Two Years Later...

Piriformis Syndrome:
I got a couple more Botox injections after Baby was born.  Since then, for the last year and a half, I've focused on strengthening through PT.  I am at the point now where I do exercise classes three times per week at the gym, albeit with very weenie weights.  But I definitely notice that if I don't exercise regularly, the piriformis spasms increase dramatically.

Hip:
The Catch-22 is that my exercise classes (squats, lunges, leg extensions) all aggravate my right hip (I am right-sided iFuse).  I have had this hip pain since Baby's birth.  I did not have this hip pain before my pregnancy with her.  My MRA revealed a labral tear in my hip.  I am managing the pain and modifying exercises to see if I can avoid surgery.  I have also asked my orthopedic surgeon his opinion on PRP (platelet-rich plasma therapy). 

SI Joints:
No pain

Strengthening

I am definitely getting stronger in PT, and my c-section pain is virtually non-existent at this point.  However, regardless of my strengthening, my glute and hip pain on my fused side is getting no long-term relief.  I feel much better immediately after my exercises, but then I have to drive or shop and the pain returns.  I am still taking lots of motrin (day) and alleve (night), along with Percocet for break-through pain once or twice a week.  After I finish my PT referral this month, I am going to ask for some new imaging if the pain is still consistent.  It's been 2 years since xrays and 3 since an MRI.  I'm sure I could go to pain management and get botox in my piriformis and maybe get something for my hip, but I don't want to do botox every three months for the rest of my life.  I want to get better.  I realize that may never be in the cards for me, but I want it anyway.  Not quite willing to accept defeat yet.  After all, I pushed and pushed until I got through with the SI pain, and now the residual, related imbalances are the only pains I have left.  Yes, they can be debilitating too, but not as much or as often as the SI pain, which was intensely crippling full time.  I'll update again once I get imaging complete. 

However, I can now say I believe that the pregnancy did not make the problem better or worse, which I am happy to live with.  I have new hip issues, but my PT thinks that's just life and aging, rather than either my fusion or my pregnancy.

Seven Weeks Post-Op

Yesterday Baby Girl was seven weeks old.  I am having aching pain in my rear, both the piriformis and gluteus medius, as usual.  My groin on the right side has a sharp pain from time to time, indicating hip involvement.  And the PT decided that my SI "flares" that I was feeling was referred pain from my low back.

That last assumption is likely correct.  The last three times I've gone in, they have put me in traction for my low back and it is oooooohhhh so nice!  And the SI "flares" have dramatically decreased. 

She has me doing one-legged bridges and side-stepping squats, the latter using a blue band around my ankles.  Actually that blue band stays with me for my clamshells and leg lifts too. This week she added in ball squats (against the wall).  Those are killer and irritate my left knee, which I strained recently, I don't know how.  I'm also doing neural flossing and some other stretches like the figure 4, pigeon stretch, and hamstring stretch.

I get discouraged because I'm so weak, and I still take so much pain medication (compared to the general population, not compared to SI victims).  However, I reminded myself today that I am only seven weeks from major surgery where I lost a great deal of blood, and I already walk 1/3 of a mile, partly uphill, as well as doing all these PT exercises.  In reality, I'm doing awesome.  Even with the new low back disc issues and new hip pain, I'm doing things now I could never have done before my surgery two years ago.

As far as medication, I'm taking naproxen every night, 800 mg ibuprofen at least once a day (sometimes twice), and an occasional Percocet for breakthrough pain (maybe twice a week). I would love it if some day I could get off the NSAIDS.  I would love to be able to get to dinnertime without pain.  I would love to be able to sit and/or stand long enough to hold a full time job again (right now the max is around 20-30 minutes without meds, maybe an hour with).  Maybe I will and maybe I won't.  But I'm taking it day by day, and today... I'm hopeful.

Better, Bit by Bit

With extensive rest, and alternating heat and ice, I am better.  Not great - I'm still dealing with SI flares and those related muscles spasming, but the abs aren't aching so much.  The hyper-sensitivity is also much better.  I start PT again on Tuesday and CAN.NOT. WAIT.  I am itching to get moving again, but have to wait until I know how to do it without hurting myself again. 

My 6-yr-old son is also starting PT for a shortened achilles, among other related things, and we'll be going together.  He's excited, so it should be fun to do together!  It may also help him understand Mommy a little more -- seeing me like that.

Sarah is growing and doing so well.  She sleeps about 8 hours at night with just one feeding half-way through.  30 minutes, typically, and we're back down for the night.  It's not as good as 8 straight hours, to be sure, but I'm so thankful that this is usually our current pattern.  She is just at one month old now.

Pulled Muscles, SI Flares

I have pulled two different abdominal muscles, and lemme tell you that hurts like heck.  For the left one I spent three days hunched over and having to push in on the spot just in order to stand.  It does make me question my c-section decision -- the fact that I've had so much trouble with this recovery, and that, at 3 1/2 weeks out, I still have so much pain.  Percocet doesn't even touch it at this point.

And BOTH my SI's are flaring up now, from time to time.  Even the fused side, which I don't understand.  I have requested the medical release and the new referral for PT, and both docs agreed, but the PT hasn't received them yet.  Being Friday afternoon, I'll have to wait all weekend and try again Monday.  And even once they receive them, it will likely be 2-4 weeks before PT can get me in.  I am in PAIN.  And I just want to enjoy my baby.  Trying to believe this is all temporary, but having lived through extensive chronic pain in the past, of course I'm getting nervous.

It's weird that I had so very little pain late in pregnancy but am fighting like crazy now trying to make it through.

Drugs

Just got out of my 2 week post partum check up. She said I'm taking too much Motrin, since I'm still taking it around the clock. She did offer me one more Rx for Percocet, God bless her. She said most people don't have much pain past the first week, and I have more because of my chronic pain issues. So she was sympathetic but also wants me to wean off the Motrin. How do you do that? I took Motrin around the clock for 3 years before I got pregnant and Tylenol around the clock after that.  But, I can tell I'm getting better every day.  My goal is to arrive at my 6 week check up and show her I still have half my Percocet left.  That's my goal.  Whether I reach it is another story.

She's here!

Sorry it's taken me so long to update the blog. Sarah arrived two weeks ago.  The c-section was beyond difficult, with a terrible reaction to the spinal which bottomed out my blood pressure and raised my heart rate to 145. Once they got that under control and started cutting, I had a 40% blood volume loss. My hemoglobin was down to 7.5.  So I had anemia to deal with, on top of post op pain and a hungry newborn. But she's worth every pain and complication.

On the SI front, my old friends piriformis and gluteus medius spasms are back. I'm sure my inactivity has a lot to do with that. When I'm able to take a percocet, that helps all my issues, but since my OB doesn't believe in giving too many pain meds, she gave me 3 1/2 days' worth of percocet for my 6 week recovery. So I've been rationing those bad boys and choosing to hug ice packs instead whenever I can stand it. I'm hoping to get back into PT soon, but that depends on getting a medical release from the OB, getting a new referral from the PCM, and managing to get a few appointments in before school lets out. Else, I don't know what I'll do with my three kids 2-3 times per week during the summer. Hubs is off work for April, but he won't be able to watch my kids all summer. Somehow it will all work out, just, in my sleep-deprived fog, I don't quite see how yet.