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.

Tuesday, August 28, 2007

The Beauty of huge Needles in Small Spaces

Yes, I had my injection today (#3 for me, I think I can start doing them myself). I had a different radiologist today than the previous times, apparently, I was supposed to have him every time, but someone (hmm, who can that be) screwed it up.

What was different this time was the doctor brought my hip through some ROM pre-injection, documented my pain levels with certain motions (hyperflexion, flexion with IR, flexion with ER), then injected, and then ranged the hip again. I went from a 7/10, 10/10, 0/10 to a 0/10 for all motions. So I got up and was pain free.

There were 3 or 4 good hours, the injection was around 10:30, 11:00, by 3:30, the anesthetic wore off and the joint felt irritated. In the past, I have had a huge flare up the night of the injection, but the radiologist told me things may be different because the hip has been operated on. He also said, before he started, that it may be a little bit more difficult and uncomfortable to inject because of scar tissue, but once he was in the joint space, he told me he felt no resistance.
So far, my pain has returned, slightly increased than pre-injection levels, I am waiting for the flare up but it doesn't seem to be happening.

In terms of the right side, it has been better since P mob'd it on Monday, s I am writing this, it just tightened up nightmarishly, I am typing on my stomach, with my body pillow folded in half under my thigh near my knee to get some hip extension and stress the anerior capsule.

Tomorrow I see Dr. Kelly. When I was in today, I was given my entire chart, photocopied. Interestingly, my first X-ray of the right hip showed a synovial herniation pit in the head neck junction, and the MRI's (both of the right) showed mild cam impingement (on a side note, the left MRI showed no cam impingement but it was found on visual inspection with the arthroscope). Clearly, this is a huge issue and I somehow have to bring it up delicately, but firmly. Any ideas?????

Monday, August 27, 2007

I Stand Corrected

I have to sincerely apologize to psoas. It was not psychotic, angry, vengeful or problemsome. It was the actual joint capsule, it tightened up like it hated me. The is why I had stabbing pain in the hip this morning with any type of motion, and awful pain the past few days.

I woke up this morning at 5:00 to excruciating pain, probably worse than surgical pain, it hurt to move, breathe or think. Walking was the best therapy. I somehow made it out the door and to work, where I explained to P the day's situation. "I am super tight anteriorly, it feels like there is a bungee cord inside my hip that pulls me backwards when I take too big a step on the right, I woke up in 10/10 pain...please help. Oh, can you do a grade 5 mob in a FABER position."

So P checked it out and began doing some anterior mobilizations, it really hurt with each thrust forward, but it felt like productive pain, if that makes any sense at all. And slowly, the capsule loosened up. He did one grade 5 mobilization, but not in FABER, in prone (on my stomach), it was extremely painful, and I tightened up and began guarding, so he had to promise no more grade 5's!

By the time he was done, I felt great. My gait was normal and the stabbing pain was gone. Around 10:30, the tightness came back with a vengeance. But after walking around for a while, it slowly let up. Later on in the day, I felt it tighten up again, but this was so different, it quickly 'grabbed' me and tightened up, but I walked on it and it loosened up again.
When I got home, I went to the pool with L and Jk, and the constant activity was good to keep it loose.

I see a huge problem though for most people and even more so for those in PT. I come in with a different complaint almost every time I have PT, but I can easily pinpoint exactly what is bothering me and we can remedy it. I think this may be a part of why many people are having unsuccessful surgeries, the surgery is successful, but there are so many 'complications' that arise later on, and describing the location and quality of pain is very difficult. I asked P what he thought about that, and he agreed, and said we are 'lucky' bc I am going through it and it will be a huge learning experience for all of us.

Sunday, August 26, 2007

Psychotic Psoas

Need I say more. I woke up this morning with an awful tightness in the front of my left hip. I couldn't take large steps, and when I would try, it felt like a bungee cord inside, pulling me back. Since doing nothing the day before clearly didn't help, I decided to do some walking. It helped. Not completely though, but it helped. When I lie down, I cannot get into a full FABER position (lying on your back, one leg straight, other one bent with the ankle resting just above the knee of the other leg, try to bring knee to the ground), so I am lacking anterior translation of the femoral head. P will have to figure something out tomorrow to fix this!!

Today is the definitive sign that no amount of pain, limp or discomfort will stand in my way, or maybe it is the definitive sign that I am an idiot. You be the judge! When I was in college, a bunch of us went out to a bar/ pool hall/ arcade etc for the night. My friend and I discovered a fun arcade game called Dance Dance Revolution, the explanation of DDR from wikipedia is as follows: "In Dance Dance Revolution, a player must move his or her feet to a set pattern, stepping in time to the general rhythm or beat of a song. During normal gameplay, arrows scroll upwards from the bottom of the screen and pass over stationary, transparent arrows near the top (referred to as the "guide arrows" or "receptors"). When the scrolling arrows overlap the stationary ones, the player must step on the corresponding arrows on the dance platform."

Since our initial DDR day, my friend and I have grown and matured, and gone on to have 2 children each. today, we took the kids to an amusement park, which happened to have an arcade, which happened to have DDR. We had to play.

We dumped the kids with the husbands and played, and played, and played, until we were both dripping sweat and I was limping! But we had a blast!! The good thing is that other than the psoas trouble, the left hip handled the jumping like a star, no joint pain, no soreness, right was sore though. But we had a blast! I think this is a good sign, P always jokes that 'next time', we will start plyometrics, which would be some jumping and landing...and I laugh at the absurdity. But today, I did it!!!

I am really happy with my left hip right now, I know I am in pain from the psoas, but if I were to judge the success of the surgery now, I would say A+! And DDR helped to prove this!

Saturday, August 25, 2007

Psoas Problems

I am on vacation (yes, again), just for the weekend. So I have practically sat on my ass for 24 hours, so yes, my right hip is in 'labral heaven'. My left hip has decided to be fresh, and it feels like every muscle has gone into spasm. I don't think I did anything too extreme. J was away on business so I did all the packing for this trip, but it didn't bother me (rather, it didn't bother my hip). It started Thursday, my adductors felt tight, and it hurt me to ER the left hip. This is fine, in my book, painful ER can only be from muscular things, and as long as there is no painful IR, I can be free and clear of any joint issues. P worked on the adductors, and left me a nice bruise, but they feel better.
But this muscle pain is awful. I have narrowed it down to the psoas, good old psoas. I feel like it has adhered to something, and I want it to 'pop' and be free. I have been stretching the heck out of it all day and it has helped a little. I also did some soft tissue work on psoas, iliacus and sartorius today, so now it is only psoas that is being a pain.
I would like someone to manipulate this hip anteriorly, but I don't think I will be able to convince P it is a good idea, but I will definitely try on Monday! That way, the joint can be pushed just past the end range and free up my motion a little (hopefully).

I was actually limping earlier today, real, actual limping, how pathetic. I still cannot understand why my muscles decide to turn on me in such ways. I would think getting in the pool would be helpful but it is so friggin' cold, I don't think it would be worth it!! I will continue to do some soft tissue work on it and update on this when I get home Sunday night.

Thursday, August 23, 2007

Ewww, Gross

My hip clicks, inside the joint, it is gross. I have very loud, clicking knees, so at first, I thought it was my knees, but then, on closer inspection, I realized it was my right hip, a loud, painless click. It clicks with rotation. L took my engagement ring 2 weeks ago and I have yet to find it. I was emptying out every drawer in my dresser in hopes of finding it when the infamous clicking began. The clicking in my knees comes after years of pain and a finding of decreased joint space (at the tender age of 22), but with activity modification as well as footwear adjustment, my knees are no longer painful, just loud.

My left psoas has suddenly decided to rear its ugly head, it just tightened up and is limiting my ER. P will definitely have his work cut out for him tomorrow!! Why is that almost everyone with hip labral tears ends up with psoas problems. After my first scope, I had so much tightness for such a long time, my gait went slightly out of whack as I would subconsciously try to have a longer stride to get a tiny stretch in the psoas with each step. It did eventually resolve on its own, and it got bad around 7-8 weeks post-op, same as I am now.

5 more days until my injection...but who's counting!!!!

Wednesday, August 22, 2007

Guilty Mother Syndrome

J is out of town so I took the opportunity tonight to order some pictures of the kids which have been uploaded for a very long time, but never purchased. I came across one picture of each kid that was so cute, it was a shame not to share!




Things have been pretty much status quo around here. For the first time ever, I decided not to take the kids somewhere for fear of how I would feel after. It was the 3rd rainy day in a row and I though maybe an indoor climbing playground would be fun, but the thought of chasing them up and down the ropes was too much for me to handle, so I decided not to go. I feel awful about it, and don't want to live my life not doing things with them for fear of pain.

Tuesday, August 21, 2007

Injection Scheduled

Sigh of relief!!!!! But the appointment is for next Tuesday, one week from today, but at least it is before I actually go in and see Dr. Kelly! So we can talk about it. It only took his office 24 hours to schedule this for me, do you think I am being unreasonable with all of my complaining?
Also, this injection is in a different location (not anatomical location, physical location, different office) than all my other ones have been, further leading me to believe that his office staff screwed up in the past when scheduling them.
My only concern is that I have theater tickets for that night, so I will not make a fun date (sorry Amy!!!), but the receptionist became edgy when I asked if there was an earlier appointment time available "You said Tuesdays and Thursdays are good for you", ok, I'll take it, I'll stop complaining!!!!!!

Monday, August 20, 2007

Time to Schedule Injection

If things have been comical up until now, this mornings incident will just add more fun! Maybe as a reader, you don't find things so funny, but from my point of view, if I don't laugh at all of this then I will cry, and it is really not something I want to cry about all the time!!
At 8:45 this morning, my cel phone rings, Dr. Kelly's office. It is his office manager, and she says "Hi, how can I help you?". Well, she really can't, unless she can magically fix this problem, decide I can have an injection, or do a total hip replacement on me (ok, bad idea..). She said "well, I have a message here that you called". yes, but not her...this is weird. "Oh, ok, what's your first name again?", didn't you just call me???? "What message did you want to leave for Dr. Kelly?", isn't it on the piece of paper where you got my number? The original message? "I want an injection, do you think you can get him that message today?", "well, I don't know if you can have the injection today, someone else makes the appointments and she has to call your insurance company", AHHHHHHHHHH that is not my question.....just please give him my message. This is going to have to be added to a previous post Incompetencies

He did just call me back, so I will call his office in a few minutes and schedule it!!!

Sunday, August 19, 2007

It Can't Possibly Get Worse Than This

I am now officially done being positive for the day and time for a lot of negativity, aggression and downright complaining. You have been warned!

I will skip the emotional aspect of this bc I know no one really cares that I burst into tears for no apparent reason at inappropriate times, but the last 3 days have left me feeling desperate for answers as well as a solution.

It all started Fri morning, shortly after PT, and now looking back, I wonder if something we did precipitated this awful mess. My right ROM in hip flexion is 90-100 degrees, at which point I develop pinching in the groin. P tried some Mulligan mobs and was able to increase that number a lot. He also did a lot of psoas work. A few hours into my day, I started getting that all too familiar achy pain, which didn't go away. My pain has pretty much always been intermittent but the pain free periods have been coming less and less. Fri was no exception. By 1pm, I knew I needed to do something and that was when I decided on the injection (still haven't heard back).

Friday night was awful, the pain just never went away, I gave in and took 2 extra strength tylenols which helped a lot. I think Tylenol gets a rap for being a 'wimpy' drug, not strong, not helpful, but I have to disagree.

Saturday, I was stupid (again) and wore heels for a few hours in the morning, not my sexy shoes, but 3" platform wedges. Whoa, bad, bad idea. Pain all day. J was nice enough to let me nap for 3 hours in the day and watch the kids, I was physically and emotionally beat. I never realized what pain can do to ones psychological well-being until now.

After my 'power-nap', we took the kids to the park, then home for a bath and bed. I again, took my 2 extra-strength Tylenols, but this time, they didn't work. Shit. Now what? I really don't want to take narcotics for this, but I saw no choice, I was in that much pain. I have a total of 4 narcotics here, all left over from each surgery and my 'trial and error' period with each. If the phrase 'pick your poison' ever held truer, I would be shocked. Here were my choices: a)vicodin b)percoet c)ultram d)darvocet
And the winner is.....choice D, Darvocet. For the shear reason that I was not 100% sure what it would do to me, the last time I had taken it, I threw up multiple times but I didn't know if it was bc I had taken it on an empty stomach or if I was throwing up from the anesthesia.
Darvocet is still the winner in my book!! It did the trick and had no side effects, I was even able to carry a conversation afterwards!!

This brought us to Sunday. I woke up in pain, took 3 extra-strength Tylenol, they took the edge off, but not enough. Not quite 4 hours later, I took 3 more, still, not enough. I really, really didn't want to take Darvocet again, so I added 1 teeny tiny Aleve to the mix. If you have been a religious Goodnight Nobody reader, you would know that I cannot take any anti-inflammatories bc of other issues, but I needed something to get me through this. In the end, the Aleve helped a little more, but nothing was quite as good as the Darvocet. I am trying not to take them, not bc I am afraid I will run out (I have 59 left) but bc I don't want to feel like I have to rely on pain meds for this.

It was our anniversary yesterday (6 years) so J went out and bought ingredients to make my favorite drink, I figured this would be better than Darvocet! Looks like all those meds don't go well with alcohol, because I ended sicker than I would have been had I taken a Vicodin! Live and Learn!

Saturday, August 18, 2007

7 weeks postop (almost)

To defelct from all the negativity I have been posting lately, here is my 7 week update on the left. For starters, it feels a heck of a lot better than the right. It is still slightly painful at times, but doing great. The psoas snaps on it, but that is more annoying than anything else, and once I realized it was the psoas, it was no longer alarming.

I still cannot run on it, and any attempt to run causes me to laugh hysterically. Imagine a limpy run! Not that I am actually attempting to run for exercise, but if the phone rings and I want to try to get it before voicemail picks up, doorbell rings, or if a kid runs away, it hurts a little bit to run, but it is funny how my body just doesn't allow for it yet.

When the psoas gets tight, my hip flexion ROM decreases, I have no explanation for this and it makes no sense at all to me. But when this happens, I will try some manual release stuff on it and then it will flex more (weird).

I cannot do any quick twisting, or quick anything on the hip, bc it causes a sharp pain, but nothing lasting too long.

Basically, I am very happy so far with the outcome on the left, and feel like it is doing better than the right was at 7 weeks out.

In PT, my routine consists of the following: Bike (10 min), isometric hip abduction/adduction against the wall, while standing on a dynadisc, squats with a black theraband around my knees while standing on the black side of the bosu ball, walking squats with the black theraband, closed chain ER on one leg, balancing on one leg on airex or dynadisc, standing hip 4 way with yellow or red theraband, bridging, isometric hip adduction supine (lying on back) squeezing a ball, hip abduction with black theraband supine, hip fallouts supine (like abduction, but only one leg at a time, really works on stability of non working leg), clam shells, seated ER/IR with theraband/ ball combination. I try to do the table exercises on my own at home because of time constraints, and pf course adjust the routine as needed due to pain on the right.

Friday, August 17, 2007

I Gave In

My 'game plan' lasted exactly 3 days, meaning, waiting as long as possible to get an injection. Today my pain was so awful I called to schedule an injection. Now I have to wait for Dr. Kelly's office to call me back....so hopefully by next month:-) Seriously, I hope to hear no later than Monday so I can proceed with this!

We just uploaded some more pics from our trip!!!




Thursday, August 16, 2007

Family Vacation

Even though my 'hip life' is kind of in the dumps right now, everything else is great! Here are some highlights from our trip to Costa Rica last week!



Jk in the pool


My sister, Sandy, and L


L, Jeff (my brother), Sandy, me and Jk

Family pic
The Girls (Sandy, my mom and Me)
Let the Party Begin

Me and J

Yes, I wore heels, my sexy shoes to be exact, 4-5" heel!!!!

Wednesday, August 15, 2007

Highlights From My MRI

I am missing the last page of the MRI report (sound familiar), hopefully tomorrow I will be able to get it (sigh), nothing can be simple, ever!!!

To illustrate the absurdity of my life at times, the chinese delivery person no longer rings my doorbell or knocks on my door, rather, just pushes it open and announces her arrival. I guess she feels that being 'invited' over 3 times per week (at a minimum) has made her a part of our family, and she can simply come and go as she pleases! The doorman no longer calls up when she arives, not that we would turn away food, regardless of whether we had ordered it or not!!!

Ok, back to the MRI, once I have the full report, I will type it up and add it, in the meantime I will just point out the parts I found interesting. Both hips are observed on the scan.
Left hip (most recently operated on, not reason for MRI)- incidental note is made of a moderate amount of fluid in the left hip joint, not present on prior study on 1/07. In addition, mild high signal is demonstrated in the anterior margin of the proximal left gluteus medius and minimus muscle, without established muscular atrophy.
Right hip- mild bony offset at head-neck junction of the proximal right femur that may contribute to a cam-type femoroacetabular impingement. There is an attenuated and frayed anterior labrum, as well as a deficient anterosuperior labrum, without a displaced tear.
Progressive Chondral loss is seen in the interval since the prior study of 1/07 with focal small full thickness defect over the superomedial margin of the acetabular dome, adjacent to anterosuperior labral detachment. (Rest of cartilage looks good, no synovitis, muscles and tendons look good, nothing going on in the pelvis)

Tuesday, August 14, 2007

Dr. Jekyll and Mr. Hyde

(yes, I had to google the spelling of that!)
I am back and forth, back and forth, and change my mind every hour, and sometimes minute, even seconds. Yes, I am definitely losing it...again (or still???)
I am not sure where I stand, and as Rachel pointed out, this gray area stinks!
I had a long sit down meeting with my 2 PTs, J and P to discuss this as well as the work issues. We agreed to really work the psoas for now, so P really did, all the way to the insertion, which is on the lumbar spine, and I felt good after.
What I had decided this morning was that for now, I will hold off on injecting anything, of course, I had minimal to no pain at the time! I want to try to really work on the psoas and see if it is really the issue. But now, as my pain level is slowly creeping up, I am yearning for an injection!
The nice thing for me is that the pain is intermittent, on the flip-side, when it doesn't hurt, I wonder if I am imagining the painful times, and I decide that I am crazy/ier!!!

I had P take strength and ROM measurements for me. The left side is doing well, almost all back to pre-op levels. Right side has lost strength and ROM since the last time we measured, around 7 weeks ago. I am going to aggressively strengthen over the next few weeks and see if I can build it up again, and try not to give in to an injection too quickly!

Monday, August 13, 2007

He Called...finally

So after 2 messages an email, and a conversation with his PA (unrelated to this issue) he called me!!
Here's the deal....the MRI report shows a fraying of the labrum, when comparing the MRI images to the scope pics, he says it is normal, and in the area of the debridement. There is no large flap or loose body in the joint. There is no sign of synovitis, but it is usually not reported, and there is some fluid around the psoas. There is also some loss of cartilage in the area of the original tear, which apparently we knew about after the surgery (I don't recall this though).

I can get the psoas injected if I so desire, at the time of our conversation, I was in no pain, now of course I am!! I told him I would prefer to have the joint injected, since I think that is where my pain is, and that I will call him when I go back to work since that is what has been causing me the most pain. I will decide then.
As for now, I am unsure what this all means. Obviously, a frank, obvious retear would be devastating, but I am pretty sure it is not my psoas.
I have PT tomorrow morning, I will have P really check everything out and we can come to a decision (hopefully together!!) about what to do next!

Friday, August 10, 2007

Work Hardening

I can be one of those commercials they used to show on TV, persuading young girls not to get pregnant, I think it went something like "baby, it changes everything". Why am I saying this? I am in the hotel room trying to get Jk to take a nap, not enjoying the pool!! Thats ok, I was ready for a baby, or 2!! Actually, travelling with kids has its perks, we got to skip the whole security line in Newark, and got to go in the "special services" line at Immigration! I have even gotten away with 'breaking the law' numerous times. Since the initiation of the 'no liqiuds' rule, things have been a little difficult when travelling with the kids. Especially the 'no ice' rule. But we travel with tons of food and snacks and milk....so I always throw in a few bags of ice, whats the worst that can happen, they will throw them away. But no, I get special treatment. All you have to do is look at me at the end of the security line, 2 kids, 2 strollers, carseat, no one is wearing shoes (yes, L and Jk need thier shoes screened as well), a diaper bag, a rollaway bag, J and his stuff, plus J putting his laptop away, his belt back on and trying to reconfigure the strollers....I usually look a tad frazzled by this point. I think the TSA officials are usually afraid to even question what type of liquid is in the sippy cup, and heaven forbid try to take my ice, for fear that I may hurt them. In the past, they have pulled me aside and quietly said "I am letting you keep the ice bags but don't tell anyone". I tend to invoke unwarranted sympathy!! The same thing happenned when checking into the airport on Wed. J went to park and left me with the kids + 6 pieces of luggage + 2 strollers+ 1 car seat, but with all 4 passports. The agent allowed me to check J in, even though he wasn't there, plus didn't charge me for the 5 lbs of overweight luggage I had, and even lied to the baggage handler about having charged me!!

Ok, so that is a quick explanation of why I have time for a long post now! Since returning to work, my right hip has been painful, and in fact, working causes pain. One of the first things they teach you in PT school is not to hurt yourself while treating (of course, first they teach 'do no harm'). So having good body mechnaics is key. If I am working on ROM, lets say, I will stand with one leg in front of the other, and shift my weight front and back, using my whole body for the ROM, not just my arms. In theory, this is great, except now, my hip gets the brunt of the work and seems to be the weakest link in my body! Sometimes, I will get up on a treatment table for certain things, if I decide to sit back on my heels, I may see stars from the sheer amount of pain shooting through the joint. I am not sure what to do about it, clearly hurting my back or shoulder to compensate for not being able to use my hips is out of the question, as is not working. I have to experiment with shoe choice, I did not wear my Danskos this week everyday (I know, fashion cannot always dictate), and my ballet slippers offer no support whatsoever (but are so cute!).

There are certain cases that need PT and need work hardening, for example, people who lift heavy loads, or work heavy machinery, they need to be trained to safely resume their normal work activities. This is not something I specialize in, nor something my practice specializes in (except my boss, but he doesn't know what is going on!!!), and returning to work as a PT does not fall into the same category as training the UPS man to carry 100lb boxes!!

(I again apologize for the spelling, I will do a retroactive spellcheck when I return to NY)

Thursday, August 9, 2007

Missed Calls

You guessed it! He called! Now that I have no cell phone service! Of course he didn't say what the MRI showed...ahhhhhhhhhhhhhhhhhhhhhhhhh!!!!

On vacation

I am in Costa Rica, with no cell phone service! I checked my voicemail last night...no new messages!! Ok, this is really dragging along. I think if by next Tuesday I dont have an answer, I will personally go down to HSS and break into the MRI department and steal my films, although if they are my films, is it technically stealing???

Also, my internet connection is sooooo slow, so I don't know how often I will be posting. My newest "issue" is that working really hurts my right hip, so P will have to come up with some good "work hardening" solutions next week. If I have time later, I will ellaborate!!!
(spell check is not working, it thinks I am writing in spanish so my whole document is highlited in yellow, my apologies for any errors!)

Tuesday, August 7, 2007

Venting...again

HE DIDN'T CALL AGAIN!
I called and left a message today (thanks for the prompting Jess!!), now I am in desperation mode...I need to know! to make matters worse, I am going out of town tomorrow, and am not sure if I will have cell phone service where I am going, so this will bring me to a week from today for finding out! (cover your ears) AAAAAHHHHHHHHHHHHHHHHHHHHHHHH!

Ok, I feel a little better now that I got that out!!! So, how am I doing? I can't do a straight leg raise...still. I had PT today, and P checked out the SLR issue. I feel pathetic enough about this whole situation, but not being able to do a SLR is just icing on the cake!! Usually, my patients who have trouble with SLR are 90 year old ladies who have had knee replacements!

So P had to help my leg move! And, I could not complete the downward cycle of the SLR because at about 30', I begin to get very unstable in the joint, it feels like the femoral head is jumping inside the joint. P thought maybe my rotators were still too weak to stabilize the joint, so we did some IR/ER exercises and tried the SLR again. One full SLR, up and down, with minimal problems! Whoohoo!! It worked! Great, we both said, then time for SLR #2, my leg wouldn't go!! P tried to help it up, but it just collapsed down to the table, amidst crazy giggling from me. Time to feel pathetic again!

My homework for my vacation is to work on hip flexion in the water, how exciting!!!

My left side was in awful pain last night, which raised my anxiety level just a touch!!! It turned out to be severe muscle tightness, mainly TFL and adductors. I put some lotion on my fingertips and gently glided the length of the tendons for a few minutes, this did the trick! I am unable to inflict upon myself the pain I would inflict upon my own patient with these symptoms, or the pain I knew P would be inflicting upon me this morning, but my pseudo muscle release was enough to allow me to sleep last night!!

Monday, August 6, 2007

Ahhhhhhh

He.


Didn't.


Call.


Me.




Sunday, August 5, 2007

Field Trip

I have been dreading today for quite some time now, J has had a business trip planned and is out of town, I am alone, with both kids, on a weekend! But they are now both in bed, asleep from their adventurous day!

We are going away this week, we have a wedding, Jk and L are walking down the aisle. L needed dress shoes, so I decided to be brave and take them both to the city. In my head, I was going to find a great parking spot, walk in, buy the first shoe she tried on, and be on my way! Again, I was way wrong!! Everything seemed to be going well, we found a parking spot 3 blocks away, and it was free! But the store was closed. The next closest store was 14 blocks away, and I did not have my double stroller. L was such a trooper and walked both ways without a single complaint! I did have to bribe her with ice cream, but she walked a total of 28 city blocks, and she is 3. That means I also walked a total of 28 city blocks, as I am writing this, I have no pain!

I did make an interesting discovery though. Since most of my readers are in similar situations as me, I have found us a wonderful solution for mobility. Since we are probably all on the younger side, because we did not opt initially for a hip replacement, looking cool is a big deal to us! Eventually, we will probably all need new hips, and begin to lose mobility. Rather than rely on a cane, walker or wheelchair, we can all buy this:

I saw a woman riding one in the city, either it needs a better braking mechanism, or she needed to learn to drive it, but with a little tweaking it can be the ride of choice for 'hipsters of the future'!

As I am moving forward, I used our treadmill today for the first time! The treadmill generated a huge argument in my household, I did not want it. I will never be able to run on a treadmill, for the rest of my life, if I want to preserve my ever so fragile hips!! I don't need a treadmill to walk, I walk outside...alot! J insisted that he would use the treadmill everyday, I insisted that he would not, and I would not, and it would become a clothes hanger. I was wrong. He uses it occasionally, I never have though, it came in the interim between my 2 surgeries. But today, I actually used it. No, I didn't run, or even jog! I used it for a total of 3 minutes and 41 seconds! I did my side squats on an incline on it! It really hurt my right hip, hence the short amount of time! But I plopped L in front of the TV to buy some time and do my exercises.

I came to a shocking discovery, I cannot do a straight leg raise on my operated leg. I know the protocol says no straight leg raises (SLR) for 4 weeks, tomorrow is 5 weeks, but I could not lift my darn leg. I finally squeezed hard enough, somehow pulled the femur in close to my body (or at least it felt like that) and lifted it a few inches. I will have my PT watch me do it this week and report on what he sees, since my account of it from the floor may no be so accurate. It also really hurt to even attempt a SLR. Prior to surgery, I could do no more than 5 or 10 without severe pain, my right leg can do 8-10 at a time, and then it gets weak and painful. Hopefully, in the near future, I will be able to do 20, consecutively!

Friday, August 3, 2007

TGIF

This week is finally over, I can't remember the last time I felt this drained on a Friday, but between returning to work, stressing over the MRI, and stressing even more over the results, I am ready to kick back!! The truth is, it is easier for me to kick back on a weekday, since my nanny is around. After today, I will be on my own until Monday. Well, J will be around tonight and tommorrow, but he is going on a business trip on sunday morning :-(

I had more pain this week than I did last week, which is understandable, yet slightly depressing, as I would like my pain to continue decreasing over time, but I can't expect this level of activity to help much. My right hip has been on again, off again. There are times when it is fine, and other times, like today, when I wanted Percocet. I was at work, and was kneeling, sitting on my heels, that is a new, deadly position for the right hip. I ended up with awful, excruciating pain for a while, hence my desire for Percocet. The left is painful too, I almost feel the raw bone rubbing (sorry, that is so gross), but I notice a difference in the quality of pain from side to side. The right side is a general, joint pain, very achy. The left is a more specific, focal area, also in the joint, but not as widespread as the right. I imagine the 2 bones rubbing together over the area where the labrum was debrided...eeewwww!!!

I am having company for dinner tonight, first time since the surgery I have any type of company. Everything is now pretty much done, I need to go out to buy ingredients for a salad...but I am so tired....I think we will do without!!!

Thursday, August 2, 2007

Quick Update

I have nothing new or interesting to report. I called Dr. Kelly's office, and yes, they have my MRI report, they will put it on his desk, but he is out of town until Monday. AAAAHHHHHHHHHHHHHHHHHHHHHH!!!!!!!!! I am soooooo frustrated, I thought that I would have a definite answer before the weekend, now I have to wait until Monday at the earliest. What is the most annoying part is that someone knows what is going on in my hip...just not me!!

My left hip has been giving me some trouble this week, probably due to the fact that I am back at work, out for walks, and chasing kids. It is very sore, and painful at times. The muscles are also REALLY tight now, but this happened last time as well, around 4 weeks I developed a lot of muscular issues. I don't think it is as bad this time. I need to slow down a bit though. I still cannot run. I just came from the pool, Jk ran away from me towards the big pool, I though he was going to jump right in, I 'ran' to get him, he stopped right at the edge, and picked up a toy he had seen! It really really hurt me to chase him, not I am dealing with the residual soreness from the "event". It is so hard to back down once you have begun to resume a life of normalcy, I missed it so much, but I don't want to hurt myself!

Incompetencies

I am now waiting to get my MRI results. Having experienced many times the way Dr Kelly's office staff works, I anticipate this to be a long and drawn out process. Nothing huge has ever happened with them, but so many little things, it makes you wonder.
-When I called to make my first appointment ever, the receptionist didn't want to give me one as my injury was not 'sports related'...how many of you actually tore your labrum playing sports? Luckily, I insisted on speaking with his PA who said "definitely come in"
-His PA called me with my first MRI results, I really wanted to speak with him, I left 2 messages....heard nothing, until I sent him an email, heard within 45 minutes (it was nice to bypass his office staff)
-When I was being discharged from the hospital after my first surgery, my Gameready was nowhere to be found...someone forgot to order it for me
-I scheduled my post-op appointment at the same time I scheduled my surgery, when I arrived at 12 days post-op, on crutches, brace, and soaked from an icy rain, I was informed that he was in his 'other' office, 2 blocks away. When I arrived there, they could not find my appointment for the day, and were unsure of what to do, as his schedule was booked. I informed the man at the desk that I was not leaving until someone removed my sutures!
-After my second MRI, it took 3 phone calls to get through to him to call me with the results
-I wanted a copy of the MRI report, it took 3 days to have it faxed over, and multiple phone calls
-Luckily, all of my pre-op requests for my second surgery went through, including time of surgery, anesthesia and post-op meds
-I am eligible for temporary disability, but your doctor must fill out some paperwork. His PA did it for me the first time, and there was no issue, this time, I specifically faxed it to her, but it was intercepted by his office manager, who called to ask me, 4 days post-op, when I was going back to work, so she would know how long to write on the form. I explained that I was hoping to be back in 4 weeks, but Arianna had filled it out for 3 months last time, so she should do the same, just in case 4 weeks was not enough. She answered me with a snotty "well, then we can fill out an extension". Why bother with more paperwork, just fill it out for 3 months, and we don't have to worry about it anymore. The story doesn't end here (are you surprised). In my fax, I had included a note that said please fax back to me. A fax never showed up at my office. So I called, sigh, they couldn't find it, so they 'must have' mailed it to me. It never showed up in my mailbox, sigh, so another phone call, I am going to fax it to you, again, please have it ready for me, I will be in the office tomorrow, to which I got a reply of "I will do my best", as opposed to "I am so sorry I never filled your request, it will be ready tomorrow". I arrived at the office, and it was ready, filled out for 4 weeks of disability. I did end up going back to work at 4 weeks, but, sigh, nonetheless!!
-To schedule my 3rd MRI, at first, they tried scheduling it in the wrong facility, then, gave me an appointment almost a week later. I ended up calling the MRI department and rescheduling myself.
-When I arrived for my MRI, they had forgotten to fax over the prescription
-2 weeks to get the message through to call me with my 3rd MRI results
-When I finally decided that I wanted an injection (right side, 6 months out), I left a message and the office manager called me to see "how she could help me", uh, not at all, please have the dr call me
-At the time of this post, almost 24 hours have passed since I called to have the dr office schedule my injection, waiting to hear back from them
-Another injection nightmare, when we decided to inject my psoas, I got a call from the receptionist early the next day, I was impressed, they took initiative. I told her when I wanted it, she said she would call back with a time. 2 days went by, I called her back, she was going to have the other receptionist call me bc she is actually the one who books it with the radiologist, another day, I called back and asked to speak with receptionist #2, she was surprised I was calling bc receptionist #1 told her she had called me and confirmed the appt. Plus it was the wrong date. She corrected the error, and I thought everything was all good. Until the radiologist called and left me a message saying he wanted to make sure I wanted the 'other' appt, bc there had been some reschedulings done, it worked out and I got the day I wanted.
-So...sigh, nothing huge, but a lot of little things which add up to a lot of frustration!

Tuesday, July 31, 2007

MRI #3...over

I am going to start this post like yesterday's...I DID IT!! ITS OVER!! IT SUCKED but its OVER!!! I feel accomplished!
I had a lot of apprehension leading up to this MRI, and I am not a nervous person, but since my last MRI sucked so much, I was pretty anxious about having to do it again. I was anxious all day, I could barely eat at lunch, and it was just an MRI. I am less apprehensive about huge needles going into my hip and even surgery, I don't get it!
I decided to bring my own music this time, at my first MRI, I was given an array of choices, classical, rock, pop, country... I chose pop and ended up enduring 45 minutes of rap music. At my second MRI, I explained to the technician what had happened with my music choice, so he put in a Billy Joel CD for me, it was better than the rap!! But everything else went wrong with that MRI (see earlier post).

So needless to say, I was scared of having another bad experience, I would not say I am claustrophobic, I hate labels, but confined spaces don't thrill me. I was mostly afraid of swallowing, and having the swallowed contents get stuck in my throat and block my airway, as in MRI #2. So I have been practicing in my bed every night, swallowing while lying down, while taking slow deep breaths. I discovered that if I tilt my head back a little, it is easier.

As I was waiting for the technician to come for me, he brought back a lady who had just had her MRI, she said he was wonderful, but I didn't think it mattered how wonderful he was, unless he was having the exam instead of me! But boy was I wrong. I told him upfront that I was scared, and explained what had happened last time. He joked around with me and just made me feel at ease. He joked a lot, it took a few minutes to set me up, with the pads in the right spot, the coil on my hip, my legs taped together...Just as I lay down, my heart started racing, shit, I couldn't swallow, so I sat up and asked him for some water, and apologetically explained that I am not normally such a pain in the ass! He was fine with my request and jokingly asked if I wanted scotch instead..YES!!!

I finally settled in, he gave me cool glasses with a mirror so I could see behind me, and see him in the little room behind the glass. I really liked him, he promised to keep talking to me and letting me know what he was doing. He showed me how to adjust the glasses, and asked if I could see the man in the room, he said "in 15 minutes I am leaving and he's taking over", "Yeah right!!", "No, I'm serious, my shift is over and I go home, you'll be fine, I'll tell him you're scared and he will continue to walk you through". OK, I can handle this, I made it this far already!!

So we began! 3 seconds in, I started to have a panicky feeling, shit, I am going to have to stop this, and reschedule with Valium. No, I am here, lets do this. So some deep breathing, happy thoughts and Green Day playing in the background got me through the worst!

He kept me informed of how long each scan would be, finally, he said, "OK, last one, 4 minutes", phew! I am doing great, only 4 more minutes, I can do this! It ended, and I am getting really hot, and the panickiness is returning, I need to get out, I know the end is near. He announces "I am just checking the pictures", in my head, I was saying, they better be perfect because that will be as good as they get! They were, and he came to take me out!!

For me, the keys to a successful MRI were: A good, encouraging technician, my own music, and keeping my eyes closed the entire time. I have added this to Learn From My Experience/ Mistakes. I hope I never have to go through this again!!! Now the waiting game begins for the results!!!

Monday, July 30, 2007

All in a Day's work

I made it. I am exhausted. But I did it!! Yay!!! I feel so accomplished. Did it hurt? Yes, but it was sooooo worth it!! I am back to work! Luckily, I had a light schedule today. There were a few "issues" involving my work performance, that I had not anticipated. First, I was working with a lady who preferred to be on a low table, so in order to stretch her, I was kneeling, sitting back on my heels, I suddenly developed that deep, gnawing groin pain, and had to find another position to work in. The other issue came from left field. I work in an outpatient orthopaedics facility, with mostly surgical and orthopaedic conditions. We also have a pool. I had a new patient, wheelchair bound, who wanted to use the pool, and needed to be transferred from her wheelchair to the table. This almost never happens, my patients are usually higher level functioning. There was no way in hell I could pull this off, probably even on a good day!!! After some discussion and shuffling, I got the situation under control!!!

Besides for that, everything was going pretty well, until my SI joint decided to give me trouble. Yes, again, when it rains it pours. Interestingly, my dysfunction was a posterior inominate on the right, normally, I get an anterior inominate, I assume it is from the hip flexors tightening up and pulling it forwards. Today it was posterior. P hypothesized that maybe it went that way bc the hip flexors are weak? I muscle tested a 4,4+/5 on that side.....so who knows. He corrected it with a MET, he said I was "stuck" on that side. He also released (sigh, again) my iliacus and psoas, which REALLY hurt. I stood up and felt great, walked to my computer, sat down, and had groin pain (sigh). I am beyond frustarted at this point, I don't even know what to think anymore.

The rest of the day was uneventful,, the kiddies slept late, until almost 5:00, so we did not do anything this afternoon, other than a short trip around the block, L on her bike and Jk in the stroller. What a sight it was, since L is not great at riding, me pulling her with one hand and pushing Jk with the other! As I sit here and blog, my hip pain is back with a veangence, and just in time for my Target excursion!!

If you have gotten this far in my post, I want to try something. One of the hardest things I found when my hip journey began was finding a list of symptoms correlated to a labral tear and FAI. If you would like to help, I want to compile a list of people's sympotms in the "comments" of this post, and in a week or so, publish it as a posting, so others have a place to compare notes.

Here were my pre-op symptoms: Groin pain, deep deep groin pain, not always excruciating, but so annoying I felt like cutting off my leg, tight hip flexors, pain with sitting, pain with walking uphill, pain with pushing my stroller. I did not have radiating pain down my legs, all the hip pain was anterior medial.

Chapter 2

I feel like I am starting a whole new phase of this surgical experience today, I AM GOING TO WORK TODAY!!!!!!!!!!!!!! Can you tell I'm excited!!! I have this nervous anxiety going on, but I am thrilled to finally be going back! wanted to go back last week, but they didn't believe me that I could spend 4-5 hours at a time on my feet (ok, I lied when I told them I could, but this staying home business is making me crazy). I decided to schedule PT on days I am not working, just for this week, I think it would be too much to work out, then see patients, next week I will change things around. Going to work should also help my super-bitch counterpart tone down a bit, hopefully!!

I have spent a good portion of the last few days/ weeks online, researching hips, again. I did this for the whole month of December, before my diagnosis, I feel like I am back there, but nothing has chnaged out there in 7 months. Tommorrow is my MRI, I am so nervous, I don't know what they will find, and if they will be able to see anything. I don't even know what I am looking for online, all I know is that I have a sore neck from having my laptop in bed with me, and I have not come across a single new piece of information, but again, I am not too sure what to look for!

Yesterday we spent a great day out with the kids, we went to the Wiggles show (for those of you who don't have kids yet, once you have kids, you will know exactly who the Wiggles are!). My hips did fine for the show and walking around the arena, the only issue I had was after the show, it was pouring rain. Of course we did not have umbrellas, J carried Jk to the car, and L and I walked together, I say walked because I am not able to run on my left hip, it just doesn't go. So we got a little wet, but no big deal. While we were in the car, I had to turn around to give Jk a blanket, I was on my knees and turned, and heard/ felt a little click in the right hip, and then my pain came back, it was weird.

Today is Monday, my MRI is Tuesday, I hope to have an answer by Thursday at the latest, in case I need an injection, since the following week we are going on vacation, I would like to have it done before then!

Friday, July 27, 2007

Ignorance is Bliss...or is it???

Let me start by saying that I scheduled my MRI, but like everythig else in my life these days, it could have gone smoother.

I called Dr. Kelly's office this morning to have them set it up, which is already annoying, I could just as easily called myslef! So the receptionist asks me when is good, I said Mon. afternoon, or Tues. or thurs. all day, but the sooner the better. She leaves me on hold for about 5 minutes, comes back and says they are not answering. I remind her I need it at HSS, whoops, she is trying to schedule me somewhere else. I need HSS bc they have my prior scans to compare. Oh. So she calls HSS. How is Thursday, after 2? Fine I say, she says ok, so I said what time exactly, bc after 2 is not very specific, so she puts me on hold again, 1:00. Fine, sigh, nothing earlier in the week? No. Fine, I take it.

Later in the day, I am not pleased with a Thurs. appointment. This means I won't have results until the following week, the suspense is killing me! So I decide to take matters into my own hands and I call HSS myself, they can do Mon. at 4:30 (too late in the day for me) or Tues at 2:30. Perfect! Sometimes you just have to speak up and do things yourself!

I have been trying to imagine that all of this is synovitis, or the psoas. I go into my old MRI reports, to see what they had shown. Did I have synovitis the first time? No, both reports specifically say no synovitis. I know this doesn't mean much, since he did find it with the scope, but I want to make sure all grounds are covered, and there are no unexpected surprises. My husband would say stop being neurotic, you know too much, but I think this helps keep me more sane than not!

Thursday, July 26, 2007

Uncertainty

I have had a day of indecisiveness!! If I had had time, I would have posted my question to all of you and maybe had some help, but I ended up coming to my own decision. So...what the heck am I talking about???
As you know, my right hip has been pretty bad, it is at the point I was before surgery, sex hurts too, so when I am ready to actually go to sleep at night, I am in so much pain, it is hard for me to fall asleep. I really don't know what to do, I was afraid that if I called Dr. Kelly, he would blow me off, tell me it is compensation, and leave me even more annoyed and frustrated, which I cannot handle now. But I was getting so frustrated with the pain as well...I didn't know what to do. My friend Amy, who has been through a lot of hip shit told me to call him, she didn't understand why I wouldn't, P, my PT said not to bc he knew I would be pissed. So after much deliberation....I called!

My message went like this: Please tell Dr. Kelly that I am having a lot of issues with my right hip, and it is not from compensation!

He called me about 4 hours later, in the past, I have waited 4 days for a call back! I am highly impressed!
I explained that I am having a ton of pain in the right, very much like I had pre-op, pain in the joint, non-palpable. He said it could be the muscles acting up, maybe we should inject the psoas...I repeated that the muscles are fine, my PT worked on them ART'd them...they are not the issue. He said it could be synovitis, the joint is inflammed from the added stress. I reminded him of the twisting episode, and how I am not sure what to think of it, especially since I went on crutches 3 days later, and I really don't know what to do, thats why I called! He said I could get the joint injected if I wanted to. Again, I don't know what I want! So he read the chart over for a few minutes, he said he is confident that I did not re-tear the labrum, this is why he likes to debride, bc there is nothing left to tear. Sometimes, the mechanics of the joint change, causing the muscles to act up. I could get an MRI if I want, but sometimes it is hard to read in the area of the old tear, so it may show nothing. Ok, I really didn't know what to do. He said continue working on it in PT, have somene work on it, modalities of my choice.... still looking through my chart...ok, get an MRI, then we can decide on the injection!!

So, now I am glad I called, at least it is all out in the open, not just on my blog! So, he thinks it is synovitis, I think his first thought is the psoas, possible tendonitis, but the joint hurt first, the psoas does occassionally flare, but it is in response to the joint flaring. So now I am nervous. First of all, my last MRI was awful, I almost panicked. I had a really bad cold and was really congested, also had a cough. Midway through, I needed to cough, alot, but I was afraid to move. But I really had to, I pressed my button, I informed the technician of my needs, he said I could under so circumstances get up bc the machine takes a picture of the hip angles in the beginning and uses them to compare all the images. So I stayed there, and began having a coughing fit, then all this gunk got stuck in my throat and I felt like I couldn't breathe, it was such an awful feeling. I have had awful flashbacks of it, and have been petrified to have to ever have another MRI, I never thought I would! Then comes the issue, what if he finds something bad? I don't want more surgery? Or, what if he finds nothing? Where does that leave me? Crazy????

Wednesday, July 25, 2007

Normalization

Today has been the most normal day I have had since my surgery. I am 3 weeks, 3 days out. Here is how the day went: I took L to camp, went to the dentist (see post below), went to the mall (I don't go to the mall as often as you think, but it is an "activity" for me since I am so bored), took the kids for a walk in the stroller for the first time, fed the kids dinner, bathed the kids, put Jk to bed (L is watching a dvd in my bed).

It feels great to be resuming my normal life again, it is like I am free! I hate depending on others for everything, as much as I hate giving baths, I have never appreciated my ability to actually give a bath before. Yes, I am totally exhausted and ready for bed, I feel like I ran a marathon today, but I completed it!

Things are definetely going so much better this time, I hope it is a sign of how things will be in the future. At this point last time, I was on one crutch, not going to the mall, definetely not pushing my monster truck of a stroller, and not even thinking about giving a bath.

I did develop a slight limp at the mall, a painfree limp though, my hip flexors are still pretty weak and it is a little bit painful to lift my leg, especially when getting into the car, but it will soon resolve. I needed a day like this to lift my spirits and make a add a more positive post to my blog.

When I decided to create a blog, it was with the intention that I would be able to portray a very positive experience with my surgery and rehab...I didn't mean for it to become a place for me to whine and complain all the time, so I apologize. I do hope that in the end, I will have a positive outcome on both sides and can move on with my life and live relatively pain free, it will just be a little longer because of my latest developments. Thank you all for your support and encouragement, it is really helping me get through this.
To those of you who actually have to live with me (if you are reading this), I apologize for turning into super-bitch. I will try to not let me pain and frustrations get the best of me, I will try to stop losing my patience, snapping and yelling. I love you!

Follow your Instinct

I have been having a lot of doubt over my decisions of the past few months, but after today, I am happy I went with my instincts. Yes, I may not be having the "happiest ending" but hopefully I will, and maybe it will take one more surgery to correct all of my problems, but I think I went the correct route. So where is all of this coming from?
About 1 month ago, I went to the dentist, I had been to him a year prior as well, for my first visit. He was a dentist of convenience as his office was located in the lobby of my building. At my first visit, he informed me that one of my old fillings needed to be redone, either with the same stuff in it now, or he could make me a crown. The tooth was not bothering me, so I ignored his advice and returned a year later for a cleaning (I was busy during that year with hip stuff so put off the cleaning!). At this appointment, he again, told me to redo the filling, but this time he said I needed a crown. I asked if he thought the problem had worsened over the last year, to which he answered he could not tell. So why do a crown? He didn't give me a straight answer, or one I was pleased with. The crown was also pretty pricey. My uncle is a dentist, his practice is a little over an hour away, so I decided to get his opinion, and let him do the work. After many x-rays and inspection of the teeth, he found absolutely nothing wrong. I am so pissed off at the first dentist. The point of this story is that when something does not feel right, or if you have questions that are not being answered, it is ok to seek a second opinion. Had I not followed my gut instinct this time, I would have spent a fortune of money on something I did not need and had to endure painful dental work that would have been totally unneccessary. I feel like calling the first dentist and telling him off!!!

Tuesday, July 24, 2007

Ups and Downs

This is really a crazy, unstable recovery! This is a warning to those undergoing it or who will undergo it! Each day can be so different. With my first surgery, I tracked my progress in terms of weeks, I used Saturdays, how much more was able to do each Saturday, and it was usually measured in terms of walking distance and assistive device.

I really spent a good part of the day in bed today, I needed a break, both physically and emotionally. My left hip feels better today, the psoas is sore as is the joint itself, but better than yesterday. The right side hurt, even while in bed. The muscles hurt as does the joint, I don't think there was much benefit to the ART yesterday. But on a more positive note, my life is definitely getting back to normal, I walked L to her tap/ballet class today (yes,I did eventually get out of bed), and tomorrow I plan on going to the pool with both kids. Once I can do that, everything will be more or less back to normal, on the outside. Of course there is still a lot of healing to do on the inside.

Because things have been so crazy lately, I have been a bit neglectful with household things. This is how L came home from camp today.

Her teacher taped a note to her dress to remind me to send something in!!! How embarrassing!
I think taking today as an "off day" will really help me to continue to progress on the left, I need to be more disciplined with strengthening on PT off days!! But one thing at a time!!!

Monday, July 23, 2007

3 Weeks post-op

I went the whole day without crutches, I think I am in the clear, but my SI joint hurts, probably because I still need a crutch, or maybe a cane, but I am so not doing a cane!! If the SI doesn't resolve, I will have P fix it on Thursday, it is not too bad though, I have taught J how to fix it for me in the past! I tend to get awful SI issues at 3 months post-partum, it happenned both times, but I have trained J well!

I had PT today, I almost broke down, but the look on P's face when he saw that I might cry was enough to make me hold back my tears, and boy did I have to fight to hold them back. He had that look that men get when a girl is aout to cry and they really don't know what to do! I am laughing now thinking about it! My office was pretty busy today, so we didn't have a room, so I really didn't want to cry in the gym, so I held back. I finally just came out and said I think my first surgery failed (then fought really hard again to hold back the tears). What??? Are you sure? I thought it was just compensation??? So he looked at it, again, and all of my symptoms were back, my original November symptoms, decreased ROM (I have practically lost all IR), sitting pain, pain with ambulation during the stance phase of gait. So he worked on that side today, TFL, psoas, both super tight. He also did some mulligan belt mobs, to try to increase my ROM, and some anterior hip glides. For the other side, he stretched/ ART'd my psoas and worked on my scope sites. Originally, I had decided to not let anyone work on the scope sites and see what would happen, and compare to the other side since they had been worked on extensively after my first surgery, but they really looked and felt awful today, so I gave in, so my trial is over!

I had to cut back on the single leg stance exercises today bc my operated leg was beginning to get irriated, probably from all the stair climbing this weekend, and lack of crutches. The (sort of) good news is that I am having anterior tightness now, I didn't develop this until much later on last time, so hopefully it is a good sign, that things are progressing quickly. I need to take an "off day" tommorrow and let things calm down in the operated hip a little, it has definetly been abused the past couple of days. I have some pain in it, it is similar to my pre-op/ post-injection pain, it is tolerable!

I added a link today in Learn From My Experience/ Mistakes, it is called Orthopaedic Considerations for Intercourse. It is not made specifically for hips, there are some positions approved for total hip replacements, these are labeled THA. What I think will work best is if you know what positions are painful for you, and use the pictures to help guide you in choosing a position that would work for you, like most things, sex after a hipscope does not come with cookbook instructions. What is helpful are the "tidbits of information" on the bottom about each position. But you may need to trouble shoot in the beginning until you find what works for you. The 7th position works best for us early on. We have been having intercourse since 2 weeks, 2 days post-op, without too much of an issue.

Sunday, July 22, 2007

A Pain in the Butt continued

I am home (sigh of relief)! The carride home was uneventful, L and Jk slept for most of the time. Now I can vent about the weekend without fear of things being left behind on other's computers!
So the whole issue with the stairs, it sucked. It is hard for me to ask for help, so I don't. I also don't always get the help I need from my IL's. I found it hard to keep asking for other's to go get my things, a diaper, wipes, a book... and bedime came, so the kids wanted me, so up and down the friggin steps again and again. As i mentioned in the first half of this post, my right hip was pretty bad all weekend, left was ok, and when I was putting Jk to bed, I had my first meltdown, tears and all, more on my numerous meltdowns soon.

Its not that I don't get along with my IL's, it is just an uncomfortable tension that exists, and has always existed between us. To make matters worse, J's grandparents were there as well, they can add tension to any situation. I just did so much walking, stair climbing and standing there, I am exhausted.

So now, at 12:40 am, I am in my own bed with my laptop. My operated hip is stiff and tight, but I just sat in a car for 3 hours. I am developing the anterior tightness I had last time, but much earlier,I remember bringing it up to Dr Kelly at my 8 week appointment, so things are moving quicker this time.

I had a few other "tearful" moments this weekend, I think I am accepting the fact that I retore the labrum on the right. I know, I said no jumping to conclusions and its too early to tell, but this pain is not compesation pain, once you experience the torn labrum pain, you don't forget. And I have no imaging to back me up, which is fine, this way it is not really reality, at least not yet. I have been upset and angry about it. I really thought I did everything right, I went to a top hip guy, we found the impingement and thought it was addressed, rehab went great, but somewhere along the line, something went awry. I keep saying that I feel like I wasted so much time, 4 months of PT, 4 weeks of crutches, and all for nothing,I am back where I started. Looking back, I don't know what I could have done differently, but I feel like I failed at this. I hope I am wrong, I hope I am having an emotional/ hormonal day and completely overreacting about it, and in 2 weeks I will wake up and have no pain!

Ok, I feel better now! Got that off my chest! So I ended up leaving my crutches behind this afternoon,Jk and I went to the mall, I got a pair of ballet flats http://www.gap.com/browse/product.do?cid=34759&pid=514975 (very cute if I do say so myself), walked around a little but then had to go home. I can't expect to be able to walk for hours on my first day of of crutches! My gait was not perfect, but it is improving each day, and I used my excursion as personal gait training,I tried to focus and swinging my leg straight through, and not around!

After the mall, Jk and I picked L and J up from the basebal game, she had a blast, as did he! We got home, I was trying to unload the car and help L run in to use the bathroom, and the nxt thing I knew I was on the ground.I tripped on some water thing on my IL's sidewalk. It was so scary, luckily, I landed on my knees/ hands and spared the hips, but I just sat on the ground, stunned, with J asking if I am ok, and if I hurt my hip. I was fine, the only damage as the grass stain on my white leggings!

So now i am home! It is such a great feeling! I can focus on my rehab and returning to work, no later than a week from tommorrow!

Looking for Advice

I am looking for advice from you, my trusty readers (I will post A Pain in the Butt...part 2 tonight).
I woke up this morning and feel a lot better. I haven't left the house though, J and my FIL took the kids to a duck pond to feed them. L and J are going to a baseball game later and I want to go to the mall to buy a new pair of ballet flats (being that my right hip hurts a lot, I figure it will be a good investment for the future, plus Gap has a few cute, cheap pairs right now).
Do you think I should take my crutch? I know, I am the PT, but I am so sick of it, and I will look stupid pushing the stroller and holding a crutch, I can do it though, if I need to, but really don't want to!!!
I am afraiud of a setback, but want to move on!!
What do you think? My gait is better today, but not perfect!

Saturday, July 21, 2007

A Pain in the Butt...in every possible way

Being that my mom left, and I was in no hurry to cook and deal with the kids on my own, I thought maybe coming to my in-laws for the weekend would be a good idea. Let me remind you, I live in New York (in a suburb right outside NYC), in an apartment, with an elevator and doorman. My in-laws live in Boston, about a 3 hour car ride, in a house, with 3 floors, and lots of steps.

Everything was going well yesterday, I walked L to and from camp, walked to the bank, to the nail salon, to the drugstore, all with one crutch, but I was on top of the world, for sure by tomorrow, I thought to myself, I can lose the crutch.

So we began our drive, we were doing great, the kids were behaving, about 30 miles before we got here, traffic came to a standstill, and practically stayed like that for 2 1/2 hours. We were on the highway with nowhere to go, my biggest fear was that L would have to use the bathroom, but she did great!


So our 3 hour car trip turned into a 5 1/2 hour car trip, needless to say, I did not practice what I preach, and remained sitting the whole time. When we arrived, I was STIFF!

Next came the exploration! Jk was running circles around us, he was just so happy to be out of the car, then he found the steps. This is when things got ugly for me. I really never have any need to do steps, I live on a high floor so never consider walking, my office has no steps and Target has an escalator (this is why America has such a high obesity rate, but I digress!) Stairs are really hard for me. And up and down numerous times was awful. I dumped my crutch when we got in the house, but desperately needed it for going up the stairs. By the time we sat down for dinner, I was in excruciating pain, but more on the right side (first hip). I was panicking, the pain was so intense, like pre-injection intense. I wanted to cry, out of pain but as well as fear. By the time I put Jk to bed, I had real tears, but kept them to myself, as I only express my "hip emotions" here!

By bedtime, both sides hurt, my gait was awful, I really needed to be using the crutch, but it is so annoying in the house, especially with kids (I know, again, not practicing what I preach), so my back started hurting because of the way I was walking/ compensating/ twisting.

This morning, I felt better, but soon all my bad habits came out, no crutch, up and down the steps... right hip pain, left hip pain, low back pain, piriformis pain. That one is new. I think my SI joint became a little rotated, which for me, causes my piriformis to spasm, you can tell that so far, the trip has been lovely. I will get into more details about why I was up and down the steps when I get home.

I have also been exhausted since I got here! I napped this morning for 2 hours while Jk did, then dozed off again in the afternoon. I have been tired since surgery, and early on had a scheduled nap each day! By late afternoon, I couldn't take the pain anymore and took Tylenol, this is big for me, I am not into pills, I prefer pain, as long as I am not in tears, like today. I find that in my case, I take something (these days nothing other than Tylenol), I feel better, I overdo it, and end up with more pain later so it is not worth it. Pain is your body sending you a signal that you are overdoing it.

I know I need to be on that crutch, I actually feel so good in comparison when I am on it, then when I am not. We walked to the park today, I took the crutch, and did great. I was not able to walk and chase the kids at the park since I had been having such a crappy 24 hours. I also end up doing a lot of standing here, the kids sit at the breakfast bar when they eat, so I am up and down getting everything, feeding them, cleaning up after them...

I am finally sitting now, at 11:30 pm, I am being rude, the whole family is downstairs eating ice cream, but I needed to get everything off my chest, and more will come when I get home! I am evaluating the day, the damage possible done and pray that I did not have setback from this mini-not-so-vacation! Live and learn!!

Thursday, July 19, 2007

One Darn Crutch

Stupid crutch. I need to get rid of it, I can't deal with it anymore. The sad thing is that it doesn't hurt when I don't use it, I just look ridiculous! It is a terrible thing to ambulate with an antalgic gait pattern, especially when it can be corrected by using a crutch. I know it is only for a few more days, but I don't know how much longer I can take, I have run out of patience. I know last time, at this point, I was still on 2 crutches, but I feel so much better this time. And I keep saying to myself, ok, this is the last day with the crutch, and then I wake up and still need it.

I saw J for PT today, I didn't tolerate a traditional ITB stretch (Ober position) so she decided to do some manual release stuff, it killed, except for over my numb patch, see, something good came of it! I was able to do some more modified single leg bridges. Later in the day, I tried some of P's "custom for me" exercises, a psoas strengthener, sitting on the edge of a low treament table and holding my knee to my chest, without my hands. I was able to do it. Last time, this would have caused a terrible tendonitis flare up of the psoas, this time, no problem. I had a lot of psoas issues last time, we decided it was tightening so much bc it was so weak, that exercise helped target it and strengthen it.

I asked P for his blessing in not doing aqua therapy this time, since it was such a pain to chnage and be wet and smell like bleach all day.... he said no problem, as long as the gait issue resolves soon. I think we are all just so impressed with the change in recovery time from one side to the other. P watched me walk like a hundred times so we could figure out the problem with the gait. At first, he wasn't too convinced with my description, I said "I feel like I am circumducting my pelvis as I weight bear on the left". Huh??? He gave me a puzzled look, then watched, and watched again, and then a few more times, hmmmmm, what the heck are you doing while you walk?? See, I told you! "You're right" he said!! But why??? So I walked more. We decided that my hip extensors are weak, and I am having trouble eccentrically contracting my hip flexors, so I can't pull my body over my leg when it is on the ground while I am walking, so I thrust my pelvis out to the side to get over the leg. It is not as bad as it sounds, but not good for you, nonetheless. It is amazing how one crutch can instantly fix this.

On a more positive note, I went food shopping alone today. I had to limit my purchases to what would fit in my basket since I can't push the shopping cart yet, but it felt like a good accomplishment.

Later in the day, I needed to go to Target. For those of you not familiar with Target, it is the greatest place on earth, you can buy EVERYTHING there, seriously, you name, they have it. To illustrate my point, I will name a few items in my cart: Diapers, ball, milk, laundry detergent, floor cleaner, crayons, t-shirts, bathing suit, spray bottle. Target I couldn't do alone, so my nanny came + L and Jk, before their nap! It was quite a site, me on one crutch, and my nanny pushing my cart with both kids in it. I got them to behave by promising them we would go to Starbucks when we were done, which by the way, is inside of Target!

Being that I am sick of the whole crutch business, I needed to prove to myself, again, that I am capable of doing things on my own. So I cooked dinner, fed the kids and cleaned up (didn't do all the dishes yet, maybe J can pitch in). I also got sick of the kid's toys being in disarray all over the living room, my nanny thinks that if she piles them all in the corner, they are cleaned up. So I collected all the stray pieces from all the toys and matched them up with their respective owners. Lots of bending and standing and back and forth from room to room. I did fine with that.

This is a long post, but I need to get everything off my chest. I am having those "am I crazy" feelings again. Since I am not sure what is going on with my first hip, and the pain comes and goes, I start to wonder if I am imagining it, or what!!! After PT, it became painful, it was that awful, deep in the joint, squishy pain-like feeling that is so annoying you want to cut off your leg. Oh, just like before the first surgery, and just like then, exercise aggravates it. Shit. I hope I am just crazy!

Wednesday, July 18, 2007

Are you reading my blog???

Hi guys! I just added a site sounter to my blog, and it is recording hits! Is someone really reading this? Then why no comments? Let me know what you think, is this helpful? Are you laughing with me or at me? Are you in the same situation? pre-op? post-op? not sure? Are you stil trying to find a diagnosis? Are you rehabbing?
Thanks
-Susie

Operative Report 7/2/07

Second Surgery
*these reports are dictated, therefore, some words are missing and or incorrect

After the patient was correctly identified in the holding area, she was brought to the operating room. Spinal anesthesia with combined epidural was administered. The left hip was prepped and draped in the usual sterile fashion.

The lateral portal was established under fluroscopic guidance and then a distal lateral accessory portal was established.

Arthroscopic examination demonstrated a large anterior superior labral tear with associated___________ lesion also evidence of a Cam delamination effect and associated synovitis.

At this point, a labral tear debridement was performed at the level of the affected tissue. A smooth contour was achieved to the anterior, inferior, and posterior superior labrum.

Then, the acetabular rim lesion was clearly identified and a rim decompression was performed to reestablish the normal contour of the femoral head and neck junction. At the completion of the rim decompression, a wide synovectomy was then performed using the Tac-S radiofrequency probe.

The cartilage on the femoral head and acetabulum within the joint were in good condition. the ligamentum teres was in good condition, as well. At this point, the scope was brought into the peripheral compartment and a Cam bump identified with clear synovial herniation and pitting.

The junction between the normal articular cartilage and the area where the impingement was occurring was clearly demarcated and a Cam decompression was performed using a 5.5 mm high speed bur. Re-contouring of the affected region was established with good reestablishment of the normal articular cartilage. At the completion of the Cam decompression, all bony debris was evacuated from the joint. No further pathology was identified.

The instruments were removed from the hip and the arthroscopy portals were closed with 3-0 nylon sutures. A "morphine" (should say marcaine) cocktail was placed into the joint. The wounds were cleaned and dried. Sterile dressings were applied. The patient was awakened from anesthesia and brought to the PACU having tolerated the procedures well.