Monday, December 31, 2007

Learning As I Go not mix alcohol with antibiotics (or at least Augmentin)
already had 2 incidents of my ever so special 'Susie Puking'
I need to add 'no puking' to my New Year's Resolution
This after less than half a glass of Chardonay...I told you I was a cheap date.

I was just remembering how I spent last New Year's Eve...I did not have a babysitter, I let J go out to our friend's party since I was no fun with undiagnosed hip pain, I was in bed early, and moving my hip in and out of provacative position, just to make sure there was still a problem, and that I wasn' crazy, since I had my first appt with Dr.Kelly on 1/3, and I was not being sent home with a diagnosis of 'nut job', or worse.....more PT!!! Looking back, I was right, there was a 'real' problem, there was no need to torture myself like that!! Again, learning as I go!!!

Why Can't Things Ever Be Perfect???

Yes, I span (spun? spinned?), I am beyond thrilled!!!
Yesterday, things in sinus infection world got bad. My eye got really red and swollen.....this was not good. Luckily, my brother in law is an opthamologist, so he came to my rescue. The redness and swelling were a result of the sinus infection, so he brought over antibiotics and a nasal spray. I have always though nasal sprays were gross, and I have always refused to use one....but I was desperate, and it made a huge difference!!! Since I felt slightly better today, I decided it was time to Spin!!!

The ride was great,I had NO HIP PAIN. It was incredible, I remember pre-op I would get right sided groin pain from riding, especially climbing. I didn't do any heavy climbing today, or any fast sprinting....I am not ready, but everything was painfree and fabulous.

I am still having the thigh tenderness though. It is still a problem if I lean with my thigh into a treatment table at work, or if one of the kids touched my leg. Otherwise, I can handle it. L had a playdate today, and it turns out the boy's father whose house she was at is a general surgeon who specializes in wound healing. I explained my situation to him, and asked his opinion. He said it may be a nicked nerve, and I should call my OS ASAP and get a 5% lidocaine patch for it. I did not call, I am obviously going to 'google' the heck out of 'lidocaine patch'. I have only seen them on patients with severe, uncontrollable pain. Basically, when there is nothing else to do for a patient and they get sent to pain management, they come back with these patches. Great! Just what I need!!
My ride exacerbated my pain/ tenderness...a lot. At first, it was not pain, but 'annoyingness', I can't think of a better word. It was not burning, aching, tingling, numb...possibly close to throbbing, but not really. Towards the end it became painful. Now it is back to annoyingness!!! Ahhhh!! Just when things were really starting to look good!!!!

My New Year's Resolution is to stay out of Dr. Kelly's OR!!!!! Or any OR for that matter!!!
Happy New Years 2008!!!



Sunday, December 30, 2007

The True Test Drive....I give my Hip a B-

I had it this morning. I hate the winter, I hate the cold, I hate ice...I am from Miami....I left for college about 10 years ago and still long for warm weather.
I decided to take the kids out for a walk this morning, a real walk, in the double stroller. I don't think we had done that since my surgery, at least not this distance. I bundled everyone up, stuck them inside the stroller sleeping bags and headed out. The stroller must have weighed 100 lbs. They either got really big in the last 7 weeks or the added weight of winter gear is more than I imagined.

I did have some pain during my walk. Nothing crazy, but pain. Mostly the adductor insertion point, or possibly joint pain, it was hard to tell while I was walking and with all the clothes on. Also, my psoas acted up a bit. but now, 6 hours later, I am fine.

Last night, I had some time on my hands so I went through some old posts, August-November. I am shocked, things got pretty bad. How quickly we forget when things are better. How lucky I feel that I don't have that kind of pain and the emotional issues I went through those months, it absolutely sucked! I know that there are so many more people dealing with similar issues who are not so lucky (or persistent, pains in the ass) to get it taken care of so quickly. And even more people still searching for a diagnosis of their hip pain. It makes me sad. At least I hope that with my blog, more people will learn about their pain and symptoms and seek the appropriate care.

I know everyone is wondering what will become of my PT routine. I am a quitter!! I think I am taking a leave of absence for the time being and seeing how I fare. If I need it, I will be taken back in with open arms!! But the next few weeks will be difficult with the nanny issues, travelling etc, and I feel great! So I am taking the liberty of dropping out. I have not done anything on my own. I should, at the least, be working on my adductors since that is my 'weakest link'. I am not. I still have hopes to return to spinning, just as soon as I am not sick anymore. I can't even make it through the day without a nap at this point. I am calling the doctor tomorrow, regardless of anything!!!

Saturday, December 29, 2007

A Look Into the Past

My neighbor left me a trashy magazine at my door today. We had been discussing the Brittany Spear's sister pregnancy thing and she mentioned that she had bought OK magazine bc it featured a story on it. I read the story (nothing out of the ordinary for a teenage pregnancy) and then read my 2008 horoscope, honestly, this was my horoscope:
Health: Last year exacerbated health issues for many Cancers, mainly due to stress and demanding work schedules. This year, your health improves, and you should have more of that cherished nesting time. Add variety to your workouts.....

I wish I knew this a year ago and I would have been prepared! 2007 brought more doctor's visits, diagnostic tests, radiation exposure and surgeries than many people experience in a year.

I think I am not going to PT on Monday, and will soon take on the official 'dropout' status.I had better keep my mouth closed though. After my second surgery,P and I had discussed 'dropping out' at 6 weeks since I was doing so well but then I had the joint capsule/ psychotic psoas issue, as well as the whole 'revision BS'.

SHIT! I had though that it was 6 weeks out when that happened, and I was free and clear. Seems like it was closer to the 2 month mark......(color draining from my face) that whole episode and the next few days were awful, especially the next morning. But I will keep a positive attitude and keep plugging along.

On a more negative note, I am still soooo sick. I am definitely going to the doctor on Monday, there is no question that I have a raging sinus infection and NEED antibiotics. It is sad that I have an entire arsenal of narcotics here, I could easily maintain a healthy drug habit with all of my pills, but I lack a simple Z-pack!!!

Thursday, December 27, 2007

Making Good Always

I went ice skating today. I went ice skating in lieu of going to the doctor for my throat/ ear/ sinuses and cough. The premise was that we would call a friend tonight to call in a Rx for me but...he is on vacation. So I am in bed, prior to 9PM, having just taken cough medicine, which totally wipes me out (at least it doesn't make me puke), and freaking out since my nanny is now officially on vacation.

I woke up this morning and became super mom/ housewife, once again. 2 loads of laundry, dishes, cooking and cleaning up. For those of you who know me, I can be a bit of a diva at times, so this no nanny business is freaking me out. To cover my ass(ets), I have one person babysitting only, and one person cleaning only. So tomorrow, I will actually have a 'staff' in my home so I can comfortably go to work and know things will (hopefully) get done and the kids will be ok. But just to make sure, I got the house ready today so that day #1 would not be too overwhelming, hence the laundry and cleaning. J said he has never seen me so domestic!

So after my cleaning streak, we went ice skating. I was pretty scared, I should not be ice skating at 6 weeks...I should probably not be ice skating even at 12 weeks! But I did. If I was my patient, I would absolutely have put a stop to the ice skating. My hip friend Amy is a professional ice skater, and was not allowed back on the ice after a scope for JUST a labral tear for 8 weeks, and she clearly knew how to skate...well! But L really wanted to go, and I really wanted to take her. Luckily, she was not too keen on ice skating, so we only made it one lap, it took about 20 minutes! I should have followed her off the ice and called it a day, but no, I decided to try a few laps. Interestingly, I could only do a single leg skate. My right leg just wouldn't work. I guess it was sending me a message.

When I came off of the ice, my ITB and TFL really hurt. But the joint is good, painfree and intact! We had a great time the rest of the day as my kids always seem to be up for an adventure.

We were at an indoor amusement/ attraction center, and they had some indoor kiddie rides. They were on the wild side, but my kids never say no to adventure. One ride took you straight up and dropped you down little by little in jolts, looked scary as hell. L tried it with a friend, L loved it but the friend freaked out. L wanted to go again, and Jk wanted to join her. Jk is 2....I said absolutely not. But he insisted and threw a tantrum, and the ride operator assured me it was safe for him and would stop it if he freaked I let him go. The kid loved it. I had to turn away and not watch bc he was wiggling around in his seat and had his hands in the air....but he had a great time!
He also rode the kiddie version of 'teacups', each time it turned, he was flung into the side of his cup, he realized that if he didn't hold on to the handlebar, he would be flung harder and faster, so he let go. Again,I almost had a heart attack, but he was having the time of his life.

Now they are both sleeping very soundly, and I am ready to join them, as I figure out how to juggle my schedule tomorrow and see all my patients, see my kids and get to the doctor!!!

Wednesday, December 26, 2007

I Think I Am Going to Become a PT Dropout

I have had it, for real this time. It has been 9 months, like a PT pregnancy, nausea and vomiting included, as well as back pain, skin marks and plenty of discomfort. I think I am doing amazingly well for 6 weeks, I am even considering going ice skating tomorrow. My only persistent issue is the 'invisible scar' pain. P worked on it today, without any progress. It is just a sore area, just anterior to the greater trochanter, across and diagonal, covering a good chunk of thigh. P did some ART there, thinking it was my sartorius, but this did not help either, other than to cause a lot of pain.

I am bored beyond belief with the exercises, my strength rocks, other than adductors, which measured today at 4-/5 on the right and 3+/5 on the left. I can technically work on this at home.

I am sooooo ready to go spinning but am still really sick. I may actually have to go to the doctor tomorrow, which poses a slight problem since I made a promise to myself when I had my sutures removed after scope #2 . (see that post if you really care :-)

So, if anyone has a solution for my invisible bruise, I would love an answer since it is extremely irritating and painful.

Tuesday, December 25, 2007

Pictures From The Train Show

We had a lot of fun but the kids have become impossible to photograph, they are so wiggly!!!!!!!!!!!!

The cutest tushies!

Monday, December 24, 2007

6 Week Update

I can't believe it has been 6 weeks since my revision surgery. I see that there are a lot of new readers, so welcome, I hope you are enjoying this pathetic rendition of what my life has become!!! J/K!! I am actually really happy!

Just to recap- I had a revision hip arthroscopy on November 12, 2007 after my original scope on 3/5/07 failed secondary to residual FAI (femoroacetabular impingement). I originally had a labral tear and cam and pincer FAI, the initial surgery did not address the cam FAI (long story). In the long run, I am very happy my surgeon was not overly aggressive because you can always go back in and take down more bone, but you can never put it back!

So, 3 hip arthroscopies later, I can say that it was all worth it because I am in a much better place.

Just yesterday, we went to the NY Botanical Gardens holiday train show, it was our 3rd year going, I guess it is a tradition now! I have vivid memories of going last year. My hip hurt so much, and this was before I had been 'officially' diagnosed. I was so anxious at the time, as well as frustrated that the simple task of pushing my stroller hurt. Yesterday was a pleasure, for my hip anyway. We waited in line for over 40 minutes just to get in, and then the entire show was done in 'line form'. The kids loved it, and we had a blast. I never once thought about my hip!

I cannot remember if I have joint pain. Clearly, it is not an issue. What is still an issue is the 'invisible bruise' on my thigh.It still bothers me at work, when leaning with that leg against a treatment table. I have learned to fold a towel in between me and the table to help add more cushioning and protection there. The scope sites have been neglected this time so are tender to the touch, they are in the vicinity of the 'invisible bruise', so the entire area is tender to the touch, still.

My numbness is still there, and most recently has began to burn. It is not constant, and has only happened a few times, but is quite irritating. The alternative would be to try a heavy duty med called Lyrica, but the side effects are pretty intense, so I can only imagine what that would do to me, so no thank you! Hopefully it will not get worse than this.

My pain in the ass is better, but my piriformis is still in spasm, not as bad as last week though, phew. I had PT today and had P work on the scars and 'invisible bruise' and stretch my psoas, which is tight (but not so tight it needs to be released!!!)

I am supposed to go back to Spinnning today/ this week as per my own goal but I have a pretty bad sinus headache/ infection so it will have to wait a few days until it clears! Tomorrow is a new day though!!!!!

My left side is almost 6 months out, doing great, with just some pretty noisy popping/ snapping. The noisiness is painfree so I am not in the least bit concerned.

Saturday, December 22, 2007

On a Nerdiness Scale of 1-10, I have reached an 11

Today, as both kids napped, I picked up a PT journal (this is not where the nerdiness ended). I began reading an article:
"Manual Therapy Intervention for a Patient With a Total Hip Arthroplasty Revision "
J Orthop Sports Phys Ther 2007;37(12):763-768.

It was about rehabbing a patient with a revision total hip replacement. As I reached the end, the authors quoted another article:
Marc J. Philippon, Mara L. Schenker, Karen K. Briggs, David A. Kuppersmith, R. Brian Maxwell, and Allston J. StubbsRevision Hip ArthroscopyAm. J. Sports Med., Nov 2007; 35: 1918 - 1921

The first article quoted the second article saying that the authors found that the primary reason for revision hip ARTHROPLASTY (i.e total hip replacement) is impingement. As I was reading, I said, out loud, WTF??? That is not what that article says, I know that article like the back of my hand and they don't speak anywhere about arthroplasty, only arthroscopy. Yes, we all know that the primary reason for a revision ARTHROSCOPY is impingement. The authors misquoted Philippon et. al. My husband thinks i have gone off the deep end...again, he can't believe I caught that, and that I plan on emailing the authors regarding their mistake!

Thursday, December 20, 2007

Distracting Pain

I think I had some ass spasms today, as well as invisible bruise pain...but I am not too sure. My knees hurt so much that everything else pales in comparison.

I woke up and they still hurt,I think the left is worse than the right, but it changes. I went to acupuncture today, and it was actually pretty cool. I asked him to be careful when putting the needles in my leg bc of the MCL sprains. He asked if I wanted him to treat that too, so I said ok. He palpated around me knees and felt where it hurt, then he put some needles into my elbows and felt my knees again... most of the pain was gone. There was still an area that was painful, so he adjusted one of the elbow needles and it got better. All I can say is FREAKY. Unfortunately it did not have long lasting effects, they still hurt. I iced a little tonight but lost my icepack to an eager 3 year old.

Why is it that I, the PT, actually injured myself during PT.
This is a lesson to all of us....Listen to yourself. I told P I didn't think I could do that exercise...but I tried it anyway......STUPID!!!!!!!!!!!!

Wednesday, December 19, 2007

The Fun Continues

Things have been 'wonderful'. Not only was my ass spasming, my thigh hurting, my adductors weak and spazzy (is that a word?), now I have blilateral MCL sprains (in my knee), whoohoo, it is a never ending party around here.

I have to admit, the MCL pain is worse than a lot of the hip related stuff, pre and post op. I have a stingy feeling on the medial side of both knees, feels like the ligament is ripping if I do certain things, but haven't been able to pinpoint what.For example, I am in bed with my laptop and they hurt. P tried taping one but it didn't really help. I should ice, it would really help snice the MCL is more superficial than say, my labrum, but I hate ice. Once again, I am hoping that I will wake up tomorrow and I will be better.

So what provoked this? Remember on Monday I tried the Fitter for my adductors. Apparently, I was sooooo not ready. It seems my knees went into too much valgus as I attempted to pull the fitter across into adduction and stressed the MCL. Ouch.

An update on my ass: It is piriformis.Much to my dismay, P did some ART on it and as painful as it was, it really did help. It hurt too. Today was rough! I am ready to pass out and have knee relief ASAP!!!!!!!!!!

I was just much more pathetic can this get, I injured myself while rehabbing!!!

Tuesday, December 18, 2007

Pain in The A$$

Before you freak out...yes, my surgery was still definitely successful. I am now dealing with the aftermath of the trauma, traction and crutches.

The first few weeks were great, I did very little, spent the first week in bed, and really was good at taking it easy. I am so done taking it easy, so now I am paying for it. It is difficult for me, I will give you an inside look at my day.

6:30 Am my phone rings, I don't pick up but let it go to voicemail. My nanny is not coming in, her back hurts and she is at the ER. I had to cancel acupuncture. I also am not sure when she is coming in. So I have to clean up the apartment. I change L's sheets, straighten up the living room, get the kids dressed (I just throw my coat on over my pajamas!) and walk L to school.

I figure since I am home, I will clean out L's room. Pre-op, all the bending and standing would have killed me, I am ok! I also made a 'fancy' lunch for Jk and I, walked to CVS and did 2 loads of laundry. Then the fun began.

I have been having serious butt pain. I can barely sit on my right cheek, I think it is piriformis but the bone hurts. I will have to see how P can figure this out as I am not letting him touch my butt! My adductors have still been acting up as well. Jk and I went to pick up L at school. He loves her friends, I think he has a crush on one of them! So they were all running around and they usually run out the door and down the block and wait at the corner. I didn't realize but Jk was with them. I saw him running towards the street and made a mad dash to get him. I still can't really run, and whatever it is I did, HURT. I got him, and was so angry afterwards as I limped to the car. I felt like my adductors were on fire. Same with my piriformis.

After school we decided to go to an indoor playground with balls and slides... Note to self: 5 weeks post-op is not enough time to be climbing rope walls and jumping in ball pits.

Needless to say, I am wiped out and in pain. I am craving anti-inflammatories! If history does repeat itself, I will be complaining for about another 4 weeks! I will not take it easy, slow down, or do less. I just can't.

I just have to remember that this is all surgical. One eventually has to resume life and cannot expect to be painfree. There is a fine line between causing damage and living life, I think I am living life, the hip will survive, if only with some complaining!!!

Hopefully I will have a good explanation to the butt pain tomorrow!!

Monday, December 17, 2007

I Still Never Learn

I spent some time tonight reading posts from August, which would put me at a similar point in recovery after my second scope. I should have just copied some of the posts and pasted them here instead of rewriting!!

It seems that my activity level is putting a damper on my pain level. I was pretty sore today, and being at work never helps this. I started to worry but see that the same thing happened in August. I guess what they is true, history does repeat itself!

My day started with pain, I hate waking up in pain, luckily I can't remember the last time this happened. Clearly yesterday's stupidity was not resolved with a good night's rest! I briefly spoke to P about the adductor and thigh pain. We agreed that nothing could be done about the thigh pain (more on it momentarily), but he agreed that the adductors needed strengthening. He decided I should do the Fitter into adduction. I didn't think I could do it, even with low resistance. He said I could and even demonstrated it to me. Ok, didn't look too bad, so I went to try it. First with the left leg. I could barely move the platform across. 'Oh', said P, 'you really are weak'. It was also really painful since all the wrong muscle tried to compensate, I felt like my patella was going to dislocate medially. Not good. So I tried a few on the right. Surprisingly, it was a little better, but still really difficult and hard on the patella. I need a few more weeks and will return to this!

We settled on standing hip adduction with a theraband and sidelying hip adduction with no weights. I was sore the rest of the day.

I was also super drained today, not sure if the pain got to me or what, but I fell asleep at 7:00 and took an amazing power nap while L slept next to me in my bed!

If history repeats itself, the next few weeks will be tough, as I return to life as it was pre-surgery with a newly shaped hip. My muscles will be sore and tight and the joint irritated and painful with my activity. But 5 1/2 months after the second scope, I am doing great and my only complaint is spasmy adductors. I can take some muscle soreness and aching joint!

Back to the pain on my thigh, which has beautifully worked itself onto the bony portion of my butt! Yep, so now it hurts to lie on my back too! Interestingly, the invisible bruise got worse when everything else hurt more, and as I gently leaned on a table or wall, it screamed out to remind me it was there. I will also have to further investigate the pain in the butt and get back to you. I will be going for acupuncture session #3 tomorrow, maybe being relaxed will help the muscles too!!!

Sunday, December 16, 2007

(Trying to) Set Limits

I just got home from a wedding, I had to wear my sexy shoes of course. This is after I attended L's ballet recital this morning. When we got there, she was being shy and didn't want to practice her solo, which consisted of her following these commands from her teacher: 'Jump out, Jump in, Jump out, Jump in, Jump out, Jump in, Boogy Woogy Woogy'. She decided that she wanted mommy to do it with her. Ok, I though, how bad can 6 little jumps be? BAD. I am such an idiot. It seems I had forgotten that less than 5 weeks ago I had a chunk of femur shaved off, so even though it has been feeling great, jumping on it wouldn't be the smartest of things to do. I am probably at risk still for a femoral neck fracture. Stupid. Anyway, I did the jumping, in fleece lined Crocs. Normally, when I do stupid things (wow, I do stupid things often enough that I can say 'normally' when referring to them), I feel the effects later, either later in the day, that evening or in the morning. Not this time. I did my jumps, took a step and was hit with 'Stupid! Why did you do that?' Even J saw me from far away and asked what I was thinking. Sometimes, a mother has to do what a mother has to do. Did I do great damage? No. Probably just some irritation on my recently shaved bone, some inflammation, no big deal. I am guessing it will feel great in the AM (I am really really hoping this)!

We then went to a wedding tonight. I did not even attempt to dance (see, I don't always do stupid things). I sat a lot, and we even went home early since my babysitter called and said the kids weren't behaving!
I am sore now, in the groin (gasp....but I am ok), it is soreness, not pain, I will live!!! I will check back in in the AM with an update!

Saturday, December 15, 2007

Pain in Weird Places

For those of you who know me well, you must be starting to realize that it is either all or nothing with me. What do I mean? I am either out, in heels, doing crazy things, or in bed, puking my guts out, and not moving. Some things never change. I am almost 5 weeks out, from a surgery I was initially told would take 3-4 months to heal from, and then 4 months later was told by my OS that he is finding patients doing still making progress at 12 months. So to put things into perspective, I am pretty far from the 12 month mark. Today I found myself out, pushing Jk in his stroller, on ice, in high heeled boots. Stupid? Absolutely. Especially when yesterday, I was leaving my building and the doorman gently reminded me that my parking lot was extremely icy and the last thing I needed was to fall! Thanks!

So after one day of gingerly walking through snowbanks and icy streets (wearing rubber, flat boots) and one day of walking in high heeled boots, I found myself with a teensy tiny limp (gasp). I don't do limps. Especially when I am so crazy and anal about gait, and how I hold on to my single crutch until every bit of evidence of a recent hip surgery and resulting Trendelenberg is gone, I found myself limping in my boots. It didn't help that I had to carry Jk and all of his 28 lbs plus a few toy trains.

I am not even sure where I hurt, it was too much to take in. It did resolve on its own when I got home and took off the boots, and put Jk down. J pushed the stroller home so that helped too.

I have been having pain in my adductors, on both sides, and they go into spasm sometimes. I think I have mentioned before, this is not something I mention to P or let him work on since it is right where my adductors insert into my pelvis. Too close for comfort, especially when we will be working together 15 minutes later. Yesterday, during my ice walk, the left side was in horrible spasm (left, yes 5 1/2 moth old surgery), and there was nothing I could do but keep 'walking' to my car. I am guessing that my adductors are really weak, resulting in this 'fun' spasm. Time to hit the gym and attack those muscles, I guess. I have been a lot more laid back about PT this time, I guess after 9 months, it sort of gets old, boring and lame (Don't tell anyone I said that).

My insurance, for some reason, is still paying for PT. I have had probably close to 90 sessions by now, my insurance covers 30 visits/ year. The people in the billing department know how to 'work the system' apparently! I am supposed to be doing 2x/week at this pint, I did one last week, and have 2 scheduled for this week. I know that after my first and second scopes, I was already doing 3x/week. I am too burnt out though!

My other weird pain is a bruiselike pain across the front of my thigh, starting medial/anterior to the greater trochanter, moving across the front of my thigh, about 1/3 of the way down. It does not hurt with activity, only to touch. It has not gotten better or worse since surgery.I am stumped. The only thing that may be related is that I had awful bruising for the first 3-4 weeks, plus all the bleeding early on.

Otherwise, things are great in post-op land!!!!

Thursday, December 13, 2007

Another Interesting Article

Radiologic and Intraoperative Findings in Revision Hip Arthroscopy

Original Article
Radiologic and Intraoperative Findings in Revision Hip Arthroscopy

Presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons, San Diego, California, February 2007.

Benton E. Heyworth M.D., a, , Michael K. Shindle M.D.a, James E. Voos M.D.a, Jonas R. Rudzki M.D.a and Bryan T. Kelly M.D.a
aHospital for Special Surgery, New York, New York, U.S.A.

Available online 5 December 2007.

Purpose: The purpose of this study was to identify possible causes of failure of hip arthroscopy by reviewing the intraoperative and radiologic findings in a series of patients requiring revision hip arthroscopy. Methods: We retrospectively reviewed 24 revision hip arthroscopy cases performed in 23 patients (14 female and 9 male; mean age, 33.6 years; 1 bilateral). The review included indications for surgery, intraoperative findings, and arthroscopic interventions for both the primary and revision surgeries. Imaging studies, including radiography, magnetic resonance imaging, and 3-dimensionally reconstructed computed tomography scans, were analyzed for the presence of preoperative bony impingement lesions (e.g., femoral head-neck junction “cam” lesions or anterosuperior acetabular “pincer” lesions). Results: The mean interval between previous hip arthroscopy and recurrence of symptoms was 6.1 months. In 13 of 24 cases (54%), patients had no significant improvement at any point after the primary hip arthroscopy. The mean interval between the previous hip arthroscopy and revision surgery was 25.6 months. Unaddressed or undertreated bony impingement lesions were found in 19 of 24 cases (79%) and were identified on imaging studies before revision hip arthroscopy. A tight psoas tendon and corresponding labral impingement lesion were identified by arthroscopic visualization in 7 of 24 cases, for which partial psoas tendon release was performed. Eight cases of failed labral repair were addressed with labral debridement and removal of suture material. Of these 8 cases, 6 also had bony impingement, which was also addressed at the time of the revision surgery. Conclusions: Failure to address bony impingement lesions of the hip and a tight psoas tendon are key factors in unsuccessful hip arthroscopy and may require revision surgery. Furthermore, failure of labral repairs may be the result of unrecognized bony impingement at the time of initial surgery. Level of Evidence: Level IV, prognostic case series.

Wednesday, December 12, 2007

1 Month PT Measurements

Hip Flexion: R=4/5 L=5/5
Hip Abd: R=4-/5 L=4/5
Hip ER: R=4/5 L=4+/5
Hip IR: R=4/5 L=4+/5
Hip Ext: R=4/5 L=4/5

Not too shabby!!!! I think this is my all time best ever, even pre-op!! Yay, no impingement, no inhibition, nothing but strength!

Work today was better than Monday, no pain until the end of my day, and even then, it was slight. I think this is a huge improvement! If it wasn't so cold, I would be testing out my limits with the double stroller!
Manually, P worked on extension mobs since I am still pretty tight anteriorly, but it is getting better. Today, me exercises consisted of single leg walking on the treadmill, I stand on the left leg on the side of the treadmill and let the right leg move backwards on the belt to the endrange of my extension. I did walking squats with a red band, isometric hip abduction, Hip IR with a blue band, hip abduction with a blue band, isometric adduction with a small ball, bridges and modified single leg bridges, sidelying abduction with added hamstring curl and IR/ER rotation, clam shells and...........

Holy shit!!!!!!!!! At 7 weeks out last time I couldn't do more than 1 1/2 SLR! This is amazing! I think Dr. Kelly added some special magic steroid so that he would never have to hear from me again!!!!! Who cares, this way we will both be happy!

THIRD TIME'S A CHARM!!!!!!!!!!!!!!!!!!!!!!!

Tuesday, December 11, 2007

South Beach Diet

Ok, I am going back on! I fell off the bandwagon after my first scope but now I need to go back on. If anyone want to be my SoBe buddy, let me know, it is always easier with a friend!!!!
I will keep you posted~

Monday, December 10, 2007

First Day Back

I WENT TO WORK TODAY!!!!!!!!!!!!!!!! want to know how it went? I actually had pain. Surprise? Not really, my job is pretty physical and was a killer pre-op. At first I was nervous bc I thought I had joint pain but it turned out to be adductor pain, which is, well, a pain, but manageable!
I was planning on taking Naprosyn when I got home (I know, big Crohn's no no) but ended up not needing it. So once again, I am flying high on life (yes, nothing else).
I skipped PT today since there was no way I was going to survive a day at work after therapy, so I will be going Wednesday only this week! We need to work on my abductor strength. I was demonstrating a step up/ down for a patient and noticed that my leg totally collapsed inward during the step down. I need to do that to head off the knee pain that will surely follow if not taken care of!

I will have P strength test me Wed. and give an update.

For those of you still having trouble, I do not mean to rub it in your faces. I have been there and want you to know that there is a light at the end of the tunnel! And when you get there, I will be there, cheering you on!

Sunday, December 9, 2007

Toys Toys Everywhere

Prior to my last surgery, this would have meant me picking up all the toys with multiple trips between the kids' bedrooms and the living room trying to sort everything out, followed by severe pain in my hip from the repeated bending and standing. Yesterday proved to be slightly different. We had our company for lunch, which totalled 5 kids under 4. After 6 hours in my house, it appeared that a hurricane had hit. Once the guests left, I was left to rearrange the entire toy collection on my own. I was nervous knowing what this had been like in the past, but couldn't bear to see my living room look like Toys R Us had thrown up in it. So after 1 1/2 hours, the toys were picked up and I could once again see the floor. But...I began having soreness in my hip. It was definitely abusive on my poor hip, who less than 4 weeks ago had a large hunk of bone shaved off, but my sanity called for a clean house. I had soreness for a few hours the rest of the night but I am happy to report that I woke up today with no problems. Whoohooo!! This really really worked, how amazing!!! I am fixed! I go back to work tomorrow!!!

Friday, December 7, 2007

Today's Accomplishments

I am having company so I finally went back to cooking, real food!!!

The menu includes soup (not shown), fish, chicken, meat and potato stew, strawberry apple souffle, popcorn cauliflower, apple pie, crunchy cookie brownies.

Wen I cook, I really cook! I have been in the kitchen all day. My leg doesn't hurt but it is very fatigued. I guess Monday will feel the same when I come home from work. I can handle this, it sure is better than it was pre-op!!!

Thursday, December 6, 2007

The Little Things In Life That Come Back To Haunt You

I was reminiscing tonight about the events of the past few months, and how lucky I feel to have a happy ending, and my thoughts turned to my career and then school. During my first year of PT school, we had gross anatomy. On the second exam, I scored a 98%, I missed one question, believe it or not, it was psoas. The muscle was tagged in a funny way and I couldn't identify it. If only I could retake that exam now....

Wednesday, December 5, 2007

If My Leg is Mine, Why Won't It Listen To Me

As Monday draws closer, and I plan on returning to work, bits of anxiety seem to be rising to the surface. I have not had any anxiety since I woke up from surgery. Now I am getting nervous. I am mentally very ready to return to work, but physically, I am not sure. My leg isn't doing what my brain commands.

Yesterday, I was walking to my car and an old lady was walking directly towards me, since I no longer use my crutch, people assume that I am 'normal' and can easily dodge these obstacles. My brain told my leg to quickly move to the right but my leg didn't quite get the message and I almost ended up colliding with the lady, I missed her by a hair.

Also, sometimes the phone will ring and I will be with the kids in one of their bedrooms, the phone will be in my bedroom, so I try to quickly get up and tell my leg to walk fast to grab the phone before voicemail picks up, but it just won't go.

There is still a little more weakness than makes me happy, but I have to keep reminding myself the extent of the work that was done plus the week I spent in bed wasting away! I am also not doing as much as I can for myself, I can do so many of my exercises at home but choose not to. I guess by the time I have time, it is really late and I would rather crash.

I am disappointed that only Jess responded to my previous post.

Tuesday, December 4, 2007

Let's Try This Again

Quick Update: I woke up today and had a serious debate with myself about taking one crutch with me to walk L to school, I hurt from the last 2 days of crutchless walking. I ended up leaving it at home and did great. As I walked, the muscles warmed up and became less achey.
On a side note- my butt hurts, like if I sit only on my right butt cheek (not that I do this often, but think of sitting/ lying in bed), also my greater trochanter is still painfu, so I am still betting on the trochanteric brsitis.

I had to go to CVS today. The pharmacy called yesterday to inform me that my Percocet which was picked up on 11/13 was never paid for (the copay). Seriously? Its been 3 weeks and you just noticed? And how the heck did you allow a controlled substance to leave without being paid for? Anyway...they had pink canes!! Had I known last week, I would have splurged on one!!

Ok, what are we trying again. I am calling on all of my readers to please post in the comments section what your symptoms of FAI/labral tear are/were. If you are a frequent poster, infrequent poster, lurker or first time reader, please comment. I want to create a list to help other people, as I was never able to come across a 'good' list. I tried this once before and it didn't really work out, let's make it work this time.


Threw Away
Hip Brace

Letting Go...of My Crutches

I went all day yesterday without crutches. It was the first time I began having any pain. Mostly, my psoas, glut med, TFL and adductors. They got really sore, I guess since I was finally using them. I tried to sit as much as possible, and kept PT light. P really worked my incisions yesterday and they REALLY hurt, as did the entire area around them.

Since I was finally 'free', I decided to run some errands at the mall that I had been putting off. Walking was difficult since I took the long way around (not on purpose) but as I 'warmed up' the muscles relaxed a little. I did develop a limp last night, since it was the end of the day and I was exhausted. But overall, the day went well.

As I sit in bed with my laptop, I feel the effects of yesterday's adventure. I will try to keep my activity light today,I need the muscles to feel better and my gait to be perfect since I am going back to work next Monday.

Sunday, December 2, 2007

Our First Snow Day

I decided I was less likely to kill myself when I went out this morning if I left my crutch at home. It went well, I had Jk's stroller to use as a 'walker', but overall I did well, I am just exhausted from it. At least I am not missing anything by being home since the weather is so awful!

Saturday, December 1, 2007

Third Op-Report

Indications: The patient is a 27 year old female with a prior hip arthroscopy with persistent pain, secondary to capsular adhesions, scar tissue and residual cam impingement.

Given her persistent symptoms and lack of improvement with nonoperative measures, she is indicated for a right hip arthroscopy and associated procedures.

After the patient was correctly identified in the holding area, she was brought to the operating room. Spinal anesthesia was then administered and she was placed in a supine position on the traction table and approximately 10 mm of distraction was achieved across the femeroacetabular joint. The right hip was then prepped and draped in a standard, surgical fashion.

A lateral portal was established under fluroscopic guidance and a distal accessory anterolateral portal was established. Arthroscopic examination demonstrated some scar tissue anterior superiorly with areas of softening and mild delamination of the anterior superior rim. There was also some synovitis throughout anteriorly superiorly and posterior superiorly. The cartilage in the femoral head was also in good condition. The acetabular cartilage was also in good condition, with the exception of the softening anterior superiorly. The labrum over the posas was in good condition.

At this point, a wide synovectomy was performed using the Tac-S radiofrequency probe and then the adhesions of the capsule, adjacent to the prior debrided labrum were removed using a beaver blade. the labral capsular junction was then debrided to remove any adhesions and scar tissue of the capsule adjacent to the labrum.

The labral tissue was freed up anterior-superiorly, anterior inferiorly and posterior superiorly, extending posterior -inferiorly. The labral tissue was in excellent condition. There was no evidence of any adhesions of the psoas tendon against the anterior inferior labrum. So no additional surgery was necessary around the psoas tendon.

All the area of the residual inflammation and irritation was anterior-superior, where the scar tissue was most prominent.

After the labral debridement, capsular scar excision and synovectomy in the central compartment, no further pathology was identified there. The traction was released and the hip was brought back into the socket for evaluation of the peripheral compartment.

A T-capsulotomy was made for better visualization at the site of presumed impingement and there was a small cam impingement lesion there that was present with evidence, also of a pincer trough.

At this point, using fluoroscopic guidance and a portal lateral to best evaluate the anterolateral neck, cam decompression was performed using the 5.5 mm high speed bur. this was contoured to the normal concavity of the inferior neck with reestablishment of normal offset.

The decompression of the cam side was extended from approximately seven o'clock anterior inferiorly, up toward the twelve o'clock position. both the lateral retinacular vessels as well as the medial synovial fold and medial___ were clearly identified and preserved throughout the procedure.

At the completion of the cam decompression, all bony debris was evacuated from the joint. Fluoroscopic guidance confirmed good reestablishment of the contour anterolaterally. The hip was dynamically moved to approximately 100 degrees and then internally rotated and no residual bony impingement was present. There was good clearance within the acetabulum, with full flexion and internal rotation.

At the completion of the cam decompression and removal of bony debris, the instruments were removed from the hip joint. The arthroscopy portals were drained of fluid and the arthroscopy portals were closed with 3-0 nylon sutures. A Marcaine cocktail was placed in the joint. The wounds were cleaned and dried. Sterile dressings were applied. The patient was awakened from anesthesia and was brought to the Post Anesthesia Care Unit having tolerated the procedure well.

What We Have Been Up To The Last 3 Weeks

Jk, in the car, on the way to Play House Disney Live

Me and Jk at the show

My awesome train set construction

Jk and L being monkeys

Jk eating my Millennial Crutches

Friday, November 30, 2007

No Cane Yet

We only had quad canes in my office, no thanks! Someone tried to fashion a cane for me out of half of a forearm crutch, again, no thanks! So it is my crutch for a bit longer. The problem, according to P, appears to be that I am not getting enough extension (or any extension) when I walk. So we worked on that with mobs, soft tissue work and strengthening into extension. He had me do single leg bridges with rotation, so you rotate away from the leg and that gives you more extension. I also did single leg walking on the treadmill to increase extension but after 5 minutes, my quad on the standing leg fatigued. I also did the Fitter into extension. Hopefully this will all help. I have my op-report, it is LONG, I will type it up and post tomorrow night when the kiddies are asleep and J is out at a bachelor party!

Thursday, November 29, 2007

To Crutch or Not To Crutch

I am tired. Crutching is a full body workout, but so is limping. I have been using my crutch for long walks but today a few times I ran in and out of a store without it. I also cooked a lot this morning and ran errands. by tonight, my limp was more than subtle. My adductors really hurt, I will run this by P tomorrow and see what he thinks. I think I need a cane, rather than 1 crutch. I don't own one, and don't want to buy one since this will be REALLY temporary. But its not like at 27 I can ask a friend to borrow a cane!! Hahaha! I will see if there is an extra one in my office tomorrow!

Wednesday, November 28, 2007

My 1 Year Anniversary

Today marks the 1 year anniversary of when my hip saga began. For anyone just beginning their journey, I can assure you that in the hands of the right surgeon, there is a light at the end of the tunnel. I am going to do a flashback to November 28, 2006.

Shit, my hip hurts. It hurts when I drive, and especially when I push the kids in the double stroller. It is a really annoying pain. It feels like something is in my joint. My friend/ PT is coming into work around 3, I will ask her to work on it and hopefully get some relief. She showed up and I told her I was dying of pain, she did a painful release on my iliacus/psoas, I felt better immediately, but in the car on my way home, things got bad again.

I went into work the next day, again, in agony. First I had one therapist stretch my hip flexors and ITB, thinking this may help. Then I had another one check it out. She said there is definitely some kind of impingement. Then I asked P for help. He was really busy so I waited until he was done seeing patients. What makes the day so memorable is that it was Jk's 1st birthday, and I was having a small dinner party, and lacking a few key ingredients. I used P's full schedule to run to the supermarket near my office but didn't find what I was looking for (which I now don't even remember what it was). P did all kinds of releases, ART, mulligan mobs...It felt good...until I was in my car again. Shit. What is this????

I got home, L had ballet and there was no food for my party! I ended up ordering pizza, Jk didn't know the difference! After we had cleaned up and the kids were in bed, I hit the computer. I had a feeling I had a labral tear, and the word impingement reverberated through my head. I think I first looked for a surgeon, before I did anything else, that is me, always thinking ahead! I was trying to remember when I had seen a hipscope, and who did them, and no one was popping into my head. At the time, there was a hipscope patient in my office and she was a wealth of information, but I wasn't willing to see her surgeon (he was in NJ), I knew it had to be someone at HSS. So I looked and searched, and researched labral tears, FAI.....Not just that night, but every night after that for weeks. After a week or 2, I decided this wasn't getting and made an appointment with Dr.Kelly. I was between him and another surgeon. I had emailed a professor of mine about this and he had recommended against the other surgeon for personal reasons. So Dr.Kelly it was. If things didn't go well, then I would pursue other options, it was just a consult, right. Hopefully he would order an MRI and get to the bottom of this. The rest is history....but in a nutshell...

3/5/07 R hip arthroscopy, Pincer impingement, labral tear debridement, synovectomy
7/2/07 L hip arthroscopy, Cam and Pincer impingement, labral tear debridement, synovectomy
11/12/07 R hip revision arthroscopy, Cam impingement, removal of scar tissue, synovectomy, upon examination, found to have beautiful psoas

11/28/07 Riding high on life (bc everything else makes me sick) and enjoying a painfree lifestyle, looking forward to ditching my single crutch very very soon! :-)

Tuesday, November 27, 2007

You Won't Believe This

I just puked.....WTF???? No more herbs for me either I guess!!!

Slowly Returning to Normal

I am slowly returning to my life as it was pre-scope, minus the pain, minus the 'am I crazy' thoughts! Today I also returned to acupuncture. As skeptical as I was, I think it was great. I had so much energy afterwards and my Crohn's issues got better. Today was no exception. I was speaking to the acupuncturist about my results.....and he checked my pulse bc that is what they do. So he said 'are you sick?', I am, I have had a cold and ear and sinus pain for a while, but have been trying to put off going to my doctor since I really don't like her anymore, after the 'stitches incident' after my second scope. So he keeps feeling my pulse, 'are you coughing anything up? do you have head pain? ear pain?', wow, is he a mind reader? I said I am sick and probably need an antibiotic, he said no, it is viral (okay???) bc my pulse is very slow and weak, my body is fighting something. Weird. He sent me home with some herbs in pill form bc there is no way I would make a tea out of dirt and drink it! I have no clue what I just took, one says take 8 pills 3 times/ day and one says take 3-4 pills 3 times/day. I hope this works. I I don't ever blog again you will know never to take strange, unknown herbs!

I have been sticking with one crutch outside, except today, I had to go to Toys R Us. Jk's b-day is Thursday and chanukah is next week. I didn't think I would be able to maneuver the shopping cart and my crutch so I left it in the car and used the cart as support. Note to self and others: carts are not intended to be substitutes for crutches. I was exhausted, really exhausted when I left, I mean, close to dead (this was before I took the herbs). I went to pick up L at school and contemplated using 2 crutches but really really didn't want to. So now my Trendelenburg is worse but I have a feeling it will be fine in the morning. Still no real pain!! Hooray!

As a gift to my hip, I had my groceries delivered today!!!

Monday, November 26, 2007

Back to Boring

My photo shoot is off! The PR company called and said they decided they didn't need more pics. I guess they finally realized that there is no story and a failed hipscope is no way to promote the hospital! Not that I have anything negative to say, in fact, I am still walking on sunshine bc I am so happy that I am doing so well and have no more FAI!

I wanted to share something not hip related, so feel free to stop reading! I cooked dinner tonight (spaghetti and meat sauce) and fed the kids and bathed them alone. It looked like a spaghetti massacre when they had finished! So I put them right in the tub and went to clean the floor and table. After a few minutes, L called me 'Jk made caca in the tub', oh shit (no pun intended) so I ran in (actually, I hobble walked quickly) to assess the damage and didn't see anything. 'L', I said, 'there is nothing there', 'Mommy, you have to put on goggles and look in the water'. I hope it sounds as funny written as it was when it happened bc I was cracking up. She always has the funniest things to say. She has also developed a new york accent, neither J or I have one, but now she says flowah, watah, papah, instead of flower, water, paper. It is so irritating.

PT, Finally!

I was late for my appointment, but I did eventually get there!! It felt like I hadn't been there in...forever! P asked what we were up to, I laughed bc we weren't up to anything really! So I rode the bike for a while, did some side to side on the wobble board since according to P I have a 'mild to moderate Trendelemburg', so when I walk, my right hip drops down bc it is not strong enough to support me yet.
I did bridges, hip adduction with a ball, hip abduction with a green theraband, lateral leg lifts. Then P showed me a progression for a new exercise he had learned at a course a few weeks ago (we are always at continuing education courses, my boss says he likes to hire PT nerds, and we so are!!!), 5 lateral (sidelying) leg lifts, then hold the leg up, 5 knee bends, then 5 times rotating into IR/ER, all while holding the leg up. I was a little shaky but I did it. Then some seated hip IR/ER with a ball in between my knees and a band around my ankle. Finally, isometric hip abduction against the wall, balancing on the right.

It sounds like a lot but it really wasn't.I am not sore at all. He did a Mulligan mob for hip extension, I put my left leg up on a chair and lunged forward, so the right went into extension, he put the Mulligan belt around my hip and applied a lateral distraction. He also did a lot of quad and hip flexor stuff and some prone anterior mobs, also for extension. I am ready for a nap!!!

Sunday, November 25, 2007

Thanksgiving Fun Cont.

Luckily we are home and have no stairs! I have minimal pain, could probably benefit from Tylenol but I have a huge aversion to anything that closely resembles a pill, or may possibly be medicinal. I didn't leave the house all day yesterday but took care of the kids crutchless. This involved breakfast, playing, lunch, naptime, snack. Luckily J did all the packing and loading of the car. We tried to minimize the stairs and stay on one level as much as possible. Stairs in and of themselves don't seem to be a problem, it was actually easier to them crutchless using a step through pattern as opposed to a step to pattern. But the hip really feels good. I have a little move I call my 'making sure I still have pain...or am I losing it', it was especially helpful post-injection 1 and 2 when the radiologist did not do a pre and post test. I stand on the affected leg and internally rotate the hip by turning my body away (out).If there is impingement, it pinches. It no longer pinches on the right, YAY!!!!! I am cured! I will have a 'brace throwing away event' soon. Interestingly, I held onto it after my first scope, something in the back of my head said to keep it. I still have the left brace too but I will toss it as well. Anyway, I wore it one day after this scope.

This morning we took the kids to a holiday cookie baking and magic show (the magician didn't show up though), it is at L's school so we walked. I walked with 2 crutches but left 1 in the stroller when we got there. Later we went out for pizza and I took one crutch. I get tired after a while, that's why in the house I was ok, I wasn't going very far in one stretch.

But it is so nice to be home, like any good Jewish family, there are always in-law issues, sibling issues and plenty of food! I have never eaten so much dessert before, hopefully my body needed all those extra calories to heal!

I return to PT tomorrow, I am not sure if I will go more than one time this week. Dr. Kelly wants me to take it slow, and it is Jk's birthday on Thursday, we are going to see Playhouse Disney Live! I will let P check my ROM and see what he thinks. Extension is going to be my biggest issue this time around I think, and I am developing some trochnateric bursitis, I think. I am still awfully bruised on the trochanter and medial to the incisions. It makes me wonder if they ever found the cushioning device that was 'missing' pre-op. L says my femur is very purple. Yes, she says femur. She is very into anatomy, and at 3, it i impressive, She knows the following bones: Scapula, clavicle, humerus, radius,ulna, phalanges, femur, patella, tibia, fibula, calcaneus. She loves medical dramas as well. We watch House, Grey's Anatomy, Private Practice and Scrubs.

I have some cute pics, we have a new camera so I will try to get J to upload them for me!! I am in bed for my daily rest!

Really Really Quick Update

I have been having trouble finding time to post as I need a few solid minutes without interruption and that is hard. It was a rarity at my in laws and I couldn't even respond to emails! I will post a longer update later. I used no crutches all day in the big house yesterday until the evening when I was just too tired so I picked up one. I woke up this morning and was ok for a few steps but then reluctantly picked up the crutch. I think I will take 2 with me in the morning when we go out and see if I can do 2 later...more to follow.

Friday, November 23, 2007

Happy Thanksgiving

We are in Boston, at my in-laws. Remember, the house with all the steps....I am being extremely non-compliant with my crutches. I am using them very little in the house since the kids are all over the place and there is not much help here. I actually just carried Jk up the stairs, crutchless, bc he wouldn't come with me when I asked nicely! It has been a difficult trip, as always! Left hip still holding up well. Actually, it is better for my left when I am off of crutches!

On the drive up, we drove with my sister in law and baby, they drove the car I didn't want to drive to my appt on Wed, it has a transmission problem and needed to be brought to Boston to be fixed.....So she drove that car and we drove our car. About an hour before we got here, the car died! So we piled all of her stuff into our car, plus the carseat, stroller, coats, blankets....My car seats 8 and we were tight! Luckily, the tow truck driver needed J to go with him to show him where to go, I ended up driving and my piriformis was not at all happy. I got to the house stiff, tight and cranky (seems to be a theme lately)!

I think we will be heading home tomorrow night to avoid traffic and crankiness!

Today I have had to walk without crutches in the house often to feed the kids, get our stuff together...I am not a happy camper! When I do too much, the incisions start to hurt and get tender. I haven't been able to have a good look at them bc they have steri-strips on them. They feel raised and hard though, P will have a field day breaking up scar tissue.

Wednesday, November 21, 2007

9 Day Revision Post-Op Appointment

My stitches are out, phew. They were really grossing me out already. My appointment went well, actually, this is probably the best appointment I have ever had. There was no talk, mention or suggestion of a future surgery! I think I turned a new page! Dr. Kelly was happy with my ROM so far, and even secretly pleased that I had been in bed for so long since it seemed to help the hip a lot. He showed me all of the scope pics, there were tons, I think more than my other 2 surgeries combined. Also the before and after x-rays. He had tons of pictures of my psoas, it looked beautiful! He said he was really nervous going in that the psoas was really going to be an issue and he had promised me he wouldn't cut it. "You were right" he said, and repeated it!! I explained that I hadn't meant to give him a hard time about it, but I truly believed from the bottom of my heart that the psoas was fine. I explained that it had always been tight and tender but hadn't changed in the whole interim of pre and post surgery and rehab. He even had a final shot of the psoas as he was coming out, just to make everyone happy!

He said there was a lot of scar tissue that he removed. The cartilage on the femoral head looked great, it was not perfect on the acetabulum but not too bad. It had been damaged slightly from the cam impingement. Now for the was there. Duh, haven't I been having impingement for a while now! The CT-scan should have picked it up, they measured the alpha angle, I have to look up the report, I believe that an alpha angle under 50 is normal and mine was 34 (don't quote me on that). Well, it turns out that I had 'special cam impingement'. It was not typical, which is why it was initially missed, it was very subtle, but not mild, meaning, it sure as hell was there but difficult to see. Just my luck! So he shaved it down and gave me a normal looking femoral head which no longer impinges ! YAY!!

I explained about the nausea and he regretted not being able to get my beloved Dr.Jules for anesthesia, but at least being in bed and doing nothing has helped with the pain. He wants me to take it easy with rehab, go slow, especially in the beginning and not to overload the other leg. Right now, it is good, and has not lost anything!

So now it all falls in the hands of rehab! I think we can handle this!!! :-)
Oh, I forgot to ask for my op-report, I will call first thing Monday morning!

I Really Am A Total Brat

A lot happened to day so I will post twice. I had a meltdown today. I knew it was coming, it was about time, I need a good meltdown every now and then. My nanny didn't come in yesterday bc her husband had surgery, major surgery, not elective, orthopaedic surgery! I need my house to look a certain way or I develop anxiety. Today, she was supposed to come around 1, take Jk to mommy and me, clean up, do laundry......but her husband wasn't doing well. She called me to tell me he was having fever and chest pain and difficulty breathing, so she needed to stay with him.

So me, the total diva, got off the phone and started crying, not because I felt bad for her, but bc I needed laundry done, the floor washed and Jk taken care of. I am shocked! How un-sympathetic of me, but it has been a long 10 days and I think this was the straw that broke the camels back. I managed to pull it together, sort of clean up the house and make it into the city for my post-op appt. I got into an argument with J over which car to take. Me, the diva, wanted my car, but since the nanny wasn't coming, J needed it to take Jk out for pizza, instead of my idea, to have J move the carseat around. Anyway, it all worked out. But I am a brat.

Tuesday, November 20, 2007

2 Steps forward....blah blah blah

No, my head is not back in the toilet! I overdid it, in a major way. My mom left this afternoon and I really have very little patience for things not being done my way. I know, this is only temporary, I should deal, but I can't. Anyway, the kids needed dinner, and they wanted more ketchup, and L wanted lemonade, then Jk wanted lemonade, then they wanted more french fries, then they needed I ditched my crutches...temporarily.

Now remember, I have had almost no pain until now...until now. Stupid, stupid, stupid. There is ignorance, where I could have said I didn't know better, but I do know better, there was no excuse. I had tears in my eyes from pain, and oh how I longed for the satisfaction of a Percocet...but ice it was. And ice really helped. As did the resumption of 2 crutches. I spread out on the couch with my precious, stolen icepack for the duration of an entire episode of Little Einsteins. Once the kids were in bed, I entered mine, and plan on staying until tomorrow and hopefully this will only be a very very temporary setback. I feel like a recovering drug addict, I long for the relief of drugs but know I can never have them again!!!

Now That Things Are Clearer....

Is it fair to say I hate the anesthesiologist? I really don't know if this is his fault, but it is easiest to blame him, since I will never see him again anyway!!!! My back hurts too, in the area of the epidural, coincidence? I think not! I don't think he liked me very much, as I think I mentioned previously, when I asked for 'Zofran, lots of Zofran', he got cocky with me and said 'studies show it makes no difference if you give more than normal....' I woke up nauseous this morning but doing better now. I long for the day that I will feel 'normal' again. To make matters worse, J is sick now too. For those of you who don't know him, he is a huge baby, so clearly, this is not good for anyone. He needs to let everyone know, every minute, that he is sick. Like we can't tell by his horribly loud hacking cough. What's even better is that since we share a bed, he hacks all over me as well, nice!

My mom is going home today, so we will be on our own, hacking cough and all. The plan was to take Jk for a haircut today, his hair has gotten a bit out of control, and my mom decided to trim his bangs bc he couldn't really see anymore, so now he looks like we purposely left a mullet on the back. He is still really cute though, if I do say so myself! The children's haircutting place here is closed Mon. and Tues., so I proposed taking him to 'real' barber shop. If it stops raining,we will head on over. I tried convincing L to get her hair cut where I get mine done. I had to take her with me a few weeks ago bc of a nanny snafu. On our way, she turned to me, and in a very serious voice she asked 'mommy, are you going to sit in a truck?'. I had to explain that grown-ups sit in special chairs and don't get to watch videos and eat lollipops during haircuts. Now, when I ask her if she wants to go where I go, she laughs and says 'don't be silly mommy, I have to go to the kid's place'!!

Monday, November 19, 2007

To Sum up a Week

The worst is over. I ate 3 meals today, and they all stayed down. Here is the current crutch situation. I walk from my bed to the bathroom with no crutches. Around the house with one crutch for short distances, but if I do too much I need 2 crutches in the house. I just got 'stuck' in the kitchen, I had 1 crutch and just couldn't walk anymore with it alone, so I needed a 'rescue'. My incisions hurt the most right now, but I feel some mild pain in the hip with 'excessive' walking. I am having anterior tightness and need to get my ass to PT. Today I became semi-compliant and did bridges and isometric hip adduction. I didn't have the motivation to go looking for my theraband yet. I will take it with me when we go away for Thanksgiving. Overall, my hip is the best post-op this time than any other time. Thank goodness, I don't think I could handle pain and nausea, or maybe I just don't feel the pain because of the nausea.

Once again, I think I was right. But no one listened to me this time. I really wanted MY anesthesiologist. I also would have been thrilled to not be sedated, I didn't even bring it up this time since I was shot down so quickly when I suggested it to the anesthesiologist at my first scope. I think we could have avoided a lot of unpleasantness though.

I have my first post-op with Dr. Kelly on Wed. so I will see the pictures clearly, not through a Dilaudid haze, and get a clearer idea of what he found within the joint.

Its Dreary Out...

But inside, there seems to be a light at the end of the tunnel. I went for blood work this morning, CBC, chem-7 and some liver function stuff... I think. I was then absolutely sick of being home so I went out for lunch. I tolerated a vegetable soup and roll, yay!!! I also walked to L's school to pick her up as well as to see Jk at mommy and me (nanny and me???). My aunt and cousin have been here since Thurs. to help and visit and were leaving today, so they also wanted to see Jk, it was a good excuse to take a short walk.

The PR company for HSS called me today. They loved the pictures and loved my 'story', they want to do a follow-up shoot in my house. Crazy! But being the desperate housewife that I am these days, I can take some time out of my 'super busy' day for this!

Now I am back at home once again, tired from this day of adventures.
Apparently I had a PT appointment this morning which I completely blew off, I do apologize P, it was rude and inconsiderate, but I thought I had no appointments this week. I don't think I will be in again until next week, I just want to take it easy and really get over this, then begin to be compliant with my rehab! I will start some exercises today, I will keep you posted!

Nausea Nausea Go Away know the deal. Better but still nauseous. I am going to get some labwork done today just to rule out something (don't know what). I posted this issue on a Crohn's board, similar to the hip boards, the responses were overwhelming, and all said it must be the anesthesia. This is the last time I have surgery without Dr. Jules! In fact, this better be the last time I ever have surgery!!!!!

Sunday, November 18, 2007

Sunday Funday

I was hoping today, once again, would be better. Last night I got out of the house for a little but had to quickly come because of....well, you know....
This morning was back to feeling like crap. A good friend came by and brought me a passionfruit iced tea from our new Starbucks (yay) which was wonderful. The combination of sweet and tart is really helpful. Around noon I had some rice, which stayed down, and later I showered and left the house! We had a good friend's b-day party. I sat in the car in fear that I would get sick, with a bottle of ice water, slowly sipping! I made it!
I made it through the party with lots of drinks and some chicken soup, and made the car ride home as well. Now I am comfortably resting in my bed! Since I was up and about, my hip hurts a drop, the incisions are the worst. They hurt a lot more this time. The pain is pretty superficial. Maybe Dr. Kelly just pretended to actually do surgery to get me off his back, made incisions and moved some instruments around to give the impression!!! Hahahaha, Paranoid or what!!

Saturday, November 17, 2007

Its All Relative

I feel ALOT better, but I still feel like crap! Today I got out of bed and actually ate, most importantly, it stayed down. I have spent the last 4 days in bed, miserable. This is definitely the worst recovery early on so far. I spoke to my GI yesterday who thought it may be a reaction to anesthesia, and to call him if I had other GI issues, which luckily I didn't.
I am still nauseated but can eat some things and drink, which is a huge improvement. I even took a short walk around the block today just to get some fresh air.

Friday, November 16, 2007

Caution: Grapic,Read at Your Risk

Believe it or not I am still sick. I put in a call and email to my gastro bc this is no longer 'normal'. I can barely get out of bed. I thought part of the problem was the side effects if the narcs and zofran (i.e constipation) so I took a laxative last night which gave me awful cramps and took 15 hours to fully work (fun). I woke up this morning vomiting stomach acid, water and the apple juice. Once the laxative had fully worked, I was able to keep down ice chips and juice. I have never felt so sick before.

Thursday, November 15, 2007

29 Hours Since my Last Hit

I am Percocet free...still. The withdrawl is going well!!! I don't think I can ever take narcotics again, I am so scared. I have been in bed for 29 hours with ice on and off, I occasionally haul myself out to use the bathroom or ride my bike for fear of a DVT. I am also trying to remember to do ankle pumps and quad sets and short arc quads in bed to help the blood circulate.

I am a lot better than yesterday but not great, I can't believe the nausea has not completely passed. I am eventually going to have to get up and do more stuff, then the pain med situation may become sticky. Worse comes to worse, I have Darvocet, which has been good for me in the past. I hope it doesn't come to that.

It is definitely not what I take, but how much. I think the levels were just so built up in my system I couldn't tolerate it anymore. Live and Learn!

A New Day, A Brighter Day

I wish! I woke up nauseous, It has now been 22 hours since my last Percocet and I still feel like crap. Last night I felt better so I had dinner, then took 2 Tylenol and went to bed. I was not expecting to wake up sick again. I have been drinking ice water only, I took a Zofran, hasn't helped much. I showered and decided to ride my bike a little since I have been so sedentary and do not want a DVT. The bike still hurt my butt, thanks perineal post, but better than Tuesday. I am losing track of days as I leave my imprint on my mattress!

I plan on icing, icing, icing, and not moving. Luckily I have a laptop so really have everything I need with me. We had grand plans to go out for dinner tonight...we will see!

Wednesday, November 14, 2007

Raining on My Parade

If you would have seen me this morning, you would have been very impressed. I was dressed, really dressed, skirt, tights, shoes, top (I ditched the hip brace). I had makeup on, my hair looked good. I looked presentable. J and I had an 'interview' for L's preschool for next year (welcome to the wonderful world of NY). We went, the school is in a small building with 4 floors, no elevator. But I was feeling great. I had taken Percocet through the night as needed, Zofran in the morning. We arrived and I did all the steps for our tour, they loved L, they even asked 'what can we do to convince you to let us have her next year?' One less thing to worry about.

After the interview, we dropped her off at her current pre-school and I walked home the 1 1/2 blocks. I came home and got into bed since my left leg was tired and my TFL and adductors were aching. I was also hungry, but nauseous and lightheaded. 'Traditionally', Wed. has been my 'not so great day' post-op. I decided on toast and tea for lunch. My stomach decided on no toast, no tea, and no more Percocet, and proceeded to expel every thing inside of it, numerous times.

This left me in a dilemma, I NEED narcotics, ok, that sounds bad, but temporarily, I am in pain and need something. I put a call into my OS office, with a note of urgency, and luckily got a call back within 20 minutes. I was told to wait until the Percocet is all gone/metabolized, no narcotics right now. This may be a reaction to anesthesia as well, not just Percocet. Start with ice chips, proceed to water, then crackers and take Tylenol. I am feeling better nausea wise. I have also iced like a madwoman, to numb it up to help with pain.

It also helps that my thigh is pretty numb from the surgery itself, hopefully it will go away on its own, it is a pretty large patch this time. All anterior, over my quad.

I had big plans to attend the PTA meeting tonight at L's school, since I had been doing so well. Maybe tomorrow I will have a more exciting day. I would love to work on my TFL on the operated side but the entire area is purple, looks awful. This is the worst I have looked after surgery ever. L asked me why my femur is purple! She is so funny. She is great with anatomy. She knows the following bones: Scapula, humerus, radius, femur, patella, tibia, calcaneus, phalanges, clavicle and 2 muscles: gluteus maximus and hamstrings. She is my little genius!

I am starving, as you can imagine. I am going to go try to eat something.

I have been in bed for 7 1/2 hours now, my leg has been climbed over numerous times but rambunxious children and is holding up!