I picture myself moving with ease, walking down to the beach with my partner and our dog, or walking in New York, or having sex, or scuba diving, all activities that I enjoy and look forward to getting back to once I’m more mobile. Studies have show that picturing the desired outcome has a helpful effect toward having it. Our brains are that powerful, why not harness that power toward what we desire rather than what we fear? I’ve found it hard to haul my mind away from the pain when it spikes and fears get louder, but I use my tools to do it: Muse, prayer, visualization, texting with a friend. It’s on me, and no one else, to keep my head on straight and actively work toward health and well-being through the miraculous and transformative process that is total hip replacement surgery.

Spiritual

1) Meditate. I use Muse (see my prior post), the Headspace app, and also sit silently. The more time I spend with my mind focused on my breath or whatever the guided meditation instructions are on Headspace, the less time there is for my mind be destructive. This has my episodes of identification with the pain (that increase suffering) pass more quickly. I don’t ignore my pain, or how hard it is when it spikes, but I also don’t spin out into a story about why I have pain, or that it will never go away, or that I’m failing somehow because I have pain, all the ways the mind has to keep me feeling bad or small.

2) Stay prayed up. I listen to Our Daily Prayer Call, a prayer call in the style of affirmative prayer, run by Jason Mitchell, an Agape Licensed Spiritual Practitioner. There is a closed Facebook group you can request to join or you can request to be added to the email list. I also have friends who I pray with, and I pray on my own. Until I’m able to return to the Sunday service at Agape International Spiritual Center, I’m livestreaming it. I also listen to The Sound of Agape online radio when I want some uplifting music.

3) ThetaHealing®. I’m trained in ThetaHealing® and do Theta on myself but around this surgery I’ve been getting ThetaHealing® sessions from the amazing Alexis Ware, my teacher. Read more about Alexis and ThetaHealing® here. It has been very helpful to all aspects of preparing for and recovering from surgery and works on all levels—physical, mental-emotional, spiritual—from the spiritual plane. She also offers Human Design sessions, which are a great way to understand more about how you’re wired.

4) I also listen to Adyashanti Weekly: Moments of Grace, a weekly download from Sounds True of an informal talk by renowned teacher, Adyashanti. It helps keep my perspective on track.

5) Once I’m cleared to move my leg into more positions again, I will resume the practice of Orgasmic Meditation (OM). This practice works on physical, mental-emotional, and spiritual levels and combines the focus of meditation with the health benefits of the orgasm state for an increased sense of well-being.

I hope this list has been helpful. It has been fun trying out various tools and seeing what makes a difference, what makes me nauseated, and what doesn’t seem to do anything. In the meantime, it’s time to get up and walk around the room again!

The Daily Mortifications

Today the toilet flooded after I pooped and I couldn’t do anything except get out of the way of the water and scream for my partner to come pull stuff up off the floor and throw down towels. So many things to clean and me useless to help with it.

Every time I drop something and have to call him over to pick it up. I’m dropping things a lot these days and a proud spot inside me dies every time I need him to pick them up for me. This also applies to when my cane slips off whatever I’ve leaned it on and I have to ask him to pick it up for me, too.

INSERT VERY COOL AND EXCITING THING: My PT transitioned me to a cane from a walker a couple of days ago because of how well I’m walking. Six days after surgery and I was already on a cane! It was a little scary at first, given that I was used to the stability of the walker, but it already feels better and like it’s facilitating my recovery more than being on the walker would.

About the cane: My partner bought me an orange and black cheetah print cane because I love orange. When he brought it home I cringed. It’s so tacky. My inner style-marm raised her elegantly coiffed head and refused to be seen with such a loud cane. I decided to work with my aversion instead of sending him back to the store. Now the cane is growing on me. Who said canes had to be drab to be appropriate? Why is even that a thing in my head?

Trying to sit on the bar stool with a pillow on it to eat at the kitchen counter and having to move because I start to cry from the pain. Being so overwhelmed that I can’t figure out where to sit. Then, once seated, being so nauseated from pain that I can’t finish my meal.

Needing my partner’s help to clean up when my pee doesn’t go into the bowl like it should but escapes to the floor through a gap between the toilet seat and the raised commode I sit on.

The doorbell ringing when my partner is out and I’m so slow getting to the door that the delivery person already gave up and left.

Going instantly from communicating calmly with my partner about the help I need in that moment to panicky tears, trembling, and incoherence when the pain is high. It’s hard to have so little control over when my emotions overflow and I become non-functional.

Not showering for over a week and the wild greaseball that is my hair. I’m grateful for wet wipes, but still. It’s not the best look.

Being unable to reach my feet to care for my dry toenails and calluses. It triggers memories of clipping my father’s fungus-ridden toenails as he was dying of cancer. Even though I did it with love and the act had me feel close to him (and I don’t have toenail fungus), asking foot-care of my partner hits my pride, so I haven’t asked yet. I’m aware that this is ridiculous and it’s still hard. It was all I could do to ask him to wet-wipe my dirty feet last night before I got into bed and it took all my attention to enjoy his touch and not wonder if he was grossed out.

Calling out to him when I wake up in pain, it’s late, and he hasn’t come to bed yet. Admitting that I miss him and that the presence of his body next to mine, even if we’re not touching, helps me settle and get back to sleep. My independent nature cringes at this sign of dependency.

Writing this list I see how much of this recovery process is about surrender, about not fighting where I am at any moment. I want to judge myself for having shame instead of focusing on the good that’s also present.

What an opportunity to confront my pride and all the places that would have me stay independent and in control. How lucky I am to get to confront my beliefs around having to look and behave a certain way to be attractive and worthy of love. If I learn to accept right where I am at all times then I get to return to the world a free woman.

I pray and meditate several times a day in order to touch a more spacious place in my mind, so that I can notice the moments of grace happening alongside the mortifications. At any moment I can choose shame or gratitude. Sometimes my choice falls one way, sometimes the other. Each little pride-death brings with it a deeper sense of freedom when I realize I’m still okay, even in a moment surrounded by poo-water when there’s nothing I can do but hobble out of the way and ask for help.

img_5135

A Win with Physical Therapy!

Yesterday I met my new Kaiser home health physical therapist, Sarah. From the moment she came in, I liked her. Turns out she lived in Brooklyn for 11 years and loved it there. She’s kind and no-nonsense, just the right combination for a good PT.

We asked her to help us figure out the best way for me to get in and out of the hyperbaric chamber. My partner and I have gotten stuck several times with part of my body in, part out, screaming at each other because I’m panicking about my hip dislocating if I move it wrong and he’s unclear which way I want him to help me move.

Of course in front of Sarah, and maybe because we’re starting to get the hang of it, I slipped into it pretty well. She saw no problems. Coming out, it went the smoothest it has gone yet, with only a couple of suggested adjustments to make it safer. We did it!

And then she said the line that made my inner dancer-biohacker-competitive-healer-body-person sing:

You win the award for the most coordinated total hip replacement patient I have right now, and possibly for the last six months!

I feel so seen. And will now do anything she says.

I told her she would have to not lowball things with me because if there’s a maximum that’s good to do I will probably exceed it if not otherwise warned. She laughed and said she could already tell that about me. (hellooooooo, hyperbaric chamber)

We have three more visits before she refers me to outpatient PT. Even though my quad and IT band ached last night and today after she had me contract and lift my leg as much as I could, I’m looking forward to seeing her tomorrow. Maybe I’ll be able to fire what wouldn’t fire yesterday and do that straight leg lift on my own, and maybe she’ll have to assist, but either way we’ll have fun.

image1

Post-Surgery, Day Four!

Hello!!! I’m back! I’m sorry for the delay in posting post-surgery. I didn’t anticipate how hard it would be to get on the computer. I can’t stand for long at my desk, nor can I sit normally or for long, and the incision is on the front-lateral side of my right leg so my lap desk puts pressure on it. Today the swelling has come down enough that I’m giving the lap desk a go.

Modern medicine is amazing! My surgery began at 8:30 am on Friday, I was in recovery by 11 am, and home by 7:00 pm. I would have gone home even earlier but I couldn’t pee. Some people’s bladders are slower to wake up after anesthesia than others. Finally they catheterized me, emptied my bladder, and sent me home. Later in the evening I had no problem feeling the urge to pee and doing it on my own.

My surgeon is so cool. He’s the only one of four local Kaiser surgeons trained to do the anterior placement hip replacement surgery, as opposed to posterior, the more common method. I wanted anterior because he doesn’t cut through the hip and glute muscles, but rather goes in through the front and pulls apart the muscles to access the hip. It makes for a faster recovery and fewer restrictions on mobility (lower risk of dislocation) for the next three months of recovery.

Over the weekend, the main painful sensations were a muscle pull in the quads, adductors, abductors, and IT band. They were all swollen, pulled, and tight, though I didn’t really bruise. By Sunday morning I also had sharp hip pain when I put weight on my right leg, but it eventually passed.

The other main source of discomfort was my belly, which blew up to looking about six months pregnant and put pressure on my low back. Some people react this way to anesthesia and pain medication. My guts did not respond for three days to the laxatives they sent me home with, so it was pretty uncomfortable.

My physical therapy visit on Saturday morning went great. I walked with the walker and did the exercises he showed me. My vitals were good. But by Saturday night I had a fever and increased heart rate, pain, and still no bowel movement. When I woke up at 4:30 am on Sunday to take a dose of pain medication, and had another round of feverish sweating, something inside told me I had already passed through the worse of it and that my cells were cooking and healing everything, so I didn’t worry about it anymore and went back to sleep.

But when the PT arrived later on Sunday morning, my heart rate and temperature were still elevated, as was my pain and abdominal distention. So he had us consult with a nurse who recommended we go to the ER and get checked out. It was one of those moments where I trusted the inner voice I heard and felt I was fine and I also felt I should go with the nurse’s recommendation, if only to confirm my voice was right.

We ended up spending about six hours at the ER, while they denied me food and water in case a test showed I had to return to surgery. That sucked and I got exhausted. My fever came down while I was there and tests showed no clots and no infection. They said that some people have mysterious fevers after surgery, so they finally sent me home with an additional three kinds of laxatives. My voice was right after all.

Yesterday I woke up feeling like I’d turned a corner. My pain management was better, I could walk more easily again, the swelling and pulling in my thigh had gone down a bit, my temperature felt normal, and I passed gas, which helped relieve the belly and back pain. My main goal for the day was to have a bowel movement, which finally happened around 1 pm and again later on in the afternoon.

My partner and I have been through our own ups and downs since the surgery. Sometimes he’s right on top of the caregiving and I’m right on top of asking for what I need in a way that feels good. We smile at and love one another until it falls apart in a moment and feels terrible. Caregiving is no joke. I’ve done it before. I notice myself trying to caretake him, knowing how hard his role is, but that’s not my job, so I stop. My job is to heal and ask for help. I can suggest that he do his centering practices and connect with friends but he has to choose to do those things for himself.

I also need to be willing to stay connected and ask for help even after he’s hit the wall and we’ve disconnected. My default is to do what I can by myself and give him space until he’s ready to come back. But when I need his help right away and he hasn’t come back yet, I freeze and suffer until it feels like a better time to ask. At that point, my ask comes out with resentment and begins another cycle that doesn’t feel good. This experience is a powerful motivator for us both to work on our communications with each other and take care of ourselves. We’re getting to experience really clearly how we each act when we go into our involuntary and learning to be with each other there. It’s a potent practice for waking up.

As grateful as I was for coming home right after surgery, I had the thought last night that it’s cruel to expect an untrained family member to be able to provide the level of help that a patient needs in the first few days after surgery without taking anything personally and going down. Like they suddenly have to grow a new arm and learn to use it impeccably without anyone showing them how. I’m still glad I was sent home but I wonder if there could be more preparation or support for the caregiver in advance.

Yesterday I felt well enough to lie on a lounge chair in the shade and look at the sky for the first time. For two days now I’ve wanted solid food for breakfast. I’m out of bed and happy on my orange couch with my orange-encased laptop in our sun-bright living room. After this post I will return to bed to do my exercises and ice my leg. My partner and I worked it out this morning and our connection feels great again. A friend texted at the right time with the perfect message. Life is good. It’s a miracle to have a new hip. I’m healing. In so many ways, I’m healing.

img_5093

Surgery Day!

I woke up early to meditate. Then, shower and wipe-down with antiseptic cloths. No water, no food, no lotion, no face creams or lip balm, no hair products.

I’m the first case of the day so we have to be there at 6:30 am and the surgery begins at 8:30 am. It should take 2-3 hours. What a miracle that I can have a new hip in that short amount of time.

I’ve asked friends to picture me wrapped in a pink blanket of love between 8:00 and 8:30. If you’d like to join in, I’d love to have the support!

Here are the three songs I’m taking in with me. My favorite songs for getting into state.

See you on the other side!