Hip Arthroscopy #4...over

My heart rate is back to normal, my anxiety has vanished, and to replace it all I now am the proud owner a very tight hip!!

I won't go into details about the day but I will share with you what Dr Kelly has just told me (for the 3rd time today but I did not retain it the first 2 due the drugs!)

My biggest concern has been whether or not I was making the right decision going in for this surgery, he has assured me that yes, by all means, it was 100% the right decision. He primarily found a ruptured ligamentum teres and a deficient anterior capsule. Most likely, the night of the "breastfeeding incident" I ruptured the ligament, the question is why did it rupture? It is most likely due to the capsule issue. He re-stitched the capsule using 5 sutures so it is REALLY tight now. He debrided the torn ligament and said that there was a lot of irritation around it.

He shaved down some bone on the acetabular rim and the femoral neck, just to cover all bases. He now has better tools and can see more arthroscopically, he found some more bone supero-laterally and the labrum was torn there too. He shaved down the bone and debrided the labrum in that area.

The cartilage looks GREAT!!! Hooray!! At least there is a silver lining in all of this!

Because of the capsule repair, I have to avoid positions of extreme external rotation and extension. When I sleep I must wear special boots that prevent the ER....fun fun fun!

All I can say is thank goodness this is over and in the past....once again, thank you everyone for their well wishes, it is truly appreciated!

Thanksgiving

Its 5 am and my heart is racing. I have done all that I can to prepare for surgery, now it is out of my hands. I am just hoping and praying that THIS IS IT. I wanted to thank everyone for their well wishes and words of encouragement. It has truly helped make a difficult situation easier to handle. J is going to try to update my blog today, especially since his posts were such a hit last time!!! I hope to share only good news with you later in the day.

Almost Panicking

As Monday morning quickly approaches, my calm demeanor is going out the window. In the end, I decided to go with an early morning surgery. I got the call on Friday to be at the hospital at 7am for a 9am surgery. This seemed strange to me because my previous surgeries had all been at 8am, but the nurse assured me that I was the first case in that room.

A little while ago I got an email from a friend who works in the hospital, he had tried to help me get my "favorite" anesthesiologist. It turns out she is away next week. He also said that I do have the first case in the room I was assigned, but BK has 2 rooms that day. I don't even want to think about what this really means. But I was assured and reassured that there would be no residents working on me! I will just repeat this request on Monday!

We are still away for Thanksgiving but coming home first thing in the morning. I haven't worked since Tuesday and I have had less pain. The only thing I have started to have is pain with flexion/ER. Weird!

I will try my hardest to stay calm and collected for the next 36 hours...

(I hope this comes out ok, I am blogging on my blackberry)

5 days to go....

I am trying to get things ready for Monday, not there is a whole lot for me to do, just the usual. Had my mani-pedi yesterday, this time, there is a new rule, no colored nail polish.....WTF??? So I had to go with clear. Yes, this should be my biggest "problem"!! Today is waxing day, which I am even more sure I need after seeing Jess's pics! I think psychologically, with surgery, you as the patient have no control over anything, so you begin to try to control the little you can! And if you're like me, and slightly OCD, this is what happens!!!!

I am also a little bit nervous because we are going to Boston today for Thanksgiving and don't plan on being home until Sunday, the day before surgery. This has me feeling slightly anxious, but I guess my mind will be better occupied there and I will have less time to worry, and more time to chase Z up and down the steps!

We are all good with the NSAIDs and I have been "ordered" by my GI to think positive thoughts and hopefully I won't have a flare-up. On the up-side, in the event that I do have a flare up, I will be on Vicodin, so it should minimize the discomfort!

Radiation, NSAIDs and Braces...Oh My!

After my conversation with BK on Sunday, I have been feeling slightly overwhelmed. Yesterday, I received a call from the company that rents out the CPM and Gameready machines. I had told his surgical coordinator not to order them for me because I won't use them. I was going to call them back to cancel the order but started to wonder if maybe the CPM would be a good idea to use this time since I want to prevent the HO.....and of course my mind started racing at 1 million miles per hour. So I sent BK a quick email to make sure it was ok to skip the CPM...its ok!!! Yay!! I hate that thing, plus, the kids think it's a toy!

I also heard back from my GI, and while I am waiting for clarification on something, he did say to go ahead with the NSAID's (Indocin)...I may flare though....given the alternative, I'm willing to risk it. So no radiation near my ovaries!!!

Just When I was Ready To Throw in the Towel....

Tomorrow will be 1 week since I had my CT scan, and I have been waiting to speak to BK about it, since I was rather concerned about the findings. Ironically, my friend B was also waiting to hear from him. B is a "hip friend", but we were friends before the "hip thing", so it is a unique "hip friendship". Tonight J and I invited B and her husband for a late (i.e after the kids were in bed) dinner.

B has had one hip scoped by BK and was waiting to discuss her latest injection on the non-operated side with him. At 9:45, her phone rang....you guessed it......it was him!!! B, being the good friend/ hip friend that she is, prefaced her conversation by saying "you know, its funny that you're calling now because I am actually sitting in Susie's living room and I'm sure she would love to speak to you too!" So, 20 minutes later, when B was done, she passed the phone on to me! Who would have thought the waiting game would have ended like this!!!

So....it looks like there may be some overcoverage on the acetabular rim....FML. I asked if he thought it was new bone growth or old...he wasn't sure. Apparently, he is (has been) concerned about ossification at the site of the labral debridement, plus that tiny ossification in the joint capsule.......all of this points to the possibility of heteroropic ossification (HO). It is treated with NSAIDs once it is removed to prevent it from coming back. I have never taken NSAIDs post-op bc I also have been "blessed" with Crohn's disease. If I cannot take the NSAIDs post-op, the alternative is a single dose of radiation... so I am stuck between a rock and a hard place. I put an email in to my GI to see what his thoughts are on my lovely predicament. I am leaning towards the NSAIDs and dealing with the GI issues as they come. Radiation in that area (close to the ovary) does not thrill me.....Any thoughts??

Reflexology

Yes, I bit the bullet and tried something "different" today. On the advice of a patient, I was told it is very relaxing. I have been having a ton of anxiety, like, to the point that I would probably benefit from being medicated at times. It has been so bad that my heart starts racing and my chest feels tight, I guess like a panic attack, only a minor and manageable version.

So I chose a 30 minute session. I have never done this before so I asked the reflexologist if she has a "routine" that she uses or if she kind of feels around for points and works on those. Her answer was basically both. It was very relaxing until she found a huge knot in one spot. She started working on it and said it was the spot that corresponded to the heart, lungs and chest. Weird, but kind of cool given my symptoms. She found one more spot that is the back/ sciatic nerve area....I told her I don't have back pain but do have hip pain, she figured that this point corresponded to the hip. Who knows but I do feel very relaxed and with less anxiety. Now if only I could get a reply concerning my CT I would feel ALOT better!!!

This is Why Doctor's Don't Like to Let You See Results Before Speaking To Them

I had my CT scan yesterday. The report is time stamped 30 minutes after I left the facility, they are fast!!!
I had BKs office fax me the report, and yes, I got it right away! Highlights of the report:
"There is a small ossific density noted in the anterior joint capsule", "small capsular calcification", "femoral version angle +8, anteverted"

So there is bone (?) in the capsule?????? OR calcification? huh? How did this happen? Its possible that it is all from scar tissue, this is probably where he cut into the capsule and the way it scarred down. Or is it nothing. The anteversion seems like nothing too.

I have sent him an email to please look at the scan and let me know what he thinks. I hope to hear back soon!!!

Psoas...once again coming back to haunt me

I have been sort of freaking out these last few days, as I mentioned previously, my pain has gotten way out of control. I assume it is coming from the psoas and today's events confirmed this for me.
My pain is now exacerbated with external rotation and extension. But, I also have pain with active flexion, so I can't cross my leg, lift it up, get in the car, get on the bed etc. I have a new co-worked who incidentally had surgery with BK a little over a year ago. She had a psoas release, so today I picked her brain on what her symptoms were pre-op. She summed it up in one sentence for me- "does your leg feel really heavy?" YES. Ok, so I am convinced that it is the psoas. I have found that if I avoid sitting, it doesn't tighten up quite as much. I also slept on my stomach last night to avoid flexing my hip at all. This helped a little. I also did some stretches into extension today with a rolling stool, all of these things are helping to make a little difference. As I type, I am back in indian style with minimal discomfort.

My co-worker was nice enough to call BKs office during our conversation and have her op report faxed over to us to see. It turns out she had no FAI, just a labral tear and a super tight psoas. I have been asked before how a surgeon can determine if the psoas needs to be released. I will quote parts of her op report:
"arthroscopic examination of the central compartment revealed demonstrated extensive synovitis anteriorly at the level of the psoas with an associated _____labrum anteriorly.
"a synovectomy was performed around the psoas irritation..."
"at the completion of the release, all pressure on the psoas was releived"

These are findings I expect on someone who needs a psoas release.

My symptoms of "psoas pain" just started and seem to be better tonight, it is clearly some compensatory mechanism, maybe for instability???????? Who knows, again, I am still anti a psoas release on me!

Bitching and Moaning

As the 30th slowly approaches, things are quickly deteriorating. For the first time last night, I took a narcotic pain killer (2 actually). I think it is the psoas issue again, and I am looking forward to Tuesday to see my new PT and have her "fix" me again. I think I am having the same dysfunction once again. Last night I decided that a little anterior glide to the femur would help, and it did! Today I was looking in the mirror and noticed that my ASIS on the painful side did not stick out quite as far as the other side, so I tried a trick I have read about and put a rolled up towel under the PSIS on that side for 2 minutes, it is supposed to help glide the inominate anteriorly, it helped a little bit. I need clarification from the PT as to what exactly she thought the dysfunction was, and I will try to pay better attention this time!

I am now limping horribly, I am really nervous about how I am going to work for the next 2 weeks. I do hope that this is just an SI dysfunction that can be taken care of like it was last week and I can go back to simple groin pain!!!

Hip Arthroscopy # 4...Scheduled

Ironically, today is the 2 year anniversary of hip arthroscopy #3, the revision of hip arthroscopy #1, which was a great success. I did really well after it, had a great pregnancy and delivery (hip-wise), and did great for 5 months post-op. After that, well.....

The surgery is scheduled for November 30th, yes, 18 days away. Shit. That is really soon. I also just got my CT scheduled for this coming Monday (I think I called and the receptionist said "shit, I forgot to schedule her CT", because she put me on hold for about 20 minutes and then asked if that day was ok...whatever, it is done and hopefully this is the last procedure they EVER have to schedule for me).

November 30th is the Monday after Thanksgiving. We are going away for the weekend, so I decided that it would be a good idea to have the surgery late in the day. I have always had them done first thing in the morning. This time, I don't really want to wake up at 4:30AM, and I thought maybe I would want to run errands, go to the supermarket, Target....but then I started thinking that I normally don't respond so well to the anesthesia and the drugs...and I don't want to be there all night...or worse, get admitted....so I am thinking of calling back and asking them to schedule me for early afternoon. What do you think? Other than I am obsessing over this too much. But hey, I can obsess over the things that I have slight control over, everything else is up in the air.

On another note, I have been in awful pain lately, much worse than ever. I think my psoas is acting up, but as you know, I REALLY don't want it released (been down this road before). I asked a colleague to work on me today and release it. She started looking and feeling around my hips, and found that they are severely asymmetrical. The right (bad) one is higher and flared out anteriorly. She thinks it is causing the psoas to impinge and cause me pain. She released the psoas, iliacus and some others (I was in a lot of pain and having a really bad day...so I don't remember details), but when she was done, everything was level and the pain was just in the joint, where it usually is. I was also able to flex my hip a little easier. She uses a different technique than P, my old therapist used, but P has left my practice, so I have to move on! She will be the one I use after this surgery. I already booked an appointment with her, but not the day after surgery, it will be Thursday, I don't want to torture myself and have to go out the day after surgery, like I have in the past.

Any suggestions on what to do about the time would be much appreciated!!!

Close Your Eyes and Imagine a High Pitched Scream

That was me you were imagining. See, up until now, my pain has been manageable, and I was sure that once I knew I was having another hip arthroscopy, it would calm down and I would begin to question whether I was making the right decision or not. Luckily, I don't have to struggle with this since over the past 2 days, the pain has intensified to the point where I don't want to walk on my right leg.

I have no idea what is wrong now but I can no longer cross my right leg over my left leg without using my hands to lift it up, and I cannot even get into my "comfort position" of external rotation because that hurts like a bitch. So to put it simply, I don't know what the heck I did to it now...but things are going from bad to worse. (no, I was not breastfeeding)

The Dangers Of Breastfeeding

Disclaimer: Before I get attacked.....I am a big proponent of breastfeeding and would never say or do anything to deter a mother from breastfeeding her child..

As I plan for another hip arthroscopy, I know I am going to be faced with the question "how did you hurt your hip". I have had to explain countless number of times to people that there was actually no injury prior to my other surgeries, which makes me feel like an even bigger ass, at the time, I was 26 and having hip surgery, with no cool and exciting injury. I dreamt of telling people that I had torn my labrum skydiving, or heliskiing, but being that I am a terrible liar, I would have never gotten away with it. Plus, half the time I was explaining that no, I did not have a hip replacement, and no, I am not too young to be having hip surgery, and my all time favorite, no, I could not just live with the pain.

This time, I was thinking of coming up with a cool sounding injury, but again, I don't know how to lie. Plus, all you have to do is look at me, 3 kids, diaper bag, spit up on my shoulder...and you know that my life doesn't get all that exciting. No one would believe me that I had time to actually go skydiving or heliskiing!!! The truth is that I hurt myself while feeding Z, more specifically, breastfeeding Z.

Way back in June, I was sitting on my bed, in Indian style, breastfeeding, as I did hundreds of other times, except this time, When I stood up to put him in his crib, I couldn't put weight on my right leg and my hip HURT. So I have come to the conclusion that I injured myself while breastfeeding!

What sounds better...I didn't really have an injury, or I injured myself while breastfeeding?

The Wait Is Over

Yes, we spoke! We decided that at this point there is really nothing else to do but a scope. Not what I really want (ever again...and no, I will NOT be re-reading old posts to see what I went through then), but given that this has been going on for 5 months, PT, cortisone, PRP, Synvisc and crying did nothing to help my pain, I am left with few options. Living like this is just not an option for me. He did ask me if I wanted to see someone else, I really don't think that I can get different answers anywhere else, nor do I want anyone else doing my surgery.

He wants me to have a CT before the surgery, to make sure that he is not missing anything. I have mixed feelings about a CT given the amount of radiation, and I have already had one on the right, plus an abdominal CT all within the past 2 1/2 years. I had a Crohn's flare back in July and my GI opted not to do a CT because I had had one 2 years prior (I didn't even mention the hip CT to him). But given what I have gone through with this, I want to make sure that ALL bases are covered and ANYTHING that is there will be seen.

As far as timing, he is going to try to fit me into the schedule the first week in December (this is when I can do it, anytime before is too soon to stop working, and too close to Thanksgiving would make it really hard for my mom to get a ticket to come help me). I won't know until about the middle of next week the exact date.

For some strange reason, I feel a little more calm right now than I did 24 hours ago, despite the fact that the S bomb has been dropped, and is now a reality. I am not sure how well I will deal with it from now until then but I will do the best I can...

Sauvignon Blanc

This will not be my choice for tonight's anxiety fest! Just to keep you informed, Tuesday...no call (Cabernet Sauvignon night), Wed morning at 4am, I emailed BK to re-re-re-schedule our call. I got an email back saying it would be Wed in the pm. By 9:30 I could no longer keep my eyes open anymore (Zk has been very confused with the time change and white wine apparently makes me sleepy) so I left J on phone duty (I also gave him one time access to my email, just in case he emailed). J came to bed around 1am (after the World Series was over) and told me that he had emailed. I checked the message...tonight at 6pm.

All I can say is that if this was a "real" date, I would have dumped him a long time ago!!!

On A Positive Note, I am Helping To Keep the Wine Store in Business

No $%&#$%&#@&%$# call. Seriously. WTF???????
For all of you psychology people out there, 2 questions:

1)Can copious amounts of wine act in similar ways to anti-anxiety drugs, or is it just the placebo affect?

2)Is it normal that as my anxiety level has gone up (dramatically) this week, so has my pain level?

I Was Stood Up!

At just around 10pm, I went to pick up my blackberry to email BK and re-schedule our "date", only to find that he had beat me to it. He had just gotten out of the OR (I would hate to be that patient) and will call me tomorrow. But, he thinks we need to talk about looking at the hip arthroscopically since I am not getting better.

I am sooo not good at this waiting thing!!

Just an Update as I Wait....

I emailed BK on Thursday night and said I can no longer wait....this is not working, lets move on (In slightly nicer, toned down words). After some back and forth, we have a set a "phone date" for tonight, where we can discuss this crazy hip business. It is 8:55 and I am beginning to think that I am being stood up!!!!