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