Thursday, August 28, 2008

Hipscope #4

I will be in Dr.Kelly's OR this Tuesday for the 4th time.....
but for the first time, I will not be on the table!!

One of my patients is having her hip scoped and I will be there to watch! You can only imagine how excited I am, and how much I will enjoy this! After all I have been through, I am so excited to see what happened after I drifted off into lala land!!

She has a labral tear, FAI and he is (gasp) releasing her psoas, but my mouth is shut. I can only be a pain in the ass when it involves my own hips and I am so grateful to be allowed in the OR!

Monday, August 25, 2008

Who's 'da Man

After a rough start to my day, I finished the morning with my ego quite inflated. Let me explain.

I am currently treating a 30 year old woman with hip pain. Plain MRI showed no pathology, I do not have the x-ray reports. Her chief complaint initially was clicking in the hip and pain and tenderness. She was diagnosed with hip flexor tendonitis. A load of crap, said I, humbly!

She did have extremely tight and painful hip flexors but she also presented with a positive impingement sign, and her pain is relieved with traction and any type of distraction I do on her hip. Her hip flexors have started to feel better from the extensive amount of manual work I have been doing but she still coplains of joint instability, clicking, and just a "funny feeling". So I have been telling her from the very beginning that I suspect there may be something wrong with the joint, despite what the MRI said. I think she started believing me and decided to go back to the doctor after we spoke on friday morning.

When I arrived in the office this morning, there was a handwritten note in my box that said to call that OS office ASAP. In my office, we NEVER use handwritten notes, every message is sent via intra-office email, and then the recipient knows who it was from in case they have questions. This had no name in it, no signature, nothing. Just to call regrding this patient, and ASAP. I thought "oh shit", I pissed him off with my brazen hip views and opinions. At that point, all I could do was suck it up and call, take him yelling at me, and move on. Ironically, the patient was in the OS office at the time I called. I also was not sure who from the OS office had called, bc the note said that his office had called, not him personally.

So I finally got through (after about 3 or 4 busy signals), and the receptionist had no idea who had called me. I went on to further explain that the patient was currently in their office and the message was regarding her. "Oh", the receptionist said, and the next thing I knew, the OS picked up the phone. "Fuck", I thought I had gotten off easy this time!

He said he had been talking to the patient regarding the clicking, and I was "right on" thinking it may be a labral tear, and he was going to order an MR arthrogram. "I think that is a good idea", I said. But I didn't stop there. I asked "did her x-rays show any sign of impingement or dysplasia?" "No, nothing exciting there" he replied,"but you are on the right track".

Ok, I obvioulsy didn't mention my own personal "battles", and how I probably know a little bit more about hip issues than the average PT, but what started out as a morning of me pracically peeing in my pants (for different reasons this time) ended up with me gloating and high fiving everyone around me!!!

Wednesday, August 20, 2008

As the Snapping Continues, I Think Happy (and cute) Thoughts

We had a great time at Victorian Gardens in Central Park with hipster Amy last week!

Monday, August 18, 2008

This is Not What I Signed Up For

Firstly, I would like to address an issue that has been brought to my attention. Mainly, it is that I am generally feeling awesome. I don't know how well it is reflected here since I usually only blog about the bad days, If you would prefer, I could post each day and write something to the likes of "Today I had no hip pain". But that would be kind of lame and boring, but it is the case most of the time. And no matter how much I complain, anything I speak of is nothing compared to pre-op and I have never once had second thoughts about surgery (revision too) and continue to be really happy with the results.

That said, I will begin by saying that what is happening now sucks! I think my pelvis/ SI joint is becoming increasingly unstable from the pregnancy hormones, so, like in the past with unstable joints, the muscles are tightening/ spasming in response. This time, it is not my psoas (yay), but my right IT band (revision side). It is so tight it has begun snapping. I never really understood the full implications of a snapping IT band...until now. It is a painless snapping that began a few days ago. My greater trochanter on that side is also tender to the touch. I don't know if maybe this is partly because I sleep on my side now, since stomach sleeping ended a few weeks ago, or bc of the tightness, or both...I don't know what came first. In addition, my left adductors are also tight and tender again. So the right side of both legs hurts, I wonder if the right side of my pelvis is more hypermobile these days, the hip joint definitely is more hyperobile on the right.

To add to all of this, the following happened last night. This is rather graphic, and possibly better suited for the ladies only, preferably the ones who have already had children, so that those of you who have not will not be scared away. So you have been warned. If you don't like graphic, skip the rest of the post.

Way back when, when I only began to realize I had a torn labrum, I also realized that suddenly, my pelvic floor muscles were also very weak. To me, this was really bad since on top of treating orthopaedic patients, I also specialize in treating incontinence and pelvic floor dysfunction. The muscles remained weak after surgery but I never had any "real" leaking. Last night, I was lying in bed and out of nowhere got really nauseous. I realized I needed to throw up, and fast, so made a mad dash for the bathroom. Once I started throwing up, I literally peed all over myself. At the time, it was not funny, now, looking back, I can sort of smile, I know it is not permanent, but standing in the bathroom, not knowing where to go or what to do, I was certainly not laughing. When it all "ended", I sat down to catch my breath, and realized my nose was bleeding as well. Another lovely pregnancy side effect. Did I mention that this is my last pregnancy????

Wednesday, August 13, 2008

More Summer Fun

I finally figured out how to get the blackberry pictures to show in full size, so I went ahead and changed the last pic I uploaded as well from the pool!

Sunday, August 10, 2008


Since this blog was started for the purpose of following my recovery from hip arthroscopy(s), I figured I should take a break from sunbathing and let you know what the story is.

Initially, I was supposed to have a follow-up appointment with Dr.Kelly this week (and Amy too) but being that my current condition does not allow for x-rays, I have cancelled and will reschedule for a later date (i.e after the baby is born). Amy and I will still try to make time for an L/ Jk outing + photo session, the plan is to go to Central Park on Thursday.

Anyway....I go most of the time without even realizing that my left hip was ever operated on. I feels great, no pain (at least not in the last few weeks/ days that I can recall as I type this). The only catch is that my activity level has seriously plummeted since the pregnancy began. I am constantly battling bone crushing fatigue so I drive everywhere. Last summer, I walked to the pool every day, this sumer we drive. The pool is across the street from the park I walked (crutched) to 6 days after my second surgery, so it is clearly not that far. The nausea still has not subsided but thanks to amazing drugs, I function! (Thank you Zofran)

The right hip is a different story. Yes, it was operated on twice, and yes, the left hip has 4 months on the right hip, but I can't help to wonder at what point my progress will plateau. Don't get me wrong, it feels great, amazing, a million times better than pre-op, but since I have a "perfect" left hip, it makes me sad to have to settle for less than perfect.

I know, my famous line is "once it is scoped it will never be the same again", I know, but one can only dream! Considering the amount of work I had done on it, I should not be complaining, but should be jumping for joy. The actual joint is great, no more FAI, no more pain in there, so yes, mission accomplished! What bothers me is more superficial pain, around the incisions, yes, the nerve pain is still there. Much diminished, but sigh, still there. My (gasp) psoas gets tight still and once again decreases my stride length. If I had the energy, I would stretch more, but every second I have to myself I am usually in bed (like now, the kids are in the living room watching cartoons and I am in bed. J is out of town for the week).

Of course, I am still anxious about the delivery. Plus, my new decision to try to go as natural as possible. I am thinking of hiring a doula, to help me during the birth. In my messed up mind, if I don't have an epidural, I will feel pain in my hip and prevent it from being put in bad positions. I had hired a doula for L's delivery and needed a c-section bc she was breech. For Jk, I couldn't even think that far ahead, all I could think about was not having a repeat c-section, I didn't care how I went about it. Also, for L's birth, I was petrified of having an epidural. I have now survived a c-section, a vaginal birth and 3 hipscopes with some form of spinal or epidural anesthesia, so the fear factor is slightly decreased, but if I can avoid it, I will. J is not in favor of a doula, he thinks it will lessen his role, but frankly, he had no idea what to do last time and I was rather pissed for a while (I think I still am a little), so thinks that I am trying to punish him by getting a doula. Whatever, next time, he can birth a child and do it his way!!!!

Tuesday, August 5, 2008

Peace, Serenity

I thought this would give you a good idea of how I have been spending my days and why things in hipville are so calm! L and Jk are "sunbathing" as I carelessly sip an iced tea 20 feet away in the sun!!!