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!

So, its been a while...

So, its been a long time since I have updated my blog just because this recovery has been so emotional and physically hard that one day I was feeling great and the next day I could barley move, nothing seemed consistent from one day to the next, which makes it a little hard to tell others how you are doing.

Since my last post my recovery had seemed to progress well, although slowly, with often setbacks.  But, by the end of May I was doing some light jogging.  In fact, the last week of May I was able to jog 3 days in one week and it felt amazing.  I had stopped physical therapy about 2 weeks before this, although I was still doing exercises at home.  I would still get occasional pain just above my groin while lowering myself down stairs or something similar, but overall, I was feeling pretty great.

Then...I had some family things to take care of which sent me home for a week in the beginning of June.  Its an 8 hour drive to my parents house and then another 4 hours to see other family in another part of the state.  I was home for a week before coming back to my house (another 12 hour drive).  I was only home a week when my grandmother passed away so back home I went (another 2 12+ hour drives).  By the time I came back home at the end of June, my hip had suffered some pretty significant set backs, I was in daily pain again.  I figured it was a short term flare up and did not think much of it, but after 2 weeks the pain was only getting worse.  I was taking 2 summer classes at Michigan Tech so I was sitting for 3 hours a day plus trying to work at my old job at the law office a few times a week.  The combination of a lot of driving plus sitting at work and school was causing things to only get worse.  I was getting a lot of groin pain, pain in the front of my hip, and knee pain.  After a few more weeks of this, I became concerned and contacted the surgeon in Colorado again.  While waiting to hear from his team I decided that it would be best to get an opinion on the femoral anteversion issue.  I called a surgeon that was recommended to me that's based in New York and scheduled an appointment for the end of September.  Dr. Philippon does not deal with femoral anteversion so he cannot really tell me much more about it other than I have it and it might effect the outcome of this surgery.  I feel like until I get an opinion from a doctor that does these kinds of surgeries I will never know if this pain is caused by the anteversion or if its just a part of this healing process.  Its been about 2 months of constant pain so far though, so I don't feel like I am making any rash decisions, even though I am tired of all this hip stuff.

So that's the update for now.  I currently have two weeks off from classes before I start taking some more classes this fall.  The break has been nice for my hip.  I am still trying to get on the bike a few times a week as well as doing some stretching that was given to me by Dr. P.  So far, the groin pain has calmed some, but the pain in the front of my hip and in the knee is still bad most days preventing me from being on my feet for any length of time.  Hopefully I can get some more answers from this surgeon in New York.

For anyone else out there suffering, I hope that you too get answers soon and that everyone has pain free days ahead!

WOW...3 months (or 12 weeks) out from surgery

So today is 3 months out from surgery and I am getting better and better each day it seems like.  Today I went to the gym and did 15 minutes on the elliptical, as well as the lunges on the treadmill and other PT exercises with minimal pain afterwards, just a little ache.  I am getting so antsy to get outside and do some yard work and walking, but alas, the weather here has not cooperated yet.  Yesterday we got about 5 inches of snow again.  Luckily its melting pretty fast by the next day but it certainly makes for sloppy, wet ground, not ideal for walking on with a newly operated hip.  So I am trying to be patient, planning a garden and such instead.

This last week has been pretty uneventful, the hip has felt good and my stomach seems to have settled down which is a huge relief as it was really getting in the way of me attending PT. Well, not much to report on this week, I just cannot believe that its already 3 months out.

Hope everyone else is pain free :)

If its not one thing, its another!

Today is 11 weeks post op!  I am in shock how fast the time has gone.  Physical therapy is still going well even though I have not been able to attend as much as I would like.  Recently my stomach pains have become the real issue, preventing me from going to physical therapy as much as I should.  Last week I was only able to attend one day.  But during that one session we really pushed the hip hard.  I did lounges on the treadmill for 2 whole minutes!  I thought that I was going to die!  I am doing 3 sets of 10 of lounges on the ground with 2lb weights as well as side leg lifts and back leg lifts.  Its crazy how much I can do and the progress that I can feel.  But I can also still feel a lot of weakness.  My pain has been minimal for the past 3 weeks, which is really promising considering I cannot take any NSAID's.  I still have numbness along the outside of my thigh and under my knee cap.  My scars seem to be healing up well, but I can feel a lot of scar tissue underneath my outer most scar.  I have been using Vit. E oil on them and massage to break it up.

My stomach on the other hand seems to have a mind of its own.  I have been taking Prilosec now for 2 weeks at the increased does yet on Thursday I had horrible stomach pains again.  Is a combination of nausea and actual physical pain.  I am not sure if anything sets it off in particular but it usually starts in the evening after having dinner.  I have tried taking Pepto and Tums but both of those usually just make things worse.  I was in pain for about 6 hours until some pain medication I took finally kicked in.  Friday was not much better, although I was able to sleep a little more.  I had a low grade fever all day which had me worried.  I called my doctor but he was out of town and the fill in doctor only suggested that if the pain got worse I got to the walk-in or ER.  Well Friday night the pain got worse so I went to the ER.  They were not able to do much for me, they basically just suggested that I call my primary care doctor about setting up an appointment for a scope of my stomach.  They were able to prescribe some antibiotics in case it is an infection, plus some pain pills to take when the pain gets really bad.  So for the past few days I have just eaten toast and drank water because of the nausea.

So overall, the hip is feeling really good, minus some aches and pain here and there but this stomach thing has really put a damper on my progress.  On Wed. I have a follow up appointment with my doctor regarding the stomach issues so hopefully then we can come up with a game plan for the next step.

10 weeks - Hope

On Monday I will be 10 weeks post op.  Its really hard to believe considering originally I was not suppose to even have surgery until this month (April).  The past two weeks have been amazing!  My hip feels so good, I don't even have words to express how excited I am.  This week I walked my dog, about 1/4 of a mile, 4 times, as well as climbing some snow banks out at Lake Superior to watch the stars.  The snow was giving out underneath my leg as I was walking and I had no pain!  Plus the physical therapy that I have been doing has stepped up intensity each time we are adding strengthening exercises without any pain!  I have not had this happen in years.  This week we even added wall squats!  Full wall squats!  Its crazy how wonderful it feels.  I feel like I actually have hope for the future, something that I have not felt in a long time.

I am so grateful to Dr. Philippon.  I really believe that he is the best surgeon in the world to do these kinds of things.  Without him and his team, I know that I would still be feeling helpless and frustrated.  I read stories of other people struggling with the same things I was (continued pain, frustration, etc.) and I just want to recommend to everyone to see Dr. P.  After years of struggling with this and seeing many different doctors, the best advice I give everyone I talk to is to get a lot of opinions from at least one local doctor (if available) and an opinion form one of the top doctors (of course its my personal opinion that Dr. P is the best).  Checking out who your doctor trained with is another really important thing.  Before I had a first hip surgery failure I thought that I would not be one of those who had to have multiple surgeries, that those things happened to other people, but this whole experience has been very humbling and taught me a lot about hips. There are a lot of underlying factors that go into whether someone is a good candidate for a scope surgery and many untrained doctors do not know how to look for these things.  Looking back on my experience, I wish no one would ever have surgery with a surgeon who has not trained under the best doctors in the world as it seems their success rates are much, much less and people suffer needlessly.

So this week the only downside that I have been experiencing is that my left hip has really started to increase in pain.  Its bothered me on and off ever since after my first surgery in 2010 but was brushed off by the surgeon as compensation pain.  With my second MRA I was diagnosed with a CAM impingement on the left, but I was hoping that once the right was fixed that it would become asymptomatic again.  So far, no luck with that, but I really don't want to think about the possibility of needing another surgery, so unless it really starts effecting my every day activity, I most likely will not pursue anything with it.

Thats the deal this week :)  Feeling really great about life and the hip situation.  I feel like my fears of needing the surgery to fix my anteversion are reduced daily and that this might be the end of the road for the hip pain in the right.  Thanks for reading!

9 weeks!

So today is 9 weeks post op!  Its crazy to think about how far out from surgery I am now.  This past week I have been feeling better and better each day.  My pain has been minimal and my range of motion is better as well.  On Saturday I walked my dog with no problems and no pain (other than I slipped and fell in my driveway, luckily nothing serious!).  I am very excited about all this!  But of course when one thing is going well, something else falls apart.  I have been experiencing intense stomach pains for a few months now and on Saturday night my stomach started giving me intense stomach pains.  It was horrible.  Nothing was taking the pain away.  So today I made an appointment with my primary care physician to see if he could help me figure out what the problem was.  I had a feeling that it was an ulcer because of my high use of NSAID's for the past few years.  So today I went to see my doctor and the end result is that tomorrow at 8 am I have an appointment at the hospital for an ultrasound of my stomach area as well as blood work.  The doctor is concerned that I may have a gallstone as when he did the physical exam on me, I was really tender more toward my gallbladder than anything else.  So, worst case scenario  I need my gallbladder removed, best case scenario, I have an ulcer and will be taking lots of Prilosec!  I have had to stop all NSAID's though, which in the past few days has made my hip ache a little more and give me bad headaches.

Physical therapy has really picked thing up a lot this past week.  I started doing the elliptical, which has felt good as well as adding some 2 lb weights to some of the exercises that I had been doing that have gotten pretty easy for me.  It feels good to start strengthening things and see some progress and things get easier and easier with each physical therapy appointment.  The best part is the pain afterwards has been minimal (except in the past few days, when I have had to stop taking NSAID's).

Hope everyone else is doing well and pain free :)

EDIT (3/28/13):  So I wanted to edit this to update the results of my ultrasound and blood work.  Everything came back normal so the likely culprit of my intense stomach pains is an ulcer.  I am on Prilosec, 40 mg's for 2 weeks and then I go back to the doctor to reevaluate to see if its working.  Its really early in the morning here but I cannot sleep because of my stomach pains so I hope that this regimen of Prilosec works fast!  Most likely the ulcer is from my NSAID use all these years in dealing with the hip problems.  I was taking about 600 mg every 4-6 hours for about 2 years straight so its no wonder I developed an ulcer.  I would recommend talking to your primary care physician if you have been or will be on NSAID's for any long length of time and see if you can get one a Prilosec as preventative measures for ulcers.

8 weeks today

Sorry its been a while since I have updated my recovery.  Last week my husband and I had to go back to our home town for a week for some family things.  I was suppose to have my 6-8 week follow up with Dr. Philippon but had to cancel to be able to go home this week.  Currently my appointment got rescheduled for April 21st.  Today its 8 weeks out from surgery and I wish I could report that things are going really well, but I can't.  My hip has been really painful and sore for the last 2 weeks.  I am having increased groin pain, pinching in the front of my hip when bending, and the infamous deep ache that is relentless.  I am having a hard time walking up stairs, doing stretches that had not been a problem, and in general, a feeling of instability.  I keep getting a feeling like my femur is slipping in the socket and all my muscles and tendons are sliding around and snapping when it does this.  Its happened a few times and each time its really painful.  I am afraid to walk far as I feel like I my leg will give way.

All of these things have me really concerned but I am trying to keep a positive outlook and not assume the worst, but thats becoming harder and harder to do with each surgery that fails.  I am assuming that part of my pain is from sleeping on a pull out couch and over doing it last week while at home, plus not having any PT, but part of me keeps thinking, its 8 weeks out and I cannot go a week without PT?  My mind keeps screaming that its the femoral anteversion causing these problems, but I don't know for sure and I am trying really hard not to assume the worst.  I have PT today for the first time in a week so I will let them know of these problems and see what they say.  This is becoming harder and harder to accept that things may never be right and I will always be in pain, but I am hoping thats not the case.

Well, I wish I had a better, more optimistic outlook for this post, but maybe that will be next time.

Edit 3/20/13:  So I just wanted to edit this post quickly because I called Dr. P's physicians assistant yesterday about the pain I have been having.  He recommended that I change up the physical therapy protocol to focus more on the outer hip muscles and glutes.  He said that once your off crutches, the muscles in the front of the hip are baring the brunt of the weight load and don't really need the focus of strengthening this far out from surgery.  So I am going to start using the elliptical before PT for 10 minutes instead of the bike, focus on strengthening the side and back of the hip muscles (which I started on Monday as my PT is great and on top of this stuff), and I am going to start trying to make it to the pool 5 times a week.  Getting to the pool that often will probably be difficult, but I love to swim!  So as soon as the weather cooperates (we are getting a snow storm at the moment) I will be heading to the pool much more often.

I had a rough night sleeping last night, but mostly because of pain in my left hip.  Its becoming more and more concerning, but I really hope that with time and strengthening it will settle down.  I am also going to look into some ART massage therapy to see if it can help break up some of the scar tissue that I have.  More updates to come!