Thursday, August 23, 2012

8.5 month follow up visit with OS

I saw my OS yesterday for a follow up visit and to discuss"what next????" He showed me my CT scan as he  ran it through his surgical planing software and showed me that no where is there any angle that is not normal, all the coverage angles, center edge angle, version etc is all within normal limits. The left, which is still pain free after 5+ years does not look as perfect, he actually said that if my left were bothering me he would be able to find places to take down bone...no thank you! The only possibility that he sort of brushed over is that my new offset on the right may be too much FOR ME, but obviously you can't put bone back and there is now way to know for sure.
I asked him to check my capsule again on the last MRI- he thought it looked ok, but its hard to really see if it actually stretched out or not but it is not torn. He would like to wait 3 more months and possibly get an MRA since injecting gadolinium will stretch the capsule and then he would be able to really get a god look at it, he also wanted to re-image the graft at that point since it was still immature at the last scan. He also wants an MRI of my left just to compare. He is hesitant to go with the MRA because he is pretty certain it will be very painful for me since I have a lot of irritation in the joint and the gadolinium is acidic, I said I'd rather just do it, than have a regular MRI and then find out we need another one. I guess I have a higher pain tolerance than a claustrophobia tolerance.
We spoke about the 'what ifs' and later on the 'whys'. If the capsule is indeed very stretched out...again, he would want to do an open procedure to support it with a mesh scaffold. The why is not known- possibly a collagen issue that is aggravated by the surgeries...the only way to know is to go see a geneticist who specializes in these things. I think its pointless since it won't change the course of treatment or outcome.
I told him I need a quick fix now- I have so much pain some days it makes life very very hard, and I can say that in the last few weeks there have been more than several times that I felt like I was going to lose it, including in his office yesterday. I asked if he'd let me get another cortisone injection. He agreed but said to add Orthovisc to the mix to lubricate the joint. Fine. I was able to have it done yesterday, this time it was ultrasound guided- all my other ones have been fluro guided. I have to say this was soooo much better, I was in and out in 15 minutes.
After the injection I had the "full" feeling in the joint and nerve pain down my leg, I was reminded by a fellow hip friend that the same thing happened last time and she referred me back to my blog for verification!!! I am hoping I get some long term relief from this. We think the issue is that the capsule is too loose and the joint is unstable and sliding around, causing inflammation and pain, so an injection is obviously a bandaid since it will take care of the inflammation and pain but not the capsule.
We discussed the possibility of another PRP injection, this time to the capsule, we ended up agreeing that it wasn't worth it at this time.
On the issue of my son, his bone scan was normal. If he continues to complain we will get an ultrasound to look for inflammation!

3 comments:

Abigail said...

Thats interesting to hear about his surgical planning software. Do you know how long he has been using it?

Hope your injection gives you some relief!!!!

Susie said...

He's only been using it in he last few years. I believe he may have used 2 surgeries ago (11/09) but did not at this last one bc we were not addressing none

Abigail said...

Interesting. I am curious if he put my scans in what they would have showed. (Surgery May 2009.) We definitely disagreed on the etiology of my pain at the time of my surgery. I was sure I had FAI, he was sure it was my psoas. My hip definitely felt better after addressing the FAI 2.5 years later, but still waiting for the psoas to recover. And on my most recent scope had more arthritis and cartilage damage than prior scopes. Will never know, but wonder if he had addressed the boney problems at the time (rather than the psoas non-problem) what things would have been like. Unfortunately looks like will need my hip replaced now at a youngish age, though putting off as long as possible. Should have waited to find a surgeon who was on the same page as me and went by my signs and symptoms.