Ugh.

Well, my 4am jaunt down to Boston yesterday was very successful, though I discovered that traffic on 93 is just as bad at 7:15 in the morning as it is at 4:15 in the afternoon, when I left the city. The good news is that I had a little navigational mishap on the way out and still managed to get back on track by my wits alone (Garmin be damned!). The bad news is... yeah, I need another PAO. Dangitall! Somehow lo these many months I've been laboring under the false impression (slash hope) that since the right hip has been largely asymptomatic, I might get away with just the one PAO. But it is not to be so!

After my pre-op check-in business and blood donation (which went very well, if somewhat bruisingly), I had some more x-rays before seeing Erin, Dr. Kim's trusty PA. After initial pleasantries, she asked "So! Which hip do you want us to operate on?" and I felt like I'd been doused with icewater. "Uh... the left? The left's the one that bothers me." A moment passes and I say "So... the right? Is it your opinion that a PAO on the right is inevitable?" *holds breath* I even tried to get Dr. Kim to disagree with her when he came in, but no such luck. Honestly I was too exhausted yesterday to even begin to process the information, but getting up this morning was a bit of a stunner. Not that I don't have much more pressing matters to attend to at the moment!

The x-rays allowed Erin to calculate the coverage angles of each hip (how much of the femoral head [ball] is covered by the acetabulum [socket]). Ideally, these angles should be in the 20-degree range - my right is about 15 and my left a whopping NINE. Which explains why the left's been such an issue, and also why the right is a bit twingey, though still far behind the left in terms of discomfort. I asked Erin what degree of dysplasia I had and she said "I'd say... pretty bad." On a scale, of course, of Zero to Bad!

Meanwhile, the list of things I need to do before surgery isn't getting any shorter - at this point, I'm really looking forward to being sedated!

Fitter, Happier, More Productive

Well, the first two, at least. :) I realized the other day that now, 2 weeks (and a day!) away from surgery, I'm feeling better than I ever have. Ferreal! My thinking has really shifted, from being defined by dysplasia (and the dire consequences thereof) to surgery being merely a brief interruption in what is otherwise an active happy life. If anything, aside from the anxiety of anticipation, what I'm mostly feeling is sadness, as I mourn the impending loss of mobility. But I'm not scared - I'm ready!

Friday's medical extravaganza was wholly successful - as it turned out my time at Boston Childrens (Waltham) went so long I would have missed my blood donation at BI anyhow. I also learned that I have "the strangest veins" ever seen by the kindly radiology nurse who spent half an hour trying to inject me with contrast. First try (left forearm) failed entirely, followed by a collapsed vein (right forearm) on second go, though she did get about 5ccs in before it went, finally getting the rest in through my right wrist, which gave a good sting. I decided to watch the last time around, since I can always use the help getting used to such things. The butterfly needles they use are actually pretty cool, and really helped the nurse work on the angle best suited for injection - apparently my veins are both in a weird place and weirdly angled, such that she was really struggling for awhile there. It all went in just fine through the wrist, though, and they gave me a handy hotpack for the collapsed vein, which really helped reduce the stinging and stiffness.

MRI wasn't nearly as scary as my first, and I had my wits about me enough to ask for a copy for myself, which I'm really looking forward to. They then sent me for x-rays (one less thing to do on Thursday!) because my initial ones (which thankfully still garnered me a speedy diagnosis) weren't the right kind. This time around they took all but one while I was standing, some with my foot at a not very comfortable angle. I had to hook my toes under the edge of the table for the lying down one, also something I would expressly avoid in my general life. Still and all, looking forward to getting copies of those as well, for one so I can finally calculate the actual degree of my dysplasia and for two... well, because I think they're cool. :)

Sunday's yoga class was especially marvelous, and I learned to love reclining big toe pose (perhaps the worst pose name yet) and the benefits it provides. Had a totally weird sensory experience where, when I lowered the leg I'd started with it felt like it hit the floor about 6 inches below my other leg. Sort of like the opposite of when you stand in a doorway pressing your hands against it and when you walk out your arms lift up, you know? Also got into my shoulders really well with some link-your-fingers-behind-your-back business, all of which I was feeling (in the best possible way) yesterday when I played A FULL 18 HOLES OF DISC GOLF! Man, it was AWESOME! Such a gorgeous day and, rustiness aside, so wonderful to get out and about. I was definitely tired by the time we made it home, but not in a lot of pain, nor am I today. Fantastico!

It's a good thing I'm such a genius...

...since otherwise I'd have blithely contaminated my autologous blood donation with MRI contrast dye. Whoops! I was talking to my dad about it the other day and said "Huh - I wonder if I can donate blood after an MRI?" Turns out no, no I can't! (Add to the bulging "Glad I Asked" file.) So now I'm driving down to Waltham tomorrow for the sole purpose of an MRI that I could have just as easily had within a 10 mile radius of my home. Best laid plans! Hopefully, though, having one less blood donation (I'm still scheduled for one after my pre-op next Thursday) won't pose too much of a problem - if need be, I can just get some anonymous blood when the time comes.

Today, however, the positive far outweighs the irritating, as last night I not only accomplished tree pose while standing on my left leg but I also DID A HEADSTAND! Ehm... except my headstand also involved assistance from Anjali and a wall (not pictured). :) But still, pretty incredible! The theme of last night's class was celebration, and we had a fine time celebrating each other's small accomplishments, including doing this crazy line of tree poses with the person next to you supporting your extended foot. And not one person toppled to the ground! It was splendid.

Yoga is medicine.

Jennifer said that yesterday when we were talking before (and during) my massage - she's noticed some real progress in my psoas and my ability to release them with her assistance. I notice that it doesn't hurt like a BASTARD when she touches them! I told her about my new persistent front-of-the-thigh pain and she immediately pinpointed it as the rectus femoris muscle (can't tell you how much I love these wiki illustrations). Turns out my work with Dr. Hoo has so loosened up my sacral region that the increased motion of my pelvis (*insert Beavis & Butthead snickers here*) has caused ol' rectus femoris to brace, just like my gluts were doing when my lower back first started loosening up. Jennifer completely eliminated the pain, though, at least through today, and when working on my shoulders had to ask which one had been bothering me - whereas 2 weeks ago the left shoulderblade was noticeably further away from the midline.

This change I definitely credit to the inclusion of yoga in my healing trifecta - we did camel pose (especially like the arrows and butt squiggle in this illustration) Sunday and a bunch of other arm things that I was surely feeling come Monday morning. I'd be lying if I said I wasn't sad/frustrated that I have to give it all up for probably 2 months at least, but heartened that I've gotten this far even with my hip issues. Just imagine what I'll be able to do post-op! Bad ass.

Oh yeah and guess what?! Blue Cross is actually paying for my PAO! Woot! Got the official letter yesterday, just in time for my MRI and first autologous blood donation on Friday. I'm not too anxious about all that - next Thursday is the real big push, pre-op, blood donation, x-rays, PT, Dr. Kim - it's going to be a long day, made longer by the fact that I can't head down til that morning, and my first appointment's at 7:45am! Best laid plans!

Monday night I was panicking something fierce (realizing that I don't stress out, I stress in, if that makes sense to anyone besides me) but yesterday's adjustment and massage combo (and the introspection it allows) set my mind right again. Back to the yoga studio this evening, which should calm me back down to baseline. All in all, I'm feeling pretty well blessed today. :)

4 weeks!

Ah, but who's counting?! :) Holy eff that's soon. The delectable yogurt I had for breakfast this morning had a June 10th expiry date and I was like "Aw MAN!" haha Just can't escape it!

Well I cleaned my parents' storagey ex-garage area for 5 straight hours on Mothers Day (because I just love my mom THAT much!) and have been fairly stiff and miserably ever since. Add to that a mega faculty meeting yesterday facilitated by my newly-trained cutie freshmen, which precluded me from an adjustment, and work at the store after school today which precludes yoga and I'm definitely feeling it. But tomorrow I'll be adjusted and Friday and Sunday yogafied, and trust I will then get back on track.

Insurance frustration continues unabated, after learning last week that my request for Prior Approval was denied because I didn't get a second opinion in-network (even though they granted my Prior Approval for a second opinion from Dr. Kim [but who am I to try to apply logic to the insurance industry?!]). The first Blue Cross dude I talked to told me I should get a letter from Dr. Bean explaining that nobody in Vermont does PAOs - information apparently left out of the original paperwork - but when I actually got the letter and called again (talking to a different person - this always yields a different answer, I've found) the woman told me that what I really needed was for Dr. Bean to set up a peer-to-peer review with Blue Cross's boss doctor person in order to set things straight. Apparently the former approach would have required me to appeal the decision, which could take weeks (and I've only got four left, in case you'd forgotten!), whereas peer-to-peer would garner a decision immediately. Um... allegedly. Alas BC has no record of Dr. Bean having made an appointment to talk to said boss doctor person and my calls to Green Mountain Orthopedics Friday and today are as yet unreturned.

Oh well, worst case scenario I just have to pay a couple thou for this grand surgical adventure! No biggie, right?!

"These stones that break your bones will build the altar of your love"

That's from a Lynn Park poem that Anjali read at the close of both Wednesday and today's yoga class, the theme of which was "cultivating your garden". As such, we tilled the (proverbial) soil of our garden by focusing on the feet, legs and hips, which is just dandy for me! We did some "toe-ga" (yes, that's yoga for your toes) and Wednesday even rocked Hanuman pose (Hanuman's a monkey - no tail necessary to complete the pose), though nobody in the class could master it without some sort of prop under them - I managed with a mere 2 blocks and was quite proud of myself! Add to the growing list of things I can do that heretofore I feared might snap my leg off at the root.

With the theme of cultivating one's garden, we were asked to identify one trait we'd like to cultivate in ourselves and one "invasive" we'd like to weed from our (again, proverbial) garden. I had a little trouble focusing on something on Wednesday, but this morning settled quickly on breathing out doubt and breathing in ease. Ah... am I starting to sound like a lunatic here? ha! Well, no matter, doubt and ease it was, and continued to be throughout the session. Today was the first day a couple of the poses really clicked for me and, though I'm still dripping sweat throughout the middle portion of the 90 minutes, I'm definitely going deeper into my practice (as they say) with each class. When we were done Anjali put out some sort of yoga-based intention cards or somesuch and invited us to choose one. Much as I'm not any sort of fan of divination, I like exercises like this (thinking back specifically to an AmeriCorps end-of-year meeting where I was struggling with a lot of frustration and picked "Delight", which completely turned my attitude on its head). I picked a card with a nice spring green border and discovered that it said "Trust". How fitting!

Hmmm... and I have some ranting to do about insurance, but will save it for another day (when hopefully the issue has been resolved!) so as not to disrupt my Positive Mental Attitude! :)

(I tried unsuccessfully to find an image of the card I pulled, but did uncover this which should suffice for ending this post on a high note. hahaha!)

My spine's having a pity party.

Okay, first off let me say that today's Astronomy Picture of the Day (at left) is one of the coolest they've ever had - check it out!

Right, so my reevaluation with Dr. Matt on Monday was a grand success - I've made excellent progress both in Spinal Range of Motion and Spinal Tissue Stress, though my Spinal Cord Tension still lags behind. The pattern I'm exhibiting in the base of my spine, he told me, is one generally associated with a "pity party" (I believe that's the medical term). I had to laugh to myself when I realized that earlier I'd been gazing at the spine model in their office thinking "My poor spine", something I think often these days. But now is the time to toss out that attitude in favor of appreciating my body's resiliency in the face of trauma and how far I've come in the past 6 months of chiropractic care. I asked Matt what he thought about my surgery and he was very reassuring, pointing out that PMA is the most important part of a speedy recovery. And I thought "PMwhat?" before realizing he meant "Positive Mental Attitude". ha!

Turns out my pelvic sway is also gone, though it was still evident at my first reevaluation at the beginning of the year. For better or worse I think this change can be credited to the increased discomfort (or at least change in comfort) in my right hip, which until now has been protected by the sway. I haven't really let myself entertain the notion of an RPAO next year, instead focusing on how this shift (and the attendant benefits to my alignment) will aid in the healing process post-op.

I had a very nice massage yesterday with Jennifer, though for some reason it was really difficult for her to access the psoas and iliacus on both sides like she usually does. Instead she spent most of our time working on my left shoulder, pointing out (or rather confirming) that the shoulderblade doesn't quite sit right on that side. She found a staggering amount of tension in the lat(issimus dorsi) and again in the teres, which we'd done some work with before. (I love this diagram!) When she got to the iliac crest I involuntarily started to squirm. It's amazing how much tension we can carry in our bodies without even realizing it! I'm feeling pretty dandy today, though - definitely sore on the left side of my back, but looser than I have any recollection of being before. Looking forward to yoga tonight, when I can give my new range of motion a spin!

I've been thinking a lot since my conversation with Dr. Matt (who says he's not a counselor of any sort, but I know otherwise!) about what exactly I'm afraid of and, perhaps not surprising to those of you who know me, it's really about loss of control. For the past year I feel like I've really taken charge of my life, and now five weeks from today (shit, just realized it's Wednesday!) I'm basically flinging myself off a cliff. However, in honor of my new "PMA", I will acknowlege that I have a lot of cushioning, in the form of my parents, my friends, the knowledge (and dare I say wisdom??) I've gained since my diagnosis, to break my fall. Matt says the spinal cord tension is in part a result of the fight-or-flight response, which makes us curl in on ourselves. Given those two options, y'all know I'm not going to chose flight!

Don't get it twisted

A breakthrough! Last night I was performing my usual pre-sleep stretch-and-pop routine and happened to twist right into a spot on the left side of my spine that returned a sharp pain. I sort of "explored" it a little (Anjali, my yoga instructor, would like that) and found that I was able to "breathe into it" (Dr. Hoo would like THAT!) and, after just a few more twinges, relieve the tension. Woot! Now, you may think I'm crazy (already or as a consequence of the following statement), but that particular subluxation is something I've been feeling for at least a decade, and I suspect at the root of my left shoulder troubles. Once it released last night I spent the next 20 or so minutes rolling my shoulders (repeated crunching sounds gone) and swinging my tingling arm (which felt about an inch and a half longer) around like a loonie. Augustus was certainly confused.

My shoulderblade itself is still pretty tight this morning, but thankfully this afternoon I have an adjustment and my reevaluation at the Rushfords, so I can both crow about my progress and start working on the next level of... ah... flexibility, I guess. I feel like Hoo would call it something like "spinal freedom". :)

Yes, so this NSA/yoga/massage combo is really doing the trick! I haven't quite come to terms with the fact that I'm going to have to give it all up in 5 weeks for I don't know how long. Not quite sure how I'm going to swing that, but I'm so glad I've had the time I have to get my alignment in order, which can only help speed my recovery time.

And did I mention what a marvelous weekend I had? Good friends, good food, great music and just a general grand old time. I managed to stay off my feet enough to not get exhausted or increase my pain much at all, though the front of my hip (which is new) has been hurting pretty consistently over the past week and my limp has become noticeable. Well, more noticeable to me - I'm sure other people have been noticing it for some time now!

Oh and my mom finally read a blog! My folks have basically been ignoring everything I've sent them over the past year+, preferring the "The less we know the better" approach (which somewhat drives me insane, but that's neither here nor there!) but I finally hooked them with AKM's blog of her time in the hospital and post-op, so they can get some idea of what to expect. I'm proud of my mom - as scared as I am, it must be even worse for her to consider watching her only offspring go through all this, and facing it head-on is no easy task.

And, finally, after waiting on hold to the dulcent tones of a Muzak version of "Take My Breath Away", I want to wring the collective necks of Blue Cross/Blue Shield. Oh, they got the first part of the Prior Approval paperwork from Dr. Bean's office Friday, but the fax cut off so it needs to be sent again. Of course, they are the only people (psychics excepted) who actually KNEW that, because apparently it's not protocol to CALL the doctor when forms are incomplete. Chuckleheads.

Well, glad I asked!

So I called Blue Cross today because I still haven't heard back about my request for prior approval, which is supposed to take 3 business days and has taken more like a month - extreme even by insurance company delay standards. Annnddddd... they have no record of my request! Called the office of Dr. Bean, the orthopedist I initially consulted with at Central Vermont who made the referral to Boston, and their very kind medical records lady has a confirmation from Blue Cross that they received the fax of the necessary documentation. Apparently, though, it's disappeared into the hazy blue beyond and needs to be sent again. Long story short, I should be hearing next week about whether they approve this business or not. I'm sure I don't have to tell you that I will not be accepting a denial without a fight!

Meanwhile, I've been reading AKM's account of her PAO experience over at What's the Hip Fix? For those of you looking for some sense of what the hospital experience is going to be like for me, her account starts here and has really helped me understand more what to expect. Also a helpful primer for those of you considering visiting me in the hospital! :)

Happy May Day!