PT, the Gym, and Pain

What, pain again?  Well, first we'll talk about PT.  Then working out.  Then...yeah, pain.

I have been going to PT for 4 weeks now, I think.  Sarah, my therapist and I have become good acquaintances.  We each have two daughters, 20 months apart--mine are 26 and nearly 28 and hers are 4 and 6, but 20 months is 20 months and not that many women have children that close together. 

Your physical therapist is by necessity very intimate with you.  Sarah straps a belt around her, puts a towel over my groin, and yanks on my leg for a while.  We have conversations, all while I'm lying down.  I've devised a method to count my reps and still talk.  (I love to talk).  I almost always feel good when I leave--but I'm also in pain.  The manipulation, while a good thing, also is painful.  It pulls my leg past where I feel safe letting it go, takes me literally out of my comfort zone.   But the sessions start with heat, also on the groin, and when I started, I couldn't relax my leg while the heat was being applied, and now I can.  In fact, I nearly doze. 

Then when we're done, I drive around the corner and go to the gym, which is in fact, upstairs--the same building. I chose it that way.  I figured I'd get to the gym at least twice a week this way.  And I do.  Sometimes three, but at least two times.  Once upstairs (I take the elevator now--I am simply not torturing myself with two flights of stairs, which is what there is) I do the elliptical.  This particular elliptical isn't frighteningly high to get on, and doesn't make me hurt to use.  I'm doing 11 minutes now.  My feet often hurt.  I'm going to say that I'm not getting as winded--I must not be, because I can't remember.  After that I do things where I sit.  I'm ready to sit.  Also...work my upper body.  In spite of being in not great shape (or maybe sort of passable shape, I have no idea, my hip has me so thrown) I'm so solid and so muscular that I can tell a difference almost right away.  I can lift more dishes out of the cupboard.  I stood around holding the cast iron frying pan the other day, while people made up their minds about what I was supposed to cook.  I can reach higher.  (I can make my boobs bounce and when I've been working out for a while, I can do them individually--probably a skill that generally involves a pole, but whatever).  I've been finishing up with crunches on the balance ball, 100 of them.  Today I was considering shooting for 200, but I had to be back out, in normal clothes, by 2, so I passed.  I might start working up to 200, though.  The stronger my core is, and the more I can engage my lower abs, the easier it is to walk and to stand.

And then, after the ride home, where I sit for 20 minutes (ish), comes the pain.  It is a deep pain, from above my left hip, through it, down my thigh (oh...my thigh....), to my knee, and then down my shin and to my arch.  It hurts all the way down.  A shrill, pulsating pain.  The heated seat in the car helps some.  But the pain stays, will stay now, for the rest of the night.  It abates a bit when I stand, but then, if I stand too long, it gets worse.  It improves when I walk, but then, again, if I walk too long, gets worse. 

It is of ultimate good.  The goal is to improve range of motion (which has occurred, to an impressive degree) and more, to strengthen the left adductor muscle, which is what they cut for the hip replacement.  Also, the gluteus, or as Sarah calls it, the butt muscle.  Well, yeah, the butt muscle.  I suppose.  Those muscles have atrophied.  This bothers me, a lot more than you'd think to look at me.  I work to build them up, I work all the time to build them up.  I make them do the bulk of the balancing or pushing when I'm working out.  I'm coaxing them all the time. 

I want a good outcome from this. I don't want a revision, I don't want an infection, I don't want the recovery time to be longer than it needs to be.  I don't want a shrunken leg, I want to wear flattering shoes again, I want to be as normal as I can for as long as I can. 

I want to climb a flight of stairs without holding on.  I want to take a long walk.  I want to climb to the Schloss in Marburg, and I want to climb the hill in Montmartre, which I've never laid eyes on, but have certainly read enough about.  I want to climb a Wendeltreppe, should one present itself.  I want to go out in Paris (my older daughter wants us to take a trip to Paris together) in high heels. 

When I am eking out the last painful rep (to help the range of motion, to build the muscle) it's easy to want to roll over, shove the knee pillow between my legs and doze off, but I want the other stuff too much.  There is a picture of my great-grandmother, my mother's mother's mother standing with billowing breasts and a basically billowing body, and she used a cane, (to hit people sometimes) and I don't want to be her.  My father's mother's mother was tall and skinny, but those genes went to someone else--someone who wasn't me or my cousins. 

Age now keeps receding.  56 is not what it once was, to the point where no one knows exactly what it is, and what should be.  But whatever it is, I want it to be the most current it can be. 

Pain

Pain is a remarkable motivator.  Pain, and I'm not saying this to be dramatic, is my constant companion.  Except maybe when I'm sitting.  Sometimes.  Which is sort of evil in itself, because I'm sitting there, feeling normal, and then I stand up and WHOMP! it hits me again.  But pain is what got me to the doctor.

I think I know why my hip deteriorated.  It's a long story and actually sort of boring, but let's just say that for the last seven years, the pain has been increasing steadily.  Late winter it finally got to the point where I more or less had no sort of life--pain prevented me from a five-minute walk.  Going grocery shopping, even with that walker in disguise, a shopping cart, left me in a sweat.  I finally decided I had to see a doctor, and so I finally made an appointment. I didn't exactly pick one out of a hat, but I more or less did.  I went to the same practice my father had gone to, before he died, just less than a year ago.

The first visit was awful--because I hadn't been in so long.  My primary reason, of course, was the pain in my hip, but there were many more things to be interested in.  My blood pressure.  The fact I hadn't had a pap smear since 2002.  The fact that I hadn't had a mammogram in that long as well.  I still haven't gotten my colonoscopy, to be honest.

Well, those things were addressed, and I'm the proud owner of four meds a day, two for blood pressure and two for pain.  Does this make me happy?  Not in the least.  But it does give me something to work toward.

So here's what I found out, when I wrenched the attention back to my hip.  I found out that the cartilage is completely gone and that it's bone on bone and that I limp because of the loss of cartilage--my left leg is now 4 (or so) mm shorter than my right one.  I found out that the only way to fix that is a hip replacement.  I'm 56.  I've heard both--you're too young!  and, better to do it now, while you're young!  I don't feel as though I have a huge choice.  The pain is too intense.  I've been attending physical therapy (which also causes pain, but at least I think it's getting me somewhere) and so I can do more things than I could before, but the pain in there.

The pain is always there.  The pain is there when I cook, when I work out, when I walk, when I drive, when I sleep or try to sleep.  When I have sex.  When I brush my teeth, when I go to church, when...you get the point.  And one of the most frustrating things is that it's unpredictable.  I have no idea how bad it's going to be at any given moment.  Sometimes it brings tears to my eyes (and I don't cry that easily) and sometimes it recedes and I'm nearly my old self. 

I'm a little afraid of a replacement.  The doctor I finally fetched up with (and more about him and the others, another day) seems to think I'm a fine candidate.  I'm looking forward to a lack of pain.  I'm looking forward to going on walks.  But I'm also looking forward to high heels.  That was something I googled as soon as I started thinking seriously about a hip replacement and before I had even seen a doctor.  Could I wear high heels after?  (The answer, if you're interested) seems to be yes, if I'm good about PT and if I'm patient.  I'll probably never be able to wear skyscrapers, and those vertiginous platforms are probably out, but I think I can probably do 3" again, if I'm good, and patient.

And then, with any luck, the only pain I'll have to worry about is if the shoes pinch.