In the past eight months, I've had three ultrasounds on my leg, two arthrograms of my hips, a mammogram + ultrasound, and now an ultrasound-guided biopsy + mammogram, all at the same imaging place. Fortunately the quality of care is amazing at this place; everyone from the people who do the registration to the techs to the radiologists are top-notch. I have no complaints, other than the fact that I have been to this place way too freaking many times over the past year.
I was supposed to see Dr. Not Friendly, the doctor who does PAO surgery, on Monday. However, he canceled last minute due to an emergency, and his scheduler offered me an appointment today. This was not doable because I had scheduled a biopsy for today, so I ended up scheduling an appointment in, like, three weeks. Whatever. My hips are pretty low priority right now. The only reason I was unhappy about my appointment being rescheduled is that it would have been a good distraction.
Anyway, I've decided to write about the biopsy here, just because. So many different things are going on my life that are impossible to separate.
I've mentioned that I have a stressful work situation right now, and I had a lot of really bad work stress today. After I got done teaching, my stress level was at an all-time high, and I wasn't getting any work done, so I decided to leave around 1:00. My biopsy was at 2:00 and supposedly I was supposed to arrive at 1:45 to do paperwork, even though I don't have to do paperwork anymore because they know me by now, and I have not moved or changed insurance since the last time I was in a week ago. LOL. Nonetheless, I vaguely remembered a tech telling me not to come in for the biopsy on an empty stomach, so I decided to treat myself to lunch before my appointment.
After two arthrograms and several cortisone injections, I wasn't expecting the biopsy to be horrible in terms of physical pain. However, I was in a terrible mental state when I arrived for my appointment. Some of the stress was due to extreme work anxiety and some was due to the unknowns. And then there is obvious anxiety centered around the results, which one cannot help but think about during the biopsy, even though those come much later. Also, my husband really wanted to go to the biopsy with me. I am a very private person when it comes to certain things, and I often do better if I'm alone, especially when the stress is something medical. I know this is an issue I need to deal with because a common theme amongst people with medical issues is that they need friends and family to help them get through, and I just don't do this well. I shut people out. My husband being at the biopsy stressed me out more than if he had not been there, but I know that him being there was his way of dealing with his own stress about this whole thing, so I had to accept it.
All in all, I was not in a good place by the time the radiologist arrived.
Both the tech and radiologist explained the procedure in detail, though I wasn't exactly listening. The radiologist said it was okay if my husband stayed in the room during the biopsy, but that he had to sit down 'so you don't pass out.' Awesome. He then observed that I looked really nervous, and tried to reassure me by saying that he had been doing biopsies since 1992, and that most women didn't find it too bad. He did add, however, that he understood that the most the stressful part was the anticipation of the results. I didn't have the time or energy to go into why I was such a wreck, so I just nodded.
The doctor started off by applying an anesthetic, lidocaine - first topically, then injecting it. This was uncomfortable, but not unbearable. I definitely cringed a bit, to the extent that the tech asked me if I was okay and gave me a washcloth. (Apparently crying is common during this procedure.) With the arthrograms, I always wondered if the anesthetic was worth it, because that was always the worst part - which, duh, makes sense, because obviously that dulls the pain, but I always wondered what the pain would be like without the anesthetic. Unfortunately, I learned the answer to my question the hard way. Once my breast was numb, the doctor informed me he would be inserting an 'automated' needle into the lump, so I would hear a loud sound and feel pressure. At that point I was thinking, okay, that sounds doable. I heard the sound - it was sort of like a staple gun only not quite as loud - then felt the pressure, then felt this intense pain radiate through my breast. At that point, I completely lost it and started crying underneath the washcloth the tech had given. That was definitely not what I would describe as 'just feeling pressure.' WTF?
I was so embarrassed that I was crying, especially after the radiologist had just told me most women didn't find this too bad. Am I really that wimpy compared to 'most women'?! And I honestly wasn't even sure exactly WHY I was crying, so I just buried my face in the washcloth without making a sound. I mean, it HURT, but I've felt worse pain before. However, after a while - probably a few seconds - the radiologist asked me, 'Are you crying because that hurt?' So... he noticed I was crying. I nodded. Work stress and general anxiety issues aside, I was crying because it hurt a lot more than I was expecting; it really took me off guard. Then the tech asked me if it hurt on the surface or deeper, and I somehow managed to eke out 'deeper.' Then the radiologist said a few things I didn't fully pay attention to, but the upshot was that due to the location of the lump, he hadn't been sure that he could get the anesthetic 'onto the other side,' but that he would try. A few more moments of discomfort followed as he attempted to get the lidocaine into a new area, and all the while I was crying into my washcloth.
Finally he delivered the second 'shot,' and that one definitely didn't hurt. That one was just as he had told me the first one would be - a loud noise followed by pressure. Both he and the tech seemed relieved when they asked me about the second one and I said it was fine. And I was also relieved to know that I wasn't some super wimpy woman who was unable to withstand a procedure that 'most women don't find too bad.' After shooting me three more times, the doctor then informed me that he was done. After the fifth, he asked the tech, 'Was that four or five?' She informed him that it was five, which thankfully meant I didn't have to. I was definitely counting.
At that point, I was crying... a lot. Once I started, I just couldn't stop. And then, after all that, I had to have another freaking mammogram, for whatever reason. (I'll have to read up on breasts as I have read up on hips.) The mammogram by itself was not a big deal, but when you're already crying and in a lot of pain, it's not exactly something that will snap you out of that. So I continued crying throughout the mammogram and in the waiting room while waiting for them to tell me if I could leave or not. Fortunately, my husband left after the biopsy, which made it a little easier. I had told him the best thing he could do to alleviate my stress was to take care of the kids, so he left around 2:45, saying he needed to get our son to gymnastics, even though I told him he probably didn't need to leave until around 3:15. (Later he told me he felt sick during the procedure, lol.)
Eventually I got the okay to leave, and since my husband was taking care of the kids, I went home and fell into a deep sleep with the ice pack the tech had given me in my bra. I slept for about an hour in a deep sleep until a text message from a friend snapped me out of it. At that point I realized I couldn't just lie in bed all afternoon with my Woe Is Me attitude; I remembered I had a night class to get to. This started a whole new round of tears, but eventually I pulled myself together and managed to get to class. I was a little worried because my class is very hands on and I was instructed to 'take it easy' with 'no heavy lifting' for 24 hours, otherwise I would have bad bruising and the recovery would be worse. I wasn't sure if I had it in me to try to explain to a bunch of strangers that I could not do certain things because I just had a breast biopsy.
Fortunately, I'm glad I ended up dragging myself to class. For a few hours after the biopsy, I definitely felt like I had been punched in the ribs, but this feeling went away fairly quickly. After I woke up from my nap, I felt pretty good, and in the end, going to class lifted my mood in a major way. If there's one thing I've learned from all of this, it's that no matter what challenge you have, you have to keep moving forward. Even if you are limping, you have to keep moving, somehow.
And so... I keep trying to move forward.
Thursday, April 30, 2015
Sunday, April 26, 2015
Perspective
I have a big week coming up. I've hesitated to write about some of this because I truly intended for this to be a short-lived blog about hip arthroscopy, as evidenced in the name I chose, '39 and Hip.' I did not think I'd still have tons of things to write here at 40, and definitely not well into my 40s, though that appears to be the path I'm heading down.
And now, as I continue to fight a daily battle with my hips, other things keep popping up, and it's hard to separate them from the hip issues. Because all of it together constitutes... my life. I have mentioned that in a previous life I was a gymnast and diver, and I have always been a big fan of Laura Wilkinson. Laura is a fabulous person, an Olympic gold medalist, a mother, and a devout Christian ('follower of Jesus' as she puts it). She has a blog I follow that merges all of these because it is impossible for her to separate them from each other. It is her life.
So given that this blog has gone on way longer than I originally intended, it is now impossible for me to separate non-hip issues from hip issues. This is my life.
About a month or so ago, I lay down in bed in a state of extreme exhaustion, and a little voice in my head told me that I needed to do a self-check exam on my breasts. I was never super vigilant about doing these, and had lapsed even more since my hip issues arose, so hearing 'The Voice' was actually a sort of odd thing. But, since doing a self-check exam on your breasts is not a big deal, I complied with 'The Voice,' and what do you know, I discovered a lump in my breast. Now, I am not a religious person, and I do not believe in a God who is watching out for me, but if I were a religious person, I definitely would have attributed this to God talking to me. It was that unexpected and out of the blue, and I'm thankful for whatever power possessed me feel myself up that night.
After my discovery of the lump, there was a lot of inner turmoil, denial, consultations with Dr. Google, and various other things. Eventually I went to see my primary care doctor - the one I'm not thrilled with - just because it seemed easier than trying to get a new OB/GYN while at the same time dealing with this lump. I've actually had a lump in my breast before, about ten years ago, but my doctor at the time told me it wasn't anything to worry about. (I can't remember the details.) I was hoping for the same this time, but... no. While my doctor did not seem overly alarmed, he said that his mother had died of breast cancer, so any woman who came to him with a lump in her breast automatically had to go in for a mammogram. When he asked how long I had had the lump, I said that I didn't know; I had discovered it a few weeks ago, but admitted that I hadn't done a self-check in a long time because I've had other things on my mind. Then, in case he didn't remember, I added, 'Like my hip.' He looked at me sympathetically and nodded and said, 'And your DVT.' Yeah, that too.
So, I went in for a mammogram on Tuesday, 4/21. I've never had a mammogram before, and was dreading it because of all of the awful things I had heard about them. Fortunately, the mammogram was nothing compared to the arthrograms. It was weird and at times uncomfortable, but not painful. I'd take the mammogram over the arthrogram in a heartbeat, or in a breast squish, lol. Unfortunately, the mammogram confirmed the conclusion I had come to after self-diagnosis and extensive consultation with Dr. Google: I have a tumor in my breast. The nature of the tumor will be determined in a biopsy this Wednesday, which, needless to say, I'm not exactly looking forward to.
I mentioned that I felt like the people at the imaging place know me way too well by now, and now on top of my DVT and hip problems, I have added breast issues into the mix. At least I barely have to do any paperwork anymore. LOL.
Also on the schedule for this week - tomorrow, in fact - is an appointment with Dr. Not Friendly. At this point, I feel like even if he told me I will become wheelchair bound within the next five years if I don't do something about my hips, I probably wouldn't care. Even that seems so much less harrowing than dealing with cancer.
I feel that throughout this entire hip ordeal, I've gone out of my way to emphasize the fact that I'm grateful that my hips are my biggest problem. The pain has been trying, for sure, but I'm grateful this is a non-life-threatening issue and feel like I have recognized that frequently within all of my whiny entries here. But I now feel like I haven't done that enough, and that the fates are trying to show me what a real problem is, for perspective. I mentioned in a previous post that given the choice of hip pain versus DVT, I'd choose hip pain. Now I feel like I need to add that given the choice of hip pain or cancer, I'd choose hip pain. Given the choice of DVT or cancer, I'd choose DVT. So in order of preference, I'd choose hip pain, DVT, then cancer. If I could cut a deal and promise to never complain about my hips ever again in exchange for a benign tumor, I'd do it in a heartbeat.
So if this blog dies out over the next couple of weeks, maybe it is because I made a deal with the powers that be to shut up about my hips already. Either that or cancer is killing me. LOL. Take your pick.
And now, as I continue to fight a daily battle with my hips, other things keep popping up, and it's hard to separate them from the hip issues. Because all of it together constitutes... my life. I have mentioned that in a previous life I was a gymnast and diver, and I have always been a big fan of Laura Wilkinson. Laura is a fabulous person, an Olympic gold medalist, a mother, and a devout Christian ('follower of Jesus' as she puts it). She has a blog I follow that merges all of these because it is impossible for her to separate them from each other. It is her life.
So given that this blog has gone on way longer than I originally intended, it is now impossible for me to separate non-hip issues from hip issues. This is my life.
About a month or so ago, I lay down in bed in a state of extreme exhaustion, and a little voice in my head told me that I needed to do a self-check exam on my breasts. I was never super vigilant about doing these, and had lapsed even more since my hip issues arose, so hearing 'The Voice' was actually a sort of odd thing. But, since doing a self-check exam on your breasts is not a big deal, I complied with 'The Voice,' and what do you know, I discovered a lump in my breast. Now, I am not a religious person, and I do not believe in a God who is watching out for me, but if I were a religious person, I definitely would have attributed this to God talking to me. It was that unexpected and out of the blue, and I'm thankful for whatever power possessed me feel myself up that night.
After my discovery of the lump, there was a lot of inner turmoil, denial, consultations with Dr. Google, and various other things. Eventually I went to see my primary care doctor - the one I'm not thrilled with - just because it seemed easier than trying to get a new OB/GYN while at the same time dealing with this lump. I've actually had a lump in my breast before, about ten years ago, but my doctor at the time told me it wasn't anything to worry about. (I can't remember the details.) I was hoping for the same this time, but... no. While my doctor did not seem overly alarmed, he said that his mother had died of breast cancer, so any woman who came to him with a lump in her breast automatically had to go in for a mammogram. When he asked how long I had had the lump, I said that I didn't know; I had discovered it a few weeks ago, but admitted that I hadn't done a self-check in a long time because I've had other things on my mind. Then, in case he didn't remember, I added, 'Like my hip.' He looked at me sympathetically and nodded and said, 'And your DVT.' Yeah, that too.
So, I went in for a mammogram on Tuesday, 4/21. I've never had a mammogram before, and was dreading it because of all of the awful things I had heard about them. Fortunately, the mammogram was nothing compared to the arthrograms. It was weird and at times uncomfortable, but not painful. I'd take the mammogram over the arthrogram in a heartbeat, or in a breast squish, lol. Unfortunately, the mammogram confirmed the conclusion I had come to after self-diagnosis and extensive consultation with Dr. Google: I have a tumor in my breast. The nature of the tumor will be determined in a biopsy this Wednesday, which, needless to say, I'm not exactly looking forward to.
I mentioned that I felt like the people at the imaging place know me way too well by now, and now on top of my DVT and hip problems, I have added breast issues into the mix. At least I barely have to do any paperwork anymore. LOL.
Also on the schedule for this week - tomorrow, in fact - is an appointment with Dr. Not Friendly. At this point, I feel like even if he told me I will become wheelchair bound within the next five years if I don't do something about my hips, I probably wouldn't care. Even that seems so much less harrowing than dealing with cancer.
I feel that throughout this entire hip ordeal, I've gone out of my way to emphasize the fact that I'm grateful that my hips are my biggest problem. The pain has been trying, for sure, but I'm grateful this is a non-life-threatening issue and feel like I have recognized that frequently within all of my whiny entries here. But I now feel like I haven't done that enough, and that the fates are trying to show me what a real problem is, for perspective. I mentioned in a previous post that given the choice of hip pain versus DVT, I'd choose hip pain. Now I feel like I need to add that given the choice of hip pain or cancer, I'd choose hip pain. Given the choice of DVT or cancer, I'd choose DVT. So in order of preference, I'd choose hip pain, DVT, then cancer. If I could cut a deal and promise to never complain about my hips ever again in exchange for a benign tumor, I'd do it in a heartbeat.
So if this blog dies out over the next couple of weeks, maybe it is because I made a deal with the powers that be to shut up about my hips already. Either that or cancer is killing me. LOL. Take your pick.
Friday, April 17, 2015
Limping Forward
I have a really unpleasant situation at work right now, which leaves me wondering just how much longer I can stand my job. I've been toying with the idea of leaving for a while now, and making a plan to do so, although I haven't quite managed to yet. But in a way, the current situation is a good thing because it makes me more certain of my choice. My relationship with my job is love/hate, with not a lot in between. Unfortunately, a few of the items in the hate column are out of my control and unlikely to ever change. Ultimately, I cannot put up with this long-term, and feel that, at the age of 40, it is time to stop languishing and just get my butt on a different career path already. The intensity of the current situation is lighting a fire to get me moving toward that path at a faster pace.
Along with the roller coaster ride of work, I've also been having some horrible hip days, which leave me wondering how much longer I can stand it. But interspersed with those bad days, I've also had a number of good days, and when I have a good day, I can't even wrap my mind around having surgery. When I have a bad day, I'm ready to check myself into the hospital and get it done already. Both hips at the same time. I'll be in a wheelchair for three months if that's what it takes. LOL. I think it's the ups and downs that are the hardest to deal with emotionally. It's crazy to think that intermittent good days are worse than constant pain, but just like with work, sometimes I feel like those good days are causing me to cling to false hope and keeping me from moving forward toward some long-term solution. Instead, I just languish. The problem is, I don't know what that solution is. But I'm also not sure I want to wait until things are really bad before moving forward, even though that would certainly give me clarity and certainty about a long-term solution, whatever that solution may be.
And so... I'm trying to keep moving forward. Slowly. It's more like... I'm limping forward, both literally and figuratively.
That said, I had an arthrogram of my left hip (my 'good' hip) last Friday, April 10th. I was having a really good hip day that day, so I kept asking myself WHY am I doing this?! Not to worry, though. The injection triggered a massive amount of pain that lasted for a good 48 hours. Although it has subsided significantly since then, my hip still hurts. So, good, at least the pain makes me feel more justified in having the arthrogram in the first place. I don't know the results because I have been really, really busy and have not called for a follow-up appointment simply because I cannot think of a time when I could actually make it to an appointment, and I feel bad when I call for an appointment and turn down pretty much every option they give me. That, and I am really bad about making appointments. I don't know why it's so hard for me, it just is. And I'm wary of new doctors, which is a bad thing, because it means I put up with crap doctors for way too long, especially if they are nice like my old orthopedist.
However, yesterday a scheduler from the doctor who does the PAO surgery called to let me know that she received a referral for a surgery consult, and did I want to make an appointment? Like I said, I was fairly frazzled at my last appointment with the new orthopedist, and I wasn't exactly sure how we had left things. But since they were calling me, I figured what the heck. It's just like with the arthrogram. I know I wouldn't have called and scheduled it on my own, but since they called me, I figured what the heck. I might as well know what's going on with my left hip, even if I don't do anything about it. And I might as well get the low down on PAO surgery, even if I don't have it done. I have to keep reminding myself that just because I am going to an informational appointment doesn't mean I have to have the surgery. I seriously don't know why I dread these appointments so much.
At any rate, I already feel so much better about the new orthopedist and his NP than I did about my old orthopedist. I mentioned that one thing that bugged me about my old orthopedist is that he never wrote any reports about our visits and never responded to any communication I sent via the patient portal. All these big practices make this huge deal about having a patient portal to facilitate communication between patients and providers, but all my old ortho ever wrote for a 'care summary' was All of the patient's questions were answered and they state they understand and agree with the discussed treatment plan. They will follow up as planned, sooner if any problems. So, when I got an e-mail today from the new practice inviting me to register for the patient portal, I did, but mostly just because portals are convenient for making payments. I decided to click on the 'visit summary' from my last appointment just to see if the doctor and/or NP had actually written anything, and was surprised that the NP had. I read the report, and it was actually very useful. I know we talked about all of it, but a lot of it was a blur to me at the time, and it helped to see it again in writing. She wrote:
Waning's history, symptoms, exam, and imaging consistent with bilateral hip femoral acetabular impingement syndrome and acetabular dysplasia, with recurrent right-sided acetabular labral tear following a hip arthroscopy and labral repair done by another orthopedist within the last 8 months. I reviewed the etiology of the condition, natural course of the disease, and potential treatment options. I reviewed exam imaging findings. The patient is now aware that she has a more complex problem, considering her acetabular dysplasia. We discussed the conservative options, including physical therapy and continued corticosteroid injections. We discussed surgical intervention, which would include revision hip arthroscopy with possible revision labral repair, versus reconstruction. Due to the severity of the patient's acetabular dysplasia, we discussed the potential of undergoing a 2 part surgical intervention, which would include periacetabular osteotomy, followed by hip arthroscopy with labral repair. She is aware that the 2 part surgical intervention would be the most reliable, secondary to structural issues in her hips. As such, we are going to send her to a colleague, Dr. Not Friendly, for evaluation regarding possible PAO. Her left hip has not undergone recent MR arthrogram, and we are going to send her for that. In either case, we would need to coordinate with her primary care provider regarding her coagulopathic issues and how we would prophylax the patient during the time of surgery. We will see her back when results are available. All questions were answered.
That's way more than my orthopedist ever wrote in eight months of caring for me. I will add this to my lessons learned from this journey so far: Second opinions are a good thing. They should be done BEFORE surgery.
FYI, here is a link to a page that describes PAO surgery in all of its gory detail: http://www.clohisyhipsurgeon.com/treatment-options/periacetabular-osteotomy-pao-for-acetabular-dysplasia
Along with the roller coaster ride of work, I've also been having some horrible hip days, which leave me wondering how much longer I can stand it. But interspersed with those bad days, I've also had a number of good days, and when I have a good day, I can't even wrap my mind around having surgery. When I have a bad day, I'm ready to check myself into the hospital and get it done already. Both hips at the same time. I'll be in a wheelchair for three months if that's what it takes. LOL. I think it's the ups and downs that are the hardest to deal with emotionally. It's crazy to think that intermittent good days are worse than constant pain, but just like with work, sometimes I feel like those good days are causing me to cling to false hope and keeping me from moving forward toward some long-term solution. Instead, I just languish. The problem is, I don't know what that solution is. But I'm also not sure I want to wait until things are really bad before moving forward, even though that would certainly give me clarity and certainty about a long-term solution, whatever that solution may be.
And so... I'm trying to keep moving forward. Slowly. It's more like... I'm limping forward, both literally and figuratively.
That said, I had an arthrogram of my left hip (my 'good' hip) last Friday, April 10th. I was having a really good hip day that day, so I kept asking myself WHY am I doing this?! Not to worry, though. The injection triggered a massive amount of pain that lasted for a good 48 hours. Although it has subsided significantly since then, my hip still hurts. So, good, at least the pain makes me feel more justified in having the arthrogram in the first place. I don't know the results because I have been really, really busy and have not called for a follow-up appointment simply because I cannot think of a time when I could actually make it to an appointment, and I feel bad when I call for an appointment and turn down pretty much every option they give me. That, and I am really bad about making appointments. I don't know why it's so hard for me, it just is. And I'm wary of new doctors, which is a bad thing, because it means I put up with crap doctors for way too long, especially if they are nice like my old orthopedist.
However, yesterday a scheduler from the doctor who does the PAO surgery called to let me know that she received a referral for a surgery consult, and did I want to make an appointment? Like I said, I was fairly frazzled at my last appointment with the new orthopedist, and I wasn't exactly sure how we had left things. But since they were calling me, I figured what the heck. It's just like with the arthrogram. I know I wouldn't have called and scheduled it on my own, but since they called me, I figured what the heck. I might as well know what's going on with my left hip, even if I don't do anything about it. And I might as well get the low down on PAO surgery, even if I don't have it done. I have to keep reminding myself that just because I am going to an informational appointment doesn't mean I have to have the surgery. I seriously don't know why I dread these appointments so much.
At any rate, I already feel so much better about the new orthopedist and his NP than I did about my old orthopedist. I mentioned that one thing that bugged me about my old orthopedist is that he never wrote any reports about our visits and never responded to any communication I sent via the patient portal. All these big practices make this huge deal about having a patient portal to facilitate communication between patients and providers, but all my old ortho ever wrote for a 'care summary' was All of the patient's questions were answered and they state they understand and agree with the discussed treatment plan. They will follow up as planned, sooner if any problems. So, when I got an e-mail today from the new practice inviting me to register for the patient portal, I did, but mostly just because portals are convenient for making payments. I decided to click on the 'visit summary' from my last appointment just to see if the doctor and/or NP had actually written anything, and was surprised that the NP had. I read the report, and it was actually very useful. I know we talked about all of it, but a lot of it was a blur to me at the time, and it helped to see it again in writing. She wrote:
Waning's history, symptoms, exam, and imaging consistent with bilateral hip femoral acetabular impingement syndrome and acetabular dysplasia, with recurrent right-sided acetabular labral tear following a hip arthroscopy and labral repair done by another orthopedist within the last 8 months. I reviewed the etiology of the condition, natural course of the disease, and potential treatment options. I reviewed exam imaging findings. The patient is now aware that she has a more complex problem, considering her acetabular dysplasia. We discussed the conservative options, including physical therapy and continued corticosteroid injections. We discussed surgical intervention, which would include revision hip arthroscopy with possible revision labral repair, versus reconstruction. Due to the severity of the patient's acetabular dysplasia, we discussed the potential of undergoing a 2 part surgical intervention, which would include periacetabular osteotomy, followed by hip arthroscopy with labral repair. She is aware that the 2 part surgical intervention would be the most reliable, secondary to structural issues in her hips. As such, we are going to send her to a colleague, Dr. Not Friendly, for evaluation regarding possible PAO. Her left hip has not undergone recent MR arthrogram, and we are going to send her for that. In either case, we would need to coordinate with her primary care provider regarding her coagulopathic issues and how we would prophylax the patient during the time of surgery. We will see her back when results are available. All questions were answered.
That's way more than my orthopedist ever wrote in eight months of caring for me. I will add this to my lessons learned from this journey so far: Second opinions are a good thing. They should be done BEFORE surgery.
FYI, here is a link to a page that describes PAO surgery in all of its gory detail: http://www.clohisyhipsurgeon.com/treatment-options/periacetabular-osteotomy-pao-for-acetabular-dysplasia
Wednesday, April 1, 2015
DABDA
Disclaimer: I am having a terrible day, so this is going to be a super whiny post. Sorry about that.
In my EMT class, we learned the Kübler-Ross model, or the five stages of grief. They are denial, anger, bargaining, depression, and acceptance. DABDA. Not that I'm grieving, nor do I want to come across as melodramatic, but I think as I've mulled over my situation for the past year, I've dabbled in each of these stages.
I do not think it took me long to decide definitively that I cannot have PAO surgery anytime soon, and I actually felt relieved with this decision, and immediately started to plan for an aggressive pain management regimen. This felt good. I reached a point a while back where I was just trying to accept my pain for what it was, and live with it. Emotionally, that was sort of a relief, but it turned out I just couldn't deal with not really knowing why I was in so much pain. But now I know why my hip hurts, and I know what I would likely need to do to fix it (assuming Dr. #2 is not a crackpot), and I know that isn't the right thing for me right now, so I think I can fully accept the pain and learn how to live with it.
I felt so happy after I came to this point. Acceptance.
And then... I had pretty much the worst hip day ever today. Worst. Day. Ever.
Stabbing pains in my right hip, and pain in my left hip all the way from my gluts down my IT band. Pain in my back. Swelling in my ankle. (This is probably the DVT.) On top of this, I have a nasty, nasty bruise on my right leg from a ridiculously minor fall I took while skiing. (Literally, I just fell over while I was standing there. Thank you, Xarelto.) It was a pain-filled day like no day I have experienced in a very long time. The fates are testing me and the decision I was so sure of and so happy about.
When I got back to my office after teaching, I sat in front of my desk and cried. I'm not kidding. I couldn't get comfortable enough to actually do any work, so I ended up shutting my office door and pacing around my office using the crutches that are still stuck behind my door from August, when I couldn't get across campus without them. It was actually sort of cathartic to pace around on crutches with no pain, and it sent my mind spinning in all sorts of different directions. I remember after I had my first cortisone injection, the doctor told me that those first 24 hours, those awesome pain-free hours when the anesthetic is active, is what it could be like all the time. I won't lie; that hope is what sucked me into the surgery. I think when you're in pain for a long time, you forget what it's like without pain; it's only when you experience those pain-free moments that you realize just how bad the pain is and how much it's affecting you.
And so now I'm back to HOW MUCH LONGER CAN I TAKE THIS?!
I realize I don't need to make a decision STAT, nor should I. This is a fairly big decision, but fortunately not a life or death one. I have the luxury of time. It's just that I'm a very impatient person, and more than anything, I don't like not having a plan. Even if the plan is to live with something that sucks, I can deal with it. (Hell, my mother-in-law lives in a cottage in my back yard, and... I deal with it. :)) It's the not knowing what to do that I hate, hate, HATE, and unfortunately, since this is not a life or death matter, there is no clear answer.
A few final, random thoughts, in no particular order:
In my EMT class, we learned the Kübler-Ross model, or the five stages of grief. They are denial, anger, bargaining, depression, and acceptance. DABDA. Not that I'm grieving, nor do I want to come across as melodramatic, but I think as I've mulled over my situation for the past year, I've dabbled in each of these stages.
I do not think it took me long to decide definitively that I cannot have PAO surgery anytime soon, and I actually felt relieved with this decision, and immediately started to plan for an aggressive pain management regimen. This felt good. I reached a point a while back where I was just trying to accept my pain for what it was, and live with it. Emotionally, that was sort of a relief, but it turned out I just couldn't deal with not really knowing why I was in so much pain. But now I know why my hip hurts, and I know what I would likely need to do to fix it (assuming Dr. #2 is not a crackpot), and I know that isn't the right thing for me right now, so I think I can fully accept the pain and learn how to live with it.
I felt so happy after I came to this point. Acceptance.
And then... I had pretty much the worst hip day ever today. Worst. Day. Ever.
 |
| The joy of anti-coagulants |
Stabbing pains in my right hip, and pain in my left hip all the way from my gluts down my IT band. Pain in my back. Swelling in my ankle. (This is probably the DVT.) On top of this, I have a nasty, nasty bruise on my right leg from a ridiculously minor fall I took while skiing. (Literally, I just fell over while I was standing there. Thank you, Xarelto.) It was a pain-filled day like no day I have experienced in a very long time. The fates are testing me and the decision I was so sure of and so happy about.
When I got back to my office after teaching, I sat in front of my desk and cried. I'm not kidding. I couldn't get comfortable enough to actually do any work, so I ended up shutting my office door and pacing around my office using the crutches that are still stuck behind my door from August, when I couldn't get across campus without them. It was actually sort of cathartic to pace around on crutches with no pain, and it sent my mind spinning in all sorts of different directions. I remember after I had my first cortisone injection, the doctor told me that those first 24 hours, those awesome pain-free hours when the anesthetic is active, is what it could be like all the time. I won't lie; that hope is what sucked me into the surgery. I think when you're in pain for a long time, you forget what it's like without pain; it's only when you experience those pain-free moments that you realize just how bad the pain is and how much it's affecting you.
And so now I'm back to HOW MUCH LONGER CAN I TAKE THIS?!
I realize I don't need to make a decision STAT, nor should I. This is a fairly big decision, but fortunately not a life or death one. I have the luxury of time. It's just that I'm a very impatient person, and more than anything, I don't like not having a plan. Even if the plan is to live with something that sucks, I can deal with it. (Hell, my mother-in-law lives in a cottage in my back yard, and... I deal with it. :)) It's the not knowing what to do that I hate, hate, HATE, and unfortunately, since this is not a life or death matter, there is no clear answer.
A few final, random thoughts, in no particular order:
- I joined a support group on Yahoo for women with hip issues. This is so not me, but I totally need some support right now. The sort of weird thing is that when I talk to people about my hip issues, they seem surprised I have hip issues because I am relatively active and fit, and relatively young (though I look younger than I am). But when I go online and try to find others with similar experiences, I realize I am relatively couch-potatoish, not fit, and older than most. But... I've already received a bunch of nice e-mails from women in this group, so I hope this will be a good thing for me.
- I'm thankful for the blogs I've read about PAO, which help me see the reality of this surgery. It is brutal, and the recovery is difficult, way worse than for a labral repair. This makes sense considering they cut your hip bone apart and screw it back together, which is a lot more invasive than sticking a few screws into your hip and tying down some loose cartilage.
- The reality of this surgery is that it involves a significant hospital stay (up to a week!) and a long and painful recovery.
- I'm thankful for the blogs because when I was talking to the NP and orthopedist about the surgery, they really didn't make it sound like a huge deal (and maybe it isn't in the large scheme of things, but it is to me, especially considering my first experience with surgery wasn't exactly awesome). Basically the NP said I'd be on crutches for 6-8 weeks, which is a long time, but... doable. I mean, after my labral repair surgery, I was on crutches for a month, and it was about 6 weeks before I didn't need them at all, so what is a few more weeks, right? But neither the NP nor orthopedist mentioned the long hospital stay with blood transfusions, needing a wheelchair, nor the massive amount of pain involved in the recovery. I mean, with the labral repair surgery, the crutches were really just to let the labrum heal. I didn't feel a massive amount of pain, and I was able to get around and be independent fairly quickly after the surgery. PAO is a whole different beast; being on crutches seems like it would be the least of my worries.
- On the topic of crutches, I've changed so much in the past year. A little over a year ago, I felt totally appalled at the idea of going out in public on crutches, and was most definitely dead set against any of my colleagues, and especially students, seeing me on crutches. I so don't care now. I mean, I do. I'd still find it somewhat embarrassing if I had to show up to work tomorrow on crutches. But if, for example, my doctor told me my hip pain would be better if I spent the next month on crutches, I'd comply in a heartbeat.
- I also realize how stupid I was to think that I could absolutely not do my job on crutches. True, I'm on my feet a lot, and being on crutches would be a challenge, but now that I'm staring down reality, I realize there are a lot of jobs that are much, much, much less crutch-friendly than my current job. The fact that I am pursuing some of these jobs is what is adding to my stress about my hip issues.
- In reading through my blog from right after surgery, I noted a few things. One is that I think I wanted so badly for my surgery to work, that in hindsight, my overly-optimistic tone is practically nauseating. But in reading blogs, I realized it was all about attitude, and I was trying so hard to be positive. My hip felt so good after surgery, but I'm starting to realize that was probably because I was on crutches, and not feeling the pain. After I started to ditch the crutches, the pain returned. Bleck.
- In reading through blogs about PAO and other major hip surgeries, a recurring theme is that the people who have gone through this have a very supportive network of family and friends, and say they couldn't have done this without aforementioned family and friends. One of the reasons (among several) that I feel like I can't do this is because I honestly don't have that. I really don't have a supportive network. I mean, I do have family, and my parents live a few blocks away from me, but they are not exactly supportive. My mom is disdainful of most modern medicine, and uses my failed surgery to back up her theory that all doctors are idiots, and you should never let a doctor touch you unless you are dying (and even then, you will probably die faster than if you went into a forest and ate moss and sang kumbaya). And my husband... well... it's complicated. Whatever lack of support I get from him, I fully deserve, because what goes around comes around. I will leave it at that for now. Lest you think I am total loser, I do have some friends, but not the 'I will take care of you if you have surgery' type of friends.
- I mentioned that I wasn't sure how I left things after my last appointment with New Doctor, but a few days ago I got a call from an imaging place telling me they had received orders for an MRI on my left hip (my 'good' hip), so I figured what the heck. It is so hard for me to pursue this medical stuff, but I seem to be on a roll, so why stop now? And I truly am curious to know if I have the same problems in my left hip as on my right. I hold out hope that I don't, because the pain is different, but I suppose we shall see.
Subscribe to:
Posts (Atom)