I always wonder how many other people have fallen into this predicament as well. What I have noticed is that these are key words that often bring people to my blog. I have no way to really keep track, but often I will scan my sitemeter which will tell me the search words used by readers. It doesn't always work, for example, "Landsickness" through google brings up my blog, o the top 10 (I checked), but so do other key words, like FAI, hipscope, hip arthroscopy,psoas....and my all time favorite, "Bryan Kelly hipscope", my blog is #1 on google if you put in those words. This is quite embarrassing as well as pretty funny, if you ask me! (If he knew, he probably wouldn't agree!)
So, my point is, I was curious, who has had a failed hip arthroscopy? or failed FAI surgery? or failed surgery for a labral tear? Who has retorn their labrum?And even more importantly....why...what reason were you given??
Now would be a great time for all lurkers to share their story, so we can all learn from each other.
Me? An conservative surgeon who didn't want to take down too much bone if it was unnecessary. We found out the hard way that it indeed was necessary, but a happy ending for all involved parties!!!
Showing posts with label revision surgery. Show all posts
Showing posts with label revision surgery. Show all posts
Monday, May 19, 2008
Monday, May 12, 2008
6 Month Post-Revision Update
Wow, I can't believe it has been 6 months already. 6 months since I tossed the hip brace, 6 months since I retired my crutches, 6 months since I was praying to a higher power to either make me stop vomiting or take me out back and shoot me, 6 month since I have had an argument with a surgeon :-)
For those of you just joining my blog, here is how it all went down: In March of 2007, I had my right hip scoped for a labral tear and pincer FAI. In July, the left hip was scoped for a labral tear, cam and pincer FAI. At that point, the right hip went bad and I realized I needed surgery again. It took a lot of diagnostic tests, injections, pleading and begging, but finally, my surgeon agreed to do it, but.....there was a catch. He was convinced that my pain was from a tight, impinging psoas, I did not think so. In fact, I was so sure, I made him promise he wouldn't touch my psoas. I wouldn't even sign a consent for for it I was so sure. So, he hesitantly agreed to do the surgery with the psoas promise, and as a compromise, I agreed to let him do a psoas bursectomy, if needed. Lo and behold, I woke up with an intact psoas as well as sans bursectomy since the psoas was not the problem.
3 months of long, intense rehab, with a few blips and bumps and knee injuries along the way, as well as some intermittent PRN PT visits, here I am.
I can't believe that 6 months later, I still walk around and gleefully think to myself "whoohoo, I am no pain", with a little smile. I still feel like I am walking on clouds some days and as if this was a dream, and I will soon wake up with that dreaded groin pain. I still say to myself almost every day. "shit, I am one lucky chick to have a happy ending after so much bullshit", 3 surgeries in 8 months really takes a toll on you, physically and emotionally.
So, what is still going on? My psoas has its moments, and more than once I have had to return for a quickie PT session to have it worked on. It also has caused me to have some back pain in addition to the muscle aches. My adductors are weak and tight, and I swear I think I have had a "snapping adductor". My psoas does snap now, I am not sure if it did, or to what extent it did pre-op. My theory to why I have so much muscle pain now is well described in prior post. I have soooo much more ROM now than I ever did and my muscles are trying to compensate by tightening up. I need to continue to strengthen them, but I prefer Spinning to PT, so who knows how this will end!
All in all, muscle pain and soreness 6 months later is a good deal for me if it means I have no more joint pain! If you need a surgeon, I have only positive things to say about mine! And what can be better than a happy ending!
For those of you just joining my blog, here is how it all went down: In March of 2007, I had my right hip scoped for a labral tear and pincer FAI. In July, the left hip was scoped for a labral tear, cam and pincer FAI. At that point, the right hip went bad and I realized I needed surgery again. It took a lot of diagnostic tests, injections, pleading and begging, but finally, my surgeon agreed to do it, but.....there was a catch. He was convinced that my pain was from a tight, impinging psoas, I did not think so. In fact, I was so sure, I made him promise he wouldn't touch my psoas. I wouldn't even sign a consent for for it I was so sure. So, he hesitantly agreed to do the surgery with the psoas promise, and as a compromise, I agreed to let him do a psoas bursectomy, if needed. Lo and behold, I woke up with an intact psoas as well as sans bursectomy since the psoas was not the problem.
3 months of long, intense rehab, with a few blips and bumps and knee injuries along the way, as well as some intermittent PRN PT visits, here I am.
I can't believe that 6 months later, I still walk around and gleefully think to myself "whoohoo, I am no pain", with a little smile. I still feel like I am walking on clouds some days and as if this was a dream, and I will soon wake up with that dreaded groin pain. I still say to myself almost every day. "shit, I am one lucky chick to have a happy ending after so much bullshit", 3 surgeries in 8 months really takes a toll on you, physically and emotionally.
So, what is still going on? My psoas has its moments, and more than once I have had to return for a quickie PT session to have it worked on. It also has caused me to have some back pain in addition to the muscle aches. My adductors are weak and tight, and I swear I think I have had a "snapping adductor". My psoas does snap now, I am not sure if it did, or to what extent it did pre-op. My theory to why I have so much muscle pain now is well described in prior post. I have soooo much more ROM now than I ever did and my muscles are trying to compensate by tightening up. I need to continue to strengthen them, but I prefer Spinning to PT, so who knows how this will end!
All in all, muscle pain and soreness 6 months later is a good deal for me if it means I have no more joint pain! If you need a surgeon, I have only positive things to say about mine! And what can be better than a happy ending!
Saturday, December 29, 2007
A Look Into the Past
My neighbor left me a trashy magazine at my door today. We had been discussing the Brittany Spear's sister pregnancy thing and she mentioned that she had bought OK magazine bc it featured a story on it. I read the story (nothing out of the ordinary for a teenage pregnancy) and then read my 2008 horoscope, honestly, this was my horoscope:
Health: Last year exacerbated health issues for many Cancers, mainly due to stress and demanding work schedules. This year, your health improves, and you should have more of that cherished nesting time. Add variety to your workouts.....
I wish I knew this a year ago and I would have been prepared! 2007 brought more doctor's visits, diagnostic tests, radiation exposure and surgeries than many people experience in a year.
I think I am not going to PT on Monday, and will soon take on the official 'dropout' status.I had better keep my mouth closed though. After my second surgery,P and I had discussed 'dropping out' at 6 weeks since I was doing so well but then I had the joint capsule/ psychotic psoas issue, as well as the whole 'revision BS'.
SHIT! I had though that it was 6 weeks out when that happened, and I was free and clear. Seems like it was closer to the 2 month mark......(color draining from my face) that whole episode and the next few days were awful, especially the next morning. But I will keep a positive attitude and keep plugging along.
On a more negative note, I am still soooo sick. I am definitely going to the doctor on Monday, there is no question that I have a raging sinus infection and NEED antibiotics. It is sad that I have an entire arsenal of narcotics here, I could easily maintain a healthy drug habit with all of my pills, but I lack a simple Z-pack!!!
Health: Last year exacerbated health issues for many Cancers, mainly due to stress and demanding work schedules. This year, your health improves, and you should have more of that cherished nesting time. Add variety to your workouts.....
I wish I knew this a year ago and I would have been prepared! 2007 brought more doctor's visits, diagnostic tests, radiation exposure and surgeries than many people experience in a year.
I think I am not going to PT on Monday, and will soon take on the official 'dropout' status.I had better keep my mouth closed though. After my second surgery,P and I had discussed 'dropping out' at 6 weeks since I was doing so well but then I had the joint capsule/ psychotic psoas issue, as well as the whole 'revision BS'.
SHIT! I had though that it was 6 weeks out when that happened, and I was free and clear. Seems like it was closer to the 2 month mark......(color draining from my face) that whole episode and the next few days were awful, especially the next morning. But I will keep a positive attitude and keep plugging along.
On a more negative note, I am still soooo sick. I am definitely going to the doctor on Monday, there is no question that I have a raging sinus infection and NEED antibiotics. It is sad that I have an entire arsenal of narcotics here, I could easily maintain a healthy drug habit with all of my pills, but I lack a simple Z-pack!!!
Wednesday, December 12, 2007
1 Month PT Measurements
Hip Flexion: R=4/5 L=5/5
Hip Abd: R=4-/5 L=4/5
Hip ER: R=4/5 L=4+/5
Hip IR: R=4/5 L=4+/5
Hip Ext: R=4/5 L=4/5
Not too shabby!!!! I think this is my all time best ever, even pre-op!! Yay, no impingement, no inhibition, nothing but strength!
Work today was better than Monday, no pain until the end of my day, and even then, it was slight. I think this is a huge improvement! If it wasn't so cold, I would be testing out my limits with the double stroller!
Manually, P worked on extension mobs since I am still pretty tight anteriorly, but it is getting better. Today, me exercises consisted of single leg walking on the treadmill, I stand on the left leg on the side of the treadmill and let the right leg move backwards on the belt to the endrange of my extension. I did walking squats with a red band, isometric hip abduction, Hip IR with a blue band, hip abduction with a blue band, isometric adduction with a small ball, bridges and modified single leg bridges, sidelying abduction with added hamstring curl and IR/ER rotation, clam shells and...........
8 STRAIGHT LEG RAISES
Holy shit!!!!!!!!! At 7 weeks out last time I couldn't do more than 1 1/2 SLR! This is amazing! I think Dr. Kelly added some special magic steroid so that he would never have to hear from me again!!!!! Who cares, this way we will both be happy!
THIRD TIME'S A CHARM!!!!!!!!!!!!!!!!!!!!!!!
Hip Abd: R=4-/5 L=4/5
Hip ER: R=4/5 L=4+/5
Hip IR: R=4/5 L=4+/5
Hip Ext: R=4/5 L=4/5
Not too shabby!!!! I think this is my all time best ever, even pre-op!! Yay, no impingement, no inhibition, nothing but strength!
Work today was better than Monday, no pain until the end of my day, and even then, it was slight. I think this is a huge improvement! If it wasn't so cold, I would be testing out my limits with the double stroller!
Manually, P worked on extension mobs since I am still pretty tight anteriorly, but it is getting better. Today, me exercises consisted of single leg walking on the treadmill, I stand on the left leg on the side of the treadmill and let the right leg move backwards on the belt to the endrange of my extension. I did walking squats with a red band, isometric hip abduction, Hip IR with a blue band, hip abduction with a blue band, isometric adduction with a small ball, bridges and modified single leg bridges, sidelying abduction with added hamstring curl and IR/ER rotation, clam shells and...........
8 STRAIGHT LEG RAISES
Holy shit!!!!!!!!! At 7 weeks out last time I couldn't do more than 1 1/2 SLR! This is amazing! I think Dr. Kelly added some special magic steroid so that he would never have to hear from me again!!!!! Who cares, this way we will both be happy!
THIRD TIME'S A CHARM!!!!!!!!!!!!!!!!!!!!!!!
Wednesday, November 28, 2007
My 1 Year Anniversary
Today marks the 1 year anniversary of when my hip saga began. For anyone just beginning their journey, I can assure you that in the hands of the right surgeon, there is a light at the end of the tunnel. I am going to do a flashback to November 28, 2006.
Shit, my hip hurts. It hurts when I drive, and especially when I push the kids in the double stroller. It is a really annoying pain. It feels like something is in my joint. My friend/ PT is coming into work around 3, I will ask her to work on it and hopefully get some relief. She showed up and I told her I was dying of pain, she did a painful release on my iliacus/psoas, I felt better immediately, but in the car on my way home, things got bad again.
I went into work the next day, again, in agony. First I had one therapist stretch my hip flexors and ITB, thinking this may help. Then I had another one check it out. She said there is definitely some kind of impingement. Then I asked P for help. He was really busy so I waited until he was done seeing patients. What makes the day so memorable is that it was Jk's 1st birthday, and I was having a small dinner party, and lacking a few key ingredients. I used P's full schedule to run to the supermarket near my office but didn't find what I was looking for (which I now don't even remember what it was). P did all kinds of releases, ART, mulligan mobs...It felt good...until I was in my car again. Shit. What is this????
I got home, L had ballet and there was no food for my party! I ended up ordering pizza, Jk didn't know the difference! After we had cleaned up and the kids were in bed, I hit the computer. I had a feeling I had a labral tear, and the word impingement reverberated through my head. I think I first looked for a surgeon, before I did anything else, that is me, always thinking ahead! I was trying to remember when I had seen a hipscope, and who did them, and no one was popping into my head. At the time, there was a hipscope patient in my office and she was a wealth of information, but I wasn't willing to see her surgeon (he was in NJ), I knew it had to be someone at HSS. So I looked and searched, and researched labral tears, FAI.....Not just that night, but every night after that for weeks. After a week or 2, I decided this wasn't getting and made an appointment with Dr.Kelly. I was between him and another surgeon. I had emailed a professor of mine about this and he had recommended against the other surgeon for personal reasons. So Dr.Kelly it was. If things didn't go well, then I would pursue other options, it was just a consult, right. Hopefully he would order an MRI and get to the bottom of this. The rest is history....but in a nutshell...
3/5/07 R hip arthroscopy, Pincer impingement, labral tear debridement, synovectomy
7/2/07 L hip arthroscopy, Cam and Pincer impingement, labral tear debridement, synovectomy
11/12/07 R hip revision arthroscopy, Cam impingement, removal of scar tissue, synovectomy, upon examination, found to have beautiful psoas
11/28/07 Riding high on life (bc everything else makes me sick) and enjoying a painfree lifestyle, looking forward to ditching my single crutch very very soon! :-)
Shit, my hip hurts. It hurts when I drive, and especially when I push the kids in the double stroller. It is a really annoying pain. It feels like something is in my joint. My friend/ PT is coming into work around 3, I will ask her to work on it and hopefully get some relief. She showed up and I told her I was dying of pain, she did a painful release on my iliacus/psoas, I felt better immediately, but in the car on my way home, things got bad again.
I went into work the next day, again, in agony. First I had one therapist stretch my hip flexors and ITB, thinking this may help. Then I had another one check it out. She said there is definitely some kind of impingement. Then I asked P for help. He was really busy so I waited until he was done seeing patients. What makes the day so memorable is that it was Jk's 1st birthday, and I was having a small dinner party, and lacking a few key ingredients. I used P's full schedule to run to the supermarket near my office but didn't find what I was looking for (which I now don't even remember what it was). P did all kinds of releases, ART, mulligan mobs...It felt good...until I was in my car again. Shit. What is this????
I got home, L had ballet and there was no food for my party! I ended up ordering pizza, Jk didn't know the difference! After we had cleaned up and the kids were in bed, I hit the computer. I had a feeling I had a labral tear, and the word impingement reverberated through my head. I think I first looked for a surgeon, before I did anything else, that is me, always thinking ahead! I was trying to remember when I had seen a hipscope, and who did them, and no one was popping into my head. At the time, there was a hipscope patient in my office and she was a wealth of information, but I wasn't willing to see her surgeon (he was in NJ), I knew it had to be someone at HSS. So I looked and searched, and researched labral tears, FAI.....Not just that night, but every night after that for weeks. After a week or 2, I decided this wasn't getting and made an appointment with Dr.Kelly. I was between him and another surgeon. I had emailed a professor of mine about this and he had recommended against the other surgeon for personal reasons. So Dr.Kelly it was. If things didn't go well, then I would pursue other options, it was just a consult, right. Hopefully he would order an MRI and get to the bottom of this. The rest is history....but in a nutshell...
3/5/07 R hip arthroscopy, Pincer impingement, labral tear debridement, synovectomy
7/2/07 L hip arthroscopy, Cam and Pincer impingement, labral tear debridement, synovectomy
11/12/07 R hip revision arthroscopy, Cam impingement, removal of scar tissue, synovectomy, upon examination, found to have beautiful psoas
11/28/07 Riding high on life (bc everything else makes me sick) and enjoying a painfree lifestyle, looking forward to ditching my single crutch very very soon! :-)
Friday, November 2, 2007
Article Review
I have been frantically trying to get my hands on an article from this month's AJSM because there is an article titled "Revision Hip Arthroscopy". I finally got it today. It found that the most common reason for a revision is persistent impingement.
Of 37 cases reported, 36 had impingement that was either not previously addressed, or inadequately addressed. 32 had labral lesions, 26 had a chondral defect, 22 had unaddressed FAI, 22 required lysis of adhesions, 13 for unaddressed instability, 12 for repeat treatment of FAI.
Just some food for thought! I feel better that most did have a labral lesion, not that I hope that for anyone...but you know what I mean!!!
Of 37 cases reported, 36 had impingement that was either not previously addressed, or inadequately addressed. 32 had labral lesions, 26 had a chondral defect, 22 had unaddressed FAI, 22 required lysis of adhesions, 13 for unaddressed instability, 12 for repeat treatment of FAI.
Just some food for thought! I feel better that most did have a labral lesion, not that I hope that for anyone...but you know what I mean!!!
Thursday, November 1, 2007
Acupuncture Consult
Today I had an acupuncture consult. His assessment consisted of checking my tongue and pulses. He can tell what is going on in 12 different organs, apparently all 12 of mine are fu___ed up! 3 are hyperactive and 9 are weak. We didn't initiate treatment today though, next time. He found the most dysfunction in my stomach, liver, and intestines, and a big fatigue problem. Plus some other stuff like neck and shoulder tension, which has been a HUGE issue for me the past week and sinus problem. All this from my tonue and wrists! We will see what he can offer me, I see him in 1 week as I have my continuing ed until Wed.
My stress has been through the roof. I have had one of the 'rougher' therapists work on my shoulders, he makes me cry, but he is honestly concerned about my tension levels. I have been super nervous about the revision. I am still hung up on the 'what if I am making this up' thing. Again- few findings on scan, intermittent pain.....you would think I would be happy about intermittent pain, but it makes me crazy! What if I wake up, and he tells me there was nothing wrong and I made it all up??????????? This keeps me up at night!
I know, I know, I am losing it again! This situation is pushing me off the deep end. There is so much tension in my neck, shoulders and head, yes head. If I had time, I would go for a massage. But I work tomorrow and my course starts Sunday morning, 8AM, 1 hour away! fun fun fun!
My stress has been through the roof. I have had one of the 'rougher' therapists work on my shoulders, he makes me cry, but he is honestly concerned about my tension levels. I have been super nervous about the revision. I am still hung up on the 'what if I am making this up' thing. Again- few findings on scan, intermittent pain.....you would think I would be happy about intermittent pain, but it makes me crazy! What if I wake up, and he tells me there was nothing wrong and I made it all up??????????? This keeps me up at night!
I know, I know, I am losing it again! This situation is pushing me off the deep end. There is so much tension in my neck, shoulders and head, yes head. If I had time, I would go for a massage. But I work tomorrow and my course starts Sunday morning, 8AM, 1 hour away! fun fun fun!
Friday, October 19, 2007
Surgery #3...scheduled
It is now written in stone (well, not really), my surgery will be Nov. 12, that is 3 weeks from Monday, really soon!
I guess they got the message after last night's email!! I received a call this morning from Dr. Kelly at 7:45. I was already exercising, no chance of waking me up at that time! He said based on everything (read older posts if you don't know what 'everything is), he feels confident that surgery will help. He will address the cam and will NOT release my psoas. He wants to release adhesions in the psoas and do a bursectomy, but, and I asked, more than once, this will not require him to release my psoas. He said that he can't in 'good conscious' release it. He even offered to give me the tool he uses to release the psoas to hold, so he has no access to it!!!
No CPM, no Gameready, Brace as needed, not a huge deal! I have to email his PA and remind her about my Percocet/ Zofran cocktail!! I requested the same anesthesiologist who did my first 2, and first case of the day if possible!
I think that covers everything. What am I going to do for 3 weeks? Oh, Spin!!!! I just finished another fabulous ride! It is amazing how much energy I have while on the bike and how I can spin through the pain, I always pay the next day but it is soooo worth it!!!
I guess they got the message after last night's email!! I received a call this morning from Dr. Kelly at 7:45. I was already exercising, no chance of waking me up at that time! He said based on everything (read older posts if you don't know what 'everything is), he feels confident that surgery will help. He will address the cam and will NOT release my psoas. He wants to release adhesions in the psoas and do a bursectomy, but, and I asked, more than once, this will not require him to release my psoas. He said that he can't in 'good conscious' release it. He even offered to give me the tool he uses to release the psoas to hold, so he has no access to it!!!
No CPM, no Gameready, Brace as needed, not a huge deal! I have to email his PA and remind her about my Percocet/ Zofran cocktail!! I requested the same anesthesiologist who did my first 2, and first case of the day if possible!
I think that covers everything. What am I going to do for 3 weeks? Oh, Spin!!!! I just finished another fabulous ride! It is amazing how much energy I have while on the bike and how I can spin through the pain, I always pay the next day but it is soooo worth it!!!
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!!
Wednesday, October 10, 2007
The NOT Pre-op Appointment
Yep, you read it correctly. Here's the play by play.
I want to start off by saying this visit did go well, and I really like Dr. Kelly a lot, I hope I can portray it as such in the dialogue!
First, I saw him in the hall as he was going to see another patient while I was waiting, and he said "Hi Susie", so he def. knows who I am, but then again, I am huge pain in the ass!!!!
He came out after he saw that patient and asked me if I had had the injection, I said yesterday, he wanted to know how it had gone, I told him I really hurt and can't really flex my hip. He thought that might be a good thing because if the psoas was inflamed, it may be reacting to the injection. But he said we will talk more when I get a room.
I only waited 1 hour! He came in, checked the ROM, and strength of a SLR, I could not do it on the right. Then we talked. He said there are 4 possible reasons for a hipscope to fail: 1) residual impingement 2) psoas issues 3) retear of the labral repair 4) severe arthritis. I do not qualify for 3 and 4, so we are left with 1 and 2. He is pretty convinced it is psoas, I don't know how convinced I am. He did say it is definitely doable with a scope, I don't need an open procedure. I asked who does 'opens' here? He said he does with his partner, some other guys in NY, the guys in Switzerland and some in Boston. I told him I sent my stuff to Boston but he told me 'to stick with you'! I had no issue telling him I had gone for a second opinion.
He wants to wait 1 week and see what happens with the injection, he feels that if it is psoas, an injection may take care of it altogether (sound familiar). And, he added, I know you REALLY don't want me to release your psoas!
So I said, you want me to call you next week? Will you actually call me back? He laughed, and said they are trying to work on a better system. Maybe email would be better, but he doesn't always check his email, so I am going to email Ariana his PA, who will pass along the message. Keep your fingers crossed.
I asked if we could just take care of it and schedule surgery, I am sick of living like this, he said that after we see what happens with the injection, he can do it next week. Seriously, I said, what does your operating schedule look like? No, I am serious, I will do it whenever you want. No, come on, seriously, I didn't believe him. He said I have been on enough of a roller coaster ride, he will do it whenever I want!
So, now another week of unknown and then we will see. We did set a tentative date of November 12.
I want to start off by saying this visit did go well, and I really like Dr. Kelly a lot, I hope I can portray it as such in the dialogue!
First, I saw him in the hall as he was going to see another patient while I was waiting, and he said "Hi Susie", so he def. knows who I am, but then again, I am huge pain in the ass!!!!
He came out after he saw that patient and asked me if I had had the injection, I said yesterday, he wanted to know how it had gone, I told him I really hurt and can't really flex my hip. He thought that might be a good thing because if the psoas was inflamed, it may be reacting to the injection. But he said we will talk more when I get a room.
I only waited 1 hour! He came in, checked the ROM, and strength of a SLR, I could not do it on the right. Then we talked. He said there are 4 possible reasons for a hipscope to fail: 1) residual impingement 2) psoas issues 3) retear of the labral repair 4) severe arthritis. I do not qualify for 3 and 4, so we are left with 1 and 2. He is pretty convinced it is psoas, I don't know how convinced I am. He did say it is definitely doable with a scope, I don't need an open procedure. I asked who does 'opens' here? He said he does with his partner, some other guys in NY, the guys in Switzerland and some in Boston. I told him I sent my stuff to Boston but he told me 'to stick with you'! I had no issue telling him I had gone for a second opinion.
He wants to wait 1 week and see what happens with the injection, he feels that if it is psoas, an injection may take care of it altogether (sound familiar). And, he added, I know you REALLY don't want me to release your psoas!
So I said, you want me to call you next week? Will you actually call me back? He laughed, and said they are trying to work on a better system. Maybe email would be better, but he doesn't always check his email, so I am going to email Ariana his PA, who will pass along the message. Keep your fingers crossed.
I asked if we could just take care of it and schedule surgery, I am sick of living like this, he said that after we see what happens with the injection, he can do it next week. Seriously, I said, what does your operating schedule look like? No, I am serious, I will do it whenever you want. No, come on, seriously, I didn't believe him. He said I have been on enough of a roller coaster ride, he will do it whenever I want!
So, now another week of unknown and then we will see. We did set a tentative date of November 12.
Monday, October 8, 2007
I Almost Forgot
As I was writing earlier tonight,I kept thinking that there was something I wanted to tell you but I couldn't remember. As I lie in bed at 11:30, it just hit me.
Dr.Millis' office called me this morning. He reviewed my films and said I should stick with a scope with Dr. Kelly. So now, one less thing to worry about!
Dr.Millis' office called me this morning. He reviewed my films and said I should stick with a scope with Dr. Kelly. So now, one less thing to worry about!
Monday, September 24, 2007
My So-Called Life
This is an email J sent me this morning, after I freaked out when I couldn't find my i-pod (It was in the car)
Firstly - u could have called and told me u found it. U knew I was up
Secondly - you need to chill out and get a grip on things
Third - you need to stop losing things
I am definitely losing objects left and right, maybe bc I am so scatter brained, and I do need to chill out a little! I am so edgy lately, I feel like any second I will snap.
Anyway, this is my current 'hip' status. Dr. Kelly's office called me Friday morning to set up the psoas injection, so they have to call the radiologist and set it up with him (sigh), so I am waiting to hear back from them (I did call today to see what the deal was, no call back yet). I also received my x-rays on CD today, so I have organized all of my office notes, scan reports and op-reports, and will now type up the letter to go with it. It will go out tomorrow, overnight!
Firstly - u could have called and told me u found it. U knew I was up
Secondly - you need to chill out and get a grip on things
Third - you need to stop losing things
I am definitely losing objects left and right, maybe bc I am so scatter brained, and I do need to chill out a little! I am so edgy lately, I feel like any second I will snap.
Anyway, this is my current 'hip' status. Dr. Kelly's office called me Friday morning to set up the psoas injection, so they have to call the radiologist and set it up with him (sigh), so I am waiting to hear back from them (I did call today to see what the deal was, no call back yet). I also received my x-rays on CD today, so I have organized all of my office notes, scan reports and op-reports, and will now type up the letter to go with it. It will go out tomorrow, overnight!
Saturday, September 22, 2007
Venting, Whining and the Ever So Importnat Shoe Choice
Last we spoke, Dr. Kelly had called, I need a revision.... fabulous! (I need to change my blog profile soon). The problem is there is never a good time for surgery, but there is no way I can put this off, my intermittent pain is beginning to give me less and less pain free periods, and the painful times are getting more and more painful.
I have spent the last 24 hours in synagogue for Yom Kippur. Aside for not eating and drinking, we don't wear leather shoes (sexy shoes fall into the leather category). Last night I wore my ballet flats. Huge Mistake. I was in agony, practically tears, they have so little suport but this has never posed a problem for me. Today, I decided to be smarter and wore my Danskos, I cannot say I did not have pain, but it was definitely a huge improvement from last night. I think I will have to begin living in those for the next few weeks/ months.
Emotionally, I don't know how people deal with pain. I guessing I have a high physical tolerance, but it is starting to really get to me. Almost every night is a mini pity party around here! I am just so fed up, and I have only had this new issue for 2 1/2 months. I cant believe it is taking this long to get things done also. What a mess! I will work on changing my profile tonight!! Let me know what you think!
I have spent the last 24 hours in synagogue for Yom Kippur. Aside for not eating and drinking, we don't wear leather shoes (sexy shoes fall into the leather category). Last night I wore my ballet flats. Huge Mistake. I was in agony, practically tears, they have so little suport but this has never posed a problem for me. Today, I decided to be smarter and wore my Danskos, I cannot say I did not have pain, but it was definitely a huge improvement from last night. I think I will have to begin living in those for the next few weeks/ months.
Emotionally, I don't know how people deal with pain. I guessing I have a high physical tolerance, but it is starting to really get to me. Almost every night is a mini pity party around here! I am just so fed up, and I have only had this new issue for 2 1/2 months. I cant believe it is taking this long to get things done also. What a mess! I will work on changing my profile tonight!! Let me know what you think!
Thursday, September 20, 2007
The Plan
He called. This is how it went down.
He said that the CT scan didn't show much of anything on the femur, the alpha angle was 30, anything under 50 is normal. Usually the CT scan will help determine if there is a bump on the femur, which is why I wanted you to have it, but it is inconclusive (I didn't mention that I was the one who actually wanted the scan, but so be it). The MRI did show the bump, but there are also post-op changes, so it is hard to tell what is there and what isn't. I think that based on your twisting/ popping, it is your psoas.
I said- originally, I had thought that we were going into surgery to address the cam, I asked him to look at the scope pics and see if he could see the bump, I don't think I got a straight answer, but I am not sure. He said he looks for the mechanism of injury and it was not consistent with cam impingement.
I started talking now, I also spoke at intervals when he spoke, but I didn't think I needed to give you a dialogue like last time! I had the popping but then went on crutches and after a few days had all the same pre-op pain.
He said- the psoas could have bled and scarred down to the capsule. He looked through my chart a little, so you had about half a day of relief from the injection?? Hmmmm........I think it may be the cam or the psoas, and as much as none of us wants to, I think we may need to go back in again and address it.
I said- What would you do? He said he would definitely take down the cam and do a bursectomy around the psoas. I said I REALLY don't want you releasing my psoas. He said it may be scarred down to the capsule.
I told him I need him to be sure that it either is or isn't the psoas, bc I REALLY don't want him releasing it. He said the only way to be sure is to have it injected, do I mind doing that? No, what's one more injection at this point.
So I then said, Ok, how would you like to proceed at this point...other than disowning me as a patient? He laughed, and said he likes the challenging ones. I didn't get a chance to ask him if he meant the challenging cases or the challenging patients!!!
So, the plan is to get the psoas injected and then see him within a week to determine if that is the issue.
So, it looks like he is definitely recommending a revision, but is not quite sure what needs to be done.
He said that the CT scan didn't show much of anything on the femur, the alpha angle was 30, anything under 50 is normal. Usually the CT scan will help determine if there is a bump on the femur, which is why I wanted you to have it, but it is inconclusive (I didn't mention that I was the one who actually wanted the scan, but so be it). The MRI did show the bump, but there are also post-op changes, so it is hard to tell what is there and what isn't. I think that based on your twisting/ popping, it is your psoas.
I said- originally, I had thought that we were going into surgery to address the cam, I asked him to look at the scope pics and see if he could see the bump, I don't think I got a straight answer, but I am not sure. He said he looks for the mechanism of injury and it was not consistent with cam impingement.
I started talking now, I also spoke at intervals when he spoke, but I didn't think I needed to give you a dialogue like last time! I had the popping but then went on crutches and after a few days had all the same pre-op pain.
He said- the psoas could have bled and scarred down to the capsule. He looked through my chart a little, so you had about half a day of relief from the injection?? Hmmmm........I think it may be the cam or the psoas, and as much as none of us wants to, I think we may need to go back in again and address it.
I said- What would you do? He said he would definitely take down the cam and do a bursectomy around the psoas. I said I REALLY don't want you releasing my psoas. He said it may be scarred down to the capsule.
I told him I need him to be sure that it either is or isn't the psoas, bc I REALLY don't want him releasing it. He said the only way to be sure is to have it injected, do I mind doing that? No, what's one more injection at this point.
So I then said, Ok, how would you like to proceed at this point...other than disowning me as a patient? He laughed, and said he likes the challenging ones. I didn't get a chance to ask him if he meant the challenging cases or the challenging patients!!!
So, the plan is to get the psoas injected and then see him within a week to determine if that is the issue.
So, it looks like he is definitely recommending a revision, but is not quite sure what needs to be done.
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!
Tuesday, September 4, 2007
My Schizophrenic Hip, or is it?
I have been laying low over the past few days, and left the posting to Amy (thanks again), and have been doing some self reflection and deep thinking. Ok, as much as I can with 2 rugrats tugging at each ankle, but maybe a little thinking.
See, my hip pain is intermittent, sometimes it can be fine for 2-3 days, sometimes the pain can bring me to tears, which is why I call it schizophrenic. So on the good days, I decided to let it take its course, and not have a revision, if it comes to that, but then on bad days, I want to call Dr. Kelly and beg him to do it that minute. And then one of the kids needs me, and I don't call him!!!
So you can see how this would drive one (more) insane, and then throw in the sexy shoe dilema, and you have a big problem on your hands.
By Sunday, I was not having a revision, regardless of anything. By Sunday afternoon, I had spoken to a woman at the pool who had just been resurfaced 6 weeks previously. She has had bilateral hip pain for over 10 years and has not wanted to deal with it. I spoke to her about my progress and PT, we compared notes (btw- she is soooooo happy with her resurfacing, but she was bone on bone). As we were finishing our conversation, she said if there is one piece of advice I can give you, it would be to take care of anything that needs 'taking care of'' now, rather than later. Your kids are still young, I feel like I missed out on the last 10 years of my kids lives because of this.
She left me with a lot on my mind, and I understand where she is coming from, but on the other hand, I do everything, I push through the pain when I have to, but will I always be able to? I also am not 100% sure of the results on my left side. It is great, don't get me wrong, and better than my right currently, but I need more time to see what my results will ultimately be. (I will give a good detailed update later in the week)
Whenever I start thinking, my mind goes racing at a million miles per hour, and it ended up thinking about microfracture. Would I want that on the right, since there is a focal area of bone on bone? I don't think I can handle the recovery from that, but maybe the long term benefits outweigh the 6 awful weeks? But that is so ahead of where I need to be thinking right now, but I do anyway. I need to focus on the 'now', and the next step is to call Ariana this week. I put it off today since I didn't feel like dealing with it, I will try to deal with it tomorrow!
At this point, I want a gameplan, I don't want to have to follow through with anything yet, but I want a plan, so I can plan my life and know what is in store, I don't want to be living in limbo, the way I feel I am right now.
In an unrelated topic, I am having a ridiculous allergic reaction, I am pretty sure it is not from the injection last week, but I have been so itchy, and full of hives, my skin is so sensitive that if I lightly touch it, I develop a red streak on that area. I am still in the investigation process, has anyone had a reaction like this from an injection? Or anything else?
See, my hip pain is intermittent, sometimes it can be fine for 2-3 days, sometimes the pain can bring me to tears, which is why I call it schizophrenic. So on the good days, I decided to let it take its course, and not have a revision, if it comes to that, but then on bad days, I want to call Dr. Kelly and beg him to do it that minute. And then one of the kids needs me, and I don't call him!!!
So you can see how this would drive one (more) insane, and then throw in the sexy shoe dilema, and you have a big problem on your hands.
By Sunday, I was not having a revision, regardless of anything. By Sunday afternoon, I had spoken to a woman at the pool who had just been resurfaced 6 weeks previously. She has had bilateral hip pain for over 10 years and has not wanted to deal with it. I spoke to her about my progress and PT, we compared notes (btw- she is soooooo happy with her resurfacing, but she was bone on bone). As we were finishing our conversation, she said if there is one piece of advice I can give you, it would be to take care of anything that needs 'taking care of'' now, rather than later. Your kids are still young, I feel like I missed out on the last 10 years of my kids lives because of this.
She left me with a lot on my mind, and I understand where she is coming from, but on the other hand, I do everything, I push through the pain when I have to, but will I always be able to? I also am not 100% sure of the results on my left side. It is great, don't get me wrong, and better than my right currently, but I need more time to see what my results will ultimately be. (I will give a good detailed update later in the week)
Whenever I start thinking, my mind goes racing at a million miles per hour, and it ended up thinking about microfracture. Would I want that on the right, since there is a focal area of bone on bone? I don't think I can handle the recovery from that, but maybe the long term benefits outweigh the 6 awful weeks? But that is so ahead of where I need to be thinking right now, but I do anyway. I need to focus on the 'now', and the next step is to call Ariana this week. I put it off today since I didn't feel like dealing with it, I will try to deal with it tomorrow!
At this point, I want a gameplan, I don't want to have to follow through with anything yet, but I want a plan, so I can plan my life and know what is in store, I don't want to be living in limbo, the way I feel I am right now.
In an unrelated topic, I am having a ridiculous allergic reaction, I am pretty sure it is not from the injection last week, but I have been so itchy, and full of hives, my skin is so sensitive that if I lightly touch it, I develop a red streak on that area. I am still in the investigation process, has anyone had a reaction like this from an injection? Or anything else?
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