Category Archives: Hip Dysplasia

Maybe Actually Good News!?!

Quick update.  I had my MRI yesterday at HSS.  If you haven’t had an MRI, imagine laying on a too-narrow super firm bed, having your hips locked into place with a brace, your feet taped together, under a sheet with a light breeze blowing over you, while you slide into giant, thumping, magnetic sardine can.  Some people freak out — I’ve had so many done I literally fell asleep.

So, I got a preliminary “heads-up” from my dr’s office that there are no significant areas of concern in my right hip, that the labrum looks good, but that I have tendonosis in my abductors and iliopsoas muscle.  This may be caused by use or may be related to the fact that I previously had an arthrscopic procedure and my hip may just need extra time and TLC to bounce back.

The reason I am cheerfully optimistic is that 1) the protocol for getting over tendonosis is typically RICE (Rest. Ice. Compression. Elevation) — and once I have my surgery on my left side all I am going to be DOING is resting!, and 2) physical therapy.  Know what’s missing from that list?  Surgery!  I may be able to get away with not having another surgery on my right side!  I didn’t realize how much the fear of another surgery was getting me down until I felt the stress literally float off my body since I got the news.

Again, all of this is preliminary and I still need to meet with my Dr. on Monday to go through the full MRI results.  BUT, it looks like I will be under the knife on my LEFT side come May 8th — and maybe, just maybe, that will be it for a while.  Yea!!!

Here we go again

Nuts. I’m anxious. I’m also 9 days away from surgery which makes sense that I would be anxious but last time, I was utterly zen. Totally calm. You’d have thought I didn’t care that I was about to be broken and put back together. Admittedly, before my last surgery I only became zen in the final 2 weeks leading up to my surgery — prior to which time I was a paniced freak. This time, though, I have totally ignored the impending surgery so I never had a chance to panic. Apparently now’s the time.

As I type, I am at HSS in the midst of my surgical pre-clearance, including a physical exam, blood work, EKG, chest x-ray, and a meeting with the hospital GP that is assigned to me for the surgery. The day started at 9am and should be done by 2pm. I’ve been through this before so unlike last time, I knew what to expect (and to bring something to read – there’s a decent amount of down time between appointments).

Most importantly, I already had my appointment with my surgeon. We briefly discussed my impending surgery (the Open SDD) but the majority of the appointment focused on my (still crabby) right hip. I still have pain in the joint and around the greater trochanter but the majority of the pinchy pain is in the area between the hip and my groin – likely caused by the psoas tendon and break in the pubis. So, I am scheduled for an MRI tomorrow, an Active Release Therapy session on my tendon on Thursday, and a follow-up with my surgeon next Monday to see if the pain is caused by a torn labrum, nonunion or seething else. My surgeon has never had to go back in to repair a torn labrum after a PAO so, lucky me, i’d be the first. As of today, we are still moving forward with the left hip but the final decision will be made next Monday – 2 days before my surgery on my left. Apparently it is gonna be a busy week.

Photos from pre-surgical screening – I like to get dressed up for my HSS appointments!

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Hey May, whatduyasay?

I canNOT believe that it’s almost May! OK, it’s 9 days until May, but those 9 days plus the following 7 days and suddenly it’s May 8th and my next surgery! Even before we get to May, I have my last sinus surgery follow-up on May 1st (10 days away), surgical pre-clearance day on April 30th (9 days away), and two medical massages.  Add that to all of the fun things that are upcoming — three (3!) Broadway opening nights; pre-surgery highlights + spa necessities; my dad coming to do the 5-Boro Bike Tour; last minute “see you after your surgery” lunches and dinners; bowling (hopefully); and, if the weather is accommodating, bike rides.

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20130421-143109.jpgIncredibly, bike riding is one of the few physical activities that I can do that doesn’t hurt my hip so last week I was able to go to two FANTASTIC 4-year-olds’ birthday party and a brunch (and wear as many patterns as I could find) — all on my coaster bike.

I am pleased to report that the cortisone injection into the psoas and rectus femoris tendons definitely helped a lot, and for the most part, the pain is significantly decreased.  However, it’s not gone.  I still have pain whenever I go up stairs, I cannot lift my right leg more than about 30 degrees without noticing pain in my joint, and the more I walk the more I hurt.  On Friday, I visited fellow Hip Chick Lauren (who just had a total knee replacement at HSS) and decided to really see what my hip could do.  I walked (with a cane) about the distance I used to walk before the surgeries — and since HSS is about a million blocks from the subway, it meant a lot of walking.  Anyway, I was a bit disappointed to realize that by the end of the night, the pain in my right hip (the hip that had the PAO) was definitely worse than the left, yet untreated hip.  I am positive that my right hip will need another surgery but for now, with rest and intensive massages, I am confident that I will make it through the May 8th surgery.

Not much else to report but here are a few cute photos I thought I’d share.  Hope all are well!

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Guy (my husband) and I, post Easter brunch.

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Bagels at the playground — Boris REALLY wants a bite

Surgeries and Surprises

First, Happy slightly belated St. Patrick’s Day! Hope you were out drinking green beer and eating corned beef and cabbage!

It’s been a little while since my last post and I have lots to report. For those who don’t want to / have time to read the full post, here are the bullet points:

1. One of the bones in my right pelvis that was broken during the PAO surgery (the pubis bone) did not grow back together. Dr has prescribed a bone stimulator / increase protein to make it grow. If it doesn’t work I may have to have ANOTHER hip surgery on my right side to bridge the gap.
2. We are a go for my Open SDD surgery on my Left Hip on May 8th (pre-op April 30th).
3. Sinus surgery is set for THIS week (Thursday, March 21st). Basically, Dr is creating a straight shot out of my sinuses / removing bone and tissue / fixing my deviated septum. Same day surgery, home Thursday evening, around a week of recovery.

THE LONG VERSION
I met my hip surgeon for my 3 month RPAO follow-up / 2 month pre- Left hip Open SDD appointment on March 15th. The appointment started with x-rays. I met with my Dr. and mentioned that although PT (physical therapy) was going well and even though I am able to walk unaided, I was concerned about a new sort of pinchy/burning feeling that I’ve been noticing in the front of my hip. It also sometimes feels like the tendon is rolling over the joint, almost like it’s catching.

During my hip evaluation, my Dr. had me sit at the end of the table and try to lift my leg up off the table (really hard to do) while he pushed down. It was excruciating and I squealed in pain, not a normal reaction at 12 weeks post surgery. The Dr. then pulled up my x-rays. The x-ray showed that one my the bones had not grown together, possibly at all. The two sections of bone appeared to be about a centimeter apart, not even touching. This is called nonunion (when the bone does not grow back together following the surgical break) or slow union. It is one of the complications that can result from PAO surgery, normally only in about 1% of cases. Oh, lucky me. Even when it does happen, is typically asymptomatic and therefore does not require further medical intervention. Unfortunately for me, it may be the reason that I’m having pain in the front of my hip and, it’s possible that the tendon is getting stuck in the break. Gruesome.

The Dr prescribed me a bone stimulator which is a machine I will have to wear every day at home and will hopefully stimulate the bone to regrow. His staff also recommended I increase my daily intake of protein and calcium as much as possible so unfortunately for the animals, my efforts toward vegetarianism are taking a break. Hopefully the bone stimulator + increase in protein works. If it doesn’t, and if I continue to have problems, I may have to have a further surgery on my right hip after my SDD surgery in May. I should know more after my next appointment. In any event, it doesn’t sound like it will prevent me from moving forward on my left hip surgery which is good.

My next appointment on April 30 is my pre-op for my Open SDD surgery scheduled for May 8. It’s so strange to think of going through all of this again when I feel like I’m not even through the first surgery but I have to just keep moving forward, partly because I don’t really have any other choice.

In other news, my sinus surgery is scheduled for this Thursday, March 21. It’s a same-day surgery so assuming that the surgery requires that I get there at 7am, I expect to be home by 3pm or 4pm. The doctor is performing a septoplasty, turbinectomy, balloon sinuplasty and I don’t even know what else. The goal is to create more space in my sinuses so that when I have allergy problems, my sinuses don’t get so inflamed that they completely block and get infected. I also started back to allergy shots, 4 shots 1-2x week.

This year is already wearing me out and it’s only March. It feels absurd to me that my hip problems have so taken over my life. I am really looking forward to getting though the next 9 months and getting back to my life (surgery free!). Until then, the saga continues.

(Mostly) Crutch Free + 12 week Status Update

It’s been 11.5 weeks since my PAO and I am crutch free (mostly)! I say mostly because I am not willing to put away the crutches quite yet, and will definitely have them with me for longer trips (and I will absolutely continue to use the motorized scooter when I shop at Target). But this weekend, when I went out to dinner with my husband and when I walked 23 (23!) blocks over Sunday afternoon I did it only with a cane. I admit, by the end of the walk both of my legs were aching something fierce but I surprised myself by going as far as I did. I don’t seem to have a limp (as far as I can tell) and my surgery’d side hurts less than my yet-to-be-surgery’d side so I am really pleased.

Recovery was tough for the last week or two – I was doing more because of PT and my hips were not happy about it, very sore and achy and my muscles always quivering. But something seemed to turn a corner this Thursday because when I went to PT it was as if my muscles all decided to start trying to work again and I felt stronger and more capable. My therapist even approved my not using crutches. I’m know that the rest of PT will not be a cake walk and that I have a ways to go to be ‘normal’ but it was nice to feel like I was improving.

For reference, here are some answers about the status of my recovery to date (as of March 9th — 12 weeks and 1 day post-op):

  • When did I feel significantly better?  My pain was well managed but I was exhausted for the first 2 months. It literally took until 11 weeks until I felt significantly better.
  • How long was I on pain meds?  Narcotics (oxy) – 11 days following surgery; non-narcotic but strong – thru Jan 10th (about 1 month following surgery); Tylenol/Aleve – consistently thru 2 months post surgery; still occasionally
  • When was I able to completely take care of myself? My mom and husband were willing to help a lot so I let them. It was until mid Jan (about 1month post surgery) that I started to really take care of myself completely. If I had needed to I could have taken care of myself completely at between 2-3 weeks.
  • How long was I on crutches/walker? Non weight bearing crutches or walker – thru 5 weeks; weight bearing crutches – thru 10 weeks.  I continue to use a cane.
  • When was I able to wear anything but sweatpants? 2-3 weeks
  • When was I pain free? Too early to answer – still have some pain and lots of soreness
  • When was I able to lay on the operated side? 4 weeks
  • When was I able to drive? Don’t drive (live in NYC)
  • How long before I had a day that I didn’t need to lay in bed most of the day? I started working from home at 3 weeks – that was when I stopped laying in my recliner as much but I continue to rest and sleep a lot more than I used to.

I passed the half-way point between my 2 hip surgeries on February 24th and I am 9.5 weeks out from the SDD surgery. The 24th was an emotionally difficult day because I realized that I am actually going to have to go through this (or something like this) again and although I have handled the physical components of recovery well, the emotional has been harder than anticipated. I am scheduled for my next follow-up with my surgeon on March 15th so we will have lots to discuss. I’m really curious to hear if he thinks that I will need another scope on my right side (please, I really hope not). Also, following my unsuccessful balloon surgery attempt, I am scheduled for full sinus surgery (fix the deviated septum, turbinectomy, balloon sinuplasty, who knows what else but ALL performed under general anesthesia) on March 21st. Good news is that recovery for that should just be the weekend, plenty of time for the May 8th SDD.

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6 week follow-up – NEWS!

So much to report! This is going to be fact / text heavy but I want to make sure I get thru all the details.

On Thursday, I met with Dr. Sink at HSS (full disclosure, I asked – he was cool using his last name on the blog) for my 6 week follow-up, although it had been exactly 7 weeks since my surgery. I took a cab to the appointment since I was not yet comfortable with the idea of taking the subway (and would have been exhausted since HSS is about the length of 7 avenue blocks from the subway).

When I first got there, I had 2 x-rays taken and was immediately whisked into an exam room. Dr. S’s nurse and PA came in to talk to me initially, to see how I was feeling and how recovery had been going. I was in a really good mood — in fact, I’ve been in a really good mood for most of my recovery (which likely has more to do with not being as hyper-stressed [from trying to juggle school / work / social life] than with recovering from an invasive operation). In any event, we had a good chat and they seemed pleased with how I was doing.

Dr. S. came in a few minutes later and we started talking about how my healing was going. I told him that I felt really good, that I was using the crutches when I went short distances and a wheelchair for long distances (walker when at home). He looked at the x-rays and confirmed that 1) the bone was filling in really nicely along all of the breaks, 2) that the head of my right femur is now sufficiently covered by my right acetabulum, and 3) that the angles (between the center of the head of the femur / hip) created the perfect 90% angle that he was looking for. He seemed really psyched about that and I was pleased to know that the surgery appears to have turned out really well. He also confirmed that I have 5 screws (I had only noted 4) and that I was ready to move onto physical therapy 1/2 x week x 8 weeks. More on that later.

We then started talking about my left hip, what type of surgery we would be looking at, especially since the surgery is scheduled for May 8th. As a reminder, although my right hip had dysplasia (which can only really be solved by a PAO), my left hip has acetabular retroversion, mild femoral retroversion, cam and pincer impingement, the neck of my femur (between the ball and trochanter) is too short, multiple labral tears, a hairline fracture of the acetabulum and what appears to be a hypertrophic (overdeveloped) labrum. We had always discussed an SDD for the left hip but at my last few appointments, Dr. S suggested that the left hip might need a reverse PAO so I was curious what he would say, having now reconfigured my right hip. After some discussion about the coverage of my femur (which looks good, side to side), he feels that an SDD is the best way to go. What this will mean is that the incision will be on the rear side of my left thigh, 8″-10″ long, and during the procedure Dr. S. will literally remove my femur from the socket, shave down the impingements on the femur and acetabulum, repair the labrum, break the trochanter and either move or remove a part of it, remove and reattach muscles, and I don’t know what else, but not necessarily in that order. As much of an invasive procedure the PAO was, this actually sounds worse. But strangely, I am totally not concerned.

The plan is that I will meet him in 6 weeks, after my PT, to see how I’m doing. Things may change and the surgical plan is fluid but at this point, an SDD is the plan. Dr. S was great, explaining all of the reasonings for doing this procedure and showing me the x-rays and MRI scans. I was at his office for about and hour and fifteen minutes and he was in the room talking to me and my husband for the majority of the time.

After my appointment I met with a physical therapist who gave me some initial exercises to perform at home. I was shocked to be told I could be full weight bearing on my crutches (and am permitted to use only 1 crutch or a cane when at home). Some of my exercises require that I stand on only one leg – the operated leg – and I was really surprised that I was able to do all of it with no pain (although my muscles are way weak). I’ll start PT in Brooklyn next week.

Finally and un-hip related, I went and had a CT scan of my sinuses / maxillofacial bones to see if there is any reason I am permanently congested / have terrible allergies in spite of allergy shots + major pills. My ENT thinks it might have more to do with the fact that I have a very small nose and that the sinuses are so small that there’s simply no space to move around. There has been suggestion of sinus surgery to see if there is some space to be opened up. I seriously need a break from surgery, not more! We’ll see what shows up those reports.

I feel like you seriously deserve a prize if you got all the way to this point in the post. I hope my honest to goodness gratitude is prize enough, but seriously, thanks so much for reading. Onward and upward (or, actually, downward since I need to do my PT exercises before bed). G’night!

Cabin Fever!

Yep, totally starting to lose my mind. Cabin fever is taking over. I’m allowed to start putting a little weight on my leg starting tomorrow (at the 5 week mark) but it my next follow-up is not for almost 3 more weeks. So until then, I am pretty much a homebody.
Cabin Fever

I did a search for “cabin fever” photographs but kept ending up with a sorta creepy movie poster but then, after searching for “cabin thermometer” I found this rare gem.  Log cabin syrup…digital thermometer.  It is just about as absurd as staying inside, almost constantly, for 5 weeks to date.

Over lunch I made a video of my mobility skills.  Yep, almost 60 seconds of me showing off my walker and how I can stand on 1 foot and shimmey side to side.  It seemed lika a really good idea at the time but, honestly, who is the target audience for this video?  I have seriously got to get out of the house from time to time!

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