Monday, September 30, 2013

Consultation with Dr. Buly at HSS

Its been a while again since I have updated my blog because I was waiting until after my appointment at HSS with Dr. Buly which was a week ago today.  I consulted with Dr. Buly originally for my femoral anteversion which was found on my pre-op MRI in Dec. of last year.  I was told that it may or may not cause continued issues, that only time would tell.  Well, before I had surgery in Jan. I told myself that I would not wait longer than 6 months to get this checked out.  Dr. Philippons team wanted me to wait a year before consulting with someone, but I had already waiting long enough for answers, I was unwilling to accept waiting any longer than 6 months from surgery.  So when I was still in some pain in August, I booked an appointment with Dr. Buly.

The few weeks leading up to my appointment with Dr. Buly I was not in a lot of pain and even contemplated cancelling, but I didn't as my mom had already set up time to come with me, etc. so I kept my appointment.  My mom and I decided to drive out to NY seeing at plane tickets were almost $500 per person.  Add that too a cost of cab fares and hotels and for a 2 night stay in NY city it would have cost about $2,000.  So driving and staying north of the city at a campground was the cheapest.  It was a beautiful drive out to NY and the campground that we stayed at was perfect.  Since we are not city people, it was nice to be able to leave the city after a busy and exhausting day at the hospital.  So we left Traverse City (where my parents live) and drove out to NY on a Sunday as my appointment was on Monday.  It was a beautiful drive and PA is so pretty!  We got to NY around 6PM and had just enough daylight to set up the tent and then fall asleep.

We left for the city pretty early the next morning even though my appointment was not until the afternoon so that we could look around the city a little.  So driving into the city was not nearly as bad as I thought that it was going to be and we got lucky because the president was at the UN, only about 10 blocks away, but FDR drive was not shut down, so we were not effected at all.  We got a little lost coming into the city, but the GPS put us back on track and we got to the hospital without a problem.  After parking we walked around a little through some of the neighborhoods and saw a cool collection of Buddist art at Sotheby's, even though scary looking men in suites follow you around.

After looking around for a bit, my hips were getting tired so we ended up back at the hospital early so I just got checked into x-ray and had those done as well as my CT scan.  After that we went to Dr. Buly's office to wait for my appointment.  Dr. Buly and his assistant Elaine are so nice and personable, it was unreal.  There were no fellows, or nurses, or other staff, it was just Dr. Buly and Elaine, it was so nice to spend so much time with the actual surgeon!  Dr. Buly, after looking at my x-ray and CT images, recommended a PAO (periacetabular osteotomy) and an FO (femoral osteotomy).  I was really shocked by this recommendation because never before had hip dysplasia been mentioned to me, which is usually what PAO are used to fix.  But I guess after all these surgeries, the rim trimmings done had actually made my hip slightly dysplasic, which when combined with my femoral anteversion means that there is not enough acetabulum to cover the top of the femur head.  Dr. Buly then called his colleague, Dr. Helfet, into the exam room so that he could look at my images and examine me to get his opinion.  He agreed that a combination PAO and FO would be the best course of action.  Dr. Buly also wanted me to consult with Dr. Sink to get his opinion about the PAO.  So we stayed in NY an extra day so that we could see Dr. Sink on Tuesday.  Dr. Sink basically agreed with Dr. Buly and Dr. Helfet.

Today I got the results of my MRI and CT scan as well, which shows excessive femoral anteversion on both the left and the right, as well as excessive tibial torsion externally.  The combination of these is known as miserable malalignment syndrome.  I also have a labral tear and FAI in my left hip with will have to be taken care of at some point.  My MRI showed a lot of cartilage wear and tear on the front of both hips, although the right hip is so much worse.  I was told that if I do not go through with surgery for the PAO and FO I will most likely be looking at a total hip replacement in 5 years.

So, now that this post is getting really long, I am now in the process of booking my first surgery with Dr. Buly for the PAO and FO.  I am really just super disappointed and scared.  3 years ago when I had my first scope, this was never suppose to be an issue, but here we are, staring down the barrel of at least 3 more surgeries to fix all of these issues.  I am still in shock I think, but time will help me get over it I am sure.  Anyways, no good news this time, but I will keep everyone updated as surgery gets closer!

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