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Sunday, May 19, 2013

Unofficially: The Hip's Shot

Fortunately or unfortunately, whichever way you want to see it, this left hip will most likely end up to be ceramic or metal within the next year (hopefully March-ish) but we will see how things shake down.

I had my appointment with a new orthopaedic surgeon this past week and after examining me, watching me walk, listening to my history and pain levels the surgeon said that when he sees patients present as I do, that they have always ended up with a THR.  The radiographs have slight joint space narrowing (not significant, nor has it changed since December), so he has ordered an MRI/arthrogram to determine the extent of cartilage damage and to see how long I can delay having to have it done.  We may do an exam under anesthesia as well, if the cartilage looks good, just to ensure that it isn't the muscles that are causing my issues (I am guarding so much due to pain that the full ROM cannot be tested in the office).

My only other option would be a periacetabular osteotomy as I lack any form of anterior hip socket (meaning very severe anterior congenital hip dysplasia).  But my cartilage would have to be good enough for that, and even then it doesn't guarantee a success.  My right side is just as dysplastic as the left, so that hip won't last me either (although it is less symptomatic than my left and I am not sorting out this hip until the left is organized).  After much discussion, we were both disappointed that the dysplasia was not identified as a problem with any of my previous surgeons, as I could have avoided several unnecessary scopes, had a PAO, and possibly avoided or delayed a THR.

I feel almost relieved, because I have made up my mind and will be perusing a THR at the end of medical school.  I have done my fair share of hip preservation and I can't go through such a large surgery like a PAO with even the slightest chance of failure (I already know I have grade II arthritis from previous operative reports).  So, regardless of the MRI/arthrogram results, I will be doing the full replacement, but the results may dictate how long I can put this off.  The surgeon feels that I need to consider taking time off from school, again, to have this fixed because I am, " young, not even thirty!" And, "...we are talking about your health here, and we can't mess around with this because you need to be able to live your life."  Both of these statements are absolutely true, but there is no way that I can mentally or physically handle another surgery in the very near future (as the surgeon is eluding to wanting to do).  I need some time to try to recover from my previous surgeries.  I realize I am exhausted from the constant throbbing, but I just don't think that I can do another surgery for a couple more months.  I feel that if I save up my vacation I can use it all at the end and finish school early and have the replacement on the left side.

I thought that he would be pushing for me to do a PAO or something, but he was adamant about the fact that a THR will most likely be my best bet.  And even if the MRI/arthrogram comes back with small amounts of arthritis, he wouldn't blame me one bit for still going through with a THR.  Enough is enough and I need my life back.  Living like this is in no way, shape, or form tolerable or desired.  Life is too short.  I will be willing to curtail my activities in order to allow my replacement to last as long as possible.  I haven't been able to do anything physical for the last 7 years, and to just get the chronic pain relief will be more than welcomed.

So that's the scoop.

MRI/Arthrogram: May 31st, 2013

Sunday, May 12, 2013

Brain Storming

So this week is the week that I meet with a new surgeon to determine what my hip's problem is and hopefully to get some pain management solutions.  I am excited, but even more nervous.  I can't stop thinking about what he might say.  What does the fresh set of eyes with no previous surgical experience inside my hips see?  I am curious and scared.  But I'll have to face the fact that something is not right with my hip.  I particularly realized that something is wrong when I was driving to the hospital last week and every bump hurt my hip, THAT was a sign that I am doing the right thing by seeking out another opinion. 

In light of my upcoming appointment I have been thinking of different questions I should ask at my appointment.  If you have any suggestions, feel free to email me or comment!

  • Pain meds/NSAIDs for day?
  • Pain meds for night?
  • Do I need a pain management referral?
  • Go through my angles (CE, Sourcil, Alpha)
  • THR vs PAO vs SDD?
  • Arthrogram still needed if I am not going to do surgery in the near future?
  • Scar tissue issue?  Could my bone structure be causing the recurrent scaring? 
  • Will I be able to wait another year if I do need surgery?

Monday, May 6, 2013

Between a Rock and a Hard Place

Yes, this is where I am.  I have to say that I am extremely thankful for having completed my surgery rotation, that was the least fun I've had in medical school to date (well, boards are right up there, but you get the idea). I am thankful that I am able to do my medical school, albeit, with physical difficulty, but I am still getting up every morning, driving to the hospital and do what I need done.  Yes I hurt, but I can't let this stop me.  I know it's not normal for somebody less than 30 years of age to be throbbing by noon time, or have hip pain while going over every bump while driving, but there are a lot of things for which I can be thankful.

I have 10 days before my appointment with a new surgeon.  I am basically freaked out...maybe I'll ask for a Xanax the day before from the residents! (hehehe) --I won't actually do this!  I feel like I'm stuck: darned if I do and darned if I don't.  I realize my pain is abnormal, but if I do find out what is wrong, that may mean more surgery.  Surgery that cannot fit into my life right now.  I have hurt this badly in the past and I have tried to get it fixed, and look how wonderful that turned out for me.  It makes me very weary about seeing yet another surgeon.  Every single doctor I have seen for my hips ends up saying that they can't help me.  What makes this one any different?  I shouldn't be so skeptical, but I can't help it.  With so many failures over the last 7 years, how can I trust that things are going to get better?  I have to, or else I will end up going's just amazingly difficult.

So next Thursday I will have my appointment with a local surgeon.  I am basically going there for some direction, for some pain relief.  I have ended up with no doctor willing to write me a single script for pain or inflammation.  This is my main reason (in addition to the fact that I'd like to know what is going on with my hip and to get a fresh set of eyes on my case).  In any event, I'm nervous.