Tuesday, April 29, 2008

The Week in Review

There is no place like home! We were in Miami for a week and a half, it was great but it is also great to be home!
The trip began with my (not so) quick MRI the night before, getting the results, L's 4th b-day party and a long trip home!
Last we spoke, my knee "issue" was TBD, possible MCL, as seen on MRI, or muscle imbalances, but I am to strengthen and stay off of my spin bike. I still think it is "joint related".

I have been off the bike for 2 weeks, the knee was ok, yesterday I was thinking that staying off of the bike was helping but this morning it was back to normal. So I was feeling unbelievably fat from lack of spinning and lots of eating (Jewish holidays=food) so I rode. I hurt, but I cannot directly attribute it to the bike.
L's party was great, its no wonder my kids love going to my parent's house, check out the BEST 4 year old party ever.

I never had a bounce house or ponies at my b-day parties!!!

While we were away, J had to come home for a day for work. The day before he was to leave, he received an email from the parking company where we leave our car at the airport. It turns out, they needed to move our car to an overflow lot since we were gone for so long, in the process, they left the car illegally parked for "a few moments" and it was ticketed and towed, due to some unpaid tickets (oops).
So, J had to go from the airport to one office in Queens to pay for the tow, tickets, storage fee, marshall fee and judgement fee, then go to Brooklyn to pick up the car! The parking company felt so bad they drove him to all of those places, paid all the fees minus the actual tickets, and gave us free parking for the entire duration of the trip (that is a HUGE savings here). It sucked that it happened but I count my lucky stars that J went to retrieve the car alone than with all of us in tow, especially after yesterdays adventure.

We flew non-stop, through DC (don't ask). We left Miami on time and made it to DC with time to spare to catch the connection. Initially, the flight was delayed an hour. We boarded, pulled away from the gate and were told we would have to sit on the runway bc Laguardia was slowing down traffic. We sat for 2 hours, then they pulled us back to the gate bc there were 6 kids on a 40-50 seater plane...not happy kids. We ended up arriving around 4PM (left Miami at 8AM), then I realized I left L's sweater on the plane. One more hour in the airport, we finally left, without the sweater, and all I could think was :thank goodness the car is here, waiting for us!)

Activity Modification....My Way

Tuesday, April 22, 2008

Even I Didn't Think I Would Hear Back So Soon

Before 3PM, my phone rang...guess who it was...you got it! J and I were in the supermarket at the time, with both kids, and both were being extremely wild (the 2 kids, not J and the kids) . It was hard to have a conversation and make sure no one got hurt/killed at the same time.

Since I had already read the MRI report report, we got right down to business! What the heck is going on? He said that there was increased signal on my MCL, so he wants me to go into a brace. To which I obviously had a reply of "hell no". See, I know I have MCL problems, which is what I majorly damaged in December. This is a different feel, I explained, it feels "like joint". He thinks there is probably a muscle imbalance, residual effects of the hip arthroscopy (I knew it would come back to haunt me) and wants me to continue strengthening it and stop spinning. (we'll get back to that soon). I am of the opinion that the MCL is not involved in my complaints, yes, it hurts at times, but there is another pain as well, it almost feels like the same pain I had in my hip, but in my knee.
So.....strengthen, avoid aggravating activities like stairs and spinning and call him in 2 months if it still bothers me and we can do an injection then. I knew he would be stingy with the cortisone! If this persists, I don't think I will last 2 months and will probably call sooner, but hopefully it will go away on its own. I will be more diligent about specific strengthening, not just spinning and pilates, and if necessary, tape my knee like P has done in the past.

So the no spinning thing.....I don't know if I can do that. I tried it for 5 days a while back but went back since it didn't seem to make a difference. I didn't spin once last week because I was super busy at work and then with my appointments, packing and travelling. This week, I had grand plans to return to the gym I used to spin at when I lived at home, but just to "test the waters", I will hold back and stay off of a bike for this week as well. I return to NY on Monday, and if my symptoms have not changed, I will return to spinning. If they have gotten better, I will probably return as well, might as well if there is no pain. So in a nutshell, I cannot give in to no spinning and I don't like bracing knees, especially in a situation like this when it will only weaken all the other structures around it.

I don't feel like I am being given the runaround, I am in no hurry to do anything drastic here, and like I think I have mentioned before, the knee is not surgical, and even if it were surgical, ITS NOT SURGICAL!

I Have The Results

I guess this is why most docs don't like faxing patients the results of exams prior to speaking with them!!!!
No meniscal tears, no ligament tears, no joint effusion, no joint space narrowing!

But...why does it hurt like a bitch?????????

I'm Taking Bets

My MRI report is in, and has just been placed on Dr Kelly's desk. It was not faxed to my office by the Imaging office but I did request that his office send me a copy.

When do you think I will a) hear back from him b)have a copy of the report in my hands

To even the playing field, the receptionist I spoke with is the more efficient one who usually gets things done for me when I need, and has always been very helpful in the past. I also asked her to put a "big, big" not on his desk to call me with the results!!

Thursday, April 17, 2008

You Would Think That By The 4th Time I Would Be Used To It

An MRI that is. Yes, today was my knee MRI, I work quickly. After a 1 1/2 hour wait (no exaggeration), they took me. At which point I was pissed off bc at my designated appointment time, they told the "appointment coordinator" was on the phone for me, she apologized profusely but said there was a "complication" with the patient in the MRI machine before me and there would be a 1 hour delay. So I patiently waited, 1 hour became 1 1/2. When I realized that the person in the MRI machine before me had walked into the facility after I had, after my "consolation" phone call", I realized I had been lied to and got pissed!

I didn't say anything to the technician since I didn't want to piss off the person who would be controlling the "torture tube". I figured I would be ok this time, even though MRI 2 and 3 were by no means a picnic. Mainly a bad cold during MRI #2 left me feeling like I couldn't breathe and leaving my "this close" to a panic attack.

I made sure my head would be out of the tube, which he said it would be, but not exactly. There is the tube but on the outside of the tube is a larger opening which to me is still a tube. So I get my headphones on with my own music, I close my eyes, and my heart begins to race. Oh no, I am actually going into a panic attack. Slow deep breaths....I end up calming myself down and continue with my breathing. Luckily, a knee MRI is only about 20 minutes and I survived! Then off to pay my exorbitant parking bill!!!!

I am packing, we are going to Miami tomorrow for a week and a half!!!

Wednesday, April 16, 2008

A Sigh of Relief

I kept my appointment, thank you for all of your encouragement! Dr. Kelly was pleased to hear that my hips great. He does NOT think I tore my meniscus bc I have tenderness at the joint line in conjunction with pain above and below the joint line. He thinks that a meniscus tear would present with pain at the joint line only. Also bc of the way my knees are angled, and the fact that it started with an MCL sprain (while rehabbing after my 3rd hip arthroscopy...of course I had to throw that one in)!

He said I can get an MRI and we can proceed from there. I asked what he did think it was, he said possible pes anserine issues or a capsular tear "which he can repair with a few sutures" to which I said HELL NO. I got up and joked that now I was going to be messed up for the rest of the day, but I was serious bc after the exam I was in serious pain...so he then insisted on the MRI. So off I go tomorrow, for the MRI, in the city again.

On a side note, many thanks to J for saving us the parking expense! Thanks to our teamwork, I arrived in the city, put the car at a 1 hour meter with a couple of quarters, and then J picked up the car and took it home. I managed to get home with hipster Amy (who also had an appt today, so we double teamed again) on public trasnportation!

I also wanted to mention a HUGE thank you to J, who has just replaced my missing engagement ring, it has been missing since August, when L took it. It is beautiful.

Now if I could only find time for a manicure!!!!

Monday, April 14, 2008

I Told You She Is A Genius

As I have mentioned before, L knows many of her bones and muscles. Here she is doing a beautiful job...until the end when she has trouble with her name! But we love her and think she is the smartest preschooler in the world!

Now if only her parents could figure out how to use proper lighting for filming....

Thursday, April 10, 2008

Why I Still Don't Think My Psoas Needs to Be Released

I have been experiencing pain in my psoas with some snapping, and no, it is (still) not pride that keeps me from running back to my OS to have it released. My feelings still hold true in my case, and in many cases regarding releasing tendons.

Many of you have asked me why I was so adamant about not having my psoas released. No, I am not a psychotic bitch who wanted to make my OS absolutely crazy, or an arrogant PT who thinks she knows everything. Firstly, I knew with all my heart that it was not the root of my problem, so releasing it would not have abolished my pain, and I was 100% correct in that, as was found on arthroscopic examination. Another point, for me, is that I have a hypermobile SI joint, which periodically gives me problems. All of my surrounding muscles are extremely tight, hamstrings, TFL, ITB, Piriformis....My feelings are that my muscles tighten to protect my SI and maintain in correct alignment.

My right hip is the one giving me the psoas issues.This is the "revision hip". This hip now has a tremendous amount of ROM, compared to pre-op, and compared to the contralateral side, since a lot of bone was taken down. Don't misunderstand, I love the way it feels now, but, my body has never functioned in this range before, it "thinks" that I now have an unstable hip, which in comparison to pre-op, I do. My ROM values are normal and not indicative of a hypermobile hip, yet I do not have the neuromuscular control yet to feel stable there. Initially, my adductors were tightening and going into spasm to stabilize. Once I strengthened them well (with a few knee blips along the way), they fared quite well.

Then my ITB went haywire, and still does occasionally, but I had been doing a lot of abductor strengthening as well. Psoas is now playing into this and making sure to get its share of the limelight. I am hoping that my new found love of Pilates will help with the neuromuscular control I need in the right hip, to help the entire joint stabilize and function well.

Lets just say, I did not have this realization, and decided that now would be a good time to have my psoas released, since it is acting up, I would most likely end up even more unstable hip and would probably begin to have problems with my ITB or maybe the adductors again. This would lead me down a vicious path of multiple releases. Even if the releases are not surgical, but rather manual (PT type) releases, things don't always work out so well, as I experienced at another course I took. It is imperative to retrain the muscles properly to avoid this and to re-educate the joint. Neuromuscular re-education needs to be a huge part of rehab, not just bridges, straight leg raises and clam shells.

I know I am having issues because I have not been the most compliant patient with my PT, especially after the MCL incident in December. But, I am pretty fed up with hip issues, so maybe I need to stop writing and get my butt into Pilates gear!!!

Disclaimer: This is in no way meant to be printed and brought to your OS to negotiate a tendon release (tenotomy), every case is different and every body is different. This post (and the entire blog) represent only my opinions, are not medically or scientifically backed, but rather, me venting and sharing personal ideas and experiences.
I will get off of my soap box now.

Update on CPM and Gameready Crap

I spoke to a lovely woman at the company who didn't seem to see a problem with paying $100/month until the balance is paid off. Now, J wants to have his HR department look into it and possibly reimburse us, since our health insurance is through his job. Again, I will keep you posted!

Gameready and CPM Crap Still Happening

As I mentioned previously, my insurance company denied payment for my CPM and Gameready. I have been in contact with the company that rented them to me through the process, so obviously I was quite shocked to find out that they put me into collections.

I called this morning and was informed that I was not really put into collections, but it was more of a scare tactic (my words, not theirs), to get me to pay. My balance is $515, that is the rental of 2 CPMs and 1 Gameready (I paid out of pocket for the Gameready for surgery #2 and did not get either machine for surgery #3).

I called and tried bargaining it down, they took off $45, I tried playing the "professional courtesy" card, they didn't buy it. Then I tried getting them to break up the payments for me, so I am waiting for a call back. I don't know what will happen.....wish me luck!!!

Tuesday, April 8, 2008

Never Stop Learning

If I ever feel that I have no more to learn, I will have to change professions. I learn something new almost every day, just by treating, being in my clinic and with my patients. I just returned from another continuing education course. It was not my favorite course, but it should prove to be very helpful in my treatments. In PT school, and in PT courses, there are no models. We do everything on each other.Luckily, this was a "tame" course which did not require the removal of clothing like some do!!

As usual, I am very "dysfunctional" when it comes to muscular and alignment issues. I am tight in all the wrong places, weak in all the other places, an overall mess. I started off the weekend with pretty bad back pain, my psoas had kicked i again and was unbelievably tight, pulling on my lumbar spine, topped with being in a different car than my own with poor back support (or poor ability of the driver, i.e. me, to figure out how to properly adjust the seat!!) My psoas got so bad that it became tender to the touch and full of trigger points. This usually pulls me into poor spinal alignment, making everything else go to hell.

So.......it turns out that my "partner"at the course used to work with P, she actually taught P how to release a psoas, irony of ironies. Today, she tried a release on me like no other. At the psoas insertion on the lesser trochanter. WHOA! Pain, but I sucked it up and let her do it, and then, less tender, and less clicking. I think this will be the only time I will have this done as it required her to put her hands in places I would rather not have P at!!! But just another trick to add to my "bag of tricks".

I am still on the fence with my knee. I am having less pain, and is always delayed onset pain. It still feels tight often, and the joint surface feels "weird", still "squishy" and "not right". One week to go before the appointment, still time to change my mind!!!!

Saturday, April 5, 2008

Click Clack Moo

That is the title of one of my favorite children's books in our "collection". It is about cows with a typewriter who demand electric blankets. Each time I read it I get a smile on my face. I highly recommend it for those of you with kids (I read it to Jk, he is 2).

Lately, when I read this book, it reminds me of my right hip. See, I have started getting into Pilates. I actually really like it alot. The only issue is that some of the moves, especially with my legs straight when I am on my back, cause my right hip to click. It is my psoas. Hahaha!! I know what you are thinking. Don't worry, it is painless clicking, but I do actually feel the psoas snapping over "stuff". No, I am not getting it released. I think that even if it was a "problem" and became painful, pride would prevent me from EVER getting it released (newer readers check out posts from October and November of 2007 to get my feelings on releasing psoas).

I have had it click every now and then. The left one clicks when I sit on a low stool or chair, or the toilet sometimes. I was doing a move on Wednesday night, you lie on your back, legs straight and up in the air, separate the legs a little, circle them around, then bring them low and together, and finish with them bent at your chest. Every time I circle them, the psoas clicks. It is more annoying than anything. Maybe something I will just have to get used to.

In the end, the cows give up their typewriters in exchange for electric blankets, the duck acts as the neutral party, exchanging notes between the farmer and the cow. The last page of the book is a picture of the ducks in their pond, the page reads "Click Clack Quack".

Wednesday, April 2, 2008

Is it Real or Am I Crazy??

Again with the fucking intermittent pain. This time, I can go a day and half with not even a twinge of pain in my knee, making me "this close" to cancelling my OS appointment in 2 weeks, and then one tiny misstep or walk down a step the wrong way, and bam, pain, and the ever pleasant "squooshiness" in my knee. I know there is a ton of psychology playing here, mainly the fact that I am praying for this to disappear, and I really really want to cancel my appointment, not lose a whole afternoon/ evening in a waiting room, pay a fortune for parking and then get stuck in rush hour traffic, all for nothing. I know, ridiculous. You are probably thinking "susie, just go for the appointment, what is your problem?" well, a lot. First, I think I have a fear of being told nothing is wronfg if I do in fact think there is something wrong, and I wouldn't be going to the appointment if I didn't think something was wrong. So, if I cancel it, it is because I no longer think anything is wrong and then I will be happy once again, and have "great joints". It stinks to think you know a lot but really, not know anything, and on top of it, have schizophrenic joints. Knee, please stop hurting and making my readers think I am a nut job. Please take the cues from my hips and behave yourself.