I finally decided to face the truth and call Dr. Kelly's PA, Ariana today. But I wasn't in the mood to deal with the front office staff, so I faxed her my pain log with a note to please call me! It worked! Maybe I will start faxing all my messages!
Again, here is a lesson, know your facts, know what you scans showed, know what procedures you have had done, and be versed in it! Here is how our conversation went.
a: ok, let me see, you had which side injected? when? what happenned?
s: do you want me to give you a quick overview of what is going on?
a: no, no, I got it, there is a note that you had a flare up over the weekend?
s: huh? I don't know what you are talking about, what is the date?
a:Never mind. So, you had some relief from the injection, so there is something going on in the joint, now is this the hip we repaired the labrum or debrided?
s: both were repaired, you may be confused if you are looking at the pictures and see a suture, he put one in and took it out
a: oh, bc if it was repaired, I would say the you retore the repair, and it would make sense
s: no, there was no repair
a: well, then I would say it is synovitis, and the cortisone will calm it down
s: there is no synovitis
a: yes, the mri shows synovitis
s: no, the mri shows NO synovitis
a: no, it does, oh, wait, you're right, it says no synovitis. Well, it may be psoas scarring down to the joint capsule.
s: no, it is not psoas, that is why I insisted on injecting the joint, that is where the pain is
a: it still may be psoas though, if we injected psoas, you would probably have pain relief as well
s:(I am starting to get annoyed) Look, the bottom line is we all know there is cam impingement in the joint, I just want to know if I need a revision, so I can plan my life
a: well, based on the fact that the injection gave you relief, I would say yes, you do need a revision. It is hard to know exactly how much bone to take down, we have only had to do a revision in the case of a labral debridement a few times, but occasionally it does happen. You probably either have a psoas issue, impingement and/ or cartilage degeneration, and we would address that.
s: Would he want to do a microfracture?
a: no, the cartilage looks good
s: not on the most recent mri, there is a focal area of full thickness cartilage loss
a: Oh, you're right. It's possible he may want to, a lot of times if we go back in, we do see a nice new layer of fibrocartilage over an area of bone that was debrided.
s: Do you think we should do a CT scan of the pelvis with 3d reconstruction, so we know what is going on?
a: Yes. He would love to get that and have more images to look at to see the extent of the cam impingement and know how much to take down. I am going to email him now and let him know about our conversation.
So, that is where things stand now. Loads and loads of fun! Oh, and then she added, 'we do the other side 8-12 weeks after the first'. hahahaha, like I am about to jump into this right now!! Lets get the CT scan, and my second opinion, then we can talk!!!! I don't know if I have mentioned this before, I plan on sending my films to an open dislocation FAI surgeon in Boston, my hope is that he will tell me he cannot help me, a scope can, I don't need an open procedure.
In the meantime, I am lonely, hardly anyone is writing to me anymore! Is my blog still helpful? Entertaining? or just sad and pathetic! I will give a good update on the left as promised, but tonight I am ready to crash!
5 comments:
Hi there Susie -
Here's a note to let you know that I HAVE been following your blog, even though not posting replies -- you know I *hate* typing!! Actually I really appreciate your transcription of your conversation with the PA, because I now realize this kind of...er... 'stuff' is actually 'normal' -- sheeeesh!!! Good thing you got it in front of her on paper!!! :-o
Which doc are you going to consult with in Boston? Millis, or...? I'm learning so much from your ...um..'adventure' -- have to be grateful to you!!
oo
KT
I is still here :-) Gawd, that PA could do with some training or something, she seems a bit ditsy to me lol Sounds like you've got the ball rolling :-) Do let us know how you get on!!
Interestingly, she is usually right on the ball, and in the past, anything she has said is exactly what he would say, there are times I have spoken with her, then call him to 'double check', and there is no difference.
In her defense, my chart almost needs a forklift to be carted arund, and with 2 hips, 3 MRI's, 3 injections....things can get confusing. So as the patient, know EVERYTHING!
I plan on sending everything to Millis as soon as I get it together. I was waiting for the CT to get everything on disc, but it will not be done at the same facility as the MRI, so I can start calling today to get everything.
Did anyone else send to Millis? I wonder what the turnaround time is?
Hey Susie - don't worry, I'm still a loyal reader!
Sorry things are so sucky lately - I'll send you an e-mail, maybe tonight?
I laughed out loud at your conversation - I think maybe you should be the PA and "a" should be...well, I don't know what! Funny (funny strange, not ha ha funny) that you were the one coming up with how to proceed with treatment!
Also, microfracture is something I was discussing with my OS last week, and he said he won't know if it's necessary until he can get in there with the scope and see the condition of the cartilage himself. Of course he failed to mention to me the extended recovery time for microfracture...time to send him another e-mail!!!
I wish I knew how successful microfracture is. I know the bottom line is that at some point, in this lifetime, I will need a hip replacement/ resurfacing. The question is when. I would want to know how much 'time' microfracture can give me, and if it is significant, because for me, the recovery time would be significant. When I have more time, I will do some microfracture research and let you know my findings, there is a lot of info on knee cartilage, not hips!!
Post a Comment