Pre-op labwork

I know what you are thinking, what can she possibly blog about concerning pre-op labwork. If you are thinking that, I suggest you do a backsearch for my blog entry 'Incompetencies'. I received a packet in the mail with the Rx to get my pre-op labwork done. I have always done it at a local lab, no issue. This time, I will not be around the week before surgery as I have a continuing education course. I was nervous to have the bloodwork done Wed. or Thurs before surgery in case it was not done in time. So I emailed my OS's office manager to schedule it for me at the hospital, like she had told me to, if I so desired. Of course, after she asked me when I wanted, I never heard back, surprise. I emailed again a week later, didn't hear back. I figured I would just call the hospital and schedule it myself. Luckily, they called me to 'confirm' my appointment! Never a dull moment!!!

Staying Healthy

I have been noticing that the hip message boards have been concerned about weight gain after injury. I have decided to try to include healthy(ish) recipes when possible. I just span (spinned???) for 30 min, couldn't go longer bc of the 'sponginess'. I am usually really hungry after a ride, soI made a quick and healthy(ish) recipe. (many of my recipes are not exact so I will 'wing' the recipe)

French Fried Vegetables
2 bags frozen California style vegetables, defrosted
3 8.5oz cans cream style corn
1 small can French Fried onions (optional, less healthy version)

Combine vegetables and corn in a medium sized baking dish (I used my large, round corningware dish), top with french fried onions. Bake at 350' until golden brown.

enjoy!!!!

Inconsistencies

I have been a lax blogger this week, other than posting the pics of the kiddies. Truth be told, I have been lax with many things. Things got pretty bad in the Crohn's world, which leaves me feeling blah! I did not go for a walk with the kids once this whole week and neglected my beauty of a bike. I passed out every night once the kids were in bed. I had a terrible reaction to a drug, luckily I had leftover Zofran from scope #2 to get me through the day. I am still in the drug 'experimental' phase, it is a trial and error game coming up with the right combination. I have been so frustrated with all of this plus my awful reaction to the meds, I have decided to seek alternative treamtent and am trying acupuncture this week (thursday). My friends are in shock that I am being more 'open minded'. I am in no way expecting a cure (that is too far fetched for me) but maybe some symptom relief, stress relief, pain relief, and added energy??? I hope this is all a possibility.

Being that I sat on my ass for most of the week, my hip has been fabulous. I had so little pain and discomfort...until today. Why? after 5 days of doing nothing, I experienced that 'spongy' feeling in the joint, like something is there that shouldn't be there. I am now even more convinced my labrum is torn, even though my OS is 'confident' it is not. It has bothered me all day, that sponginess, even after an hour and a half nap, which has left me groggy and eager for more sleep!!!

I am fast approaching my 4 month left side anniversary. I think I am at 17 weeks now, which is the point at which things went seriously downhill for the right. Let's hope this will not be a repeat scenario and I can have a bilateral happy ending!!!!

L smiling

I stand corrected! I just received pictures from L's school trip...adorable!!

Family Portraits

I have to admit, I have not been taking as many pictures of the kids as I should because our cameras are broken. Yes, both of them. The better of the 2 was dropped, and is dead. The other one works but the screen is cracked, so I never know if I have the flash on, red eye, nighttime....so I do my best. I decided to post some of my favorites!!

L and Jk are 19 months apart. This is what a 3 day old baby and a 19 month old toddler look like! Note the disarray of my home in the background!

My home gym, put to good use!!!

Jk loves smiling for the camera, It is a challenge to get L to smile!

Finally, L smiling nicely!!

And not so nicely!!

The reason why I am not getting a cpm the third time around...

Insomniac

I have really been up since 3AM, it is now 11PM and I cannot go to sleep? Anxiety????? I think this happened last time once I scheduled. Do I need a shrink? Xanax? Sleeping pills?

Reflecting

I have been up since 3am. Out of shear boredom, I have been reflecting on the past few months of the soap opera that has become my life! Don't worry, I am still laughing. I laughed as I downed 7 pills this morning for Crohn's. I tried for one week to skip the steroids my gastro had wanted me to take, but the other meds alone were not enough. I laughed as my right hip ached in bed, as I did nothing. I laugh as I spin each night since I know all the possible damage I may be inflicting will soon be fixed. I laughed especially hard as I looked over my PT visits this morning, as I logged in to my office's server from home, to schedule my post-op PT eval, and decided to see how many times I have had PT. A whopping 60 visits.
I am not being sarcastic, I really laugh, you can't take things too seriously bc then you will really run into problems!! At least I had plenty of time for hair and make-up this morning!!!!

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!!!

Still in Limbo

I have not heard back yet. This makes me incredibly pissed off, especially since I made it clear at our last conversation that I need a return phone call. I sent out another email last night since I have a tentative date for surgery, but nothing has been finalized, that date is 3 weeks from Monday (I know, shit). If I do not hear back by today, I may possibly lose it, again, for real, so if I never post again, it is because they do not provide Internet access in the psych ward!

My Butt hurts

I went for ride #2 yesterday afternoon. I didn't have a lot of pain after my first ride from the seat. Once I sat down for a second ride, the situation was slightly different. I feel totally bruised, I know this will go away as I become re-accustomed to the narrow, hard saddle!!
I need to get back into shape though. I have been pushing really really hard on the bike, and I think I am becoming hypoglycemic. I am totally fine while riding, the second I get off, disaster strikes. I am wobbly, dizzy and horribly nauseous. I have been told to eat protein+carbs before riding to avoid this little issue!

Yesterday my right hip was pretty painful following my first ride (it did not prevent me from riding more though!) We will see how today goes. Oh, I did not hear back from Dr. Kelly, shocker!

When P worked on me yesterday, my hip flexors were really really tight, especially on the right! But with some TLC, they loosened up! I am not surprised, cycling is all about those muscles!!
If all goes well, I will ride again tonight!!!

My First Ride

I still have it!!! I don't know what 'it' is, but I still have it! 2 babies and 2 hip surgeries later and I still have it! I definitely don't have the speed I used to have but hopefully with time, energy and chondroplasty, it will return!

I had my bike put together today!!! It is up and functional and awesome! I love it! 1 year later, but I got my bike! I am approaching the 1 year anniversary of my 'hip thing', just around the time I decided I needed a bike, but held off due to pain. My first ride was not that exciting, I used one of the DVD's that the guy who sold me the bike sent. It was a lame ride, but a good one for my first. Not too much resistance, no racing/ sprinting, which is what really gets my heart going. The thrill wasn't as great as I thought so tomorrow I may forgo the video and freeride with my ipod!

The left hip was a little sore in the beginning but once warmed up, it did great! The right was OK on seated flats, but any resistance or increased hip flexion was painful. I did complete the ride though, I knew I would, even if I had been in excruciating pain, I would have completed it, I have waited too long to have a bike to not ride!

I emailed Dr.Kelly tonight. Let's see when I hear back!! I need a finalized plan! I want to be the spinning maniac I once was and need his help!

I am lying in bed with an extremely sore right hip, I am paying for my ride! I will try to post an update in the morning on how I feel. I leave the house before 7 to get in my PT before I see patients!

Bike Status

My bike has arrived. It is sitting outside my front door, in the hallway! Can anyone HEEELLLLLLLLLPPPPPPPP!!!!!!
I already called Vinny, my handyman, he is coming by later in the afternoon, I hope I can ride tonight!!!

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!!

Lurkers....De-Lurk, please!!

I want to meet everyone who is reading my blog! I know there are plenty of you who are reading and simply lurking which is great, a big part of this is educational, and I hope you learn a lot. But I would love to meet you! Leave me a comment, introduce yourself, and why you find my blog interesting. Did you have surgery? Do you have FAI? Labral Tear? Problem with a hipscope? Trouble in PT? Undiagnosed hip pain?
I want to meet you!!!!!!

Always a Party at Casa de Susie

My psoas is a lot less sore today, it doesn't hurt unless I try to really abuse it, like lifting my leg onto the bed, or try a SLR, but it is still weak. The joint hurts, so where does that put me with this injection? What a mess.

To make things more interesting, I had doctor appt #3 today (warning- not hip related). My stomach has been funky the last few weeks, so after countless emails back and forth with my GI doc, he finally told me to come in and see him. After discussing what is going on and trying to piece everything together, he didn't think my last CT scan (in June) made sense based on his exam and my symptoms, so while I waited, he called the radiologist. He re-read the films and changed the diagnosis. So once again, different body part but same issue- everyone reads scans differently. Hopefully, the re-read will work to my benefit, he changed all my meds. It also helped that I was in the office and we were actually having a live conversation as opposed to back and forth over the Internet. So we will see what happens, of course the pharmacy was out of my meds!

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.

Ultrasound Guided Psoas Injection

If you ever have the choice between getting your hip joint injected or your psoas, go with the joint. It really hurt. It hurts now, alot, I am limping. At least I was smart enough to go get waxed last week since they inject slightly higher than when the joint is done.

In the past, my injections have taken 20 minutes start to finish, this was 1 hour. First, the radiologist had to find the correct place to inject. He injected the local and that was fine. Then the big needle came, it took him a fair amount of time to slowly guide it into the correct place, at one point he said he was going to angle it differently. This whole process really hurt, it was not sharp pain but a lot of pressure and a weird pain. He did hit one area that apparently was not numb, but it was for one quick second. (just walked away from computer to pop a Darvocet).

There was a long period of time that the needle was in me as he moved it around and injected various things, also, he added some more local anesthetic partway through.

Before injecting, he motion tested me to see what hurt and had me give a painscale number, so flexion, 7/10, flexion with IR and adduction, 10/10, ER with abduction, 0/10. He retested after the injection, I went to 5/10, 3/10, 0/10 respectively. But the whole hip HURT. I told him, he said the muscle is sore from the needle. Holy shit, is it ever.
I limped out of the hospital and came straight home, and am still limping now. This better get better soon, I am an unhappy camper, and now I think I have mixed results with this injection! Dr. Kelly will have to sort it out tomorrow!!!

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!

Snafu Number ?????

I thought everything was all set for this week, injection on Tuesday followed by OS appt Wed. Wrong. Friday afternoon I get a message from the radiologist who is doing the injection to make sure I really wanted to change my appt from this week to next week, bc he is pretty sure I want next week. NO! I want this week. What the hell is going on now? I thought this was actually going to go smoothly. Luckily, we touched base today and straightened this all out, so injection tomorrow and OS appt the next day.
I also spoke with my GI doc today, he would like me to come in as well this week, so I have 3 doctor's appts this week! I think that is my all time record!!

My left psoas is being a pain, it is so tight and snapping all over the place, P worked on it today, hopefully it will stop snapping, again, like it already has!
I will report back after the injection!

This Week

Before things get busy, I know this is a big week for a lot of people. So good luck with surgery to blog readers Amy, Rachel and Yona. If you are having surgery and are a blog reader, let me know, we will be thinking of you! Jess, good luck with your OS appt, it should be coming up, my father in law (hopefully NOT a blog reader) good luck with your surgery too, and I have my OS appt and injection (hopefully), will update on OS office snafu tomorrow with full and hopefully 'taken care of' story!!!
Keep us posted on your recoveries!!!!!

The Nanny Diaries

I have left you again, and I apologize. But I am back now, for good!! I have been dealing with a couple of things, Jewish holidays, nanny issues and a Crohn's flare up. The right hip has been a lot better than it was last weekend, ever since the pain peaked and I took a Darvocet, it has been better. I will explain the nanny situation and why I think it is related the my Crohn's flare up! Warning... this is not hip related but I need to vent!

3 weeks ago, we went to Miami, in the airport, my cel phone rang, it was my nanny's sister. She was calling to let me know that my nanny was in the hospital and she would be working for me all week. Anyone else would just be relieved to have a back up nanny, but I was so annoyed that she was coming, I needed some extra hours, J was going out of town so I needed her to be here very early so I could go to PT before work....I was pissed. To make matters worse, I actually needed her Friday night and all day Saturday, but the sister said she couldn't work those days. Oh, and she said she was in the hospital for back pain. On Mon., she said that my nanny thought she would be discharged on Wed., but could not work for me this weekend. I started getting suspicious, so I started asking questions. The sister said it may be her kidneys so tomorrow they will do a CT scan, hmmmm, why not today? I asked which hospital she was in, the sister wasn't too sure. Earlier, she had told me that she had an IV in her arm and they were giving her medicine that way, now she told me that she hadn't been able to go visit her in the hospital bc she was busy working for me and cooking for my nanny's husband. That was weird bc my nanny has her health insurance through one particular hospital, around the corner from her house. So I asked the sister why she didn't go there? She told me bc they don't have bathrooms in the rooms. This whole time, I had been trying to call her on her cel phone with no luck.

By now I was really suspicious and angry as well. On Wed., the sister told me she was running upstairs to another apartment to give them her number bc they were looking for a nanny, she walked into my apartment, on her cel phone, and this is the conversation as she walked past me: " Oh, your cel phone died....and you didn't have the charger, oh, and you didn't get a phone in your room bc it was $10/ day..oh, hold on, here is susie". Do you know what the first thing she said to me was.... why didn't you come visit me? Well, apparently no one knew where you were and your cel phone was dead. So she answered, you know I only go to the hospital around the corner here, and my cel phone dies. So I answered, but your sister said you were NOT there. She told me she went bc her back pain got out of hand and then when she was there her blood pressure dropped...nothing about her kidneys.

So by this point I am pretty sure she is lying to me, and I am ANGRY. I decided to do some detective work, just to back myself up, not that I would ever confront her, bc I am too scared! But just so that I would know. If she was lying to me, my goal would be for her to know that I know she is lying, but I wouldn't need to discuss it with her, I am too passive aggressive to deal with it, basically, I am scared of her bc she takes great care of my kids, runs my house and L and Jk adore her. I had J call the hospital to find out if she was a patient, NO. Then I went on their website bc I didn't like the story about the $10/day for phone. The website says 'all patients get a FREE phone in their room for local calls' BUSTED.
At this point, I was mega ANGRY, but I had no outlet, I told a friend who is a social worker that I needed serious anger management. The only way I could describe how I was feeling is that it was 'eating away at me inside'. My friends said they had never seen me so pissed off before. It kept getting worse. The sister had to leave early a few days, she kept feeding the kids chicken nuggets for lunch every day (they are my emergency only food). In reality, I may have overreacted, and should have been glad for the backup, but I felt so betrayed and she was an accessory to the crime.

The next week, my nanny came back and we went away on Wed., so she had no kids thurs or fri., but I wanted some things done around the house....to her defense, she came back to work with an awful cough, but I was still pissed and was acting like a diva, so I told her I needed her to do all this work for me. To which she answered "I don't need you to go away on vacation in order for me to clean your apartment, it can all be done next week when you are here, and anyway, I am really sick and have to go to the hospital". This pushed me over the edge, she was having 2 days off, had not shown up the week before, and was giving me attitude. We left it off by her saying' fine, if you want, don't pay me for these 2 days'. I should have yelled and screamed and gotten all of this off of my chest, but I didn't, again, the fear factor.

This whole time, J was upset about having to pay someone else to watch the kids over the weekend since she was supposed to do it to make up for all the days she had been off, so he decided to deduct $100 from her pay. I hadn't yet told him about our latest fight.

I was so scared to come home, I was crapping in my pants! On Monday, she came and said nothing. She asked me if I had paid her or if J had paid her, I said J, oh, bc there were $100 missing. Hmm, I'll speak to J about it, I just bought myself another day! Wed., she brought it up again, no escaping her this time, Ummmm, J deducted it bc we had to pay someone else for the weekend when you couldn't come. Oh. Shit, she was pissed, this was soooo not worth the $100, I am going to kill J.
On a side note, the reason I am left to deal with the shit is bc of a language barrier between J and the nanny, they do no communicate, ever!
I then ran out to the store. On most days, I let her go home early, I don't need her around, and she will stay late or come early if I need her to, it is a nice working compromise. I got home and she was sitting on the couch, I told her she could leave.
No, she said, this is how things will work from now on,. I will stay everyday until 5, regardless of whether you need me to or not, I will never work late for you, never come early for you, you have no regard for me and no consideration for me, I was sick, and this is disgraceful. She went on and on, I argued a little, she did most of the talking, I agreed to give her the $100.
Things ended well, everyone is happy, I am relieved, I got totally walked allover but at least I still have her. For me, it is priceless to have her, I walk out the door in the morning, I never call her to tell her what to do, where to take the kids, what to feed them.....she is in total control...of everything apparently!!

During my anger/ angst over what she would do minus the $100, my Crohn's kicked up. I don't know if I believed that stress can cause a flareup, I am now convinced.

3 month Update

It has been 3 months since my second hipscope, wow, time flies when you're having fun! The left hip is doing great, fabulous, awesome!!!! I am thrilled with the results. I have minimal groin pain when doing a lot of walking, and the only other time I really experience any pain is when doing plie's at work, still getting adductor pain on the way up. I think I can live with that!

P took measurements for me today, here are my ROM and strength test results:
ROM:
Right hip flexion: 110' with pain, 112' with severe pain
Left Hip flexion: 120'
External Rotation: R: 42' L: 35'
Internal Rotation: R: 36' L: 38'

Strength:
Seated Hip Flexion: R: 4+/5 L: 4+/5
Prone Hip Extension: R: 4/5 L: 4-/5
Sidelying Hip Abduction: R: 4/5 L:4/5
Seated Hip External Rotation: R: 4/5 L: 4-/5
Seated Hip Internal Rotation: R: 4/5 L: 4/5
Supine Straight Leg Raise: R: 3+/5 L: 3+/5

My PT exercises have not changed since the last time I listed them, I have added a new exercise, I do not have a name for it, I'm sure P does. I will describe it. I stand on the left leg, P places a cone directly in front of me, one to my right, and one behind and slightly to the left. The objective is to touch each cone with my foot, they are placed so I must reach for them, and the one behind me requires rotation and extension, very challenging. I am supposed to add sidelying straight leg raise in adduction but I keep forgetting!

My hope is that once my right leg is 'taken care of', it will do as well as the left! As it stands right now, I think the ROM is as good as it will be, but the strength can improve a bit!!

The Joy of Scheduling

In my craziness over the last few days, I neglected to let you in on the fun time I had scheduling my injection. After I was called on Friday to find out when would be good for me, I, of course, never heard back from anyone. I called again on Monday, spoke with J, who said A would call me, but she would let her know that I had called. Wednesday, no one had called me yet (and then you wonder why I have had pain for 3 months and am finally starting to get it resolved now), I called again. J answered. I told her no one had called me yet to let me know when my appointment would be. She put A on the phone. A: J told me she called and told you the appt would be on the 16th. sigh. Me: No, she didn't call me. And...after I initially spoke with J, I called her back and told her I had given her the wrong date, I need the week before, followed by an appt with Dr. Kelly. A: Oh, so J never called you? Me: No.
She was going to have to call me back to reschedule this, but the problem was that Dr. Kelly was only going to be in the office for half a day the next day. Screw it, I will leave work early, this is always soooooo complicated. It doesn't help that someone else is making appts for me. So while I was away, A called and left me a message with the appt time. I have to call and confirm it, wouldn't it be 'funny' if she gave away the appt bc I didn't call back soon enough!!!

Where Have I Been

Sorry to leave you guys in the dark for so many days. Truth be told, there is not a lot going on these days anyway, but in my defense, I was away since Wed. I am home now.
I finally have an appointment for my psoas injection, it will be a week from Tuesday (the 9th maybe), and then I see Dr Kelly the next day, when all decisions will be made. I am waiting to hear from Dr. Millis' office regarding my package.
The last few days were ok, I find that I go in cycles. My right hip was so bad in the beginning of our trip, I endued up taking a Darvocet on Friday and have been fine since then. The same thing happened to me a few weeks ago, the pain escalated to 'awful', I took a pain med and then didn't hear from it for a while.
I am thrilled with the left hip, It rarely hurts, occasionally it will remind me that there was a problem there, but I can run after the kids without a problem there. I am just about 3 months out. In the coming days I will post a detailed 3 month update, maybe I will have P take measurements and post them!!

Too good To Be True

I do not have a date set for my injection. When someone actually called me to schedule it, I was shocked. Having not heard back from them with a day and time is more the norm. I will see what tomorrow brings.

I feel like I have finally "made it" in this world!!!
I have a feature on Google called 'Google Alert", I type in certain keywords or topics, and whenever a new webpage comes up in Google with these words, I receive an email with the link. Today, I received an email for my Google Alert keyword 'hip arthroscopy', guess what the webpage was? MY BLOG!!!

Second Opinion (A good place to start if you have just joined me on my adventure)

Here is what I wrote in the letter for my second opinion:

Thank you for taking the time to review my films/ reports. Enclosed you will find radiology reports, operative reports and office notes from Dr. Kelly, as well as my MRI’s, x-rays and CT scan on CD. I would like to consult with you regarding my right hip. Below is a brief history of my problem.

I am a 27 year old physical therapist, mother of 2. I began having right hip pain in November 2006. At the time, physical therapy did not help and I decided to consult with Bryan Kelly at HSS in January 2007. I had positive impingement signs and clicking in the hip, as well as pain with resisted hip flexion. Dr. Kelly ordered an MRI which showed cam impingement and a labral tear. An intra-articular injection of marcaine/ kenalog/ cortisone initially relieved all of my pain. We decided to do an arthroscopy to address these issues, on March 5, 2007. The scope addressed pincer impingement and debrided the labral tear.

I was doing very well after that surgery, with the exception of some residual pain at end range hip flexion, and flexion with adduction and internal rotation. Additionally, my left hip began bothering me during the period of time that I was partial weight bearing, and I had identical symptoms on the left as I had pre-op on the right. We decided on another scope, July 2, 2007. Four days before the surgery on the left, I had a twisting injury on the right side, I was weight bearing on the right and turned to the left, at that time, I heard and felt a pop, and had severe pain. The pain persisted for the entire day and subsided slightly over the next few days.

On July 2, I had the left hip scoped. The scope addressed cam and pincer impingement and debrided the labral tear. The left side is doing well. The right side continued to bother me after the left scope, being on crutches exacerbated that side and all of my pre-op symptoms returned.

Towards the end of July, I contacted Dr. Kelly regarding my symptoms as I was extremely concerned that I had possibly re-torn my labrum. He ordered an MRI, followed by an intra-articular injection which gave me complete pain relief. I have been very concerned about the cam impingement remaining in my right hip. He also ordered a CT scan. At this point, Dr. Kelly has suggested a revision arthroscopy to address the cam bump, and possibly address the psoas, as he feels I injured it when I twisted that hip. I will be having the psoas injected in the coming weeks to determine if it truly is an issue or not.

At this point, I am unsure of how to proceed. I am skeptical of having another arthroscopy since the first one was not able to fully address my impingement. I am writing to you to see if you think my impingement would be better treated via an open procedure, and to see whether you think I should make an appointment to see you in person.

Again, thank you for the taking the time to read this and review my file.
If you have any question, please feel free to contact me at (phone #), or via email (email address)

Sincerely,

Susie

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!

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!

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.

Stressing

To sum up my day, I took a Darvocet at 4pm. I was at my wits end. It probably doesn't help that this has been an insane week for me. It started with my nanny's sister calling me Sunday to tell me my nanny was in the hospital and not coming in for the entire week, and she would be covering. I have since decided that this is a lie and everything they have told me is complete bullshit, yet I don't know what to do about it. J is out of town. My hip hurts (did I mention that). L's school is still not opening (I don't think I have mentioned this yet), they have had dept of building issues and now licensing issues, it is such a headache. My friends are pressuring me to switch her to another school, but I keep thinking things will soon be resolved.
I needed my nanny to work for me Fri. night and all day Sat., just this week, but her 'illness' does not allow, so now I have to pay someone to do this. The nanny's sister came in 30 minutes late today, making me late for my first patient. I had a message that one of my patient's surgeon's was pissed off bc he didn't receive a note which I did send, 2 weeks prior.
So you can see what kind of day I am having.
Around 3 pm, I was developing a limp. Jk didn't want to go to sleep, L wanted to watch TV in my bed and my hip was throbbing. I went to look for Tylenol but couldn't find it. This was definitely not Tylenol pain though. I knew I needed something stronger, but based on my history of pain meds and side effects, I was scared since J is not here and my nanny is AWOL, so I decided on half of a Darvocet. It took away approximately half of my pain, but I was definitely more than half stoned! Since I rarely take any of this stuff, I have such a low tolerance.
I am happy I took it, I really wanted to get the kids out of the house but the pain was too much for me to walk on,let alone push the stroller. I ended up taking a short walk and going to the park with a friend.
I am not sure what my take is on pain meds, as this has been a topic of conversation lately on the message boards. I did feel like I was 'losing the battle', but I was able to get out and do things. I am on the fence with this one.
Oh, Dr. Kelly has not returned my phone call. I am pissed off.
I did get through to the medical records/ radiology dept at NYP, they are making me a CD of my x-rays! Should arrive in a few days and everything can go to Millis.

Left hip- I was demonstrating plie's for a patient, almost like mini-squats (for pelvic floor training), each time I would come up, I had adductor pain all the way to the groin and about 1/3 of the way down my thigh.I called J, the PT, not J my husband, to see what she thought. I told her abt my earlier trouble with SLR and how this is a similar instability type of muscle pain, she said keep strengthening the adductors and rotators. Will do!!!!!!!!!

Still no Definitive Decision

I am so sick of the waiting game. He didn't call me today either. Shocker. I need to know, now. Maybe he is trying to straighten out that radiology report! haha!
I did call about my x-rays, I have to fax in a request, before they can even attempt to find them. So First thing when I get to work I will send off my fax request for the x-rays. Of course it can never be simple!! I will keep you posted, as always!

Today's accomplishments

I sit in front of my computer with a CT scan report and Dr. Millis' address!
Here's what happenned:
I forgot that I was pissed off at Dr. Kelly's office staff and I called them to get the report. It worked, they had 'just received it' and she was going to 'put it on his desk'. I asked her to fax me the report and leave him a note to call me.
I have the report, but no phone call as of today (we know how this goes).
So....here are some lovely excerpts from the report:
-Evaluation of the osseous structures demonstrates a deformity in the anterior aspect of the head-neck junction of the right hip. This may represent a postsurgical site for a femoral dysplastic bump and correlation with the clinical history is requested.
-Findings suggestive of postoperative change in the anterior aspect of the head-neck junction of the right hip presumably representing resection of the dysplastic bump. There is irregularity to the cortex in this location, however, this does not appear to represent subchondral cystic change.

Are you still with me? Did you notice anything funny? If you are a die-hard "Goodnight Nobody" fan, you should have. Ready....WHY THE HELL ARE THEY SEEING POST-OP CHANGES ON THE FEMORAL HEAD NECK JUNCTION WHEN THERE WAS NO SURGERY THERE. AHHHHHHHHHH
Ok, glad to get that off my chest! The report is dated the day of my scan at 3:32pm, my appt was at 2pm, that is pretty good. The friggin' radiologist could have called me to find out what exactly was done during surgery, or called Kelly's office.

So I am waiting to speak to Dr. Kelly on that!
I called Dr. Millis' office to find out what to do. I left a message, on a machine, and got a call back on the same day from a real live person who was actually helpful. Maryanne was super nice, took my information and told me to send my stuff (x-rays, MRI's, CT scan, office notes and op-reports), Dr. Millis will look at them and determine if I should come in or not. The only problem is that I do not have the x-rays, I will have to call for them tomorrow, and I anticipate a headache. I hope they will come as quickly as the MRI CD did so I can send off my package!
I will also write an intro letter at some point tomorrow and post it here, so my story can be clear here from beginning to end.
So...did you catch that 'femoral head-neck' thing or am I just the queen of anal/crazy/neurotic!!

add on- I just remembered that I also asked for a copy of my last office visit note. That was when we had our discussion about the cam impingement and the possibility for a revision. Here is what the note says:
"She is here regarding bilateral hips, left side is 8 weeks out. She is doing well from the left side. On the right side she did have this twisting injury and had developed increasing pain on the right side. It really has not gone away.
At this time we are going to see how she does with the injection. She is going to call us in one week and let us know."
Hmmmm, is that really what happened????????

This Week's Plan

1) Call the imaging center and see if they will fax the CT scan report to my 'PT'(they will fax it to the doctor but not to me bc of HIPAA, they will mail it to me), if they say no
2) Call Dr. Kelly's office and have them fax it to me (sigh) and
3) Leave a message for him to call me about the CT scan and our "plan"
4) Call Dr. Millis' office in Boston and see if I should make an appointment or just send my scans and info up
5) If they say "send", I will do so tomorrow

Weekend Update

I wore my sexy (black) shoes on Thursday

I wore my new Burberry gold shoes on Friday

I hurt

I will never learn

Warning....Complaining to Follow

My hip really hurts today. And for the past few days...a lot. I am completely back to pre-op/ pre-injection pain levels, when you feel like you just want to hack off your leg. Granted, I have done a lot of walking the past few days, but just walking, no running, no jumping, no cycling.....just plain old walking.
Just wanted to get that off my chest.

CT scan...done

I wish I could have done only CT scans and eliminate MRI's from my diagnostic testing repertoire. What a pleasure! No tube, no loud noises, in and out 4 or 5 times, and beautiful, 3d pictures on a CD! There was even a sky painted on the ceiling!
So now I have a disc of MRI's and a disc of a CT scan, and my entire chart photocopied. I need to make a copy of each and I can send it out for a remote consult. It is going to have to wait until Monday though since we are going out of town early in the AM. I will keep you posted!

A Look Inside My Head

No, it is not full of air!!!! At least I hope not!
To leave off on a more positive note....
I am not constantly in a state of pissed off-ness
I think this is a case of bad luck
I think I am lucky that Dr. Kelly was more conservative, luckily, my problem can be fixed (I hope) with another arthroscopy, if he had taken off too much bone, then I would be royally screwed, I would have a ton of instability, a lot more pain, and would most likely need a total hip replacement, now, at 27.
I guess I should count my blessings!!!???!!
Additionally, just adding my 2 cents here, I am forever grateful that I chose a local doc and not one across the country, if I had, then I don't know what I would be doing at this point!!!

In Limbo

I have lost some steam at this point, and am at a standstill. I did receive my MRI's on disc yesterday, and have yet to call the doc in Boston for an appt/ remote consult. I guess I am telling myself that I am waiting for my CT scan, which will be tomorrow, and once I have that as well, I will move forward. I don't even have a follow-up appt scheduled with Dr. Kelly. I guess all of this is still sinking in and I am getting used to the idea that despite all of my long hours of research, journal articles, emails... I still have FAI in my hip.

I hate not having a plan. This is the hardest thing for me, but I am scared shitless to go back on crutches for any amount of time since both times, crutches landed me in surgery. Ok, obviously, the first time there was FAI already in my hip, and the crutches were the 'straw that broke the camel's back', oh, but that was the case after the second surgery too. So now what???

I know there are no answers, but I need to VENT.

Since I am venting, and you have stuck with me up to this point (feel free to stop reading if you are sick of the complaining), my right hip really hurts. It hurt all day at work, then, I went to (surprise) Target, and pushing the shopping cart is agonizing.

Still with me? I understand now the psychological aspect of pain, which is probably why I am relating very well to my patients. I was just 'commended' on how good my stats are at work and how quickly after my surgery my schedule filled up again. I am going away (again) this week and I know that some of my patients will not be in until I get back, they will not see another therapist.

So, to put a positive spin on this, I am the queen of hips! I love treating hip pathology, and I love giving other's advice on how to treat their patients with hip pathology, as much as they appreciate my personal experience with it. I am soooooo sick of PT though, I am into my sixth month, ugh! I need a break, which I took last week! I am ready to be discharged, for good! Only I know I have at least another 3 months coming my way! (sorry, I got negative again).

The good thing is that just as easily as I have had a bunch of bad days, I may begin to have a bunch of good days at any point now. I do need a plan soon though, I am not a waiter, as you can tell with my surgery decisions up to this point.

I will stop rambling now, hopefully, my next post will be more helpful to the general public!

10 week Update

As promised, here is an update on my left side.
Surgery was almost 10 weeks ago (7/2/07). I am doing everything I was doing pre-op. I am able to run, I don't, but I am physically able to, as opposed to a few weeks back, my legs wouldn't run. I am not painfree. I have less pain than I did pre-op, and definitely less pain than on my right, but 10 weeks is too soon, in my book, to be 100% painfree. I actually don't know if I will ever be 100% painfree, but definitely better than now, and definitely better than pre-op.

In PT, things haven't changed much since the last time I posted. I probably am ready to 'kick it up a notch', but my right side is holding me back. Here is my full routine, given my time constraints, I don't always do everything, and since my injection, I have only worked out once, but I am back at it now! (each exercise separated with semi-colon)
Bike; standing on dyna-disc, one leg, isometric hip abduction with other leg; standing closed chain hip ER; squats on black side of bosu ball with theraband around knees; walking squats with theraband around knees; squats on inclined treadmill (really hurts right side); seated hip ER with ball in between knees and theraband around ankle; bridges; bridges with ball in between knees; hip abduction in supine with band around knees; hip fallouts (one sided only supine hip abduction); isometric adduction with ball in between knees; clamshells; straight leg raises in abduction.

I think that is everything, I did 7 SLR yesterday, yay!! I occasionally will bend down and feel some instability in the femoral head, it is weird and very painful, but it only last that second. I can fully squat down, sit on the floor, work, drive. Oh, I cannot kick in the pool, if I wanted to swim laps, regular kicking hurts. I rarely do stairs, but I think they are not a problem.
The joint capsule tightening I had 2 weeks ago has pretty much resolved itself, with the help of P doing some aggressive mobilization, while lying on my stomach, he mobilizes the femur anteriorly, first in neutral, and as the capsule loosened up over the course of the week, in more ER, now we are only doing it in extreme ER, since I am still tight there. Also, always a good hip flexor stretch before we call it a day.

My scope sites are flat, red and shiny. In comparison, the right side scope sites are almost invisible. I never ever let them see sun, and P did a great job working on them early on, ignoring my tears and requests for mercy!! In a few months I hope the right ones will look just as good!

I think I covered everything, let me know if you have any questions!!

Itching...be gone

Well, the good news is I don't seem to be allergic to my hip injection, the bad news is, I may be allergic to the medication that got me out of my Crohn's flare up a few weeks before surgery. I went off of it on Tuesday, as suggested by my friend, an allergist, today I saw one of her partners, and he agreed, especially since I seem to be a lot better now. So why am I concerned? Well, first of all, this was the only med that helped back then, second, the flare up came right in the middle of some pre-op stress, combined with drugs I shouldn't have been taking but let my pain get the better of me.

Now that I am back in a mega-stressful situation, I need to watch the drug intake, absolutely no anti-inflammatories, if I have too much pain for Tylenol, I will have to turn to Darvocet.

Today I took a long walk with the double stroller, my first since the surgery, believe it or not. Not because I thought I couldn't, but because I preferred to spend the afternoons at the pool. The pool is now closed for the season (except for 3 more weekends), so I am back to walking in the afternoon. The left side was not perfect, but it shouldn't be, in my opinion, at this point. A lot of work was done in there, I had muscle soreness during the walk on that side, mostly adductors. I have been slacking in PT but will return at full force tomorrow morning. The right side hurt a lot, especially uphill (sound familiar), and when I got home, there was an achiness that lingered for quite some time. I wonder how long I can deal with this before going completely, certifiably, insane!!!

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!

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?

Thats what friends are for....

As I have previously mentioned, I got together this week with my 'hip friend' Amy, who has had her left hip scoped twice by Dr. Kelly and will be having her IT band released in the next few weeks/ months. I asked her to write a guest blog post.

Susie asked me to write a guest spot for her blog.... Hmmmm.. what to say?!?! I met Susie as a result of posts on the labralicious and FAI listserves. We had been talking as she had decided to see Dr. Kelly and I had experienced surgery with him. We talked quite a bit on-line and by phone. When I flew up to NYC on March 21st, the day before my surgery, we decided to meet. Needless to say, we clicked. My ride home to my friend's apartment in the city fell through because of complications with getting my surgery started, and Susie came to my rescue just two weeks after her own surgery. She drove in to New York Presby to pick me up and take me to my friend's place. Of course, meeting her two adorable kids in the car on the way home from the hospital sealed the deal!! We are forever "joined at the hip!" On my next trip up, we met and went to the Central Park Zoo together. I had a blast with Susie and her kids and it was a welcome afternoon of fun for both of us. Being able to jump in puddles with L and JK was the highlight of my day!! As a result of meeting on the listserves, we have become friends with this horrible hip problem in common. We have been through each other's ups and downs and frustrations. .... and the "emotionally unstable:" e-mail subject line on multiple occasions. It is wonderful to have the support of someone who is going through the same thing... and with the same doctor. It also doesn't hurt that she is a PT either, and I have picked her brain on multiple occasions!!! This last trip up was just as much fun as it was frustrating... I flew in to NYC on Tuesday afternoon and met up with Susie and the kids. We went to the swimming pool and chilled out for a while. I had a blast taking pictures of all of the kids at the pool, and it has cemented my feeling that maybe I should consider getting back into photography for a living... That evening, we went to see Xanadu with my best friend, Marni. The three of us had a blast at the show, but looked like the walking wounded headed away from the theater! But, for that 90 minutes that the show was on (with us seated on the stage), we were feeling no pain! Well, except for when one of the cast members hit me on the head with a rubber mallet! The frustrating part was the visit to Dr. Kelly. I hate waiting in doctor's offices. It seems like you wait for hours and then get to see the doctor for a few minutes. I think that Dr. Kelly really didn't want to deal with me, because Susie's appointment was 20 minutes after mine and he saw her before me!! He agreed that I need to have my IT Band released but that it should be done back home in Pittsburgh by Dr. Gruen as an open surgery because he has never done an IT Band as messed up as mine with a scope. At least he admitted to is limitations. That is a big thing for a surgeon. As you have already read in Susie's blog, he admitted to missing part of her impingement in the original surgery. We are in the same boat there, as he did not address impingement in my first surgery either. It is a very frustrating thing to deal with to say the least. I did have the opportunity to strangle him playfully when he mentioned our last "argument' over the phone and I was telling him that both of my hips hurt now!! So, for all of you who have wanted to strangle your doctor (Kelly or other) I did it for you too!! I had a happy mood swing that afternoon when I took L to Wave Hill for a "supermodel photo shoot." We had so much fun, and L posed beautifully for me. Her Mom never gets pictures like that... always the "cheese" face, never the cute stuff!! It ended too soon as I had to catch a flight home. It truly amazes me how friendships can develop out of adversity. Heck, I even told Susie that if she has to have another surgery and her Mom gets sick of being there I would come up and help her out. (Provided I am on my own two feet at the time.) After all, That's what friends are for!

The 5 Stages of Grief

Denial

Anger
Bargaining
Depression
Acceptance

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???)

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.

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?????

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.