Sunday, August 28, 2011

The Plan...Finally

So after 6 months of pain, x-rays, MRIs, injections, talk of alternative therapies and talk of crazy surgeries, I think I have found my happy medium. I spoke with my OS and this is what we decided.

First of all, he is not upset at all that I went to see OS2,
he said he prob should have sent me himself.
The only reason he has suggested open surgery for me is bc he feels that after 3 failed scopes, we prob should try something different. But at the same time, the scopes were all done for different reasons. Other than having to send a young patient for a hip replacement, one of the things he really hates is unnecessary open surgery. He told me there is nothing he cannot do arthroscopically that can be done with an open surgery. I think this was one of my happier moments of the past 6 months!
He said usually, in a scope, he will use an autograft from the capsule and rectus femoris to augment the labrum. Since my capsule is already compromised he will do it with an allograft. Since my capsule has already been repaired once and failed again, he will use allograft tissue there as well, he will also use a scaffold to strengthen it (this is apparently done often in shoulder surgery).

We discussed the ligamentum teres and my wishes for a new one! He said that u don't need it unless ur capsule is compromised. My thought is if ur already scoping me, just do it. He said it is EXTREMELY experimental surgery, they still don't know a lot about the biomechanics of it, and he wouldn't know how tight to make it, and he thinks I will hate it. He said right now I am having trouble bc the ligamentum teres is torn and getting caught. Once he debrides it and fixes the capsule, I will be happy again.


I am concerned about the post-op period, since I tend to be lax with the brace and weight bearing. I asked him to put me into a very restrictive brace post-op. He said absolutely, he will have me fitted for a hip dislocation brace and have it set to slight IR, and not allow more than 30' ER for the first 6 weeks. He warned me that I will hate it!! I'd rather be miserable for 6 weeks than be back to where I am right now in another 2 years.

I asked if he's ever scoped someone's hip 4 times, he said never his own patients, other ppls screw ups yes, but never his!

So I have to let him know when I want to do this, so he can plan accordingly, get his allografts and scaffolds together!
Even though it will be my 5th surgery, I am so happy that we have found a way to do it that doesn't make me want to throw up every time I think about it!

7 comments:

Anonymous said...

the brace is miserable, but doable. i did it for 6 wks after my capsule tightening. i still have issues, but not like yours. so maybe because i was in that brace for those 6 wks is why i got to stop with 4 surgeries and not go to 5. good luck. i still pop in on your blog occasionally. i am just letting the arthritis slowly take over--but im older than you.
soccermom

Susie said...

Hi soccer mom!long time no spk! Did ur os use anything to tighten ur capsule? Or just a nip tuck lol!

Anonymous said...

rGood luck. I've been following your blog for a while, but have never posted. I'm 31 and have had a bad left hip since I was 20. I've tried everything to fix it, and in Oct 2009, I finally had hip surgery. I had my ileopsoas released, head reshaping, and labral tears repaired. Well, that worked great until Fall 2010, and my hip has been killing ever since.

After an MRI, arthrogram, xrays, and meeting with the top hip specialist in the state, it's been determined that I have FAI, labral tears, and a CAM lesion, and it's been recommended that I have another surgery. I was hesitant, but hate the constant pain, so I agreed to book the surgery.

Well, when I met with the surgical scheduler in April 2011, to book the surgery, she said, "Oh, you have Aetna? I'm sorry. They won't cover this. Can you pay cash?" Hahaha! No!

So, I've been fighting Aetna tooth-and-nail for the past 6 months, and just keep getting denied time and time again. Looks like pain, limping, crutches, and medication continue to be my only option.

So, good luck!! I hope this will finally help your hip, and you can get rid of your pain once and for all.

Susie said...

Anonymous- What I have heard of people doing who have Aetna is have the surgeon submit for the surgery including the labral repair but NOT submit the FAI portion and have the patient pay for just the FAI portion out of pocket. This is still ridiculous but probably more doable for many.

Anonymous said...

yes, nip and tuck on the capsule--really need a nip and tuck in other parts as well ;-)

i was told the brace was to promote scaring down of that capsule. i was really tight when i got out of the brace but it has been almost 2 years now and im loose again...but not like i was.

he left a drain in until morning so i was stuck in the hospital overnight.

soccermom

Maria said...

Suzi,

I had my ligamentum teres removed as it was shredded beyong repair. I have had no problems with that hip.

Anonymous said...

Hi. I have looked into just paying for the FAI portion, and that comes to $4,000. It's much better than paying for the entire surgery, but my husband and I just cannot afford that. So, I'm basically arguing with Aetna over $4,000. Ridiculous. That's pocket change to them. So annoyed!!