Tuesday, December 15, 2009

46 Questions and then some ......

So today was the "Big Day"..big day meaning that I was finally meeting w/ the next man who was going to cut open my hip..woohoo!
 Dr. M (I am tired of nicknames..keeping it short but sweet)

So after an hour wait in the waiting room at Children's Hospital of Boston (outpatient center) me and literally a room full of babies (so does that give me the right to act like one or is it a "suck it up..your old and can handle this situation"..not sure) I met face to face w/ Dr M..and we had a TWO HOUR conversation..I know I know..unheard of..but for reals..it happened!

Dr M..strolled into the room (first impression =kind) he then preceded to tell me he went over my MRI's from my first surgery at Children's and my X-Rays from Baptist and my notes from My visit w/ Dr Yen (2nd impression=smart, thorough, and kind DR)

Even w/out knowing about my notebook full of questions he said before you ask any questions I want to tell you what my impression of your hip is and what I see from all you test. He said I have Cam and Pincer FAI

"FAI generally occurs as two forms: Cam and Pincer.  The Cam form (Cam comes from the Dutch word meaning “cog”) describes the femoral head and neck relationship as aspherical or not perfectly round.  This loss of roundness contributes to abnormal contact between the head and socket.  The Pincer form (Pincer comes from the French word meaning “to pinch”) describes the situation where the socket or acetabulum has too much coverage of the ball or femoral head.  This over-coverage typically exists along the front-top rim of the socket (acetabulum) and results in the labral cartilage being “pinched” between the rim of the socket and the anterior femoral head-neck junction.  The Pincer form of the impingement is typically secondary to “retroversion”, a turning back of the socket, or “profunda”, a socket that is too deep.  Most of the time, the Cam and Pincer forms exist together"

He then went to draw a picture to help explain Cam and Pincer FAI...not Only is Dr M. a Dr he is a regular Picasso ;)

Surgery recommended: OPEN
Surgical dislocation of right hip
femoral head-neck ostrochrondeoplasty (totally could have spelled this word wrong)
labral debridement versus repair
possible microfracture
possible psoas lengthening

He was pretty concern about the case of extreme psoas tendinitis I have..he will not release the tendon if it still swollen and inflamed like it is currently (to deal w/ this quite painful issue= light stretching, rest, ice, anti inflammatorys  meds, and possible brace to keep it still if it doesn't get better after surgery to get that tendon pure rest so it can finally calm down.) Either my surgeries has caused this tendinitis or my messed up hip..only time will tell on that.  If my tendon calms down after my hip is fixed then it was stemming from my hip..if not than most likely it was from having arthroscopic hip surgery (possible side effect). I wasn't to happy about this info, but it is what it is, and I will have to deal w/ it either way, but he promised it would not be a life long issue..worse case scenario is a brace and crutches for it for a month to give it pure rest once my hip is healed.

So I won't write up all 46 questions..but here is a sampling for all my hip peeps,  for all the curious, and for my friends and family so they can have some of the important info....

1. How long is the average recovery for this surgery:?    6 months

2.How long is the average person on two crutches for?  minimum 6 weeks

3. Average Hospital stay?  5 days..more if I have problems, w/ pain, eating, meds, or crutches, due to stairs in my house I may be sent to a rehab place for a bit afterwards..the first 6 weeks is just resting hip totally

4. Can I get a temporary Handicap pass for my car:? Yes and I should for before surgery and for my recovery (I will work on this ..this week)

5.Will I eventually need a hip replacement even after this surgery?   possibly.. but it may buy me a lot more time

Will i have a CPM machine: Yes

"Continuous Passive Motion (CPM) is a postoperative treatment method that is designed to aid recovery after joint surgery. In most patients after extensive joint surgery, attempts at joint motion cause pain and as a result, the patient fails to move the joint. This allows the tissue around the joint to become stiff and for scar tissue to form resulting in a joint which has limited range of motion and often may take months of physical therapy to recovery that motion.
Passive range of motion means that the joint is moved without the patient's muscles being used. Continuous Passive Motion devices are machines that have been developed for patients to use after surgery."

6. Will I need to have the 3 screws put into my hip during this surgery removed from my hip eventually?   possibly..only if they cause me pain..if I do have them remove it is day surgery

7.What risk do I have from this surgery? AVN....but very rare for this to happen

8. What's going on w/ my left hip? It also has FAI but my right hip is a lot worse..most likely will need to fix my left hip..but since I have had no surgery on it it most likely can be done arthroscopically...after my right hip is all better... (ugh)

9. Will I be having a Cat Scan? will be done before surgery..he uses them for surgery 

10. What should I be doing for meds? Advised that I should take my prescibed Vicodin for pain and to try alleve or motrin (if my stomach can handle it..usually it does not) during the day to help w/ the inflammation.  I will be taking blood thinner injections for 4 weeks post surgery to prevent blood clots (not sure what med that is....and will I be injecting this myself..hmmm..I guess I got to email him that ?..I guess this post is now 47 questions..;)