Saturday, March 29, 2008

5 Month and 9 Month Hip Updates

I haven't mentioned my hips in a while as other things have taken precedence lately. But here we go:

I am back to normal, or as normal as I will get with scoped hips. I will not use the treadmill, I think it is too hard on them and I really want to keep "these" hips for as long as possible.
I am getting more aches and pains now than I did before the knee thing (BTKT) began, so I totally attribute it to compensation. Previously, I had almost no achiness. Now I occasionally get achiness, right more than left (right was scoped twice), my adductors still get spasmy occasionally, more now than BTKT. I also now have a alot of clunking and clicking in both, I think left more than right. It is painless but loud. I have gotten into he habit of "cracking" my back, so I use various techniques, adopted from what I would use in the clinic. I always say that whatever needs to crack will crack with a manipulation, so at time, I will be focusing on my low back/ SI joint and will get a nice crack in a hip. I still hold onto the theory that it is scar tissue, and I don't worry one drop about it because it is painless, there is no FAI in either hip anymore so I won't tear my labrum again, plus, a good chunk of labrum was debrided so even less likely to tear (bc it is gone), and it is important to stay positive.

My IT bands get tight and tender sometimes, but I think they always were, even before the hip shit started. My "invisible bruise" on the right is still there, believe it or not. It does not interfere with my life anymore and the box of lidocaine patches sits on my desk, untouched. The area does consistently get smaller but the pain level is about the same, just in a smaller area.

I can push my stroller with no hip pain, I spin with no hip pain, I work with no hip pain, what more can I ask for :-)
A big part of healing, and healing well, is staying positive, focusing your energies and returning to life and moving past this messy chapter, and always remembering, things could always be worse!

Tuesday, March 25, 2008

I Got Denied

By my insurance company on my second level appeal for the CPM and Gameready :-(
The billing people in my office had told me that if it got denied I could attempt a grievance appeal or something like that.

I thought is was a great letter. I will include it below since I have been asked for copies if it by readers.

To Whom It May Concern:
Please be advised that I have received a bill for a Game Ready TM Vasopneumatic Compression and Cold Therapy device, as well a Continuous Passive Motion Machine (CPM). These 2 pieces of equipment were prescribed to me by Dr. Bryan Kelly, the bill is from Biodynamic Technologies.

I went to see Dr. Kelly for disabling hip pain secondary to a torn labrum, which Dr. Kelly was able to repair via arthroscopy. Dr. Kelly prescribed the equipment mentioned above to maintain and increase range of motion (ROM) as well as to decrease inflammation and decrease pain, and prevent the build-up of scar tissue. At this point in time, there does not exist a CPM primarily for hips, therefore, a knee CPM must be used for all hip surgery. I would imagine that you do not deny charges for CPMs for patients that are status post knee surgery.

The Game Ready is unique because it supplies a combination of continuous cold therapy and intermittent pneumatic compression. RICE (Rest, Ice, Compression, and Elevation) is the universally accepted method of treating acute musculoskeletal injury and post-surgical trauma. The Game Ready device combines the two most difficult to manage aspects of the RICE regimen (ice and compression) in one easy to use system.

I am shocked to know that if an in-network physician prescribes a product to a patient, which in turn will help relieve their pain and reduce the possibility of further injury that you, a credible insurance company, would not pay for that product. I was under the impression that anything prescribed by my doctor would be covered. I believe that this decision was made unfairly, and would hope that you will rectify this matter immediately.

I have included a copy of bills from Biodynamic, Information on the Game Ready and a select list of clinical studies on cold and compression.



I thought it was a great letter!!! I don't have the "select list of clinical studies" since I forgot to make a copy before mailing the letter. I obtained it by calling Gameready directly and explaining the situation to them. I will keep you posted on the progress!

Dejavu AGAIN

I feel like someone has put me in a time machine, taken me back to 15 months ago, and moved my hips about 18 inches down. All of my "am I crazy" thoughts have returned, along with INTERMITTENT PAIN.

Ok, so really, I should be happy that my knee doesn't hurt all the time, but what happens is I get excited, like the problem has gone away. But then, without warning, it comes back. It is not even activiy dependent anymore, sometimes certain things will bother me, and then the next day I do the same exact activity and I am fine. Go figure! Then, my other knee will get cranky, further pushing me into a state of psychosis!

OMG, I think I may have plagiarized that entire posting....from my hips!!!!!

Sunday, March 23, 2008

Someone is Watching Over Me...Why Did I Blow It???

As I was ordered, I have stayed away from my spinning bike, I remained compliant for a total of 5 days, but today, the urge was too intense to resist so I rushed through the kid's bedtime, jumped into my workout gear and mounted my bike. I clipped in and attempted a pedal stroke and heard a loud crash/clunk/metal grindy noise that scared the crap out of me. I then lost all resistance on the pedals, and further freaked out as I thought the pedal had fallen off (mind you this whole scenario lasted about half a second). I looked down and saw a piece of the chain hanging down.

Hmmm, maybe this is a sign that I shouldn't be spinning right now, "baloney" I said to myself (actually, it was more like "WTF, I need to ride"), so I emailed the company I had bought it from and the owner got back to me within the hour (on Sunday, on Easter). Obviously, I had to put J on the phone since I had no idea what he was talking about. But between J and our friend and neighbor Dave, the bike was fixed and I got my 'fix'!

I never learn! Need I say more!

Good People Really do Exist in This World

Warning- not orthopedically related but I really had to share

On Wednesday morning, I put my ipod and phone in my coat pocket and proceeded out the door to my car. We live in NY, so my parking lot is about a block away, a HUGE luxury (seriously). I started the car, stuck my hand in my pocket, and there was no ipod. Shit. Where is it. I assumed I had just thought that I had out it in my pocket but really left it in the kitchen since I have been borderline crazy this week again. When I got to work, I called J and asked him to check the kitchen for me. He forgot, but I assumed all was well. I got home and there was no ipod. My nanny hadn't seen it and L and Jk swore they hadn't touched it. To add insult to injury, my first ipod had been stolen about 1 year ago when I found a super parking spot in front of my building and chose not to park in the lot. Stupidly, I left the ipod in plain site, someone smashed my window and snatched the ipod and the thingy to listen to it through the radio. Buying ipods cannot become a yearly event.

By Friday I had decided it was gone, J was being nice and had loaned me his ipod, probably for fear that I would just go out and buy myself a new one without first truly searching every inch of the apartment. Last night, J went out and called me from the car. 'There is a note on the car " he said, "Did you lose something pink? Call me". Holy shit, it was my parking neighbor. "What did you lose that is pink?" J asked "MY IPOD". Hurray! I am totally shocked. How nice are my parking neighbors?I don't even know them, if I have seen them 1x it is a lot. They live across the street so I will go retrieve it today.

Just in time for me to resume Spinning, as I was 'ordered' to "modify my activities and NOT spin". It is not working bc I am stil in a motherload of pain, so why not do what makes me happy, it is not making a difference!!!

Friday, March 21, 2008

Purim 2008

Today we are celebrating the Jewish holiday of Purim. All the children dress up and have a blast. Can you guess what L dressed up as? Jk was a dog but refused to wear his ears!

L and Jk making Purim art projects

Wednesday, March 19, 2008

And Reality Begins to Set In

This is not going away. I am slowly starting to get over my denial! I made an appointment with Dr.Kelly today, then I emailed his PA. She said to do 8 weeks of PT and then see where I am.

Have I mentioned that I HATE PT. Not PT's, but PT. I have had it. To make matters worse, I began strengthening my quad tonight with some simple, old lady style quad sets, AND THEY HURT. I didn't spin bc I worked an 11 hour day and basically passed out when I got home. It is probably a good thing since it totally killed me last night. I was compliant and iced for a long time tonight. For some reason, I am more inclined to ice my knee than I ever was my hip. Maybe it is due to the superficiality of the knee structures, I can palpate tender spots on it, I never was bale to touch anything on the hip.

Tuesday, March 18, 2008

My So Called Life (Part 2)

Left knee has been bad, right hip is yelling at me to fix left knee so it can go back to optimal function. J is being a complete ass about the whole thing, as if I wished this upon myself. I wish men in general were more understanding about the way women work, think and act. He asked me what body part will be next, since it seems like a pattern going on, this time a zig-zag, since we went right hip,left hip, right hip and now left knee.Maybe next will be right ankle? J, I hope you never have to experience any ortho issues bc heaven knows I won't be as supportive as I could be, or should be. As the husband of a PT, you could receive optimal treatment from diagnosis to recovery, but you will be on your own.

Ok, I am (sort of) done venting. Am I the only one with a partner who is totally clueless?

I had pain for the first 20 minutes of my spin tonight, then 10 minutes of "OK" then I had to stop. I iced and now I feel swollen and tight (there is no obvious visible swelling). I am tempted to make an appt with Dr Kelly to figure this out, but am mentally exhausted from all of this. I know, I should, but it is a lot to process right now. There is a lot going on in my life these days. Maybe he can offer a quick fix, like cortisone, I love cortisone!!!! I am in no way shape or form accepting surgery as an option right now, which is why I sort of feel a visit with him is a waste, ah, the beauty of having to make simple decisions. And, nothing says I can't cancel the appointment once it is made. But once I make an appointment, it makes this more real, or in J's eyes, makes me more crazy and neurotic, and needy too. J, maybe you should post a comment in your defense, if you have one. If not, stay tuned to more husband bashing to come in the future.

Monday, March 17, 2008

Still Dealing With Crap From Hip Arthroscopy numer's 1 and 2

My wonderful (not being sarcastic) insurance company covered all cost of surgery, hospitalization, anesthesia, rehab (sort of), basically everything associated with the surgery, except the Gameready and CPM, which I was later told by someone in my OS office that these are "luxury items", and "I told you they may not be covered".

Me, being me, initially ignored the bills, which totaled around $700 but were knocked down to $500 for me. After a while, I decided I should stop ignoring them and do something. Again, me being me, I had no idea what to do.Luckily, one of the people in the billing department of my office used to work for one of the companies that rent these same machines, and get this, her job was taking care of denials. So she gave me a huge stack of appeal letters to pick and choose from. I also called Gameready and they sent me literature and journal articles supporting their products. So I wrote a great letter and sent it in, in January.

I then forgot about the letter, until another bill arrived. So I called my insurance and they agreed to "expedite" the claim. Today, I received a letter from them. Excitedly, expecting a check, I opened the letter, which was informing me that they received my letter and will let me know of their decision within 30 days. I can't imagine having to have gone through this for the surgery itself. sigh!

Sunday, March 16, 2008

Weekend Update

I think I must make a vow to myself that this will not in any way shape or form become a 'knee blog'. No sir. This is going to have to go away. I do not want to deal with this. But yet I find myslef in a deja vu of how my hip issues started. I go through the day saying "I can ignore this, this is not a big deal, oh, now there is no pain, oh shit, now it is back, what am I going to do". Literally, this is what happens. But I really want this to go away.

An update to the taping: Shortly after I blogged, the joint pain came back, the pes and MCL pain stayed away. The tape began to irritate my thigh (I had recently seen a terrible skin reaction on one of my patients from the tape so I got nervous) so off it came. My MCL and pes anserine are ok, but the joint pain comes and goes. Yesterday, I was in a lot of pain again. Today, I did less and felt better. I am not quite sure what to do at this point.

I feel like I am "one of those people", there is always something wrong.I just want to feel normal again, no aches, no pains, no numbness and tingling. Believe it or not, until 15 months ago, I was normal!

Friday, March 14, 2008

I Am Not Dead

So I am still in pain!! Actually, now, I may headed into a state of unconsciousness thanks to P's grand ideas! My knee was hell today and yesterday. Today, I was limping, I could not jump down from treatment tables onto it, I could not squat. I was wearing my good shoes with orthotics. I was not a happy camper.

I have tenderness right at the medial joint line, on the meniscus, as well as the MCL and pes anserine. P taped my tibia into internal rotation to better align my knee and de-stress the pes and MCL, and miraculously, the joint pain went away too. Now, the key will be how to maintain this, I can't be taped forever, it is pretty ugly!

Wednesday, March 12, 2008

Back to PT, Back to Working Out

I saw P today since my hip has been tight and my knee is a mess. I am pretty convinced the 2 are related, when the knee pain got bad, the hip started acting up. He did a great job on my hip, working the iliacus/psoas area (painful but it has been much worse), doing some anterior hip mobs and stretching my psoas. Then on to the knee. The meniscus is tender, but so is my MCL and my pes anserine. So...for now, I have been ordered to wear more supportive shoes and if necessary tape my foot before I exercise. I pronate...a lot, and this seems to add to my problems. I had a negative Mcmurray's test, a positive Apley's Compression and a positive "knee scour", the evidence shows that these tests are not all that great though.

I skipped all lower extremity work on the bosu today and focused on my abs. I will know in the morning if it was a good workout if I wake up sore.

I plan on wearing good shoes tomorrow to see if that helps! AHHHHHHHH!!!

Tuesday, March 11, 2008

Fun and Games on the Bosu Ball

Whoa, where is your mind wandering off to? J is out of town anyway!
I bought a Bosu ball a long time ago, the kids loved coming to my office and jumping on the mini trampoline but I didn't think it was safe to have in the house since the springs made me nervous. So I took them back to my office to try the Bosu and they loved it, they call it the "jumping toy". It has been in my living room forever and I just decided to try the video it came with.

First off, my abs are shot. Beyond shot, they are just about non-existent. I had to modify some of the exercises ALOT bc of my weakness. There was also one exercise where you lie sideways across the bosu and hold your legs up off of the floor, my adductors were too weak to keep the bottom leg off of the floor.

All I can say is thank goodness I was in the privacy of my living room and not at the gym, I would have been mortified!

I did squats, lunges, balancing....the hips did pretty well, the right one did give some indication that the bouncing was not a good idea by throwing in some occasional groin pain. The knee was not happy at all with the squats and step ups, and I didn't even attempt any of the twisting exercises.
It was a short, condensed video but I am going to look into finding some more, with mainly ab work.

I can't believe my abs have come to this, I knew they were weaker but this is bad. Time to kick up the workouts a notch!

Monday, March 10, 2008

I Think That If I Ever Wake Up Painfree I May Actually be Dead

So where do I begin the tale of this beautifully hideous Monday. Maybe with the continued knee pain, or with the fact that I am no longer a PT drop out. Yes, you heard correctly. P will have the pleasure of seeing me again (as a patient) on Wed.

Why? Why is this happening? Should I look at this logically, scientifically? Or more in the "why do bad things happen to good people" way? So....the knee pain is there, it is not constant but it can get pretty bad at times. Luckily, it goes just as quickly as it came. But....I must be somehow compensating (ahhhhh....I hate that word) since my right hip (left knee is troublesome) started acting up yesterday. I have been stretching and FABERing and doing all sorts of fun things but I think it is out of my hands now and needs some 'more' professional help. Hence my crawling back to P to work on it and also have a quick look at my knee since I think this is all due to that adductor exercise way back when.

I am pretty sure the hip thing is the adductor insertion point onto the pubis becoming tight and painful, I am also having trouble getting into a full FABER position. Honestly though, I am not very good about stretching on my own and Spinning is all I do for exercise with a (really) quick stretch at the end. Maybe I need to practice what I preach a little bit more.

I will see what P has to say but the thought of even an MRI at this point makes me want to live in pain for the rest of my life. Also, I don't know how much I want to know what is going on in this knee, in grad school I had it x-rayed for similar issues and it showed decreased joint space and an MRI showed a joint effusion. I never followed up bc I had custom orthotics made which helped 99.9% and then I got pregnant with L, finished school, got pregnant with Jk, had 3 hip I have been sort of busy. I am seriously hoping that if I am diligent about wearing my orthotics (cut back on the cute Tory Burch's) and start strengthening and stretching the right muscles, things will get better!

Sunday, March 9, 2008

Ok, Its Really Not Funny Anymore

BODY....STOP! I am just besides myself at this point. A while back I did some stupid stuff in PT at the insistence of P, who was looking out for my best interests. I was too weak and I knew it, but tried the exercise anyway. Now, 3 months later, I am pretty sure I tore my meniscus. Cute right! Unfortunately (or fortunately), this is going to be ignored to the fullest bc I am not even interested in knowing the extent of he damage to my knee or what my options are to correct it. I think 3 surgeries in 8 months is plenty for now. The knee is tolerable and only hurts when (what I am assuming to be the ) torn piece gets in the way of the joint. Also, if I wear good shoes with orthotics I feel better. So what's one more injury at this point? I am I 27 or 72? Sometimes I forget.

Friday, March 7, 2008

ITB, WTF????

So I did overdo it yesterday, but there was a Tory Burch outlet! Yes, I went shopping, but not just any shopping, outlet shopping. Which includes walking and walking and walking. Right hip was on strike yesterday, I guess it read my previous post and said "hahaha, I'll show you how happy you can be" and acted up all day. My ITB was sore during the mall trek and my adductors once again began firing little spasms. I am having a ton of company this weekend so I spent some time in the kitchen last night, plus, I am on the committee of a big event on Sat. night so I spent time setting that up. By the time I got home to make my Moroccan meat turnovers, I could barely stand. Add to the picture that J was actually home and wanted to (gasp) help in the kitchen, I made turnovers for about 30 minutes (could have been done in half the time had it been a solo job, but its the thought that counts!)

Fast forward to this morning, 6AM alarm clock goes off and ITB is KILLING me. I mean REALLY killing. Like, call P and beg him to squeeze me in today killing. But I didn't. If things don't shape up by tonight I have a foam roller at home I can roll over the ITB. Or, if J is still in a good mood I will teach him how to stretch it!

Wednesday, March 5, 2008

One Year Anniversary

Today marks exactly 1 year from my first ever hip arthroscopy. This was supposed to be the ONLY surgery but as luck would have it, it opened the flood gates and resulted in 2 more surgeries, bringing me to a whopping 3 hip arthroscopies in only 8 months. Its like winning the lottery! hahaha!

1 year ago today, at this time, I was most likely downing a Vicodin and in a ton of pain. I actually remember very well that I decided (stupidly) to sleep through the night and went 8 hours with NO pain meds. When I woke up in the morning, I lunged for the bottle and took 2. That began the vomiting with hipscope #1. I learned after that and never went more than 4-6 hours without drugs. I even went to to PT the next morning (absolutely barbaric) and lunch, but that was where the fun ended. It was back to praying to the porcelain god for me!!

I ended up getting Compazine (pretty light weight for me) and Ultram because my pain was so bad, I stayed on the Ultram for 2 weeks. I was in a lot of pain after the first scope. I imagine that it was due to the f---ing impingement remaining in my hip. I noticed a huge difference immediately following scope #2, even from day 1. Its a shame that my left hip didn't become painful first.It would have saved me a lot of time, pain and a hell of a lot of aggravation.

One year later, the results speak for themselves. Yes, there were a few extra (not so) minor bumps in the road, but the important thing is the end result, and my hips rock (for the most part)!

Too bad I didn't begin my blog 1 year ago, but like I have said, I didn't think there would be anything to blog about!

Monday, March 3, 2008

Ride On!

The weather was beautiful today so I piled the kids into the double stroller and went to the park. For those of you who do not remember, pushing the double stroller was what eventually landed me in Dr Kelly's OR 3 times.

Just to recap, I drive this:
And I push


This is one of the first times since my revision scope that I remember pushing the double stroller all the way to the park, so it felt like an accomplishment, plus, I like having the experience and knowing that I can do it. My right hip felt weak while pushing. Then again, I am pushing 35lbs of stroller and about 70lbs of kids. I also had discomfort in my trouble spot. The area along the front of my thigh along all of the scope sites, where I have supposed nerve damage. It didn't hurt but I could feel that it was an area that was not done healing.

As for my arm, the tingling has diminished.I have decided to see my acupuncturist this week, I will let you know what happens.The good news is that I don't think it is too serious and the tingling has centralized to my elbow. The bad thing is that my elbow hurts now. I think it may be the way I am doing a manipulation at work so I will have to be careful.

In an unrelated story, have you been following Carlos Delgado's story, from the NY Mets? He was flown from Florida to NY to have an MRI at HSS, the findings were that it is not serious, it is just an impingement in his hip.

WTF???? Not serious? How many of you have been sidelined bc of a simple "hip impingement"?

Sunday, March 2, 2008

Why Can't My Body Just BEHAVE????

Just as things are hip world as as close to perfect as I could have dreamed, I have developed numbness and tingling in my left hand/arm. All I can say is SHIT. I think it has started to improve, but I have no idea what to do, who to see (other than NOT a surgeon). Initially my fingers were going numb but now it has moved into my hand and elbow, so it is centralizing, a good sign.

We went to a party last night, I wore high heeled boots from 8:00-1:30, not a peep from my hips!
52 Sundays ago, I was home, having my closets redone, begging the guy installing them to finish quickly bc I was having surgery in the morning and would not be able to finish organizing them past today. Boy have we come a long way!