Luckily we are home and have no stairs! I have minimal pain, could probably benefit from Tylenol but I have a huge aversion to anything that closely resembles a pill, or may possibly be medicinal. I didn't leave the house all day yesterday but took care of the kids crutchless. This involved breakfast, playing, lunch, naptime, snack. Luckily J did all the packing and loading of the car. We tried to minimize the stairs and stay on one level as much as possible. Stairs in and of themselves don't seem to be a problem, it was actually easier to them crutchless using a step through pattern as opposed to a step to pattern. But the hip really feels good. I have a little move I call my 'making sure I still have pain...or am I losing it', it was especially helpful post-injection 1 and 2 when the radiologist did not do a pre and post test. I stand on the affected leg and internally rotate the hip by turning my body away (out).If there is impingement, it pinches. It no longer pinches on the right, YAY!!!!! I am cured! I will have a 'brace throwing away event' soon. Interestingly, I held onto it after my first scope, something in the back of my head said to keep it. I still have the left brace too but I will toss it as well. Anyway, I wore it one day after this scope.
This morning we took the kids to a holiday cookie baking and magic show (the magician didn't show up though), it is at L's school so we walked. I walked with 2 crutches but left 1 in the stroller when we got there. Later we went out for pizza and I took one crutch. I get tired after a while, that's why in the house I was ok, I wasn't going very far in one stretch.
But it is so nice to be home, like any good Jewish family, there are always in-law issues, sibling issues and plenty of food! I have never eaten so much dessert before, hopefully my body needed all those extra calories to heal!
I return to PT tomorrow, I am not sure if I will go more than one time this week. Dr. Kelly wants me to take it slow, and it is Jk's birthday on Thursday, we are going to see Playhouse Disney Live! I will let P check my ROM and see what he thinks. Extension is going to be my biggest issue this time around I think, and I am developing some trochnateric bursitis, I think. I am still awfully bruised on the trochanter and medial to the incisions. It makes me wonder if they ever found the cushioning device that was 'missing' pre-op. L says my femur is very purple. Yes, she says femur. She is very into anatomy, and at 3, it i impressive, She knows the following bones: Scapula, clavicle, humerus, radius,ulna, phalanges, femur, patella, tibia, fibula, calcaneus. She loves medical dramas as well. We watch House, Grey's Anatomy, Private Practice and Scrubs.
I have some cute pics, we have a new camera so I will try to get J to upload them for me!! I am in bed for my daily rest!
Showing posts with label cam impingement. Show all posts
Showing posts with label cam impingement. Show all posts
Sunday, November 25, 2007
Wednesday, November 21, 2007
9 Day Revision Post-Op Appointment
My stitches are out, phew. They were really grossing me out already. My appointment went well, actually, this is probably the best appointment I have ever had. There was no talk, mention or suggestion of a future surgery! I think I turned a new page! Dr. Kelly was happy with my ROM so far, and even secretly pleased that I had been in bed for so long since it seemed to help the hip a lot. He showed me all of the scope pics, there were tons, I think more than my other 2 surgeries combined. Also the before and after x-rays. He had tons of pictures of my psoas, it looked beautiful! He said he was really nervous going in that the psoas was really going to be an issue and he had promised me he wouldn't cut it. "You were right" he said, and repeated it!! I explained that I hadn't meant to give him a hard time about it, but I truly believed from the bottom of my heart that the psoas was fine. I explained that it had always been tight and tender but hadn't changed in the whole interim of pre and post surgery and rehab. He even had a final shot of the psoas as he was coming out, just to make everyone happy!
He said there was a lot of scar tissue that he removed. The cartilage on the femoral head looked great, it was not perfect on the acetabulum but not too bad. It had been damaged slightly from the cam impingement. Now for the cam.....it was there. Duh, haven't I been having impingement for a while now! The CT-scan should have picked it up, they measured the alpha angle, I have to look up the report, I believe that an alpha angle under 50 is normal and mine was 34 (don't quote me on that). Well, it turns out that I had 'special cam impingement'. It was not typical, which is why it was initially missed, it was very subtle, but not mild, meaning, it sure as hell was there but difficult to see. Just my luck! So he shaved it down and gave me a normal looking femoral head which no longer impinges ! YAY!!
I explained about the nausea and he regretted not being able to get my beloved Dr.Jules for anesthesia, but at least being in bed and doing nothing has helped with the pain. He wants me to take it easy with rehab, go slow, especially in the beginning and not to overload the other leg. Right now, it is good, and has not lost anything!
So now it all falls in the hands of rehab! I think we can handle this!!! :-)
Oh, I forgot to ask for my op-report, I will call first thing Monday morning!
He said there was a lot of scar tissue that he removed. The cartilage on the femoral head looked great, it was not perfect on the acetabulum but not too bad. It had been damaged slightly from the cam impingement. Now for the cam.....it was there. Duh, haven't I been having impingement for a while now! The CT-scan should have picked it up, they measured the alpha angle, I have to look up the report, I believe that an alpha angle under 50 is normal and mine was 34 (don't quote me on that). Well, it turns out that I had 'special cam impingement'. It was not typical, which is why it was initially missed, it was very subtle, but not mild, meaning, it sure as hell was there but difficult to see. Just my luck! So he shaved it down and gave me a normal looking femoral head which no longer impinges ! YAY!!
I explained about the nausea and he regretted not being able to get my beloved Dr.Jules for anesthesia, but at least being in bed and doing nothing has helped with the pain. He wants me to take it easy with rehab, go slow, especially in the beginning and not to overload the other leg. Right now, it is good, and has not lost anything!
So now it all falls in the hands of rehab! I think we can handle this!!! :-)
Oh, I forgot to ask for my op-report, I will call first thing Monday morning!
Tuesday, November 13, 2007
Details, Details,Details
I am in bed, took a Percocet about an hour ago. No one else is up in my house yet so there is no point in geting out of bed.
I had to be at HSS at 5:45AM. I had already filled out the majority of the paperwork last week, so I waited. In the meantime, I met the people from the magazine who were doing the photoshoot. They didn't call me in until after 6:30. I had to take a pregnancy test (negative, phew), and put on one of their cool hospital gowns with the heater attachment, and the 'hip scope breakaway' shorts! The camera crew came in to take some pre-op pictures. The PA came to do his mini pre-op physical around 7, 7:15. J was still in the waiting room. I was getting nervous bc in the past, everything has been done by 7, but hey, it wasn't like they were going to start surgery without me, right!
Next came the woman who washes the surgical body part, so she washed my hip. Then J was allowed to come in and we hung out for a bit.
Anesthesia came next. It was not Dr. Jules, the one I had requested. But I remember Dr. Kelly reminding me that all the anesthesiologists are great, so I was ok.He asked if I had had issues with anesthesia in the past. I explained that when I had a spinal with scope #1, it took me a long time to recover, so scope #2 was done with a combined spinal epidural, much better. So he said he would plan on that.
The nurse was next, almost 7:45, we were running out of time. She had to go over my medical history again, then start the IV. She wanted my to lay down, I assured her I wouldn't pass out, but she insisted.
While she was doing her thing, Dr. Kelly showed up to 'sign' my hip. I asked him to please write 'do not release psoas', in case he forgot! He said he would remember, and wanted to know if I was going to have the psoas police in the OR!! He even showed me the consent form, he said 'look, it is not even on here', so I said 'good, bc I don't consent'. I asked if I am his biggest pain in the ass patient, he said not even close, I just know too much. I didn't have a response bc just at that second, the nurse inserted the IV needle which silenced me! He said he was just going to go in and remove scar tissue, adesions and obviously the cam bump. Ok, fine,I could deal with that.
The OR nurse came next.She looked at my hip brace and asked where the rest of it was? Huh, thats all I have. What about the posts and pillow?Huh?? That's all they gave me. So off she went, super annoyed, to find whatever it was that was missing (I still am not sure). she came back to bring me to the OR, 'we are 5 minutes behind' she said. I left J, and we went to the OR. We passed someone who was looking for whatever it is she was missing.He said 'I told Dr. Kelly', to which she got clearly annoyed and said 'don't tell Dr. Kelly'. I assume they found it bc we proceeded into the OR. The camera crew was in there with someone showing them all the scope tools, I was trying to get a glimpse, but they needed to get the anesthesia going. I was laying on the table and the anesthesiologist gave me something to relax me, and asked if I could sit up,I told him I didn't want to feel the needle go in, he told me he would make my skin numb, and then I was out!
Part 2 to follow after coffee!
I had to be at HSS at 5:45AM. I had already filled out the majority of the paperwork last week, so I waited. In the meantime, I met the people from the magazine who were doing the photoshoot. They didn't call me in until after 6:30. I had to take a pregnancy test (negative, phew), and put on one of their cool hospital gowns with the heater attachment, and the 'hip scope breakaway' shorts! The camera crew came in to take some pre-op pictures. The PA came to do his mini pre-op physical around 7, 7:15. J was still in the waiting room. I was getting nervous bc in the past, everything has been done by 7, but hey, it wasn't like they were going to start surgery without me, right!
Next came the woman who washes the surgical body part, so she washed my hip. Then J was allowed to come in and we hung out for a bit.
Anesthesia came next. It was not Dr. Jules, the one I had requested. But I remember Dr. Kelly reminding me that all the anesthesiologists are great, so I was ok.He asked if I had had issues with anesthesia in the past. I explained that when I had a spinal with scope #1, it took me a long time to recover, so scope #2 was done with a combined spinal epidural, much better. So he said he would plan on that.
The nurse was next, almost 7:45, we were running out of time. She had to go over my medical history again, then start the IV. She wanted my to lay down, I assured her I wouldn't pass out, but she insisted.
While she was doing her thing, Dr. Kelly showed up to 'sign' my hip. I asked him to please write 'do not release psoas', in case he forgot! He said he would remember, and wanted to know if I was going to have the psoas police in the OR!! He even showed me the consent form, he said 'look, it is not even on here', so I said 'good, bc I don't consent'. I asked if I am his biggest pain in the ass patient, he said not even close, I just know too much. I didn't have a response bc just at that second, the nurse inserted the IV needle which silenced me! He said he was just going to go in and remove scar tissue, adesions and obviously the cam bump. Ok, fine,I could deal with that.
The OR nurse came next.She looked at my hip brace and asked where the rest of it was? Huh, thats all I have. What about the posts and pillow?Huh?? That's all they gave me. So off she went, super annoyed, to find whatever it was that was missing (I still am not sure). she came back to bring me to the OR, 'we are 5 minutes behind' she said. I left J, and we went to the OR. We passed someone who was looking for whatever it is she was missing.He said 'I told Dr. Kelly', to which she got clearly annoyed and said 'don't tell Dr. Kelly'. I assume they found it bc we proceeded into the OR. The camera crew was in there with someone showing them all the scope tools, I was trying to get a glimpse, but they needed to get the anesthesia going. I was laying on the table and the anesthesiologist gave me something to relax me, and asked if I could sit up,I told him I didn't want to feel the needle go in, he told me he would make my skin numb, and then I was out!
Part 2 to follow after coffee!
Monday, October 15, 2007
Objectives Vs. Subjectives
I can't believe no one 'de-lurked'. I am very disappointed. I was going to go on a blogging strike until you did, but this is killing me.
I am going out of my mind. I have been having so many doubts about whether I am making the right decision or not with revision surgery. I think L sees that I am losing it. I went out tonight, to Target (needed milk, light bulbs and undershirts), as I was leaving, she said to me: "Mommy, be careful, don't step into cars, wait for the walking man and if a car comes, stop." How adorable is that, L is only 3!
So here is my dilemma. I went through this with my first surgery as well. I always have good days and bad days. On the good days, I wonder if I am going crazy. What would calm my fears was that I had an MRI which showed pathology, it disproved my theory that I was crazy (at least in this sense) . This time, I have inconclusive scans. But, there is the cam impingement. Do you see where I am going with this? Yes, straight into the psych ward!!!
My intra-articular injection got rid of all of my pain, the psoas injection helped with some of the pain but the joint injection was a million times better. I really don't want my psoas released, and Dr. Kelly knows that (maybe bc I repeated it like a million times!). But what if I am wrong? What if he is right? But none of my imaging revealed a problem with the psoas, but then again, it didn't reveal a problem with much of anything. But he has never touched, stretched or looked at my psoas, much of our discussions have been over the phone. So really he is going on all of my subjective complaints. It is scary. So that is why I have been freaking out.
On a different note, I ordered a spinning bike. I am so excited, it should arrive tomorrow. I used to be a maniac spinner, nothing in the world gives me the same high as spinning. I don't see any reason why I can't go back to spinning, I desperately need to exercise and this is perfect for me and my lifestyle since I don't have time to go to the gym! Hopefully by tomorrow night I will be able to go for my first ride!!
I am going out of my mind. I have been having so many doubts about whether I am making the right decision or not with revision surgery. I think L sees that I am losing it. I went out tonight, to Target (needed milk, light bulbs and undershirts), as I was leaving, she said to me: "Mommy, be careful, don't step into cars, wait for the walking man and if a car comes, stop." How adorable is that, L is only 3!
So here is my dilemma. I went through this with my first surgery as well. I always have good days and bad days. On the good days, I wonder if I am going crazy. What would calm my fears was that I had an MRI which showed pathology, it disproved my theory that I was crazy (at least in this sense) . This time, I have inconclusive scans. But, there is the cam impingement. Do you see where I am going with this? Yes, straight into the psych ward!!!
My intra-articular injection got rid of all of my pain, the psoas injection helped with some of the pain but the joint injection was a million times better. I really don't want my psoas released, and Dr. Kelly knows that (maybe bc I repeated it like a million times!). But what if I am wrong? What if he is right? But none of my imaging revealed a problem with the psoas, but then again, it didn't reveal a problem with much of anything. But he has never touched, stretched or looked at my psoas, much of our discussions have been over the phone. So really he is going on all of my subjective complaints. It is scary. So that is why I have been freaking out.
On a different note, I ordered a spinning bike. I am so excited, it should arrive tomorrow. I used to be a maniac spinner, nothing in the world gives me the same high as spinning. I don't see any reason why I can't go back to spinning, I desperately need to exercise and this is perfect for me and my lifestyle since I don't have time to go to the gym! Hopefully by tomorrow night I will be able to go for my first ride!!
Tuesday, September 11, 2007
Warning....Complaining to Follow
My hip really hurts today. And for the past few days...a lot. I am completely back to pre-op/ pre-injection pain levels, when you feel like you just want to hack off your leg. Granted, I have done a lot of walking the past few days, but just walking, no running, no jumping, no cycling.....just plain old walking.
Just wanted to get that off my chest.
Just wanted to get that off my chest.
Wednesday, September 5, 2007
From the Horse's (PA's) Mouth
I finally decided to face the truth and call Dr. Kelly's PA, Ariana today. But I wasn't in the mood to deal with the front office staff, so I faxed her my pain log with a note to please call me! It worked! Maybe I will start faxing all my messages!
Again, here is a lesson, know your facts, know what you scans showed, know what procedures you have had done, and be versed in it! Here is how our conversation went.
a: ok, let me see, you had which side injected? when? what happenned?
s: do you want me to give you a quick overview of what is going on?
a: no, no, I got it, there is a note that you had a flare up over the weekend?
s: huh? I don't know what you are talking about, what is the date?
a:Never mind. So, you had some relief from the injection, so there is something going on in the joint, now is this the hip we repaired the labrum or debrided?
s: both were repaired, you may be confused if you are looking at the pictures and see a suture, he put one in and took it out
a: oh, bc if it was repaired, I would say the you retore the repair, and it would make sense
s: no, there was no repair
a: well, then I would say it is synovitis, and the cortisone will calm it down
s: there is no synovitis
a: yes, the mri shows synovitis
s: no, the mri shows NO synovitis
a: no, it does, oh, wait, you're right, it says no synovitis. Well, it may be psoas scarring down to the joint capsule.
s: no, it is not psoas, that is why I insisted on injecting the joint, that is where the pain is
a: it still may be psoas though, if we injected psoas, you would probably have pain relief as well
s:(I am starting to get annoyed) Look, the bottom line is we all know there is cam impingement in the joint, I just want to know if I need a revision, so I can plan my life
a: well, based on the fact that the injection gave you relief, I would say yes, you do need a revision. It is hard to know exactly how much bone to take down, we have only had to do a revision in the case of a labral debridement a few times, but occasionally it does happen. You probably either have a psoas issue, impingement and/ or cartilage degeneration, and we would address that.
s: Would he want to do a microfracture?
a: no, the cartilage looks good
s: not on the most recent mri, there is a focal area of full thickness cartilage loss
a: Oh, you're right. It's possible he may want to, a lot of times if we go back in, we do see a nice new layer of fibrocartilage over an area of bone that was debrided.
s: Do you think we should do a CT scan of the pelvis with 3d reconstruction, so we know what is going on?
a: Yes. He would love to get that and have more images to look at to see the extent of the cam impingement and know how much to take down. I am going to email him now and let him know about our conversation.
So, that is where things stand now. Loads and loads of fun! Oh, and then she added, 'we do the other side 8-12 weeks after the first'. hahahaha, like I am about to jump into this right now!! Lets get the CT scan, and my second opinion, then we can talk!!!! I don't know if I have mentioned this before, I plan on sending my films to an open dislocation FAI surgeon in Boston, my hope is that he will tell me he cannot help me, a scope can, I don't need an open procedure.
In the meantime, I am lonely, hardly anyone is writing to me anymore! Is my blog still helpful? Entertaining? or just sad and pathetic! I will give a good update on the left as promised, but tonight I am ready to crash!
Again, here is a lesson, know your facts, know what you scans showed, know what procedures you have had done, and be versed in it! Here is how our conversation went.
a: ok, let me see, you had which side injected? when? what happenned?
s: do you want me to give you a quick overview of what is going on?
a: no, no, I got it, there is a note that you had a flare up over the weekend?
s: huh? I don't know what you are talking about, what is the date?
a:Never mind. So, you had some relief from the injection, so there is something going on in the joint, now is this the hip we repaired the labrum or debrided?
s: both were repaired, you may be confused if you are looking at the pictures and see a suture, he put one in and took it out
a: oh, bc if it was repaired, I would say the you retore the repair, and it would make sense
s: no, there was no repair
a: well, then I would say it is synovitis, and the cortisone will calm it down
s: there is no synovitis
a: yes, the mri shows synovitis
s: no, the mri shows NO synovitis
a: no, it does, oh, wait, you're right, it says no synovitis. Well, it may be psoas scarring down to the joint capsule.
s: no, it is not psoas, that is why I insisted on injecting the joint, that is where the pain is
a: it still may be psoas though, if we injected psoas, you would probably have pain relief as well
s:(I am starting to get annoyed) Look, the bottom line is we all know there is cam impingement in the joint, I just want to know if I need a revision, so I can plan my life
a: well, based on the fact that the injection gave you relief, I would say yes, you do need a revision. It is hard to know exactly how much bone to take down, we have only had to do a revision in the case of a labral debridement a few times, but occasionally it does happen. You probably either have a psoas issue, impingement and/ or cartilage degeneration, and we would address that.
s: Would he want to do a microfracture?
a: no, the cartilage looks good
s: not on the most recent mri, there is a focal area of full thickness cartilage loss
a: Oh, you're right. It's possible he may want to, a lot of times if we go back in, we do see a nice new layer of fibrocartilage over an area of bone that was debrided.
s: Do you think we should do a CT scan of the pelvis with 3d reconstruction, so we know what is going on?
a: Yes. He would love to get that and have more images to look at to see the extent of the cam impingement and know how much to take down. I am going to email him now and let him know about our conversation.
So, that is where things stand now. Loads and loads of fun! Oh, and then she added, 'we do the other side 8-12 weeks after the first'. hahahaha, like I am about to jump into this right now!! Lets get the CT scan, and my second opinion, then we can talk!!!! I don't know if I have mentioned this before, I plan on sending my films to an open dislocation FAI surgeon in Boston, my hope is that he will tell me he cannot help me, a scope can, I don't need an open procedure.
In the meantime, I am lonely, hardly anyone is writing to me anymore! Is my blog still helpful? Entertaining? or just sad and pathetic! I will give a good update on the left as promised, but tonight I am ready to crash!
Friday, August 31, 2007
The 5 Stages of Grief
I thought I was in 'anger' over this whole possible 'revision' business. I have been so pissed off, moody, and down right sad. But I think I may have reverted to denial yesterday at the Burberry sample sale. Take a look at what I bought.
Will I ever be able to wear them???
(if so, what do they go with???)
Wednesday, August 29, 2007
The Appointment
Ahhh, the dreaded/ anticipated appointment. I went with my friend Amy, also a two timing hipster, so I had someone to hang out with in the waiting room. I met a blog reader (Lakewood) who said "Susie, as in Susie711?" It was nice to see there are actually real people who are reading this that I can meet!! I didn't catch your name though, but I hope your appt went well, if you have any more questions feel free to email me suzq613 @ aol . com (take out spaces).
So, I waited about an hour. Dr. Kelly came in with Arianna, we discussed the injection, and what happened with the right hip and what is going on with it now. He quickly checked my ROM, nothing else really, and said he is not really sure of what is going on. I mentioned that I had gone over the radiology reports and noticed that there is cam impingement in that hip (thanks Rachel), he sighed and said "I know" in a concerned tone. Then he sat down. Let's see what happens with the injection, if it is an inflammatory reaction, then the cortisone from yesterday should take care of it, call us in 2 weeks and we can talk about it. He also said that when he was in the joint with the scope, he didn't think the labrum had torn from the cam, since the lesion didn't look 'peeled back', it looked to be consistent with the pincer impingement, that's why he left it. Then he looked at me and said "you don't look too convinced", I said no, I'm not, I have always had residual pinching, even from the very beginning, with the second surgery, I had great ROM from the very beginning, so looking back, something has been not right with the right. I have pain with flexion, IR and adduction, so no, I am not convinced that this is inflammatory. So he said, sometimes, he does need to go back in a second time to correct more impingement, this did not make me at all happy. Then he said, you know what, call early next week instead of in 2 weeks so we can figure this out and figure out what the next step is. So this is where I stand, no concrete answers yet, but the possibility of a third surgery looms.
So, I waited about an hour. Dr. Kelly came in with Arianna, we discussed the injection, and what happened with the right hip and what is going on with it now. He quickly checked my ROM, nothing else really, and said he is not really sure of what is going on. I mentioned that I had gone over the radiology reports and noticed that there is cam impingement in that hip (thanks Rachel), he sighed and said "I know" in a concerned tone. Then he sat down. Let's see what happens with the injection, if it is an inflammatory reaction, then the cortisone from yesterday should take care of it, call us in 2 weeks and we can talk about it. He also said that when he was in the joint with the scope, he didn't think the labrum had torn from the cam, since the lesion didn't look 'peeled back', it looked to be consistent with the pincer impingement, that's why he left it. Then he looked at me and said "you don't look too convinced", I said no, I'm not, I have always had residual pinching, even from the very beginning, with the second surgery, I had great ROM from the very beginning, so looking back, something has been not right with the right. I have pain with flexion, IR and adduction, so no, I am not convinced that this is inflammatory. So he said, sometimes, he does need to go back in a second time to correct more impingement, this did not make me at all happy. Then he said, you know what, call early next week instead of in 2 weeks so we can figure this out and figure out what the next step is. So this is where I stand, no concrete answers yet, but the possibility of a third surgery looms.
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