The Small Victories

“She’s doing what??!!!”

Apparently, this was my doctor’s response when my physical therapist ratted me out on the activities I was doing. This does not worry me as this is not the first time a doctor has made this exclamation on my behalf. My response is that if the doc hadn’t done such a great job, then why am I able to do stuff I’m not supposed to be doing? OR, if you didn’t want me maxxing out my range of motion, then why didn’t you put me in a body cast? The answer to this is that they don’t really expect you to get close before the six-week time frame is up. The other part is I think they are so used to putting new hips in people with no flexibility, that the expectations of full range of motion at 2 weeks are pretty low. Being approximately 20 years premature for this surgery, my tissues are responding pretty well, and a lifetime of beating the crap out of myself has gotten me used to pushing limits a little early in the process. So when my physical therapist told my doctor I was walking with one crutch and pushing my hip flexion past 120 degrees, the response was a little incredulous.

Not only was my PT supposed to impose a writ of cease and desist, but my doctor’s office threatened to call me and give me the what-for. I got a very funny telephone message from my PT when I was unable to successfully make it to the phone on time due to my slow crutching.

“This is a message for Tori. Tori, I talked to your doctor today about pushing your range of motion. The general consensus was ‘she’s doing what?!” Anyway, they said they might call you and I just wanted to let you know that I wasn’t trying to rat you out, but rather trying to clarify the doctor’s order....,” (which was written for 140 degrees of flexion, by the way. )

Her tone was one of professionalism and worry. While she and I both knew that no damage had been done and that all was well with my joint, we were both a little sheepish for stepping out of the doctor’s parameters. I think we both felt like a couple of kids who just got busted for staying out past curfew. No harm, no foul, but we were both anticipating the safety lecture. I had to giggle. Even at 44, I am still pushing limits and defying authority. Some people just never grow up.

Fortunately, my doctor didn’t call me at home despite having my defense rehearsed and ready. However, I spent the next few days in bed, resting and doing basic range of motion exercises just to put a little karma back in my karmic trust fund. Yawn.

It takes healthy tissues at least six weeks for healing to be complete. Two essential components comprise the healing process: Regeneration and Repair. The regeneration phase is characterized by the proliferation of surrounding undamaged specialized cells that replace damaged tissue. In repair, granulation occurs and granulating tissue matures and forms scar tissue. In the repair process, 4 broad and overlapping stages are taking place: Bleeding, Inflammation, Proliferation and Remodelling. Bleeding is often short term and is usually done 6-8 hours after injury or surgery. Next is the inflammatory phase. This phase is critical for release of chemicals that promote healing. It’s onset is immediate and peaks within 2-3 days. However, the whole process lasts over the next couple of weeks. The Proliferation phase is the generation of repair material, i.e. the production of collagen. The peak of the proliferation phase doesn’t occur for 2-3 weeks post injury (or surgery). The remodeling phase, often underestimated, is the phase where the healing tissue starts to behave like the tissue it is replacing. The remodeling phase begins when the proliferation phase peaks and goes another 2-3 weeks. These processes of healing are well-designed and there are no drugs or therapies that enhance this process. The best way to survive these healing components is to be patient, to rest, stretch, and let the body heal the way it is designed.

For someone like me, this can only spell one thing: B-O-R-E-D-O-M. No running, no jumping, no stretching, no playing. Just rest. A person of boundless energy such as myself has great difficulty with the patience required to simply “heal”. Try telling a 4 year old to lay down and rest. Yeah, it’s like that. Sure, after 1 or 2 weeks, I think it’s great. Motherhood is insanely busy and we could all use a little ‘down” time, but take it to the next level, and soon, it becomes a prison sentence. What’s a girl to do?

Well, today is the day I rode the stationary bike for the first time. It was on the Physician’s "approved" activity list, and it was like heaven. I set the bike up on our porch with the magnetic trainer and started riding. My unaffected leg did the work while my leg with the new hip went along for the ride. It was heaven. I felt semi-normal. The sun was out, the air was crisp and there was just enough breeze to make it seem like I was actually moving. I had my iPod nano cranking out the motivational tunes and I spent palpable minutes pedaling my way to normalcy. It’s funny how the small victories are so important in the recovery process. Whether it’s meeting your range of motion goals (however minimal they may seem), spending time on the stationary bike, or walking from point A to point B, it is essential to celebrate these micro-victories. The funny thing about these small affirmations of progress are that they are so subtle, and you, the healing person, are the only one that can truly appreciate them. No one celebrates them with you, and some people may think you have actually lost your last marble, but the truth is that the small victory is the spark to the fire. It’s as if you have a special secret that no one else knows, and it leads to big changes down the road.

Time flies when you celebrate the little things., and it creeps exponentially slower when you wallow in misery. It is very important that you surround yourself with happy, inspirational people and entertainment. For example, you should only rent motivational movies and listen to inspirational music while recovering from surgery. DO NOT UNDER ANY CIRCUMSTANCES, watch sappy, tear-jerking chick flicks, especially while taking pain meds. Time will literally stand still and that is a deep psychological hole for which there is no shovel big enough to dig one out. Stick to the funny stuff or the uplifting sports dramas. Some of my favorite movies include, The Replacements, The (New) Karate Kid, The Blind Side, Gladiator, The Shawshank Redemption, Miracle, Remember the Titans, and any movie where the underdog overcomes the bullying protagonist with witty one-liners and clever insolence. Movies such as these have all the elements of successful recovery: sarcasm, winning against unbeatable odds, satire, wit, did I mention sarcasm? Laugh your way through the sporty comeback movie and your own recovery will zoom by. As a bonus, you’ll have a less likely chance of doing something stupid.

Needless to say, I found my groove listening to old AC/DC tunes while pedaling a stationary bike in the crisp, outdoor sun and before I knew it, 20 minutes had zipped by. This being my first day, I thought 20 minutes was taking it easy. However, as you may guess, it was just over my limit….. I love the whooshing sound my limitations make as I whiz right by them. In a moment, I went from celebrating victory to being spanked by reality. I got stiff and sore and resorted to wrapping my butt in ice. Looks like two more days of rest lie ahead. It was worth it, because along with celebrating the small victories, there is hope. Seeing a glimpse of your future, uncrippled self does wonders for your bored, healing soul despite the minor consequence. Six weeks is no longer an eternity or a sentence. It’s merely a matter of time, and patience, and a really good movie.