Sunday, April 17, 2011

Video Presentation on the Ligamentum Teres

During my "research" today, I came across this: More than 120 physicians from around the world gathered in Vail, Colorado on March 17–19 for Smith & Nephew’s 5th annual Vail Hip Arthroscopy Symposium. The three-day educational event was led by Marc J. Philippon, MD, managing partner of the Steadman Philippon Research Institute. Link to Symposium info The focus of the symposium shifted to “New Procedure and Unique Cases” on Day Two. Richard Villar, FRCS, Spire Cambridge Lea Hospital, UK, opened the session with a presentation called “Ligamentum Teres: The Forgotten Ligament.” Mr. Villar described the three classifications of ligamentum teres injuries; Type 1 (complete tear), Type II (partial tear) and Degenerative (not torn but not functioning). Treatment options include removal (with RF or shaver) or reconstruction. Mr. Villar reached the following conclusions:  The ligamentum teres is likely to have a function; do not ignore it  Arthroscopic surgery (of whichever sort) appears to work  The ligamentum teres may have healing potential Video


I had my latest PT appointment on Thursday, it was incredibly disappointing. I guess I am looking for a miracle and there really isn't a miracle out there at the moment. I said to my PT "so, he didn't know what to do with me so he dumped me on you", he agreed!!! He is at a loss, pretty much, and with his expertise, if he is at a loss, I am screwed!! He said he wants to treat it like an ACL/PCL injury in the knee, where all the stabilizing structures are gone. So we started with some gentle isometrics and proprioception exercises. I am going on vacation tomorrow so will continue to do them while I am away and see him when I get back. In the meantime, I deiced to explore some other options and contacted another PT who may have a different kind of approach. I am going to see her at some point as well when I get back from vacation. I hope she is more optimistic and can help me, bc I don't know how much more pain I can take at this point.

Wednesday, April 13, 2011

The Latest Appointment, Still No Answers

I saw my OS yesterday...he still doesn't really know what's going on. His best guess is that ligamentum teres is torn, which is why I am having so much posterior pain and so much trouble sitting, and that the capsule got stretched out, which is why I am having muscle spasms, to try to stabilize the hip. I have a lot of clicking going on, he initially said its prob psoas but then he actually heard it and said it is not psoas, sounds like intra articular clicking, maybe ligamentum teres...bottom line is he said avoid doing it! He also said that he was actually really upset that I had relief from the cortisone injection since it does mean that the problem is coming from the joint, he was hoping that it wouldn't help at all and we could address things outside of the joint. We discussed the drugs I have tried so far, Celebrex made my Crohn's disease flare up, and Ultram made me dizzy and crazy. "Lucky" for me, I brought J along with me for "support", my OS wanted to know how Ultram made me crazy, "basically, it turned me into a psychobitch", to which J added "well, it was hard to tell the difference from how she normally is". Thanks J, really appreciate the support :-) I made him compare my 2 MRIs side by side, to actually see if there was a change in the capsule, they both looked pretty good (one from this month and one from last year), so he doesn't think the capsule is actually torn. He wants me to go back to PT, gave me Baclofen for the muscle spasms, and see what's happening in a few weeks. He also wanted to give me a medrol dose pack for the pain but we ended up agreeing that it wasn't what I wanted bc of the very remote possibility that it can cause AVN. He wants me to be patient and try to work through it w PT and see what happens! When I came out of the room his PA was there, so I said to him "he basically has no idea what is going on", and he told me that my OS studied my mri so hard, trying to see a problem. "I guess I have really photogenic hips" I said So that's the story!

Sunday, April 10, 2011

Turning Point

Last Friday was definitely "rock bottom" for my latest hip saga. Things began turning around this past week, I think I was wrong about the cortisone and it is finally kicking in, it took its sweet time but yes, I began feeling its effects mid week. Most importantly, sitting is not excruciating anymore. The best days were Wed and Thurs I think, I had absolutely no posterior hip pain at all, I had some groin pain those days, but I did well physically and emotionally. Friday was not as good as Thursday and Saturday was not as good as Friday, but I hope to continue to get some help from this latest injection. Yesterday I had an event to go to and I had to wear heels. I had no pain while wearing them, but I just did not feel good about it. My hip could not handle the heels and the joint just felt "slidey", like it could not control my leg in the shoes. Ironically,I came home and put on sneakers and had a ton of pain, go figure!!! As I sit here writing this, It is getting a little difficult to sit. My husband keeps telling me to "stop thinking about it", but how can I not, I am still nervous, and I am still in pain. I see my OS on Tuesday, stay tuned for an update Tuesday night!!!

Sunday, April 3, 2011

And The Saga Continues

Monday was my cortisone injection, Tues-Thurs were a little bit better. I went for a session of reflexology on Thursday afternoon, since it usually helps relax me, and my nerves have been shot lately, Ive never had so much anxiety in my life. I was speaking to the massage therapist about my "issues", and he thought I should get a massage. My muscles are in horrible spasm, I kind of wanted a massage but was scared of getting one because in my mind, the muscles are in spasm for a reason. I texted my PT, he said to ice and tape my hip. I really cant tape it on my own, and I cant stay in bed all day with ice. I texted him again on Friday morning and asked if I should just get a massage to ease up the spasm. He called me back and said that a deep tissue massage would be a bad idea, but a lighter massage may help. I told him that if one more person at work asked me if I was ok, if I should be working, if I should be doing this, I was going to scream. He gave me permission to punch the next person in the face :-) He also, again, said I need pain meds! So he called my OS office and I got Ultram. I took one Ultram late Friday afternoon, it helped with the pain but not fully. so I decided to take another. Bad idea. I could barely get off the couch, I was so dizzy and lightheaded for the rest of the night, and I didn't sleep well. Saturday I took 1/2 of a pill and was less dizzy, but dizzy nonetheless. The good thing is that for me, a little goes a long way and it has really helped my pain. I don't want to take one today because it is L's b-day party in the afternoon and we have a lot to do, and I don't want to feel like crap. Icing also goes a long way for me, unfortunately its hard for me to find time to do it. The second I lie down with ice my kids either need my ice, need me to get up and do something, or decide to jump on my leg.