8 JAN 2019: THR accomplished.
22 JAN 2019: 1st Post-op followup and 1st PT. Everything looks good. Weaned off the Oxycodone in 10 days. There’s a disturbing perception of the left leg feeling significantly longer. Left foot got hurt a little (bruised), but otherwise fine. Much PT to do now..
1 FEB 2019: Continuing to use cane in the left(?) hand for muscle strain and soreness on the right side. It is spiking to unprecedented levels now that I’ve started walking on the new left hip*.
8 FEB 2019: Muscle strain persists, despite walking better and using the cane less. Tried not using the cane continuously, but the autonomous muscle clenching remains very strong. Tightness/tension builds in the lumbar/pelvic area immediately upon getting out of bed and any time I am on my feet. Can’t stand up straight and/or walk properly at all.
11 MAR 2019: The autonomous clench response continues producing severe tightening/strain in the lower back, thighs and glutes. Walked 30 minutes yesterday with minimal joint discomfort, but right leg was paralyzed. PT (Jeff) says it’s normal, just need to work it out. This is a new symptom.
3 APR 2019: Muscle clenching continues impairing my ability to walk or stay on my feet. Using foam roller on back/glutes multiple times/day for temporary relief. All lumbar supporting musculature is in a severe chronic strain condition.
CUMULATIVE ASSESSMENT: Muscle tensing became extremely aggravated in the early weeks following the 8 JAN surgery on the left hip.* Been using a cane primarily in the left(?) hand, both before and after the recent surgery. Strain starts building in my lower torso, hips and legs immediately upon getting up in the morning. Glutes and right thigh continue to worsen after being on my feet, with or without a cane. The longer I walk or just stay on my feet, the worse it gets.
10 APR 2019: No improvement. Can’t stay on my feet without sitting breaks every half hour. Being on my feet, not even walking, stiffens the glutes, back and right thigh. Right thigh becomes the most painful. Low-level daily activity leaves me struggling to walk at all by the end of the day.
26 APR 2019: Erectors still flaring/tensing immediately upon getting out of bed in the morning. The lumbar obviously got tweaked during the hip procedure. That has been the only issue since I stopped taking painkillers 10 days after the operation.* Cannot remain on my feet 5 minutes before glute-erector-thigh tightening ensues. Hip healed and re-hab’d quickly, despite difficulty working through that with the accompanying lumbar issue.
16 MAY 2019: Still have a perpetual knot in the right glute, right thigh always stiff/sore.and the erectors went from feeling like steel cables up my back, to more like taught ropes now. The sensation is the same as first described to Jeff (PT) back around the middle of March – like wearing concrete underpants. Hard to imagine this is considered normal. New hip is fine, only mild discomfort, and reaching flexibility not seen in years.
4+ months after the THR using cane almost always, sometimes switching hands. Cannot stay on my feet, much less walk. The hip was more painful, but I actually feel worse than before the operation now.
17 MAY 2019: Showed this to George (Ortho PA) today and he says nothing to worry about, could take up to a year for soft tissue mal-adaptation from the surgery to re-adjust. Problem is, he doesn’t recognize the fact that the mal-adaptations are from the surgery itself!
6 JUN 2019: It is improving. Today was the 1st day I noticed being able to stay up for longer periods. Muscle tensing is still there, but lessening. I am beginning to sense the lingering effects of deep muscle strain damage in my right thigh – still very sore. Rehab discomfort is still strong on the foam roller from ongoing muscle strain in the back, glutes and thighs. But I am however, slowly re-gaining functionality.
7 JUN 2019: Upon reflection it is clear to me, my biggest issue arising from the 8 Jan THR was the period of time amounting to over a year from when I knew I needed a hip replacement, to when I convinced VA staff I needed a hip replacement. I suffered through a malfunctioning hip for a year, throwing the entire right side of my body into an acute compensating strain condition. I knew that prior to the surgery. Dr. Sluder could have known that by just listening to me, but chose rather to do some exams looking for lumbar issues. Delay. Dr. Park could have known that when he saw me enter the office using a cane in my left hand, assuming he had a better idea about that, electing to have a blood test causing further delay, then scheduled me 4 months out. Fortunately near-frantic begging on my part then shortened that wait. The cure has been worse than the disease for the past 6 months, thanks mostly to VA inaction, indecisiveness, diagnostic confusion and scheduling nonsense.
https://elifesciences.org/articles/45183
7 JUN 19: Submitted IRIS Inquiry 190607-000418 to complain about the slow-roll and post-op disdain. Got a call from George about 8hrs later, going back on the 18th.
18 JUN 19: Went through it again w/George and (3hrs later) Dr. Park. Explanation seems to be maybe they cracked something with a holding pin(?) during surgery. X-Ray and MRI orders submitted. Symptoms have not improved much, only evened out side-to-side. Both glutes now with perpetual knots, erectors constantly tense any time standing or walking, and even the obliques are now strained to the point of chronic pain, which I began noticing only just last week. Still can’t walk properly – slowly with small steps is the best I can tolerate.
26 JUN 19: Called to ask about the X-Ray – negative – made MRI appnt for 16 JUL.
5 JUL 19: Received sacroiliac and kidney support belts from Amazon. Feels better wearing those, staying up longer, but still can’t walk right – only light, small steps, while the largest muscles in my body autonomously compensate, leaving me physically exhausted and hurting all day long.
16 JUL 19: Had sacrum and lumbar MRIs. Symptoms have shifted and gotten worse. Thighs have recovered, glutes remain “less” strained. Erectors and obliques are firing continuously any time on my feet. The right side erector emits a radiating sensation with moderate to severe pain now. The hip feels good, like it’s still going through different healing stages with minor, intermittent discomfort.
21 JUL 19: MRI shows an L4-5 annulus tear. Sounds about right. I just thought that was the worst of the muscle strain.
27 JUL 19: Dr. Brikins said he ordered an EMG test and started the process of outside referral due to time/travel constraint.
8 AUG 19: Learned that neurology nixed the consult put in by Dr. Binkis, saying Physical Therapy would be making that call. When did physical therapists start diagnosing spinal injuries?
15 AUG 19: Managed to get an appointment with a spine doctor in Longmont next week. Been wondering how much worse PT made this from what they did to me back in Jan-Feb. It’s definitely not getting any better. Rolling knots out of both glutes every night. Entire lower torso, hips and thighs in continuous, chronic strain. Any standing or walking causes increasing tightening in the erectors, glutes and obliques. Getting winded with minor exertion. Radiating ache from right side of L4-5 accompanied with sharp jabs on bending/twisting.
The insomnia with this is different than earlier bouts. Falling asleep is no problem. Lying prone is the only time the primary muscle tensing symptoms seem to subside. Even just sitting is a bit uncomfortable. Then, if the dogs bark or I get up to pee at 4am, there’s no going back to sleep, because any meds are worn off and the dull ache from L4-5 I don’t notice as much throughout the day becomes emergent.
21 AUG 19: Submitted paper form for Primary Care transfer at/to Loveland clinic.
29 AUG 19: Dr. Gerlach at Front Range Orthopedics confirms conservative treatment only for the annulus tear. He clearly was not interested. Started with a 10-minute spiel about low back pain affecting millions and how there’s not much that can be done. He literally simply refused to believe me telling him it was a toxic annular tear from a traumatic injury.
4 SEP 19: Waited on hold for 40 minutes attempting to re-schedule the PT appointment from last week which conflicted with the spine eval. I could only afford to wait 20 minutes yesterday. That part sure seems worse now, too. Finally determined later in the day when I managed to get through, the consult was invalidated, can’t re-schedule – need a new consult.
6 SEP 2019: Left another message with “old” primary care. Wondering how long it takes to make that switch. Sluder still shows in the system and the girl in Loveland said it could take up to a month to process the change. Will an new primary care doctor be any help?
24 SEP 2019: Today a different spine Dr. in Longmont by the name of Smith said he wanted to isolate the problem with steroid or anesthetic injections. I declined his offer. A CT Discogram is the only diagnostic tool that will show the extent of the annular tear. Apparently the spine consult needs re-written correctly. Symptoms are morphing into a more complete neuro-muscular dysfunction up and down the entire right side of my body, with increasing acute pain from the lower-right spine.
7 OCT: 2019: Heaviness in the glutes, right thigh sore to the core, erectors and obliques flaring badly, knots throughout my right side and glutes. Symptoms seem to have gone full circle and intensified, including severe strain and knotting all the way up my back and into my shoulder. Increasingly sharp, acute jabs from the lower right lumbar on bending and twisting.
12 OCT 2019: The glute symptom was more of a burning sensation for a period of a month or so early summer – but it started in January with this same heaviness feeling like it’s returned to now. There is now also a low-to-moderate aching pain in both butt muscles from the perennial knots now embedded there. A dull ache is also building on the right side in the cervical/thorasic transition zone, with much knotting concentrated in the rhomboidius, infraspinatus, and latissimus dorsi. Up-time tolerance is waning. Started taking the Flexeril prescribed by Dr. Thieman today.
16 OCT 2019: Flexeril had a modest effect, making walking a bit less uncomfortable. The constipation wasn’t worth it. Distress/pain has been slowly rising for a couple months – steady, moderate aching pain emanating from the lower/right spine, most apparent upon getting out of bed. Seems a little worse, seemingly lasting a little longer every day.
1 NOV 2019: Halfway through a course of Methylprednisone CSI gave me and it appears to do nothing. I actually felt worse yesterday, but that was probably just the same negative trajectory I’ve been on pretty much all year.
2 NOV 2019: On further eval, the steroid is working to diminish the morning pain from L4-5 swelling overnight – just took a few days to for effect to happen. This is beneficial, with the only perceived side-effects so far being a mild tension headache – probably unrelated.
7 NOV 2019: Here’s the list:
Morning acute pain from swollen L4-5
Insomnia (from above)
Aberrant nerve signaling (muscle twitching, mostly right glute)
Muscle tightening/clenching when standing or walking (Glutes, erectors
and right thigh)
– with associated acute muscle pain if pushed more than around 10-20
minutes, depending on what I am doing
Muscle knotting in both glutes, right erectors and right shoulder/back
Limp to the right
Ilial flaring badly/acutely
Entire right side of body lit up with the tension thing (I can actually feel in
the right side of my head)
BP steadily on the rise for the past couple months – presently clocking around 150/90, but I think my own general anxiety level might be contributing to that. I have to remember to try it right after I wake up to go to bed one of these days.
13 NOV 2019: Morning symptom (L4-5 swelling) is bad again – worse than ever now. Steroid worn off?
2 DEC 2019: After a brief few days respite from the discogram steroid injection, acute pain from the injury site is worse than ever. Muscle clenching/strain continues unabated. Muscle relaxant pills makes walking and standing slightly less uncomfortable, with accompanying constipation. Radiculopathy from nerve damage has settled into a basically static state of exhausted muscle tissue throughout my entire midsection, right thigh and right torso. Can’t hardly stand or walk at all anymore without great discomfort. Using cane in left hand again, always.
14 DEC 2019: Constant glow from the injury site itself is now on the rise, probably I suspect, due to the discogram. It’s running a steady 3-4P level now, with the occasional movement jabs amplified as well. Activity like walking or just simply standing push it much higher, more quickly now. Being basically sedentary has become a constant state of discomfort, punctuated with insomnia and acute flare-ups. Muscle clenching and aberrant signaling continues unabated, depending on activity and medication levels.
20 JAN 20: Worsening symptoms now include the left leg and right shoulder. I suspect the present shoulder portion may be related more to the preexisting cervical condition itself being somehow aggravated by the worsening lumbar, due to lack of therapy(?). Re-started cervical spine decompression last week, but staying away from inversion on the lumbar for now. Radiculoppathy is forcing me into a state of complete immobility. Glutes, erectors, obliques and thighs totally exhausted, stiff and sore 24×7. Any ambulatory activity at all is a difficult, painful struggle. Fusion surgery scheduled for Feb 11th.
10 FEB 20: My only question at this point is how long can it go before going totally septic and killing me?
14 FEB 20: two days into recovery and things seem good. I’m getting some strange sensation in back of the left knee.
23 FEB 20: Staples out 2 days ago. Nerve pain initially felt in back of the knees is expected and slowly resolving. The injury site (L4-5) feels much different – not anything like before. Bone pain from surgery rebuild is about all I feel in there now. Found a couple more rehab stretches online.
26 FEB 20: Post-Op pain is >50% resolved at this point – almost off the oxycodone. It makes a good sleeping pill. Sleep loss has been an issue all along. IME, spinal fusion hurts more than a hip replacement, but resolves quicker. Stretches going well, adding up. It’s like a year’s worth of that crippling problem is gone. Morning pain from the injury site is gone, and the need to constantly sit and stay off my feet is diminishing. Right leg and knee remain unusually tender and sore. A year of waiting for a hip replacement, followed by another year of stumbling around on a broken back took their toll. BP normal at 114/67.
4 MAR 20: Off painkiller 4 days, everything feels good. Constant nerve pain disappeared at some point, not exactly sure. Stopping the Gabapentin. Sleeping more normally, using brace less. Still feeling sharp jabs on movement at the job site, normal, expected. Radiculopathy seems diminishing, with muscle strain focused in the erectors and obliques now and minor cramping in both thighs. Glute and upper-right back strain diminishing. Feels like I am finally on the road to recovery.
9 MAR 20: Stayed on my feet almost an hour walking the dogs and watering outside yesterday. Strong clenching focused in the erectors, seems normal under the circumstances. That was the longest I’ve been able to stay up since before the hip replacement, January 2019.
16 MAR 20: 1st followup w/Dr. Donner showed the bone grafts healing as expected. All other symptoms have evened out and diminished noticeably. Midsection still straining, but the back brace makes walking tolerable. It is subsiding now, because the switch that was turning it on (spinal stenosis from an inflamed, festering injury) is gone. My body still knows it has a major repair underway, but is now successfully dealing with the surgery, instead of fighting a losing battle against an internal injury. I’ll be ramping up later this week after another little cold snap.
31 MAR 20: Overall improvement continues at a steady, slow pace. Uptime increase to an hour or more with the back brace now achievable. Imposing lumbar and hamstring flexibility loss drives increasing rehab effort. Strong radiculopathy focused at the lumbar continues stressing the erectors, obliques, glutes and ilials. Most discomfort and pain from the job site is resolved. There is a sense of something missing there, I suspect akin to the feeling an amputee has for a lost appendage. I can sense there “was” something there, but it doesn’t hurt any more, with the old connections to it faintly sparking like downed power lines.
27 APR 20: 2nd followup with Dr. Donner showed the lumbar healing as expected. Questions about losing the brace and increased activity were met with “be careful and don’t push it” response. So it looks like another couple months of convalescence is in order. Flexibility loss and muscle soreness from the clenching are the only troubling symptoms remaining. Minor healing discomfort in the lumbar is all that remains there. Rehab now seems to apply to the entire midsection. The new left hip apparently did not get properly re-habbed, due to the back injury. Right side was severely beaten by the left hip incubation period and following year of back injury abuse. Bones and joints seem good as they can possibly be now, if I can just struggle back to some state of relative normalcy.
18 MAY 20: Reached a point where I can stay up and walk more than 10 minutes at a time now, but only with the brace. Without it, tightening starts kicking in pretty quick. Flexibility is improving, but very slowly. My body seems to have an entire midsection that was pretty badly chopped up in recent years.
29 MAY 20: Went with just the kidney wrap all day yesterday, but so sore I can barely walk today.
17 JUN 20: Going all day with no structural support now. Still pretty sore by nightfall, but improving. It now seems latent effects of soft tissue damage done by a year long untreated back injury and the remaining nerve damage is what I am going through now. The most recent surgeries, both hip and lumbar fusion, are good to go.
7 JUL 20: Starting to look like a full recovery is not in the cards. Right thigh/ilial and glute remain lit with radiculopathy, now perpetually stiff and sore. There seems to be a latent imprint on the L4-5 associated soft tissue, with the entire right side of my body now normally enjoying a heavy, stiff sensation throughout. The lumbar job site itself is relatively pain free.