Surgery Day... .again! March 16, 2009

Well like any other day I started out by waking up ,but this day was a little different than the norm..NO FOOD OR WATER till surgery..ugh! Well surgery is called for 6pm and I have to be at the hospital by 4pm..I can do this. Seriously by 10am I was already dying of thirst..I think it goes back to the old saying..you want what you can't have..man was I thirsty. Lucky for me I had a good book , and family and friends to distract me from thirst and nerves.


4pm: Arrive at hospital..pretty much all I am thinking about is how thirsty I am..and ironically enough my wheelchair gets parked in front of a water cooler and coffee station..seriously so not funny..I was ready to take somebody out for a cup of water if I wasn't in a wheelchair and dying of thirst ;)


4:30ish..get taken in to pre-op..get an IV put in..not as good as a cup of water but dehydration is calming down..seriously can't I get an ice cube at least.


5pm- meet w/ the Anesthesiologist I let him know my concerns w/ my lungs from my last surgery..they take extra precautions by giving me a nebulizer treatment just to make sure my lungs are nice and clear..already feeling more confident w/ this hospital and the Dr's.


6pm- No Dr



7pm-No Dr


8pm- Dr Fabulous arrives (ok I am not thinking he is so fabulous at the moment probably due to the fact I am dying of thirst and starvation..ok just had to vent that one more time)

Dr. Fabulous apologizes for being late, and lets me ask my questions that I wrote down ( another sign of a great Dr. is one who lets you ask all your questions, listens, and gives you answers..Dr. fabulous did all that) It is very important to write down any questions or concerns you may have for your surgeon before surgery ,because between the nerves and the starvation component you most likely will not remember what the questions you had are. Anesthesiologist comes back in and says he is giving me something to make me feel more relaxed..1 min later...very relaxed.....alright lets rock!


I think the most nerve racking part of surgery is the time they take you from pre-op to the O.R..man that ride in is very surreal..the drugs probably make it more surreal, but I say that is the scariest part for me personally.


11pm-Wake up in recovery and literally the first thing I think is "where am I" 2nd thing is "Can I please have a glass of water". Nurse comes over tells me where I am and denys my water request for now (damn..seriously does anyone understand how thirsty I am). I tried to find out what happened during my surgery the nurse told me that the Dr Fabulous told my mom so I will find out later.


Somewhere around 12:30/1am I get brought to my room...nurse comes in does new patient intake, stats, gives me my pain meds (your choice this evening is either morphine or Dilloted..you decide), explains the run down of the hospital and then finally gets me a glass of water....I have never enjoyed a glass of water so much!

It was a long night in the hospital..anesthesia difficulty again..not as bad as last time but still not pleasant and somewhat scary....every time I started to fall sleep my oxygen level decreased and a loud buzzer/alarm went off (lucky I had nice roommates)..respiratory team had to come in gave me a little machine to keep blowing in to keep my lungs strong and inflated so there was NO sleep at all for me that night..I did however drink about 13 glasses of water.

Thank you Dad, Mom, N , and all my friends and family who called and sent me well wishes. You all helped me out with your support and keeping my nerves calm prior to surgery! XO

**Ironically enough the one thing that didn't bother me that night was my hip ;)

pics of me in Hospital day 3..glasses courtesy of my friend christopher.

Last Hurrah..Pre-Surgery

March 7th, 2009
Well I had been trapped on bed rest for 2 weeks so I decided that before I go off to surgery I needed a night out w/ my friends to take my mind off my hip and get out of the house for a bit.

I am not a big fan of going out on crutches..people constantly staring at you trying to figure out what is wrong, HEAVY DOORS, long distances walking can be hard on your hip and arms, but I decided I would not worry about all that and just enjoy being out of the house. I went out to the Beehive in Boston (great place highly recommend it especially for someone on crutches.) Even though we had reservations there was about a 20 minute wait so the manager got me a chair to be comfortable and then when our table was ready they gave me my own bodyguard who escorted me to to the private elevator out back and took me downstairs to our table. As we were walking to the table he pretty much made everyone get out of my way..seriously I kind of felt like a Rockstar..ok so maybe going out on crutches really isn't that bad ;) My bodyguard even offered to pick me up and carry me to the table, but I didn't think that was a good plan, but I appreciated the offer. After dinner when we were ready to go my bodyguard came back and made sure I was returned safely back to the front door..I really got the royal treatment. Thank you to the Beehive and my bodyguard..you guys rock!

Ps. On a side note it is interesting that when you are on crutches how many people come up to you wanting to share their stories about their injuries, or the time they spent on crutches..it's like mini support groups..I think everyone just likes to be heard and let you know that they have been there to..so they understand...which is nice.

P.P.S. Even though you might be in a lot of pain it is good to make yourself do things to take your mind off of it ..Thank you so much to my friends for making me go out that night...love you guys..xox

Feb 17th 2009-/aka OMG is this seriously happening again

Backtrack for a moment..was having more pain than usual in my hip for a few weeks decided to get a cortisone injection on Feb 11th.

Feb 17th
Started off like a regular day..went to work..busy busy busy..hip still feeling a twinge weird since cortisone injection but kept on working..about 1/2 way through the day I started limping which hasn't happened since before my first surgery..I chalked it up to my cortisone injection irritating my hip and tried to do the best I could at work. Getting close to the end of the work day I took a break to sit down when I went to get up from my chair I felt a horrific pain..one that brought me to tears (at work you can catch me laughing or smiling but never crying..but it hurt that bad) I couldn't put any weight on it and not only was I in A LOT of pain I pretty much new what was happening..I have felt this before and i new my hip just had it..so much for the conservative methods of treatment (hey I gave it my best shot) I called Dr. Fabulous and he got me in at 8am the next morning.

Dr. Fabulous told me that my hip had so much swelling that they had to put me on predisone and that they couldn't do the MRI arthrogram until swelling was better..so it was crutches, meds, ice, and bedrest for a week. Got the Arthrogram done ..again ( this time took pain meds before test and it went much better..less pain during test and actually fell asleep during the MRI part..it only took 3 times to learn that trick) Surgery was booked for March 16th..Dr. Fabulous was going on vacation and was very booked up ,but because he is so fabulous he squeezed me into his schedule on his off night of surgery and the day before his vacation since my pain was so bad , see I told you he was fabulous ;)

2007/ 2008 A Years Journey of Recovery, Pain, Questions, and Answers

Since I started this blog 2 years after I first injured myself it is hard to go back in time (well unless you are on the show LOST..cause they make it seem quite easy..(lost reference/fave TV show..had to do it. ;) Since this all started two years ago and I am just writing it now I honestly don't remember all the details..this is more of a "brief" description of my post surgery year to my current situation.

My recovery from my first surgery was a long process..3 months on crutches..1 month on a cane, and a hell of a lot of pain was only part of it. There is was also the situation of HAVING to be dependent for the first time in my adult life on others.. not being able to drive for 4 months (damn right hip..if it was my left hip the driving wouldn't have been an issue), being on crutches makes simple chores difficult like cooking and bringing a glass of water to your room, with both hands being occupied you need to get creative with sweatshirts that have pockets, kitchen aprons w/ pockets, having tables close together to move things around a room. Stairs are a nightmare as well as heavy doors (heavy doors are everywhere, restrooms, entrances to stores and restaurants..I never realized the difficulty of heavy doors until I was on crutches) I vowed to start a ban on heavy doors once I was off crutches..but I never did get around to that..and now I am on crutches again and I am dealing w/ heavy doors once again(I really should have worked on that ban). If I didn't have amazing friends and family I would have had a lot tougher time and I can never truly express the thanks to all the amazing people in my life who have helped me through all of this (If you are one of those people reading this..and you know who you are..THANK YOU WITH ALL MY HEART XOXO)

The other issue I had to deal w/ after surgery was the chronic pain. The pain never totally went away after my hip surgery which was the most frustrating component of the whole situation. Chronic pain messes w/ your head like nothing else I have experienced. When you are in pain constantly it is hard to not get depressed or to function normally. I believe partially due to the fault of my Dr and partially due to the fault of myself I had unrealistic expectations from my surgery. I really felt that I was somewhat led to believe that after surgery I would be back to myself and my hip would be like it was before I was injured. After 3 months on crutches and still a great deal of pain and not being able to be the active woman I was prior to my injury those expectations were crushed for me which made the experience almost harder to deal with. I learned from that moment you need to hope for the best but don't expect it will be that way. The human body is extremely complicated and you don't know how each individual body will recover from surgery. After my second surgery my mindset is now to deal w/ my hip and the pain on a day by day basis, and not to think so far ahead into the future and final outcome.

With all that said ..after being off of crutches and getting back to being the independent woman I was, the pain never fully went away. I did physical therapy for a long time but my body wasn't letting me work out the way I could before surgery which was beyond frustrating to me because I loved working out and it was a huge stress relief to me and not being able to do what I could before was heartbreaking and frustrating to me in many ways. Even silly things like wearing heals (and I love wearing heals) I couldn't do until almost a year after surgery. I also had nerve damage in my foot due to the traction table from surgery (if you have this surgery please ask your Dr to wrap your foot as much as possible so that the chance of damage to it can be reduced..I made sure my Dr triple wrapped my foot before my second surgery.)

Since I never fully recovered from the pain I knew there was something still not right..My Boston Dr said my pain switch just didn't shut off. The thing is that I am with my body 24/7 and I know when something isn't right w/ it and I knew it was more than turning off a pain switch. Dr's are great and helpful and I do place a certain amount of trust onto them but they are also human too, and are not always right. I have always went w/ my gut instinct and my gut (and my hip) was telling me that my Dr was not right in this case ,so I went for a second opinion.

After researching Ortho Dr's by asking around and searching online I made an apt to see my now current ortho Dr. I was so nervous about getting a 2nd opinion..feeling that Dr would think I was doubting the diagnosis of the first Dr and side w/ him. I don't know why Dr's intimidate me..they just do..so I was scared he would be protecting the first Dr's diagnosis instead of listening to me( who am I..just a patient..doubting a Dr.) But my new Dr. was FABULOUS...not only was he nice and had a great bedside manner (quite the opposite of Boston Dr) he told me that he was glad I took it upon myself to get a 2nd opinion and that another set of eyes looking at a situation is always a smart thing to do especially when something doesn't feel quite right. So Dr. Fabulous asked me if Boston Dr did another Arthrogram MRI on me after I was still complaining of pain..I said No..so he set up an apt to repeat my arthrogram MRI (wasn't thrilled to go through that procedure again but this time I knew what to expect and I was at the point that I would do anything to make the pain go away).

The results of the Arthrogram MRI was that I had another tear in my labrum..Dr Fabulous suggested that I should have the surgery again. I honestly was floored , I was happy to know where my pain was stemming from but I couldn't believe that I would have to go through all this again especially since the results of the first surgery were not very good. I decided to get a third opinion at this point because I was not ready to rush into surgery, so I set up an apt w/ one of the top Dr.'s at Baptist Hospital in Boston brought all my information (I have a Hip book w/ all my test results,surgery notes, pt notes, and a timeline of my hip situation,etc...very helpful to have if your are dealing w/ an ongoing health problem and dr's appreciate the info..it helps them to help you) The Baptist Dr did his own testing and xrays and agreed w/ Dr. Fabulous that surgery was the right option for me.

I went back to Dr. Fabulous and I asked him what conservative measures we could do ,because I just wasn't ready to do surgery again and since I could still function in my day to day life, and I didn't have any signs of an infection in my hip,I didn't feel I wanted to mess w/ my body if I could hold off. We decided together that we would do cortisone injections to see if that would help w/ my pain as well as more PT sessions to help strengthen my body around my hip to see if that would help. I decided that was the course of action I felt comfortable w/ and that is what I did from Nov 12th 2008- Feb 17th 2009. I also did massage therapy for my hip and psoas tendon to help w/ pain. I spent a lot of time researching hips on the web as well as read blogs of other people who were going through similar things (thanks so much Susie:) ) and educate myself as much on possible about hips and hip problems so I could understand better what was going on in my body and how to deal w/ it as well as be an informed patient when I went to my apts w/ Dr. Fabulous.

First Surgery and Recovery May 1, 2007

May 1, 2007: Surgery

1. Debridement of Labral Tear

**2. Microfracture of Acetabulum

3.Excision of Loose Bodies:

" Health cartilage has a smooth, billiard ball-like surface. As degenerative
arthritis progresses, turning that smooth surface into a cracking surface, some
of the cracks break off and float unattached in the joint. Those fragments are
called loose bodies; they can become an annoyance that leads to trouble" from
Cedars Sinai website

4. Synovectomy:

" When the synovial lining of the hip joint is so inflamed it causes disabling
pain, it may have to be removed" From Cedars Sinai website

When I woke up from surgery I really had no idea what was going on..all I saw was a long blue tube across my body..that freaked me out a little..then again I was wacked out on meds from surgery so it was a little easier to get freaked..ended up being an ice machine for my hip..totally rad invention..keeps hip constantly cool..and the one thing I have learned from all of this hip pain is...ICE IS NICE! Between the anesthesia and morphine I didn't feel a lot of pain but then a complication happened due to the the anesthesia (sticky lung) and than all hell broke loose with the end result being a 3 day stay in the hospital...so much for day surgery.

Here is the timeline after my hospital stay to get me off of crutches and walking again..it was one long summer.......

May 1st-May 3rd: Stay in Hospital due to lung collapse from anesthesia.

May 4th-May 14th- Bed Rest at Home/ Crutches no weight bearing

May 14th- 2 week check up w/ Boston doc

May 16th- Start PT

May 29th- Start Partial weight bearing on crutches at PT

July 2nd- Started using One Crutch today at PT

July 10th- Start Using Cane..done w/ crutches..yay!!!!!!!!!!!!!!!!!!!! (see picture above first real walk w/out crutches)

July 3oth- Apt w/ Boston Doc..decide to do injections for Iliopsoas Tendinitis (My tendon started acting up post surgery never had problems w/ it before my surgery)

August 7th- Injections w/ Boston Doc @ Hospital: Right Hip Arthrogram w/ Iliopsoas and Rectus Sheath Injection…IV Sedation.This injection did help alot with the sore and tight psoas tendon. I am glad I did it. I got about 3 months of pain relief from it.

August 7th- 11th: Stay at home and Rest

Aug 13th- follow up apt w/ Boston Doc

Sept 3rd- First Time Driving since Surgery..it was like I was 16 all over again..man it was a long time w/ out driving ...but I was now officially crutches and cane free after 4 months..A LOT longer than originally estimated by my boston doc. I learned at that point never to count completely on dr's estimation for recovery time.

**From the Wake Forest University Baptist Medical Center website:
Microfracture
What Is It?
"The body has many moving joints such as
the shoulder, hip, and knee. These moving joints are called “synovial joints”.
Synovial joints are able to move freely because of the cartilage covering across
the two bones that make up the joint. This cartilage covering is referred to as
“articular cartilage”. Injury to articular cartilage is called “chondromalacia”.
The most significant type of chondromalacia occurs when the articular surface is
damaged to the underlying bone.
When the articular surface cartilage of a
joint is damaged down to bone, one may consider treatments to regenerate the
injured joint surface. One such option is the microfracture procedure where
the damaged joint surface is surgically stimulated to release local stem cells
which fill-in the cartilage defect with a type of “clot”. Through post-operative
rehabilitation, the goal is to encourage the clot of cells to transition into a
cartilage-like substance called “fibrocartilage”. While not as durable as one’s
original joint cartilage, it functions as a reasonable substitute."

The lead up to find the right diagnosis/aka finding the right Dr and right diagnosis is harder than you might think!

It took a few months to get the correct diagnosis. While I was searching for what was wrong w/ me I went to a few Dr's, did a round of physical therapy, and a cortisone injection, while I limped around in pain. I am lucky it took me only 3 months to find a dr who new what to look for but through my many searches online about hips I have read hundreds of stories of people running around for years in pain til they got the right diagnosis so I actually consider myself one of the lucky ones..so here is my time line of misdiagnosis until I found the correct answer...

Jan 5th 2007: First Apt w/ recommend Orthopedic Dr. recommended by Primary Care Dr.

Jan 6th-12th- on bed rest for leg, per order by Dr. for groin/muscle strain..use crutches

Jan 12th- Follow -up apt w/ Dr

Jan 15th- Start PT (twice a week)..assigns pt for pain and strengthening..still using crutches

Jan 19th- Apt w/ Dr..decides to get MRI of Hip/Groin area

Jan 23rd- Get MRI

Jan 24th: Get also sent for a Cat Scan

Jan 25th Apt w/ Dr. …said MRI was ok (never saw report) gave me cortisone injection in groin area in his office to see if that helped the pain (it did for a week or so) the dr so nicely said to me before he jammed the needle into my groin area (w/ out really giving me a chance to make a decision if this was the right thing to do since I never had a cortisone injection before) " This will either help your pain or show us that you don't have any pain at all" just love a good bed side manner.

Feb 07: PT twice a week all month

AT THIS POINT PAIN WAS GETTING WORSE AND WORSE AND I FELT DEEPLY WITHIN MYSELF THAT THERE WAS SOMETHING MORE GOING ON THAN JUST A MUSCLE STRAIN TO PUT ME IN THIS MUCH PAIN...USUALLY I GO W/ WHAT MY DR SAYS BUT I STRONGLY FELT SOMETHING WASN'T RIGHT SO I DECIDED TO TAKE MATTERS IN MY OWN HANDS..DID SOME RESEARCH ON ORTHOPEDIC DRS AND GOT MYSELF A SECOND OPINION W/ A DR IN BOSTON

March 5th: First Apt W/ Boston Dr. wanted 2nd opinion due to pain and I was unsatisfied w/ other dr. because I was not getting better. This was the first time I heard that there could be something wrong w/ my hip..honestly I didn't think I could injure my hip at 32 unless I had a traumatic accident so I was a little taken aback. Boston Doc felt I tore my Labrum in my hip and the only way to figure out if that is correct was by getting a arthrogram MRI:

From WEB MD. COM: "An arthrogram is a test using X-rays to obtain a series of
pictures of a joint after a contrast material
(such as a dye, water, air, or a combination of these) has been injected into
the joint. This allows your doctor to see the soft tissue structures of your
joint, such as tendons, ligaments, muscles, cartilage, and your
joint capsule. These structures are not seen on a plain X-ray without contrast
material. A special type of X-ray, called fluoroscopy, is used to
take pictures of the joint.
An arthrogram is used to check a joint to find
out what is causing your symptoms or problem with your joint. An arthrogram may
be more useful than a regular X-ray because it shows the surface of soft tissues
lining the joint as well as the joint bones. A regular X-ray only shows the
bones of the joint. This test can be done on your hip, knee, ankle, shoulder,
elbow, wrist, or jaw (temporomandibular joint).
Other tests, such as magnetic
resonance imaging (MRI) and computed tomography
(CT), give different information about a joint. They may be used with an
arthrogram or when an arthrogram does not give a clear picture of the joint."

March 14th: Mri arthrogram ...OUCH! Uncomfortable procedure and the next day you will feel the pain but worth it for the fact that you will get a diagnosis from this form of MRI if you are having a hip problem.

March:26th: Apt w/ Boston Doc .....tells me I need hip surgery ASAP!

3 months from first pain I found out that I had a large tear of my labrum in my right hip w/ loose bodies floating around. I was scared about having to have surgery, but was relieved to finally have a correct diagnosis. I was though also upset that my other ortho dr as well as the emergency room dr. never once thought it was my hip or even did this form of testing to make sure they had a clear picture of what was going on w/ me. The physical therapy my first ortho dr had me do actually made my hip worse..this is when I realized I have to trust my own instincts and know that sometimes dr's are not always right. You do know your own body best...trust in that!

Definition of the hip labral tear :By Mayo Clinic
staff

"A hip labral tear involves the ring of soft tissue that
follows the outside rim of the socket of your hip joint. This ridge of
cartilage, called a labrum, works a little like a suction cup to help hold your
hip joint together. "

and it all began...2006

December 23rd 2006. It started like any other day for me ,had a training session w/ my trainer at the gym at 11:30 and as always I was totally pumped for a good workout. I remember walking into the gym that day thinking that I felt like I was in the best shape of my life and I was hitting the goals I wanted for myself physically.

The first half of the session went smoothly..a good sweat..pushing myself a little further.....and then came the squats. At first I started feeling a twinge of pain in my top half of my right leg but in my mind I kept telling myself push through it, it must mean that my muscle was a little weak and I wasn't going to give into it. It got to be about the 12th squat and my leg was actually starting to shake uncontrollably at that point I couldn't ignore it so I decided to take a break and walk it off. I continued the work out in pain..but in my head I kept saying no pain no gain..plus I had always seem to get pains in that upper right side when I had a really hard work out so in my mind that is what it took to strengthen that particular muscle group..I felt it was my weak spot.

Unfortunately the pain continued to get worse as the day went on..I tried ice..lots of stretching, rest but it seem to get worse and the pain in my upper right thigh was spreading into my groin area and down my right leg to the point that I was limping. I believed I must have pulled a muscle so i decided to take a break from the gym for a few days..plus it was the holiday time of year so I tried to focus on that and forget about the pain that was radiating down my leg.

I made it till Jan 2nd and woke up that morning in the worst pain of my life..it literally felt like someone was cutting the circulation off from my leg and the pain was so bad in the right side of my groin area I decided I had to go to the emergency room to check it out..after hours of waiting, pain med injections, and Mri's I was told that I had a muscle pull/groin pull and that I should stay off my leg for a few weeks and make an apt to follow up w/ an orthopedic Dr, use crutches for 2 weeks to stay off my leg, no working out, and no driving, I was so upset but happy that nothing major was wrong.......or so I thought.