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Wednesday, June 19, 2013

To PAO or Not? That is the question.

I can't believe I am even flippin' considering this as an option.  Really? I mean having somebody breaking my pelvis in three places so as to give me a hip joint...sounds just...barbaric!!

According to my MRA results, the cartilage looks surprisingly good...great rather.  Like what the heck?! I'd rather not have a decision.  But now that I have a decision.  Do I want to look like this:

Or do I want to look like this:

I do not know at the moment.  I have started to get my crap together to send to a world re-known hip surgeon who does the PAO.  And if he agrees with my current surgeon, I am afraid I will have to submit and have it done. Although I would MUCH rather get a replacement for current pain levels, but is this the best thing to do in the future?  I need to be able to walk when I'm 70!  But I also need to function now.  There are no guarantees that the PAO would work either.  I am so incredibly confused.  I wish I had seen a PAO surgeon a LOOOOONG time ago!

The only thing I know now is that I want my life back.

Wednesday, June 5, 2013


Physical Examination:
Left Hip:

  • Flexion:  90 degrees
  • Internal rotation at 90 deg: 10 degrees
  • External rotation at 90 deg: 30 degrees
  • Internal rotation prone:  20 degrees
  • External rotation prone:  40 degrees
Right Hip:
  • Flexion:  120 degrees
  • Internal rotation at 90 deg: 30 degrees
  • External rotation at 90 deg: 45 degrees
  • Internal rotation prone:  40 degrees
  • External rotation prone:  60 degrees
  • mild joint space narrowing
  • subchondral sclerosis
  • Lateral CE Angle:  20 degrees
  • Tonnis Angle:  15 degrees
  • Posterior wall sign
  • Anterior CE angle:  14 degrees

Sunday, June 2, 2013

Arthrogram #4 MRI #8

On May 31st I had my fourth arthrogram and my eighth MRI test.  And let me tell you, this was one of the least pleasant experiences I have had (as far as arthrograms go).  I was nervous about this test for a week prior and the day of was no different.  I had to work in the morning so I was at my hospital prior to having to drive across town to another hospital.  Morning rounds were fairly uneventful (although we had a couple of very interesting yet puzzling cases on our list).  We had noon lecture where I couldn't gag any food down my throat because I was so nervous.  The residents let me go after lecture and I headed off to the hospital in which I was to have my test.  I had to arrive 30 minutes early to fill out paper work, get changed, and then sat around for only 10 minutes or so.  Then the real fun started.

After I climbed onto the fluoroscopy table, I found that the PA was the one doing my injection.  I thought it was odd that a PA would do it, but whatevs, it shouldn't be terribly difficult.  I couldn't have been more wrong.  After explaining what she was going to do, she started up the injection very nonchalantly.  Then she started wiggling the needle and making weird faces at the monitor.  I was like, umm, this can't be good. She moved the needle around more and more and, after 15-20 minutes of trying, the radiologist had to come in and he had to put sterile gloves on and try.  He tried for 30 more minutes to get the needle past my hip capsule into the joint space.  He kept saying that it didn't feel right as he was jabbing me, poking me, repoking me, and grinding against bone (which is a horrendous noise).  He explained that my hip capsule is so thick that they couldn't tell if they had any space at all in which to inject the gadolinium.  To make matters even more complicated, my entire hip is scarred down so none of the muscles felt normal as the needle was passed through.  He did finally end up getting a good blush in the joint and then sent me on my merry way to MRI.

In between the MRI I had to walk around to get the joint well lubricated with the gadolinium.  It seems that this wouldn't be such a problem because I was all numbed up, until you think about having extra fluid in an unstable hip.  I could barely walk since my hip felt like it was going to fly out the front of my body (no joke, horrible feeling). After my limping around for several minutes I was called back to the MRI.

In the MRI, I was happy to be vertical for a bit.  I got all strapped in with the intensifier around my left hip, they put on my favourite country music on the head phones, and the banging began.  It wasn't terrible, but very long.  It was most uncomfortable for my back since I've been having a flare up of the back pain lately.  When all the banging stopped, they pulled me out and told me that they were going to MRI my knee.  I was totally caught off guard, but apparently my surgeon is doing a study on knee anatomy and people with hip dysplasia.  So, back into the machine for a couple more rounds of banging.  By this time my ankles were sore from being taped together all afternoon and my back was pounding.  Luckily my hip was well lidocained up and wasn't too painful.

I managed to get a CD of my imaging but it is a shame I don't know how to read it.  I got home and iced up real well and had pizza for supper.  Which was absolutely amazing since I hadn't eaten anything all day.  After supper came the pain.  I took a tramadol thinking it would curb the pain a bit.  Boy was I wrong.  I felt like I was post op, pain extremely bad and radiating all the way down my knee and anterior leg.  It made me cry and had to simply go to bed.  I figured I would be sore given they shoved a needle in and around my hip for 50 minutes, but whoa!  Dude, UNCOOL.

Saturday was a bit better than Friday evening, but I was still having a very difficult time walking.  I hurt when I put weight on my leg and if I move too quickly it catches me and makes me do that grunting sound and takes my breath away.  I'll tell you, it is extremely sexy when trying to walk when you have to stop and grunt.  I can't stand up straight because my hip still feels like it is going to fly out the front of my leg.  It is still a very odd sensation.  Frankly, I am super unimpressed with this entire experience.  I have had arthrograms before and they were 90% easier than this.  It is almost ridiculous how sore I am, I still couldn't get comfortable this evening on the couch with a Tramadol on board.  I am seriously hoping tomorrow is better because, like, whoa, I can't do this much more without stronger pain meds.

I will be getting a phone call from my new surgeon when he reviews the study.  I was supposed to call the office and leave him a message after my studies were done, but since it took 2.5 hours total, the office was closed for the weekend.  I called the answering service but my only option was to have them call the ortho doc on call to see what he could do.  And I know what it is like to be on call and I wouldn't want to have to deal with a patient who just wanted an MRI result.  So I'll call Monday and see if I can leave a message and the surgeon should call my cell to tell me what he finds and what he thinks our next step should be for this hip.  Although I am very certain I want a hip replacement, having this study will give us a better idea of what we are up against and how long I can possibly put surgery off.  I reeeeeeeally hope I can get a THR in March-ish if I can save up all of my vacation time.  Fingers crossed!  I will def post again when I hear back about what the heck is really going on inside my hip.