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Wednesday, October 31, 2012

Happy Birthday / 5 Weeks Post Op

I had had an update planned yesterday since it was officially my 5 week date since my surgery, but my day ended up with a melt-down/freak-out session and I thought better than to update here status post melt-down.  But here I am, one year older, and (hopefully) one year wiser, and totally looking forward to getting on with my next year of life.  This is the second birthday in the past couple of years on crutches recovering from surgery.   My family and friends really made it special though.  My Dad's parents took me (and my brother) out to lunch, where we all had burgers.  It was good!  I'm not the burger-ordering-type-of-girl usually, but they were on special and thought I'd try it.  It wad good, but waaay too full of meat.  I like ground beef, but not THAT much ground beef.  It was really nice to get out of the house and see people!  I then slept all afternoon (well, only a couple hours, but it constitutes the majority of my time from lunch to supper).  And then I went to my other set of grandparents, they gave me their gifts, and then we ate supper: chicken wings, ravioli, and egg rolls.  Yummy!  But, I ate all day and barely had room to eat my dinner.  Ah well, I'll have a bit for a snack with my pills tonight; no boring granola bar before sleep time for me today!

I got a bunch of wonderful things, but the best present was my completing my CPM torture time.  No CPM or puffers for this girl for a loooooong, time, like forever (pray to God!).  I'm pumped about this as it has freed up 6 hours of my day.  Which is a long time.  And now I can sleep in silence without having to hear my puffers go off every minute.  I can now leave the constant battle with the CPM - we've exchanged many words in our countless hours of time I spent in it.  Also, happy birthday to me: my insurance sent me a letter stating that the bill for my CPM use after my June surgery will not be covered and I owe $1100. So, I got the appeal letter together and we will be fighting it.  And all of my other stuff for this past surgery has been changed to "in progress" on my webpage account.  Please pray that my surgery is covered and that all of my procedures will be covered.  

As far as my hips go, my right is getting pretty good, the joint feels like it's my elbow, but the swelling is ridiculous.  I didn't do myself any favours by standing up as Maid of Honour on Saturday and standing, sitting, moving, shivering too much.  I've blown up like a blow fish.  Wow.  But the joint isn't hurt, just the soft tissues.  My left hip has me a bit worried as my groin pain as increased.  He's got less flexion and less internal rotation the he did before my right surgery.  He's probably just stressed out, but I am worried.  He clicks and clunks, and my psoas refuses to work.  My PT is calling the PA for Dr. P to see what else we can do to get it working. I'm just paranoid!  Ah well, Dr. P will have to figure out something because I am so over surgery! I'm done!!! :)

Tuesday, October 23, 2012

4 Weeks Post Op (for the 6th time)

I am proud to announce I am four weeks post op.  And I have survived so far  My right hip is doing amazing as far as ROM goes.  The flexion feels like it's my elbow bending:  easy, smooth, painless, not restricted, internal rotation is amazing as well with absolutely no pinch.  The external rotation has limitations due to muscular pulling but nothing we can't iron out with some clams and FABER slides.  Extension is coming along, but we can only do it side lying in PT since I still have four weeks of not being able to lie on my tummy.

I started my 50% weight bearing today.  It is wonderful to stand on my two feet while I brush my teeth. It is still a bit sore when I stand due to the swelling I decide to keep for quite some time.  My legs are thinner and thinner due to atrophy.  And my calf is squishy and just hangs off my tibia; it looks like a boob hanging off my bone. :O

Lefty is still pretty smooth inside.  ROM is more restricted and painful compared to the right and my strength in flexion isn't as good on the left as the right.  I can already flex up my leg more on my post-op leg....I really kinda wish my psoas wasn't released.  Grrrr.....

No information on the insurance front.  Everything has been received but no decisions made.  I pray each and every day that the surgery is covered.  I hate the suspicion and worry that my financial situation could change dramatically.  It isn't something I would like to deal with....but it's coming and I hope things are covered.  Lord knows that all the procedures I needed were medically required.

I am now gearing up for my huge weekend:  I am Maid of Honour at my good friend's wedding. The rehearsal dinner is on Thursday and the wedding on Saturday.  It should be a beautiful wedding and I am so happy they are getting married, I just wish that I didn't have to crutch up the aisle, sit on a stool beside the bride, and go to the reception crutches.  Absolutely no dancing nor drinking for this lady :(

Sunday, October 21, 2012

Inflammation, Shiminflammation, I Hate Inflammation

I am not sure what is happening with my body.  On Friday evening my lower cervical/upper thoracic region of my neck became sore so that I couldn't turn my head.  This occurred over a period of minutes.  I thought, ugh, and nothing more of it. I went to bed and didn't sleep very well because of the pain in my neck.  Yesterday was a complete washout as I couldn't move my head at all because of my stiff neck.  I went to PT and he said that it was so inflamed and swollen that he didn't want to mess with it, and decided to do a simple adjustment and we will work more on it this upcoming week.

Today is a bit better considering I can move my neck slightly.  Although I noticed some other strange things.  I may call my surgeon's PA tomorrow and just run it past them since my hip got all hot today and swollen most concentrated around my graft site.  Plus, I have a tooth that bothers me only sometimes and it now hurts to bite down.  This whole inflammation deal is not cool.  It seems to me that this is a flare of some sort.  I'm not sure how to describe it.  Odd.  I didn't have any fever but I was extremely cold on Saturday that I had to use heating pads to make my feet thaw.  Saturday was a washout, I lied on the couch, not moving.  Although I did drag myself to PT midday.  All of this doesn't add up to much.  And maybe it is a coincidence that all of this happened at once, but I haven't a clue how to put it together.  I've been checked for RA, HLA-B27 and come back negative.  It seems systemic to me having several body parts flare up like this.  So this is the paranoid side of me.  Maybe it's just par for the course at this point in the recovery process:  using crutches for several weeks, adding external rotation exercises into my regimen.  And I'd rather not call the PA, but I think I may, just to ease my mind.  In the mean time, I've started taking 440mg of naprosyn BID to help calm the inflammation.

My hip joint on the right feels great. I have wonderful ROM that is pain free in all directions.  Far better than my left hip.  This makes me ecstatic and worried all at the same time.  So happy because my right hip feels the best it has in years and I really believe it will stand up for a while now.  But unhappy because having my right hip feel like this really makes me notice that my left hip is still not perfect.  Perhaps time will be my friend and that is all I need to be able to get my hip to a place where it will be good for my future education and residency.  I certainly hope so!  It's just still hurting and the lateral ITB flicking, bursitis, and psoas issues are the majority of my concern, although all motions gives me a pinch at the end point (which is not there on the right).  I know, I know, the left has had four surgeries and the right has had only two, but still, the fact that it still hurts is concerning.  I betcha it will calm down once I'm more weight bearing on my right side, although I do wonder what my surgeon is going to say when I see him next (Dec. 10th)....his last words regarding my left hip were: "...the pain is unacceptable...we will inject during the right surgery and go from there."

On a more positive note, my Mum is teaching me how to crochet.  I learned the single stitch today and am making a bright yellow scarf for my grandmother for Christmas.  It is a lot easier to learn and faster to do than knitting.  I love learning new things and will force myself to finish this project as I tend to start many things and never finish them.

Monday, October 15, 2012

20 Days Post Op

Twenty freaking days!!!  Wow!!!!

Today marks two days in a row in which I have not taken any pain meds during the day.  Go me!  It feels great to have a clear head, now if I could only get any motivation to do anything.  This will come with time, but I have to drag my butt to the pool and get a-movin' ...I had every intention on doing it today, but I had a visitor in the afternoon and no car in the morning.  Also, I accidentally slipped on the ONE step down into my living room and wham, stepped full weight onto my surgical leg.  This was uncool since I am still supposed to be 20# weight bearing for another week.  Let's say that I am not ready to do any sort of weight bearing on my leg yet.  It hurt just to touch the ground lightly for an hour.  So stupid!  So annoying!  I know better than to rush up/down stairs.  I'm sure I didn't do any damage, but it really didn't feel lovely.

I can shower, get dressed, in and out of my CPM (depending on how tired I am), and all sorts of things now.  Having the pain reducing is well welcomed, I appreciate not being so throbbing and exploding all of the time.  Although I know my set of bad and good days are ahead of me, I'll take any sort of improvement and cherish it.

Sunday, October 14, 2012

19 Days Post Op

I can finally see some improvements in the pain levels.  Which ROCKS!  I still feel like my hip is going to explode out the side with pain when I stand up near the end of the day, but this is slightly less breathtaking and doesn't start to occur until suppertime.  This means that I have been taking pain meds just to get me through the evening time to bed.  And now I have cut out the Valium and replaced it with Robaxin at night.  This combo seems to work, although the Valium works better and allows me to get more time in the CPM without having to get out due to a sore back, but the less drugs the better at this point.

Functionally I believe I am doing pretty well.  I can put my own socks and shoes on (as I have no flexion restrictions) without pain.  I can shower without having to get my feet lifted in (I can hoist my feel up and over the ledge myself).  I can get dressed (but this takes about 3 times longer than it should).  I can get in and out of bed myself if I'm not in the CPM (getting in and out of the CPM is still kinda difficult because it requires a lot of hoisting and I am not looking to hurt my hip flexors (which are super finicky these days).

My right hip joint feels great though.  It has so much smooth, glorious motion! Flexion and internal rotation, and abduction.  I can't do much adduction due to the swelling from the ITB and my external rotation and extension restrictions get lifted Tuesday.  I only have incisional pain on the right side.  My left hip isn't feeling wonderful.  Before my surgery I thought my left hip felt so good, and it did compared to what it had before and compared to my right hip.  Now seeing how great my right hip feels, my left is still not perfect.  Maybe it never will be.  And I'm okay with that, but it needs to be functioning enough to get me through school (and preferably residency).  I hope this groin pain, getting stuck is all just inflammation from being the sole weight bearing.  I am sure that it what it is!  And my psoas!  My PSOAS!  Ack!  That says it.  I kinda wish it was never released.  I've had so many failures, it's hard to trust the hip.  I must trust!

I had a conversation with my mum the other day, made me think.  I was talking about my hips and how seeing Dr. P isn't a waste of money/time because he is the best in the world with some of the best success rates.  My mum then said that she hasn't seen his results come through.  I thought for a second, and she is right, he has operated on my left side twice and I still haven't a hip that I can trust.  I really believe my right side will be amazing once all healed, but this left.  Makes me worried.  He promises me not to give up on my hips, but I refuse more surgery at this point and need a left hip that works relatively pain free.

Thursday, October 11, 2012

The Swelling & Pain

Alright.  After surgery everybody expects some pain.  To a certain extent it is reassuring as you can know that things have been fixed and you are healing up.  Well, I'm over it.  I had planned on updating every day or every other day, but I decided to not update yesterday as it would have been, simply put, depressing.  It was one of my worst pain days so far. I couldn't believe it.  My ITB was so uptight and rigid it made my knee hurt like the dickens and radiated all the way down to my ankle.  The muscle spasms were horrible.  Then, after supper, my hip flexor freaked out.  And that was it.  I had had enough.  I took another Norco ahead of schedule, took a whole Valium and went to bed.  Taking that amount of medication seriously knocks me out, but I didn't care.  I slept all night and was thankful.  Ha, I wasn't gonna post yesterday to avoid being negative and there I go, writing all about it, being negative.

I am continually doing my home exercises, which are minimal at this time, but I am faithful and do everything I am supposed to, including my two 20 minute sessions of biking each day, 6 hours of CPM per day, 20 minutes of circumduction each day.  All very helpful and small things to do considering how much I've done for my hips thus far.  My right hip joint itself feels amazing.  Seriously amazing. I can flex and internally rotate like it is my elbow (maybe not exactly as my elbow is all loose and my hip is stable), but, point stands, it feels great.  My muscles on the other hand are very sore.  In the packet I was given, it stated that after 21 days one shouldn't need narcotics anymore, that means that in a couple of days I shouldn't need any form of narcotic?! It worries me because I can't get through until supper-time without taking a Norco.  I am expecting a call from somebody on Dr. P's team in the next couple of days and will ask about the pain.  I remember hurting more when they messed around with my ITB in January, but it wasn't this bad.  I will have to check back on my posts from then to see how I felt and when I stopped my meds (which may not be fair since that surgery was a blow and made me worse).  Dealing with the pain is exhausting, but it will decrease soon.  Until then...I love drugs!

It's been a bit difficult to see all of my classmates moving on and getting interviews for residency.  I started my medical journey with all of them and now they are moving on.  I am so happy for all of my friends since they deserve every interview and residency program they desire, but I am not going to lie to say that I am not a bit disappointed I am not there with them.  I know everybody has their struggles and life does not stop because one is in the thick of their medical training.  I realize this, but it is crazy how much has changed since a year ago.  Last year at this time I had just found out that Dr. Philippon had agreed that he could help me and that he would operate on my left hip and I was just getting into the swing of things in the hospital.  How much has happened since then? I have had two left and a right hip surgery and have taken off school for 8 months.  I would have NEVER thought this would have happened to me!  But it did, and here I am, recovering and making the best of it.  I really think that because I was in pain that I would not have been able to chose a specialty in which I wanted, truly wanted, because I would have chosen something that was easier on the body.  Now I will be able to rotate through a couple more areas before I have to make my mind up, and I will do so with functional hips which will allow me to be able to make a better decision on my future.  At least that's how I currently see it!

Tuesday, October 9, 2012

14 Days Post Op

Today marks two weeks since my surgery.  It has gone by so quickly!  I can't believe that I am all fixed on the right side and am simply healing.  I really feel that my right hip joint is fixed and is going to feel wonderful once my surgical incisional pain dissipates.  Compared to my left hip, the right is already feeling much smoother.

 I really can't believe the swelling and scaring that I have experienced this time around.  Very, very impressive.  My pain is still a bit much for my liking.  I mean, I can deal with surgical pain, but my goodness, the throbbing and exploding every time I stand up.  I am still taking Norco at least twice during the day and Valium or Robaxin at night for the muscle spasms.  I am thinking that it is all the IT work that I had done.

I don't believe that I have listed everything that I had done during my surgery yet.  So, here it is:

  • CAM removal
  • Rim trimming
  • Labral repair
  • Labral reconstruction (ITB autograft)
  • Labral reconstrution (allograft)
  • Synovectomy
  • Iliofemoral capsular plication
  • Ischiofemroal capsular plication
  • Chondroplasty
  • ITB release
  • Bursectomy (greater trochanter)
Let's hope the insurance company decides that all of these procedures were medically necessary!!

Sunday, October 7, 2012

Happy Thanksgiving

Today is Thanksgiving in Canada.  Although it is not as publicized or blown up as big as in the United States, we still celebrate with full turkey dinner's, family gatherings, etc.  It is usually a fun time for all.  Fall is full of changing colours and festivities: Thanksgiving, Halloween, my birthday.  All very festive times.

As a family tradition, we used to always get together with my aunts and uncles, cousins, and grandparents on my mum's side to have a humongous turkey dinner at my grandparent's house.  I remember the days of stuffing my face full of food until I thought I was going to explode, and then I would leave dinner early to go skate.  I never remember skating very well on that day. why?!  The last couple of years though, it has become too much for my grandparents to host our entire family and we have sort of had our own dinners with our own families. Some parts of the family would get together, the ones not busy or in town, but I miss the days of 25 people packed in my grandparents basement eating turkey, mashed potatoes, and dressing. Mmmmm!

The last couple of years I have been in school in the states and because they don't celebrate Thanksgiving until November, I tended to work and do school stuff on Thanksgiving.  I missed dinners and family gatherings, but then I got American Thanksgiving off which was a longer vacation than we get here in Canada, so I didn't mind so much.  This year though, it is much different.  It kind of reminds me of old times, with a twist.  This year I am off school until February to get my hip ordeal under control.  My family was invited to Thanksgiving dinner, but I am not able to go feeling the way I currently feel, so my brother came in from out of town, and my mum is making a full blown turkey dinner for my family.  I am so incredibly lucky for her kindness and love.  Since I am basically still stuck on the couch or in bed at this point, we are going to have a full dinner and everybody is going to eat on the couch and in the living room with me.  My family is the best!  Seriously? I doubt, but would hope, that other families would do this for somebody who was recovering from surgery.

I am not going to lie when I say that I have certainly had my set of challenges this year, but, despite the difficult times, I have so so so much to be thankful for....seriously....I am blessed.  I am thankful for my family who has stood by me and supported me as I faced the most difficult year of my life.  They never gave up and helped me after every single surgery this year; going above and beyond what was expected. I am thankful for God, as He has provided the strength and is my rock.  He gives me hope and the strength to keep on.  The sovereignty and love he has shown me this year has been mind boggling.  I am also thankful for the new friendships I have developed and the ones that have grown this year.  My medical school friends really stood by me this year, we had many heartfelt and tear-filled Skype chats about serious situations and they helped me come to terms with my health situation and that it was okay to take time off from medical school.  All the friends with whom I have made because of my hip journey has been incredible.  They just get it.  Plain and simple.  The number of texts, emails, messages I have received from all of you have are worth their weight in gold.  I wouldn't give up the support worth anything.

It would so easy to sit around the house these days in self-pity, wallowing in my currently sucky situation.  And, I am not going to lie, it happens.  I have moments where I can't believe I'm recovering from another surgery.  This past surgery really is taking a toll on the pain receptors, and it is so difficult to not let it consume me.  I don't get many visitors these days, which does place me in a situation that is quite socially isolated.  But, this is only temporary and I will get through.  Once the pain subsides and I can get off of the narcotics, I plan on studying quite a bit which will lend a wonderfully welcomed distraction.  Until then, I have to count my blessings, making this Thanksgiving day and the meaning behind it, especially important this year.

Thank YOU!!

Friday, October 5, 2012

Surgery Pix

All my lines and bracelets.  

The entrance to the hospital.

Due to my several capsular repairs, external rotation is forbidden for 21 days.
Shoe laces tied together does the job whilst waiting to board the plane.

Thursday, October 4, 2012

Rocky Mountain Pictures

I have been out to Vail in every season this year for either surgery or for a follow-up appointment.  When I went in January I was in amazement of the mountains as I had never seen a mountain before.  It was glorious, magnificent.  Then I went back in the spring for appointments and landed back in Vail in June for another surgery.  Then, I thought I loved Vail most in the summer with the lush, green landscape, wild flowers, flowing creeks.  I was mistaken.  Coming back in the fall was, hands down, my favourite time to see Vail and the Rocky Mountains.  Breathtaking.  I only took pictures with my camera, so they aren't the best, but they can still share some of the amazing landscape.

Driving from Denver to Vail.

Driving from Denver to Vail.

Notice the haziness in the backdrop which was the left overs of the smoke from the wildfires.
When we arrived in Denver you couldn't even see the mountains because the winds were blowing the smoke from the wildfires in Oklahoma, Utah, etc.  Initially it was an eerie scene until the sun came out and the wind blew the smoke off the mountains.  

View from Wal-Mart.

View from our condo.  At times the rain clouds were so low they covered the top of the mountains.

One of my favourites.  Happy 50th Birthday Vail!!!

Another view from our condo.

Rock formation.

Driving back from Vail to Denver.  Right hip all fixed up.

I wish the reflection of the window wasn't there. :(

Wednesday, October 3, 2012

Right Hip Scope Surgery 9/25/2012

After a restless night's sleep, I was able to drink clear liquids until 10:00 am.  This was a blessing since not having anything to eat or drink past midnight really does stink.  I had stopped eating the night before, but the Gatorade really did make me feel better.  We got all of my paraphernalia ready (CPM pads, hip brace, SCD puffers, crutches) together and basically waited around until 12:30pm before we headed to the hospital.  I was to check in at 1:00pm since I was his last case of the day because he expected it to be complicated (or so I was told).

When in pre-op all the regular things happened.  Johnny shirt goes on, IV in, electrodes on.  They also removed blood for PRP injections into the hip once done.  They then had to scrub down my hip.  This caused an ordeal because in in the summer they used chlorhexidine and I had a reaction to it so they had to use betadine for a scrub.  Also, I had to wear a bracelet with an allergy alert.  When the fellow and OR nurse came back to see me prior to wheeling me into surgery, they all were very concerned about this allergy as it is standard to use what I was allergic to.  Anywho, after this, the anesthesiologist came and talked to me about the epidural and the type of sedation.  Dr. P doesn't use general anesthetic anymore as they were having too many complications.  Fine by me!  We talked and anesthesia was going to just use some light sedation with the epidural and I would be good to go.  I agreed it sounded good.  

I really didn't have to wait too long before they were wheeling me back.  I got a shot of Versed which makes everything all better.  Once in the OR, I was sat up and had an epidural placed.  This time it actually hurt a bit.  More than I had remembered from June or January.  Then, another OR nurse (the same one that did my work in the office) came in and was all excited that she made it.  She was not scheduled for my case but wanted to be there anyway.  She asked the anesthesiologist if it would be okay if I stayed awake if I wished.  I totally took them up on the opportunity.  We had to wait for Dr. P to see if that was okay, and when he came in he said it would be fine and that now he would have to be on his best behaviour.  The fellow then took out a remaining stitch on the left and did an intraarticular injection into the left hip.  By then I was feeling a bit sleepy and I don't really remember much from that point on.  I remember talking with the surgeon as he did my scope, but I don't remember much.  I remember him pointing out that I had a bit of arthritis on the acetabulum, but nothing that necessitated any treatment.  I also remember asking to be "less out of it" as I really did want to see what was going on.  The anesthesia team switched half way through the case, and the new guy was really good about letting me be more aware.  He stopped all medications and then I remember fully everything from the graft removal from the ITB to the end.  Only thing is that the new anesthesiologist decided that he would quiz me during my surgery.  Really?!  He was asking me things, and then Dr. P piped in saying that I probably didn't come to have surgery and be quizzed at the same time.  The questions stopped coming.  I remember Dr. P leaving my side to prepare the auto and allograft.  Apparently the allograft was huge and he couldn't possibly see a reason for it being so large.  Before he put the allograft in, he dangled it above me so that I could see.  It was an inch by an inch and very wiggly.  How cool!  He then put it into my hip.  I should mention that when each of the anchors were placed, I could feel them hammering my hip and I shook.  Also, every time I had traction, I was pulled under the sheets (they had taped the drapes to my neck so that I could see the monitor they had set up for me).  The traction was the craziest thing, I could feel my own legs being pulled out of the sockets and I didn't care, it didn't hurt at all.  They also had to tighten the capsule because I was so unstable, this was interesting because I had so much scar tissue that he had a difficult time passing the suture through the tissue and he kept leaning on me with all his weight and grunting trying to get the capsule closed.  After all the procedures were done, they inserted the foley catheter and I was rolled to recovery.  

I was completely aware and talked to everybody in recovery.  My mum came back and it felt so surreal.  I remember everything from my surgery and was not sick or anything because I didn't have to wake up from anything.  I was numb from just above the belly button to the toes.  It was amazing.  I spent then next several hours simply chilling in my hospital bed.  In fact, Dr. P came in at 11:40pm to see how I was doing.  That man never sleeps!!  When the time came, the nurses loaded me up with pain pills before they were going to shut off my epidural.  With that, I slept until they had to get me out of the CPM, change my dressings, and then shut off my epidural at 3AM.  I slept until about 5:45am when I woke up because, guess what, my hip hurt.  

Tuesday, October 2, 2012

Pre-Op Right Hip/Post-Op Left Hip Appointment

After an extremely uneventful travel out to Vail, we had a day and a half to spare before I had my appointments with Dr. P.  On Saturday, it was a washout, because when I arrived in Vail, I decided, against my will, to get a migraine.  I am assuming it was the perfect combo of stress and pressure changes in the mountains.  This landed me in bed with the curtains drawn and a moist towel on my eyes for several hours followed by several hours of sleep.  Essentially the entire day and evening were shot.

Sunday came and it had simply turned into a headache.  Which is something I can totally handle.  On Sunday we went to Wal-Mart and got all the food we needed for the week, plus some other small things. Then we walked around Vail Village.  It was so incredibly beautiful in the fall.  I can say that I have been to Vail in all the seasons, but, autumn by far is the most beautiful.  We walked all through the Village and farmers market.  It was a lovely sunny Sunday afternoon and I enjoyed every single minute of the day (with the exception of having the nagging hip pain, but that is completely expected when you are actually there in Vail to have your hip fixed).  In the evening we watched several shows on HGTV and a couple of Intervention shows (I haven't a clue why I like watching this show as it gives me cognitive dissonance!)

Monday rolled around, and this was the big pre-op day.  At 9:00AM, I had a sports endurance test. This started out with single legged squats on the right side.  I did about two minutes of it.  Then came jumping laterally from my right side onto my left with an elastic band doohickey around my waist.  It wasn’t great, but at least I could do it.  Next was the same thing but lateral jumps.  My left hip would not allow me to do it without pain, so we stopped.  Then I  did (aka tried) some lunges.  I attempted both hips and then looked back at the dude doing the test, where he said that they didn’t count and we stopped the test.  Needless to say, I failed.  But not unexpected.

At 10:30AM, I had measurements with the athletic therapist and PA (plus some additional help with the OR nurse).  We measured strength and ROM.  Both sides were similar, but my left side hurt a bit more.  My FABER was 21cm on my right side and 22cm on my left side. The only thing that stood out between the two sides is my left side flexion was much weaker than my right and my ROM was still less on the left compared to the right side.  Ugh to say the least when the left is going to be the sole weight bearing side in a matter of hours.

This appointment continued on with the OR nurse having me sign consent and have me fill out a post op questionnaire, and a whole bunch of other papers.  Gross.  She is so, so, so nice.  She definitely has the mother figure of the Steadman Clinic going on!  Then the fellow came in, did a very rough hip exam on both sides.  He came to the conclusion that my left side was still unstable!  I made it very clear that I had had that capsule tightened twice this year.  He said that it must have loosened up again.  WHAT?!  He then proceeded to flex my right hip up to max flexion which is about 90*.  When it was there he kept pushing and asking if that was all it did.  To which I replied YES!  In my mind, OUCHIE.  Then the fellow went through my MRI and radiographs.  I have slight dysplasia (CE angle of 26* on the right and 28* on the left).  We discussed the chances of having an osteotomy.  To which he replied that it could be a possibility, but that it isn’t a concern until the CE angle changes to the teens.  This could happen, but this does not contraindicate my chances of having a successful hip scope.  We will keep an eye on the angles in the future and cross that path if/when we get there.  He said that I we would definitely need to repair the labrum, maybe a labral reconstruction/augmentation, CAM and pincer impingement removal.  And my acetabular rim is fractured off just a tad and they will remove the bone and fix the fracture site.

Then I waited for an hour and half for Dr. P to come in.   When he did, the first thing he said was, “oh yes, I remember you, you are a very difficult case".  He proceeded to explain to the fellow that I had a very extensive history with less than optimal surgical outcomes using standard rehab protocols. When Dr. P did the more gentle hip exam, he said that it felt much better than before.  The fellow piped in saying that they were both still tight.  Dr. P said he should have felt my previous left hip stiffness and that I have the stiffest hips he has ever seen.  And that tomorrow they would have to be very, very careful with any tissue manipulation because of my response to surgery.  

He had me walk, and he was very happy considering my lovely hips. I said that I think that the pain is muscular, and he said that although he is happy with the functional improvements, the pain concerns him and that it is not good enough for him and that we have to try more injections and see if the pain resolves.  So in surgery tomorrow he will be doing an intraarticular injection into my left hip, removing some left over suture from the last surgery.  Then he will do a right hip scope with the aforementioned procedures (although I signed for a bunch more procedures that include microfracture….hope I don’t need that).  Then we discussed injecting  my right hip after surgery.  He is going to give a talk at a meeting out of town, but he has taught another doctor to give US guided injection on Friday (three days post op).  He said he wishes he could be here to inject but that it isn’t possible.  And that I need it done because we have seen what prior surgeries have done, that we have to take every precaution to reduce inflammation. 

I then got a pregnancy test, dropped off my scripts, and saw the preop nurse, took my vitals, and, DONE.  It's GO TIME!!!!!

PS. Since I am writing this post several days after the fact, I should mention that October 2nd is my 4th year hippiversary for the right side.  10/02/08 was my very first hip surgery and the last time somebody was inside my right hip.  This most recent surgery was exactly one week shy of four years.  It is crazy how much has changed since then.