Category Archives: Nonunion

1 Year post-PAO

1 year ago at this hour I was in the PACU (Hospital for Special Surgery’s post-surgical ICU), newly broken hip held together with screws, drugged to the nines and unable to move my right foot (because, as we later learned, the epidural was in a bit too deep). I was just at the beginning of this latest stage in my hip journey. I was hopeful that my right hip would be in pretty good shape by this past May and had not even started to realize how hard my recovery would be.

There’s no new news today but I felt that this is a day I needed to acknowledge, like a birthday for my sorta-new right hip. In less than 3 weeks the 5 screws will be gone – they will be removed along with the 3 screws in my left femur (the remnants of my May surgery). My right hip scar is healed to the point that it’s hard to see, in some places, where the incision was. That will all be reopened soon enough but for now, it seems like such a long time since I really even thought about it.

People ask me if my right hip feels better than before the surgery. The thing is I think it does but I don’t really know. Before the surgery I had pain when I would do certain strenuous activities. Now, I have some level of pain anytime I’m not sitting or lying flat on my back. I don’t do strenuous activities because the pain makes it impossible. I feel confident that once the screws are out and the soft tissue stops getting rubbed the wrong way I will be able to give a better ‘status report’. Like the one year ago version of me I am hopeful.

Before my surgery I had posted a very personal message to those of you who have followed my surgeries and recoveries. I promised to update my site and all of you, to push myself out of my shell and write even when I wanted to hide. And I asked you to stick by me so that I would not have to go through this alone. Please know how incredibly thankful I am for all of you.  It has been a rough year and I cannot thank you enough for sticking by me, and continuing to do so.  I have also been happy to learn that my site has been a resource for other ‘hipsters,’ with over 12,000 views from people in 65 countries.  I am certainly not alone.

As an aside, some holiday carolers we’re wandering down my Brooklyn street and for the first time this year, it felt a little bit like Christmas. Since I likely won’t post again until closer to the New Year and my next surgery, let me wish you all a lovely and joyful holiday season full of love, happiness, and a whole lot of hope.

Lurching Into Month 2

Today is my one-month anniversary of my left hip SDD surgery. Although I’ve been reluctant to give an update since not much has been going on, I thought that the anniversary warranted a new post.

The first month of this recovery was easier in general than the first month following my PAO. I have been able to sit in a restaurant chair, go to the movies, work on my computer, ride in a car, and generally move myself. My scar looks good, though a bit lumpy – I will try to get a photo soon although it’s placement makes photo taking quite difficult. AbductionThat said, it’s not exactly cotton candy and unicorns. I cannot abduct my left leg AT ALL (see drawing) since even the most minor movement causes a pain that takes my breath away. My pain tends to center around the greater trochanter (the part of my femur [leg bone] that was broken and screwed back together), in my glute muscles, and in the joint where the surgeon repaired the labrum. The inflammation is still pretty bad, even a month out. I have discomfort in my hips legs and knees when lying on my right side and cannot lie on my left at all. I can’t bend over, or sit at a 90 degree angle, or put 50% of my weight on my left side, or cross my legs. I’m tired all the time and I absolutely cannot walk (crutches being my main form of transport).

Lurch Instead, I sort-of lurch around the apartment, hobbling and trying to keep my left leg facing straight ahead. Not an attractive look I can assure you. My physical therapy has consisted mostly of leg extensions, stretches, foot flexes and the like. Something about the pain makes me feel like the more intense PT (that I will likely do at HSS) is going to be a lot more difficult and time consuming on this left side. I’ll have a better idea at my 6 week follow-up in a week and a half.

I’ve been using my bone growth stimulator 24/7 — in the day time it’s attached to electrodes on my right hip, at night to my left. Bone Growth StimulatorIt doesn’t feel like anything is happening, no buzzing or vibrations as I had anticipated; however, it looks like I am permanently wearing an AM/FM radio clipped to my waistband (see photo). Hopefully it is working — I’ll know more at my next appointment.

I continue to use Access-A-Ride (the MTA’s paratransport system for individuals with disabilities) to get to my appointments. I can’t say enough positive things about the program – it is truly a life saver and saves me from having to take a cab every-time I need to leave the house.

In other news, I have been busily working from home (full time for a few weeks) and I started back at law school where I am taking two summer courses (one of which is almost entirely online — an incredible boon with my limited mobility). There is even a chance that I will be able to participate in graduation ceremonies in May 2014 (!!!). I’ve been in school for so long that the idea that I could eventually be done at some point literally never crossed my mind. I have to admit — I’m really excited!

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My next appointment with my surgeon, my 6 week follow-up, is scheduled for a week from next Monday. Until then, I lurch along.

The Final Countdown

With approximately 36 hours until I have to be at Hospital for Special Surgery, I am truly in the final stretch leading up to my Open SDD surgery. I will receive final confirmation tomorrow on the time but am anticipating that the surgery will be at 2pm on Wednesday the 8th and I should be in until at the earliest the 10th and more likely the 11th.

I met with my surgeon today to discuss the results of last week’s MRI exam. As I had previously been told, I have tendonitis in my iliopsoas and abductor muscles/tendons and it’s likely a labral tear in my right side. I might eventually need an arthroscopic procedure on my right side to fix the labrum / shave down some more bone if the pain persists at 9-12 months post-op, but again, that’s all hypothetical and not the main attraction of this week.

Ideally, I would be pain free and fully healed before moving onto the left. Honestly, if time were not an issue, I might consider waiting to move forward with the SDD surgery (as was encouraged by my surgeon and his PA to consider doing). As my surgeon pointed out, at less than 5 months following my PAO my right hip is still in pain and although the pubis bone appears to actually be growing together (YEA!!), it’s not fused. While it is safe to do the left side and while it’s not clear what impact the left surgery will have on my right hip (good, bad, or indifferent), waiting would be the ideal course of action.

However, time is an issue because I have to get back to law school (I took the spring semester off expressly to focus on healing). As it stands, I am hopeful (though not totally confident) to be back for the fall semester, though only time — and my healing — will tell. I also believe (and my surgeon thinks it is possible) that my right hip will benefit from all of the rest I will get from sitting on my butt for 8+ weeks. In any event, I am in pain and my mobility is dramatically reduced so it doesn’t make much sense to wait.

One cool thing that did happen at today’s appointment is that my Dr. helped to set me up with a bone growth stimulator! It’s kinda crazy because it’s a little machine about 2/3 the size of an iPhone that you can clip onto your clothes, and that connects through two wires to electrodes that are stuck on either side of my (slowly healing) pubis bone. I wear it 24 hours/day, every day (except while i’m in the hospital), and the wires (though not the machine) stay on even when I take a shower. It feels like NOTHING — no buzzing, no electrical stim feeling. I have basically no idea what it’s doing but I really hope it works.

So that’s it until the big day. Tomorrow will be filled with a liquid diet and final preparations. I’m pleased to report that I am not a bit nervous (a pleasant surprise). I’ll be sure to update from the hospital as much as I can — as always, wish me luck!

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

Living Life on Hold

I am very pleased to report that sinus surgery this past Thursday seems to have been a success. At the very least, I haven’t had any significant pain or discomfort following the surgery and I was able to work from home the day after the procedure. The nasal stints are scheduled to be removed tomorrow – those puppies are BIG!  I feel sorta stuffed up and sleepy but apparently it’s normal and resolves itself within a few days. I can’t do any lifting or bending for the time being but should be 100% within a few weeks. Yea!

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I’ve been thinking more about the nonunion of my pubis bone and the pain in my hip and front of my right leg that seems not to be getting any better, even though I can walk. As  I understand, nonunion is normally asymptomatic but in my case, it may be causing the pain and may be the reason my recovery is stalling (even though I am able to walk). I learned from other ‘hip women’ that I could request copies of my x-rays from the hospital, which I did. I figured I’d post the x-ray of the nonunion so that everyone can understand what I’m talking about.  For perspective, imagine that the camera is facing me and I am turned 90 degrees to the left.  My left leg is placed facing forward, in front my body, and my right leg is turned out 90 degrees and placed back and to the right.  That’s why it looks like my pelvis is torqued.

I’ve also learned that as part of my May Open SDD surgery on my left hip (which is 6 weeks and 2 days away and which will require more recovery time than my PAO), the surgeon breaks off a small portion of the greater trochanter bone from the femur to gain access to the joint and later reattaches that section of bone at the end of the procedure with two or three screws. Sometimes (I’ve heard up to 40% of the time) the screw heads catch on muscles or tendons in the leg and the screws have to be removed in yet another surgery.

So, if you’re counting, which I am, I had a right hip scope surgery (January 2012); right PAO (December 2012); sinus surgery (March 2013); and will have Open SDD on the left side (May 2013). Add to that the possibility of a surgery to fix the nonunion of the right side AND, if I’m lucky (said sarcastically), screw removal. Between all these surgeries, there is recovery and pain and holding patterns. I know that I can’t expect to have all the answers but COME ON!!! I just want to take my life off hold and start living again! Ride my bike, take a walk, NOT watch TV like an obsessive, go back to school, lose some of the weight I have gained from sitting around all the time.  I have tripped down the rabbit hole and I would like to find a way to climb back out.

I don’t wanna be whiny but man, it’s spring, almost April, the days are getting longer and soon the weather’s gonna be nice.  Let’s get this show on the road!

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.