Hosptial Stay

POD#1
I felt great considering I had just had my pelvis broken.  PT came by and got me out of bed and I crutched into the hall and back to a chair in my room.  This was no easy task.  I did shed a few tears, but I did not yell at the physical therapist, so that was good.  My pain was initially under control with a dilaudid PCA, which was stopped in the afternoon and I had a foley catheter, which was also removed in the afternoon.  I had not had a bowel movement but I was able to urinate.  My dad went and got me a pumpkin spiced latee with whipping cream from Starbucks too--which totally made my day!! :)  I used the CPM every time I was lying in bed.  The surgeon came by after his work day at a different hospital and told us that the surgery had gone very well and that the right hip was in much better shape than the left hip and he expects me to get like 20 years out of this hip.  That puts me at 50 years old! I can handle never having another right hip surgery until I am 50! (excluding screw removal which will happen in hopefully 6 months time).

POD#2
Early in the morning (maybe even prior to midnight, things are fuzzy as far as chronological order goes), I started having extreme nausea. I was given Zofran which did not help and ultimately Phenergan which did help but not before I was puking my guts out.  I think I threw up like 6 times.  Vomiting after having your pelvis broken is very, very, very painful. I don't think I had ever experienced pain like that before. And, not to mention this vomiting was not the normal 'let's throw up in a bucket type', it was projectile. YUCK.  But after this occurred, things settled down.  I had my drain removed in the morning as well as my surgical dressing.  Ok, so obviously they just slapped that dressing on haphazardly and didn't even consider where they were placing the sticky bit of the dressing because holy crap it hurt to remove the dressing from the sensitive areas!! Like COME ON, if I had wanted a full bikini wax, I could have done it myself with less pain than when they removed the dressing. Ouch.  On this topic, (sorry if TMI, but if you were a gal having this surgery, you'd have these questions too!), I thought I had 'cleaned up' down there enough before surgery.  I was all trimmed and shaved the day of surgery laterally just to ensure they didn't have to shave in the OR.  Well, they shaved me anyway! I was so put off, like I was NOT messy and it was not in the way and they still removed a significant amount of hair. So, best piece of advice, clean up WELL.

PT also came by today, which again produced tears. I was able to get up, crutch out of my room, and then up the stairs.  It was funny, there were only two stairs this time.  Last time there were four stairs.  Having said this, I could be wrong (was on a lot of dilaudid) and am just exaggerating the number of stairs because it was so painful to move last time that the stairs were very daunting. I passed the PT and was moving well enough to have her sign off.  I didn't need OT this time either since I was "a pro at hip surgeries by now". Oof, sad....8 hip surgeries later, you would expect me to be able to navigate and move around alright s/p an operation.

Today, I didn't throw up anymore, I didn't poop, and I did pee.  I was still using the CPM.  My appetite had significantly decreased from my nausea that comes in waves throughout the day.

POD#3
My night was uneventful, slept a lot as my nurse was incredibly paranoid about controlling my pain. We had chalked up the previous night's events to pain which had got out of control and lead to my nausea (well, when I say 'we' I mean me because when my surgeon rounded later on this day, he took off the dilaudid and wanted the resident to take off the Norco as well and just suck it up with Tylenol, but the resident refused to remove the Norco as he understood I had a big surgery and didn't want me to suffer needlessly). This night also was the start of my urination problem. If you've ever had urinary retention after surgery, you will know it is a big ordeal. So, I had to pee around 2am. The nursing assistant got me up from bed and into the bathroom where I sat for 20 minutes trying to pee. Absolutely nothing was coming out. But I thought I could feel the urge, just I couldn't get it out.  They bladder scanned me and found 500cc on the scan, so I got straight cathed for 650cc.  This was such a relief to have my bladder emptied, but not a fun experience to have to get that done.  I've only ever had a catheter placed in the OR when I am out stone cold. Not the most fun experience.

My surgeon rounded again today in between his cases in the OR. He told me that he wanted to take off all narcotics (as mentioned above) to reduce the nausea.  He asked if he thought I could do with just Tylenol, in my head I thought 'ARE YOU CRAZY!?!?!?! YOU JUST BROKE MY FREAKING PELVIS!!!!'....I politely told him no, I didn't think that would be a good idea, so I got Tramadol in addition to the Tylenol to manage my pain. Sweet, no narcotics after breaking my pelvis, a hip scope, and screw removal. Rolls eyes. Anyway, he was so nice otherwise.  I don't understand his drastic change in personality compared to my first PAO round.  First time he was literally kicking me out of the door with discharge orders in on POD#2 and now he told me to take my time, we were in no rush to get me out of here and that I should stay as long as I felt I needed so that I was comfortable to go home.  The only thing we were waiting for was for me to ensure I could urinate decently and my nausea.

After my surgeon left, I decided that I had to pee. Ok, so really, shouldn't be a big deal right? Lug my sore and swollen body to the crapper and pee. Nope. Honestly, there was no way I could get my pee out! Even if my life depended on it, it was NOT coming out. The nursing students were instructed to bladder scan me. The one nursing student had to be a fresh as they come as she didn't know anything.  So I had two nursing students trying to figure out the bladder scanner.  They were scanning and saw 700cc in there, they quietly whispered to themselves that this couldn't be right when I told them that it definitely could be right, and probably is because it HURTS. They got their preceptor and of course my nurse was on lunch, so I had the covering nurse who was a crazy woman come and fix this pee problem I had so nicely developed. She didn't have an order for a straight cath so she decided to insert a foley catheter just in case they wanted to put a foley back in, then she called the resident who didn't answer, then she called my surgeon! (In my head I thought, great, she's totally over reacting and she was all frantic when talking to him, and all he said was straight cath the freak who won't pee...ok, I bet those weren't actually his words, but I bet that was what he was thinking). Anyway, the foley came back out since they just wanted to straight cath me. It's a joy having catheters put in and out of your bladder every 8 hours. While on the pee topic, they decided that I should be bladder scanned 8 hours later to ensure I didn't have pee in there.  Well, 8 hours rolled along and I did not have the feeling of a full bladder. They scanned me and looky looky--600cc of urine in there, my fabulously gorgeous orthopedic surgery resident (yes, he was HOT) so graciously put in an order for a foley catheter to give me bladder rest. Sweet. Not.

POD#4
My night was uneventful. In fact, I actually slept through the night. My pain was worse since I was only on Tylenol & Tramadol, but I was managing alright.  My appetite was not there at all, and I was just simply exhausted.  I still used the CPM and was basically just waiting for my bladder rest to finish so I could go home.  The plan was to keep it in until tomorrow morning when they would take it out and see if I could pee.  There was a possibility that I would go home with a foley and then follow up in the urology clinic the following Wednesday to try and remove the catheter. This totally stressed me out as there was no way I was gonna go home with a foley! I came in for hip surgery, I did not want to leave with a freaking foley. UGH.

I basically chilled all day.  I got up with the help of my parents and crutched down the hall a few feet (maybe 10?) and then didn't do much. My appetite was completely gone, all I ate was cottage cheese and Jell-O.

POD#5
I was determined that I was gonna go home today.  I got my tank top on under my hospital gown, put on my favourite Lululemon headband and sat up in the chair to eat breakfast.  While eating the resident came by and was all happy that I was eating and we would remove the foley for a trial of void.  I told him that I wasn't hungry but I was eager to try to pee. Not 10 minutes later, I was extremely nauseated.  I had the nurse and aid help me to the edge of my bed.  That's when the puking started.  But this time, it wasn't going away. I threw up over and over until I was just retching with nothing coming up (sorry for the disgustingness of this, but it is what happened). The hot resident came back in and was flabbergasted that I was like this, he was gonna tell me I was going home and now I was throwing up. He waited outside for this to stop and every time he came in, I started retching again.  At one point we were talking when I had to interrupt him to dry heave into the cute rose coloured barf bucket. He kept trying to talk to me while I threw up, but I couldn't pay attention to him.  Ended up the nurse, kinda sternly, told him that this was not the time to try and talk to me and he agreed to come back later. Before he left he told me that I would likely not be going home today.  Really?! I can't go home like this? Ugh. He didn't come back later that day.  All I was instructed to do was stay in bed and minimize movement.  I slept all day thanks to the Phenergan they kept giving me. What a waste of a day.  In the hospital another day. 

My surgeon was off this day and could not come in so he sent one of his covering partners to come in. Which was awkward. I was still puking and a strange man without a name tag wearing a plaid shirt and jeans came into my room and stood there staring at me. I turned to him (between pukes) and asked him 'who the heck were you?' In retrospect, I was kinda mean to him :/ He explained who he was and then was like 'Oh! You're the one with the urinary retention. We've had a lot of discussion about you with the residents and your surgeon." At this point I was writhing in pain because, again, that much pressure on the pelvis after having it broken was horrendous.  All this doc said was that I had to relax! RELAX?! You try throwing up after a PAO! He said he was gonna take a look at my medications and try to figure something out for me.  His solution: Valium for anxiety.  I wasn't anxious, I was in pain.  I didn't get any Valium during my stay.

I slept the rest of the day after the vomiting was controlled.

POD#6
The night was uneventful again. Thankfully. I just chilled in bed with my buddy the foley catheter. In the morning they were gonna remove the catheter and then I was gonna try and pee.  The foley came out at 6:00am. The resident was by at 8:30am and I still hadn't peed, but we were gonna send me home with or without a foley, didn't matter because I needed out of here.  He got all of my medications ready and left me to do my thing.  I made it to the bathroom and...wait for it...I peed!!!!!!! Praise The Lord! As I was in the bathroom, the resident came by and was checking to see if I peed, and I told him I had.  Always nice having a conversation with a hot resident about peeing through the bathroom door.

Everybody was happy I peed. 400cc  And no big post void residual either! I got my medications and was discharged.  Though, I was instructed to stop my birth control pills for risk of clotting. Ugh, not that I'll be engaging in activities requiring birth control in the near future, but my periods will now be all messed up. Two months without birth control.  But at least I didn't have to go home with a foley.

So FINALLY is was discharged home. Nearly a week after my surgery.  What a crazy ordeal which I was glad I was over.

Wow, that was long.  I detailed this more for my own records than for your enjoyment because who really is gonna read a play by play account of my hospital stay? Ha, not many.  But, there you have it: a 6 day stay after a periacetabular osteotomy. Boom.

Over and out....

9/30/14: Right Hip Arthroscopy + Right Periacetabular Osteotomy + Left Hip Hardware removal

The day prior to my surgery date, I got a call stating that I was scheduled for an OR time of 3:45pm. When I had called earlier the previous week, they stated that I was scheduled for 5:30pm, so the earlier time was much appreciated.

I woke up very nervous on the surgery day.  I was allowed to drink clear liquids until 11:45am.  I tried to drink some black coffee but, due to the nerves, it made my tummy upset.  I opted to drink some ginger ale (which I nursed until 11:45am).  I decided to shave my legs nice and carefully, took a shower, did my eyebrows, and then looked online at jewelry (what doesn't settle a girls nerves more than online shopping for earring and necklace sets?!).

When my parents got home from their half days of work, we left for the hospital. We arrived just on time! I checked into the south surgical waiting area and we were given a ringer (like the ones used in restaurants) and it went off after five minutes or so.  I was then brought back where I took a pregnancy test, got changed into the hospital gown, and then waited.  The nurses then started an IV in my left hand, I signed the consents, signed my right hip. There was confusion as the left screw removal was not on the consent.  This was settled when the surgeon came in.

We waited, and waited.  The anesthesiologist came in and discussed that he would try to mimic the previous regimen from the last PAO, I got a scopolamine patch, and then waited some more.  The surgeon came in and he signed my right hip and he agreed to take out the left sided screws as well.  Though, he was surprised as he thought that we were going to take out all of the screws (on both sides) at once.  He seems a bit put off by the fact that I wanted them out, but he ultimately agreed to take them out.  After another hour of waiting, the room flooded with the CRNA, OR nurse, and a bunch of people.  They didn't give me Versed until I was getting on the OR table (at my request).  I said my goodbyes and then was wheeled into the operating room.  Of course it was cold, and I waited on the bed for a few minutes until they were ready for me to slide over to the operating table.  I was then given some Versed which didn't do much. While I was arranging myself on the table I could hear the surgeon telling people the order in which things were going to happen: right scope, right PAO, then screw removal.  I wish I had my glasses on while in the OR because I really couldn't see anything other than the black boots attached to the OR table that were going to be used for the scope.  After I got settled down, a mask was placed over my face and then I was off to sleep.

The surgery took 2.5 hours. And it went really well.  Although there is some arthritis in the hip, it wasn't nearly as bad as the left hip, and I should be able to get 20-ish years out of the hip before I need a replacement.  My labrum was intact (not all shredded like the last time), and everything went smoothly.  Thank goodness!!

I remember waking up in the PACU this time. (which is actually quite unusual for me as I'm usually zonked for hours).  I woke up very confused and frightened.  I couldn't understand where I was or what was happening to me or if the surgery was even done. After I got my glasses I settled down a bit.  They had set up a morphine PCA and morphine boluses.  Problem was morphine wasn't working! They quickly switched it to Dilaudid and I got immediate relief.  I was then transferred to my hospital room (which I remember as well....crazy how different things were this time).

Once in my room, I of course, made a big deal that the PCA wasn't working well enough. They increased the dose and then I dosed in and out of consciousness until the morning.  I ended up getting to my room around 11:00pm. Once I was settled in, my parents left and the rest of the night was history.

I survived my second (and LAST) periacetabular osteotomy.  Praise The Lord!




...detailed hospital stay is to follow in subsequent posts

2 Week Follow Up

I saw my surgeon yesterday for my two (and a half) week follow up and everything looks like it is going according to plan.  He wasn't very descriptive of how the surgery went or what he expects the outcome to be, but he did say that the PAO was the right surgery to have and that my hip joint is stable now.  He is a wee bit concerned about my nerves:  my lateral femoral cutaneous nerve is completely numb laterally and I have a patch of tingling, pin-like sensation on my inner thigh (I am assuming it is the ilioinguinal nerve).  We are going to watch it for now and hope that it improves.  I would rather not have to start something like Neurontin.  He refilled my pain medication but reduced the dosage of hydrocodone to 7.5 with is fine with me.  I am allowed to ride the stationary bike without resistance now...in fact, I have to since my atrophy is extensive already and it's just been 2 weeks.  I have to work on my flexion and external rotation lying down as it gives a better stretch on the hip.  He reiterated the fact that being aggressive early will help the overall outcome of the hip...so...let's be aggressive!

Overall the appointment went fine.  He is less than talkative and is rather quiet.  I have to drag information out of him.  I did get him to show me my scope pictures and radiographs.  The scope showed cobblestoned and yellow cartilage on a large portion of the femoral head, mostly the weight bearing portion, and some smaller areas of smooth cartilage  And the xrays look fine.  I have four nice screws holding things together.  I took a picture of the AP and false profile, but only the AP saved to my phone.  The AP doesn't show the significant correction I received anteriorly.

As far as pain right now, it is rather constant and I need pain medication every six hours.  I have stretched it out to eight hours once, but since going to see the surgeon, the pain has been more severe.  Crutching to the office, going to get x rays, getting on the exam table, him examining my hip (resistive adduction hurt like the dickens....i'm not sure I have much muscle activity there), and ROM testing, followed by a crutch back to the car....adding a total of 1.5 hours of driving made for an EXTREMELY painful day yesterday.  Today was better though. 

I am doing passive flexion, external rotation, and resisted adduction like A LOT (feels like all day), I lie flat on my OMM table frequently to stretch out the hip flexors.  And I did gather enough courage to ride the upright bike today at 18 days post op.  It wasn't as bad as I thought it was going to be.  It did hurt my ischial tuberosity, but I was able to unweight myself with my hand on the seat, which made if much more tolerable.  I did five minutes without resistance and that was enough for me!

Otherwise I just get up and crutch every so often so as not to get too stiff and lounge around.  My existence seems extremely boring.  I'm used to being busy at the hospital or clinic on rotation and now I'm lying around like 100 times more than usual.  BOOOOORING.  I find I text some of my friends a lot more often.  When they are out being productive and Im at home distracting them and decreasing their work productivitiy. I bet they will be happy when I'm done recovering too!

So, I have another month of recovery before I see the surgeon again.  I hope that the nerve pain decreases some and I get some more feeling on my lateral thigh because it is totally numb from greater trochanter to knee and about four to five inches in width, plus the medial thigh burning and pin sensations.  Boo.  I'm also going to work on my bone growth :)  I need to fill in that lovely gap with callous, cartilage, then bone...and that seems to be like a heck of a job!

I will put pictures up, but I think I may wait until I get a false profile at my next visit to the surgeon, as the AP isn't that dramatic.

HERE"S TO HEALTH AND HEALING!!!!

Hospital Stay

So after my surgery I had to stay in the hospital for a couple of days.  Needless to say, it was an experience that was painful and I don't wish such a stay for anybody.  The first night after surgery was a blur, I remember swearing that the PCA pump was not working because when I pressed it, it did not relieve my pain.  I remember lots of people telling me that my light was green and I could press the button again (I guess I was drugged and couldn't remember when to press it).  I also remember the resident coming in and asking if I needed higher pain medication dosage, and I remember saying that I am squirming because of the pain and needed more if he wanted me to sleep at all.  Other than those three things, I don't remember much. 

The first day post op was a blur, I remember the PT coming in and trying to get me to stand and walk.  But this was not going to happen because of the pain.  I basically got three steps out of bed and that was it.  I was unable to get to the bathroom so they got me a commode.  Which was nice, but I don't remember when it was taken away from me (it wasn't there long, that's for sure).  The foley catheter was removed this morning, so I had to make trips out of bed to pee.  Other than that, I don't remember anything else.

Second day post op, I had my drain removed bright and early by the ortho resident.  This was fun as it bled all over my bed when it was removed.  He had to come back thirty minutes later to change the dressing as it was still oozing a lot of blood.  It wasn't the most painful thing to be removed.  It didn't tickle, but it was odd and hurt a bit.  My surgeon rounded on me soon after, and his two minute swing by was less than helpful.  All he said was that I needed to get up and walk since most people are walking by now, and that he put the orders for me to be discharged that day.  He tested my sensation and motor function.  I was definitely strong enough, but my sensation on the lateral and medial portion of my thighs were not right.  The lateral femoral cutaneous nerve distribution was completely numb and the medial was almost completely numb.  The PT then came was very, very persistent and I was going to walk out of my room and down the hall a bit.  Walking this far (10-15 feet) took approximately 45 minutes.  It was horrendous and the worse possible pain that I could imagine.  Every single step hurt so much that it made me cry, sweat, and feel nauseous and like passing out.  I was given dilaudid beforehand, but this didn't matter.  I did do this, but it was REALLY painful.  Needless to say, I did not pass my PT and was there for another night.  My day nurse was bent on me having a bowel movement and ordered me a bowel protocol.  This caught up to me this night as I had horrendous diarrhea and made a trip to the bathroom every 30 minutes.  Which meant that I didn't get any sleep at all.  And every trip made me more and more sore.  It was really not fun at all.

Third day post op, the resident came by and told me that no matter what, I was going home today.  The PT and OT came in and said that my surgeon had told them that I am going home and that I was going to do what I needed to get done to be discharged.  So, I struggled, but did 3 stairs and walked to and from the bathroom.  I put my own socks and shoes on and got in and out of bed by myself.  All in all this was again an extremely painful experience and one that I hope never to repeat. But I ended up getting it done and was discharged home.  After a 45 minute drive home, it took 35 minutes to get into the house, up 5 stairs into the kitchen and into the living room where my bed was.  I think that it was a bit too soon to come home, I mean really, 35 minutes to get from my car to the bed? 

The next couple of days all blur together because of the constant narcotics and anesthesia brain.  I do know that my first trip to the bathroom from the living room took 35 minutes and it was almost impossible for me to crutch in our bathroom because it is so small.  So my parents ended up renting a commode to put in the living room for the time being and as I get stronger, I can use the regular bathroom.

February 28th, 2014: First look Arthroscopy + Left Periacetabular Osteotomy

Despite this being VERY delayed, I thought that I should finally start up my blog and record my experience of my first PAO.  Until now, I've basically had almost zero concentration or motivation to do anything.  I have a lot to update on here, but I figured that the best place to start was on surgery day and make up the lost time in later posts.

Friday February 28th, 2014:  SURGERY DAY.
I had received a call the day prior that my surgery time was 4:45pm so I was to be at the hospital at 2:45pm.  This meant that I had a LONG time to wait before my surgery on that day.  Phew.  It gave me a lot of time to be nervous.  But I felt like I handled it pretty well.  No dry heaving or throwing up! ;) I got to drink clear liquids until 12:45pm.  So I drank up all morning in hopes of feeling a little less empty.  I was very very nervous, but I had waited such a long time for this day, that I just needed it to come and be over with. 

We left for the hospital nice and early as I had to show my parents how to get out of the hospital easily (the roads around the hospital are quite confusing and I was worried about them being lost late at night), and I had to return my pager and ID badge from my Radiology rotation.  It was nice to not be rushed and get there with plenty of time.  When I got there, they almost immediately took me back and got my IV started, I peed in a cup for the pregnancy test, and basically sat and waited.  They were concerned about my temperature since it was so high, but the room had the heat blasting on and I was almost on the verge of sweating.  They ended up retaking it a couple of times and then just decided to tell my surgeon that it was the room and that I didn't actually have a fever. 

The anesthesiologist came in and we discussed that I would get general anesthetic.  I made it very clear that I had got EXTREMELY sick in the past despite using Scopolamine patch, Zofran, Phenergan.  He said that they would pump me full of all antinausea medications before I woke up and do their best.  An hour later he came back and said that he had been thinking of me and had discussed my concerns with his colleagues and they wanted to do the Scopolamine patch still and that they would really be alert to my nausea levels.  This anesthesiologist was not the one on my case, when I met the one on my case she happened to be a graduate from my medical school.  It's too bad I don't remember this bit of information as the Versed had already kicked in at this point, but my parents told me because it was kinda ironic.

The surgeons resident came in and asked me a bunch of questions, I signed my leg, then my surgeon came in and signed me leg.  He was very brief (as expected).  And told my parents that if they saw him come out in half an hour...it was a bad thing as this could indicate that the arthroscopy to check the cartilage health showed more arthritis and that the PAO was not an option.  Next thing, everybody flooded my room, I got some Versed (which is a pretty fast way to feel high), I said my good-byes, and vroom off to the OR.  I don't remember going to the OR, but I remember transferring over to the fracture table for the first portion of the surgery.  They gave me a mask to take deep breaths and that was it.  I don't even remember waking up really.  I remember being in my room on the ortho floor and complaining that my PCA wasn't working.  That's about it.  Nothing too extraordinary from my end as I had the easiest job there...simply being present while everybody else did the work.

As far as the surgery went, my surgeon actually stopped operating after the scope because apparently the cartilage was worse than he thought and he didn't know if he should do the PAO or if I should get a THR in a couple of weeks.  He went out and talked with my parents about each of the choices they had, and it ended up that he and my parents decided that the PAO would be the best bet, even with the arthritis, because it could give me a few to several more years with my own hip and would make the THR last longer if the dysplasia was fixed.  So he took another hour and a half to do the PAO portion of the surgery.  I'm not sure how long this PAO is supposed to last or how much pain relief I am supposed to get from this surgery, but I think I would have made the same decision had I been awake and able to decide what I wanted for my hip.

I will elaborate on my hospital stay in another post. 

Just Do It: THE PAO

The PAO.  Those letters sound terrifying.  Really.  Who wants their pelvis broken, twisted, then screwed back together.  Nobody in their right mind.  So, perhaps I am crazy, but I am going to call the surgeon's office this week and schedule a left PAO.  Ugh, I can't believe that I just typed that. 

So here are the plans: suck up the next 6-7 months doing medical school rotations and then take all of my vacation at one time (giving me 7 weeks off).  So at 8 weeks post op, I will return back for one month of rotations (likely radiology/pathology...something that is not very intense), and then I'll have a month off after this rotation before I start residency.  It ends up that I will be 15ish weeks when I start up my new job (wherever that may be).  It sounds reasonable to me!

In the mean time I have a lot of 'hanging in there' to do!  It's a daily struggle as I can't stand for more than 2 minutes without needing to sit down. I'm taking Tramadol almost daily.  I am not sleeping well anymore.  I suppose this all comes with the territory of having dysplasia, but doesn't mean I have to like it.  So, that's the scoop.

Now I have several months to mentally prepare myself for this surgery.  And I'm gonna kick the PAO in the butt! The left hip better watch out, cuz he won't know what hit him!

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.