Monday, May 7, 2012

I am Just Completely Worn Out With This

Interestingly, my husband and I bought our current home in 2006, immediately after, things started to go downhill for me health-wise. That was when I was officially diagnosed with Crohn's and immediately after that, FAI. You know the FAI story......It seems that the previous owners developed a liking for multiple mirrors, and my house is lined with mirrors, in a lot of places, and in a lot of places where you wouldn't ordinarily expect a mirror (bathroom ceiling???). My point is that I can't even walk from my bedroom to the kitchen without having to catch a glimpse of myself, and what I have noticed is as time has gone by, I am just looking completely worn out. I do think I do an excellent job of not letting see what is going on, I don't have a visible limp, I am able to attend PTA events, social outings (usually), my kids' sporting events, but the toll this is asking on me is becoming quite evident to me in the multitude of mirrors.

I sent an email of desperation to my OS last week. We spoke on Fri, I am not sure what he really thinks is going on but he said he wants an MRI of my hip, to see what is going on and why it responded so well to the cortisone, and to get an image of the tissues etc. He also said he wants one of my back. I said look, I don't think there is a problem with my back, I am pretty sure it is all coming from my hip, but if you feel strongly about it then I will get an MRI of my back too. He decided to wait until I see him in 1 1/2 weeks to make the decision about my back. He thinks that at this point my problem has now become even deeper and is a neuromechanical problem. He said he thinks I am having trouble finding a balance in my hip, and that is why I go from hip to back pain over and over again.  This article may provide insight into what that means.

The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment.


Hospital for Special Surgery, 525 East 71st Street, New York, NY, 10021, USA,


The level of understanding of pain in the non-arthritic hip has made significant strides in the last couple of decades beginning with the discoveries of Reinhold Ganz, MD. However, even with the detection of subtle bony abnormalities, including femoroacetabular impingement, a clinician's ability to differentiate pain generators in the hip has been ambiguous. Deciphering the etiology of the pathology versus the pain generator is essential in prescribing the proper treatment. The Layer Concept developed by Dr. Bryan Kelly, is a systematic means of determining which structures about the hip are the source of the pathology, which are the pain generators and how to then best implement treatment. Four layers will be discussed in this article. Layer I, the osseous layer, Layer II, the inert tissue layer, Layer III, the contractile layer and Layer IV, the neuromechanical layer.
[PubMed - in process]

 Of course this is what they know the least about at this time. He also spoke about finding a PT that I can work with, that will WORK. I said its been 5 months, I'm pretty sick of PT and I really don't want to be in PT for the rest of my life.He agreed with that. I asked if I should go back on Lyrica, he said to try it and see if it helps. I also had an acupuncture treatment 2 nights ago, it definitely helped the spasm in my back and I slept better than I had in weeks. I also had a massage 3 days ago but I might as well have flushed the money down the toilet. What was interesting though was that it actually helped the pain in my back temporarily but made the pain in my hip worse.

What I started doing to help my pain and core is a series of exercises that I have been using on my older patients, those that are either low-functioning, are post-op from spine surgery, have osteoporosis etc. I find that while I am doing them I get pain relief, so I will continue. they are from a book called "Walk Tall" by Sara Meeks. I highly recommend this to anyone who is having back issues that are not responding to any other therapy. These are simple exercises, each one very carefully and specifically explained with pictures, they are easy to do and easy to follow, I keep the book with me when I am treating.

So the current plan is Valium+MRI, see OS to review MRI and possibly obtain back MRI.


Diana said...

I know exactly where you are coming from. But despite being completely worn out by this you still have it in you to be a supportive friend and help me through my hip crap. Thanks again!

Anonymous said...

Susie, it's awful that your pain can't be figured out. I've been following your blog for a long time and I always hope this surgery will be The One That Works.

Here's my question: Is there ever a point when you (me, the rest of us with hip pain that won't resolve) would be a candidate for a hip replacement? Or are these two different issues. I always want to ask my OS, but I'm so scared he'll say, "Sure, let's just do that."

My colleague who had both hips replaced seems like he has fewer problems than I do (torn labral repairs, both sides). Maybe he hides it well.


Anonymous said...

You have done a great job documenting the FAI surgery journey! I had surgery in August 2011 to repair a badly torn labrum after a car accident. My Dr also said I had FAI and did the acetabular and femoral neck bone recontouring also. I did pretty good through my recovery but started to develop a nasty ache when sitting at about 6 months post op. This ache then increased to the groin, outer hip pain before I had surgery. I have had 2 injections in the past 2 weeks that have made no difference (1 for trochanteric bursitis 1 intra articular). When the Dr. gave me the intra articular injection via ultrasound he said there was a large amount of scarring and my capsule barely would bulge when he injected it with corticosteriod. The PA at my visit before the injection(s) said that 6-8 months post op is when they sometimes see scar adhesions in the capsule that require another surgery. I am scheduled for an arthro MRI on Tuesday. Have you heard from anyone else having this issue? I just don't think I can handle another surgery!