Book Club on Thursday, Orthopedist on Friday (17 Weeks + 4 Days)

Exactly four months post-surgery

As has become the norm for the past three months, I had book club on Thursday followed by an appointment with my orthopedist on Friday. I wasn't looking forward to the appointment after my display of jerkiness a few weeks ago, plus I knew that nothing would come of the appointment, so I should have just canceled it. But... I didn't. I could have just said I was sorry for the nastygram, but I just couldn't bring myself to apologize because I'm not exactly sorry. I sent multiple polite e-mails requesting follow up communication, and that didn't work, so I felt like I had no choice, other than to just sit around for months with no follow up, which IMHO is Not Okay. I guess I have pretty high expectations when it comes to communication. I spend a few hours a day responding to e-mails, mostly from students, which is important when face-to-face time is limited. Sometimes they don't like my response to them, but... I do always respond, usually within a few hours, and with very few exceptions, almost always within 24 hours.

Anyway, no one said anything about my nastygram, and everyone was very pleasant and cordial. The orthopedist's MA seemed to be trying extra hard to be friendly. When we were walking back to the room, she started off by saying, 'I just have to warn you...' and I immediately thought Uh oh, then anticipated her saying something like, The doctor hates you. However, she was just warning me that she was super busy and hadn't cleaned the room yet, so she was going to need to clean it while I was sitting in there, which she thought would be better than keeping me out in the waiting room. Fortunately, 'cleaning' in an orthopedist's office consists of throwing away the paper that covers the examination table and pulling out more. LOL. She asked me how I was feeling, and I told her I was feeling much better. Then she sort of surprised me and asked if I thought I was actually feeling better or if I was just getting used to the pain, ha ha. I admitted there might be some of that, but that I did think I was genuinely feeling better. I said I had a period of a few weeks when I felt awesome, and I really thought this was finally OVER, but that over the past couple of weeks I've felt the pain creeping back. Nevertheless, I was pretty sure that I still felt better than I did at the last visit.

The MA apparently relayed this information to the orthopedist because when he came in he cheerfully declared, 'Rumor has it you're getting better!' I repeated the information to him, including the pain creeping back, to which he replied, 'No. No creeping is allowed.' LOL. Seriously, I love this guy's personality. It's hard to explain, but on some fundamental level, we really click, which is probably why I was stupid enough to let him operate on me. Even when I want to be really angry with him for being a douchebag of a doctor, I just can't stay mad. Plus, he never keeps me waiting, either, which is always a plus, and a very rare quality among orthopedists (in my experience). He then went through his usual spiel of most people feeling back to normal after three months, but for some people it's six months and others nine months, then just as I was telling him not to even mention the nine-month category to me, he added that hopefully I was in the six month category.

Then I got up onto the examination table so he could do his useless set of 'tests' on me. The MA had told me to put on a pair of those hideous exam shorts in case the doctor wanted to do some manipulations or whatever. I smiled and nodded my head and didn't bother changing, because I didn't feel like it and knew the doctor wasn't going to look that closely. (He has never even looked to see how the incisions healed except when he took the stitches out two weeks post-surgery.) However, he did comment on my shoes, asking me if they were Danskos. I said they were. Then he said he wore Danskos when he operated, and I replied that I didn't know they made Danskos for men. He said somewhat sheepishly that he definitely only wore them during surgery, otherwise he got weird looks. LOL. I told him I had started wearing them when I started teaching back-to-back anatomy labs for six hours straight and needed comfortable, closed-toe shoes. They are the shoes teachers and nurses, and apparently even male orthopedic surgeons, swear by.

Other than the shoe conversation - shoes must be his thing, as I remember him having a conversation about my mom's shoes prior to surgery - highlights include the following:

• My blood clot is much improved. My doctor apologized for taking a while to get back to me about it (which I appreciated), and then gave me a copy of the report from the radiologist. (He is getting to know me!) He said there was some residual clotting that might never go away (??) but that wasn't enough to keep me on the Xarelto (??) I sort of smiled and nodded my head and didn't mention I had gotten a second and third and fourth opinion about this. 

FINDINGS: The common femoral vein and proximal and mid portions of the superficial femoral vein are normally compressible. In the distal SFV and extending through the popliteal vein, there is chronic thrombus, which causes the vein to be incompletely compressible. This is significantly improved compared to the previous exam. The calf veins are compressible, with no DVT present. 

IMPRESSION: There is residual chronic thrombus in the distal superficial femoral vein and popliteal vein. There has been improvement compared to the previous venous ultrasound study from 8/8/2014.

• I have trochanteric bursitis in both hips, which I knew. Fortunately, it's not hurting terribly, and according to my doctor, it will magically and spontaneously resolve itself at some undisclosed date in the future. He did mention that we could do cortisone injections to help speed up the healing and when I vigorously shook my head no, he agreed that, 'Yeah, you've already had so many shots.' We also both agreed that going back to PT would not be helpful, as it's actually PT that caused the bursitis in my left hip in the first place, and it's actually feeling much better since I stopped PT. So, I'll just wait it out.
• When I go from sitting to standing, it hurts, just like it did before surgery (which is what worries me). Supposedly this will also magically and spontaneously resolve itself at some undisclosed date in the future.
• It still hurts when I flex my hip, although mostly only when I go up stairs, whereas before it hurt when I went down stairs as well. At least the sharp pains I used to have are gone, so that is a happy thing. My doctor said I have some tendonitis, but it seems to be in my sartorius, which is more lateral than the major hip flexors. Not that it really matters, because this too will magically and spontaneously resolve itself at some undisclosed date in the future.
• I will follow up in two months, at which point hopefully my pain will have magically and spontaneously resolved itself.
• There is so much to look forward to in the future. :)
• In writing this, I was trying to think of reasons that my pain seems to be returning, and it dawned on me that I stopped taking the meloxicam a while back because I was having GI issues. Since my GI issues seem to have at least gone dormant, I think I'm going to try taking the meloxicam again.

In other news...

On my way out, I stopped by the PT room to say hello to my therapist. He said he had recently done a music gig (he is a professional musician by night) at the university. Interestingly, I attended an evening event at the university tonight and chatted with one of the music professors about my therapist. The professor mentioned that AJ was one of just three 'professional level' bass players in town and was sort of a 'go to' guy for jazz musicians. He seemed surprised that a professional musician could have such a respectable day job, much in the same way that my students seem surprised when they realize that a lot of university faculty have talents outside their narrow fields of study. It's all rather amusing when you think about it.

Also at the function tonight, I spent some time with a colleague/friend who had the same surgery I did, but two months after I did. She is now about two months post-surgery and told me that she basically doesn't have any pain at all, except on rare occasions when 'I do something stupid.' She really felt there must be something wrong for me to be having so much pain four months later. Hmmmmm.

And finally, I turn 40 on Sunday. I have so many mixed feelings about that. I feel like my 30s brought so many great things to my life, but I've heard that the 40s can be even better. So here is to what is likely to be my last post here as a 39-year-old. Cheers!

No News is Good News (16 Weeks + 1 Day)

I don't have a lot to say, and that is a GOOD thing. Very good!

• My hip still feels good! Given that I was feeling good the last time I saw my orthopedist, and that I'm still feeling good, I must be going on almost four weeks of feeling good. I still have low-level pain, and pain when I get up after sitting for a while (déjà vu all over again), but it is so much better than it has been, and even better than it was before surgery (um, finally). It seems sort of ridiculous to be excited over the fact that almost four months after surgery, I feel better than before the surgery, but, hey, whatever. 
• Of all the things I've tried post-surgery, it seems like the best thing I've done for my hips is to stop physical therapy. (LOL - What's wrong with this picture?)
• My surgeon's MA called me last week, on Friday. My cell phone told me it was from ABC Orthopedics, which immediately made me nervous. It was my orthopedist's MA, who seems like a super sweet woman. I don't know if it's because she really cares a lot or if it's because it's her job to clean up after unresponsive orthopedists and she's just really good at her job, but either way, she's always super nice and seems extremely competent as well. I was relieved it was her and not my orthopedist (although who are we kidding - why would it be him?). She said she had gotten 'another e-mail' from me and went on to say that she was sorry my doctor hadn't responded to me, that she had given him my results, and said that she would have stayed on him if she knew he hadn't gotten back to me. Eventually I figured out that she was talking about the nastygram I sent on Tuesday, and I told her that my doctor had in fact gotten back to me. She seemed relieved, and when I told her, 'Yes, I finally worked a response out of him,' she laughed somewhat knowingly and said apologetically, 'I'm sorry you feel like we aren't taking care of you.' She actually sounded very sincere and not snarky or anything. Since I was at work and didn't really want to get into it with her (it's not her fault), plus I was shocked by her apology and didn't know how to respond, I just said, 'Oh, well, thank you for that,' and confirmed that I would see them on November 7th. And that was that.
• In other other news, I've been having some GI issues. I'll spare you the details. LOL. They started about two weeks ago after having sushi, which can always be a cause for concern - though I've never gotten sick from sushi, even sushi that I've eaten in a strip mall in Nevada. (I can't say the same for McDonald's.) However, since no one else in my family got sick, I ruled out the sushi. Of course my next concern was that it is the medication I'm on, as both the Xarelto and the meloxicam are causes for concern. And then there is always the concern that I'm just a hypochondriac, and the anxiety I cause myself by being a hypochondriac either causes or exacerbates symptoms I already have (which may be due to anxiety from hypochondria or 'real' reasons). I do have some experience with GI stuff, and GI stuff is tricky. Eventually I concluded that anxiety and hypochondria alone were unlikely to produce such nasty symptoms for so long. (In my experience, anxiety can produce pain, but not usually bleeding.) So, I stopped taking meloxicam on Friday because of concern over my GI tract, plus the fact that my hip is still feeling pretty good. I figured it would be a good test for my hip, and not taking meloxicam hasn't had any effect on my hip. Granted, it has also not had much of an effect on my GI tract, but I have to figure if it's having zero effect, good or bad, I might as well not take it.
• I've been feeling sort of crappy overall, so I added Vitamin D back in to my pill-taking regimen. So now instead of taking Xarelto + meloxicam in the morning, I take Xarelto + Vitamin D. So far it doesn't seem to be helping, when I subtract out the possible placebo effect. Which leads me back to my original diagnosis of anxiety and hypochondria. HA!

To summarize: overall, things are looking good. Time is flying; it seems like last week that I saw my orthopedist, but I know it has been almost a month because next week I have book club on Thursday night followed by the orthopedist on Friday, which seems to be fairly standard these days. Also, on the Sunday following my appointment, I will turn 40, which will make my '39 and Hip' moniker seem a bit passé, but hopefully it means I won't have much more to say about my hip, which was certainly my hope when I started writing this. :)

And the verdict is... (15 Weeks + 2 Days)

Okay, so 'verdict' is probably too strong of a word, but I did get an 'emergency' second opinion today (via husband via his doctor, who saw me for my DVT after I was treated in the ER). He and my husband actually have a text-each-other-regularly type of relationship. My husband recently had some routine lab work done as part of his annual physical, and he told me Dr. A just texted him the results telling him he was fine. Oh I'm so jealous.

Anyway. Dr. A stuck by his original suggestion, which was to take the Xarelto for six months. He hadn't looked at the report (because I'm not even his patient), but said that he would, but that it basically didn't matter. Six months, and he was going to stick with that. Add into that the fact that the clot isn't even gone - it's just 'better' (supposedly?) And even if it were gone, you continue taking the medication for a period after it's gone to make sure it stays gone.

And then he asked my husband, 'How do you hide a dollar from a surgeon?' (See answer below.)

On a related note, I was talking to a friend today who also has hip pain and has been taking meloxicam as well. I asked her if she was still taking it and she said no, her doctor told her she shouldn't take it for more than a month because it can cause heart problems if you take it for too long. WTF? I've now been taking it for two months. This made me seriously wonder if my orthopedist flunked pharmacology in med school! However, when I got home, I consulted Dr. Google, who didn't say anything about adverse long-term effects. In fact, Dr. Google told me that meloxicam is indicated to treat pain for rheumatoid and osteoarthritis, which makes me think it must be (relatively) safe long-term, given that these are permanent conditions. (???) Maybe this means my doctor isn't the only doctor out there who failed pharmacology in med school. LOL.

And by the way, the answer to my Dr. A's riddle: You put it in the patient's chart.

A Ship without a Sail (15 Weeks + 1 Day)

This is not my proudest moment. But... sometimes you have to do what you have to do.

I feel like all I've done lately is bitch and bitch and bitch and piss and moan and bitch some more. Since I feel so overly negative, I've been trying to leave out a few details about my orthopedist that have been really frustrating me pissing me off. Honestly, I try pretty hard to give people the benefit of the doubt, especially medical professionals. I can get along with most people, at least on a superficial level. And I've tried reeaaaaally hard to be positive about my orthopedist, who is a super nice guy, and who I really want to like. However, I've had a few concerns about him. Specifically, I don't have any confidence he knows how to handle DVT appropriately. Not that I know how, either, but based on everything that I've read and opinions from other medical professionals, I'm... unsure. And this is sort of a big deal - it's not like getting a bad opinion about a sore wrist; this is acute and extensive DVT, which can be really serious. I know that orthopedists don't really 'do' blood clots, but shouldn't they at least be... I dunno... proficient? Maybe he is and maybe I read too much shit on the Internet, but I do have my doubts.

Also, it's not just my lack of confidence in him, although that is obviously the biggest and most pressing issue. However, I'm also less than thrilled with his lack of responsiveness to the questions I've sent him via the patient portal, which claims that you will receive a response within two working days. Of course, he was extremely responsive to me pre-surgery and his medical assistant was very responsive for the first week post-surgery and then post-blood clot. But lately... no responses. And it's not as if I'm constantly sending him e-mails with huge demands or anything. After my September appointment, when he said that my labrum had not healed yet, I got to wondering if it was okay for me to be, like, doing stuff, if he thought my labrum was still torn. I mean, that's why he said I had to be on crutches for a freaking month - to let the labrum heal. I sent him a quick e-mail asking what type of activity level he would recommend. He never responded. After my last visit, I mentioned that he had only ordered an ultrasound on my calf and the back of my knee (which to be honest didn't give me much confidence that he's even paying any attention to what's going on). I sent him an e-mail making sure the ultrasound would be of my entire leg. (Hello! It is the clot in the femoral vein that has been the most distressing from the start!) I wasn't sure if it was necessary for the order to explicitly state this, especially since I was having the repeat ultrasound at the same location, but I didn't want to take any chances. He never responded. I took care of it myself. After my ultrasound a week ago, the tech told me that my orthopedist would have the report by the end of the day. My orthopedist had told me he would follow up once he had the results of the ultrasound. I had talked briefly to the tech, who knows stuff, but said that a radiologist would read the images and send an official report to my doctor. I gave my orthopedist a few days, then on Friday sent an e-mail asking if he could let me know the official results - i.e., prognosis? recommendations? He didn't respond. Not that I expected a response on Friday, but I gave him two business days before unleashing my fury on him today (Tuesday).

And unleash I did. As I said, I'm not proud of it, but man. Seriously? The title of my message was 'Can you please respond?' LOL. Given that the only time he has ever personally responded to any of my inquiries was pre-surgery (i.e., in the wooing phase), I was doubtful he even gets the e-mails. Or if he does get them, it seems doubtful he actually reads them, given his lack of response. I figured if anything, his MA reads them, and he only responds to the ones his worker bee can't handle. Perhaps when I composed my pissy e-mail I had it in my mind that no one was actually going to read it, given that there is no evidence that anyone does. I mean, I GET that orthopedists are busy. I GET being busy. I, too, am a busy lady. But, if you are that busy, then the patient portal should not be programmed to send an automated response that someone will get back to you within two business days if no one is actually going to (which I wrote in my pissy e-mail). Maybe I am a problem patient, but I really don't feel like I'm being that high maintenance with a few basic questions + one refill request for Xarelto within the past two months ( = four e-mails total - including the refill request and and my repeat request for my ultrasound results). It's not like I'm a Patient Portal Abuser. And the alternative to the patient portal is calling the office, waiting on hold for 10-15 minutes, getting the runaround, then being routed to an MA's voice mail (which I also wrote in my pissy e-mail). Who has time for that?

I know reports and e-mail are a huge time suck for health care providers, and trust me, I understand the time it takes to answer e-mails. I get (and respond to) many, many e-mails a day from students, and I'm aware that writing a report takes a lot of time. E-mail and reports do not seem to be my doctor's strong suit. Not that the latter really matters - after all, the whole idea of the patient having access to her/his reports is something that comes along with the patient portal, which as far as I know is a fairly recent invention. (For routine health care matters, we always seem to go for the solo practitioners, none of whom can afford this.) At any rate, since the patient portal seems to be mandatory for being a patient at this particular practice, it has been interesting for me to read the 'care summaries' the doctors write. Notably, my doctor never writes anything, except 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. This must be some default option in the report-writing software. Interestingly, the only time my doctor has ever written anything other than this was after I had my second cortisone injection. The doctor who gave me the injection asked me what my doctor thought of my ongoing pain and I said I didn't have any idea what he was thinking. I noticed the report after that actually contained information. Word-for-word:

September 5, 2014: still having some sharp pains in her right hip. She has been going to physical therapy. She is still taking her Xarelto for her blood clot a 39-year-old female 2 months status post right hip arthroscopy with labral repair. At this time her hip has flared up and she states she would like to proceed with a intra-articular corticosteroid injection into her hip at this time. She states the Voltaren were not working for thus I will switch her over to meloxicam 15 mg once daily. She'll continue doing the physical therapy to help decrease her pain and improve her function. She'll continue taking her Xarelto also for one more month and we'll check an ultrasound of her right calf at that time I will see her back in 4 weeks' time to see how she is progressing. I do go she is frustrated with her progression but I did reassure I think that she will continue to improve we'll continue doing her physical therapy and try to improve her function and decrease her pain September 10, 2014: Patient here for right hip injection. she underwent a hip arthroscopy by Dr. Z. She says her pain now is worse than before the surgery. She is here for a repeat injection of her right hip joint.

(I'm so glad English composition is a requirement for most med schools!)

Anyway. Apparently my doctor does receive the e-mails through the patient portal, which actually makes it more unforgivable that he hasn't responded in the past. I sent my pissy e-mail close to 6:00 tonight. After putting the kids to bed and taking a shower, I came back downstairs and saw there was a message on our answering machine. The only people who call me after 8:00 PM are my mom, and lately, political campaigns, so I pressed the 'play' button on the answering machine while debating whether or not I had the energy to call my mom back at 8:30 on Tuesday night. I was shocked to discover that the message was from my orthopedist. WTF? I guess my pissy e-mail got through to him. I sort of feel bad about it, but sort of don't. For one, if he had just responded in a timely manner, there wouldn't have been a pissy e-mail in the first place. Also, as someone who works aaaaaalllll hours of the nights answering e-mails and grading, I'm hardly going to cry a river for someone making ten times more than I do who has to work outside the standard 8-5 business day.

(On a side note, I totally freaked a student out one time. I was up late grading assignments, which my students submit online, and I received a 'panicked' e-mail from a student claiming that she had submitted her assignment on time, but for some reason Blackboard was telling her that her assignment was late, and this was obviously a glitch on Blackboard, and she just wanted to make sure she wasn't penalized for this. I immediately shot her an e-mail back - around 1:30 AM - assuring her that I had been on Blackboard ALL NIGHT, for the past six hours, and her assignment was definitely not submitted before the deadline. Just like my orthopedist, the student never responded.)

But back to my original point. My orthopedist seemed super pissy on the phone, and to be honest, I don't blame him. The last thing you want when you finish a long day of work is a pissy e-mail from a patient you're obviously sick of. I know the feeling; I get lots of pissy e-mails from students and respond (semi) pissily. Here is a transcript of his message, plus imagine this in fast-forward mode; he was definitely talking ridiculously fast, as if to make the point that I don't have time for this shit.

Hey Mrs. Moon how're you this is Dr. Z giving you a call sorry to call so late just got done operating. It is... Tuesday night got the results of your ultrasound um they look good so I'll be able to get you off that um blood clot um blood clotting medication um looks good there's still a little... a small clot in there but it looks greatly improved from your last study so we can go ahead and get you off the Xarelto at this time and I think you should be doing just fine any questions feel free to give us a call back at the office tomorrow otherwise I'll talk to you soon thanks bye.

On the one hand, I don't feel like I should complain. This is what I wanted, isn't it? On the other hand, I don't trust this. So I'm supposed to stop taking Xarelto just like that, based on a seven-second message from my orthopedist? As much as I'd love for this to be the case, I can't find any evidence to indicate this is the right thing to do. I get that my doctor is probably super annoyed with me right now and probably just wants me to Go Away Already, but is this grounds for giving bad advice? Is he so pissed he wants me dead? LOL.

Additional concerns:

• This does not seem consistent with what the ultrasound tech told me. When I expressed my disappointment to the tech, she said it wasn't really realistic for such an extensive clot to resolve that quickly; it often took six months or even a year (and she should know). I realize this is ultrasound tech vs. orthopedic surgeon (via radiologist) but for some reason I'm feeling more confidence in the tech. Considering the whole reason my blood clot was even diagnosed and promptly treated was due to a PT assistant and ultrasound tech, I'm not feeling huge love toward the more highly educated.
• Following an episode of acute DVT, especially extensive DVT, it seems pretty standard to be on Xarelto for at least three months, more likely six months, and possibly even a year. I mentioned that I saw my husband's PCP the Monday after being treated in the ER, and he said that I would need to be on Xarelto for six months minimum. I realize that family practitioners don't necessarily 'do' blood clots any more than orthopedists, but considering my orthopedist doesn't even realize the clot was in my thigh, I'm... nervous. Fortunately, I asked the imaging place to have the results sent to this family practitioner as well, and I am considering consulting him as a second opinion. 
• Also, I've been communicating with my former PA for reasons unrelated to my hip. However, my hip did come up, and she said, (S)o sorry you ended up with those complications! DVT's are both scary and annoying. Will it be 3 months on the Xarelto? What did Dr A say? When I replied that Dr. A had said I needed to be on Xarelto for SIX months because the DVT was so extensive, she replied, 6 months sounds right for such a big event. So.... what to think? Again, I'm putting more confidence in my former PA than my surgeon, but... my PA is a really smart woman who knew/knows me so much better than my orthopedist. 
• So basically I don't know what to do. As much as I'd love to stop taking the Xarelto, I'm REALLY wary of just ditching it willy-nilly, and as far as I can tell, my orthopedist is the only person who is okay with this. And... I don't trust him. At the same time, after my pissy e-mail and his pissy call to me, I don't feel comfortable trying to facilitate any further communication with him.
• I realize it might be a good thing for me to find a new doctor, especially given that none of this even addresses my ongoing hip issues (remember those?), but a.) I'm starting to think all orthopedists are the same and b.) I'm feeling impatient at this point. Even if there is a better orthopedist out there, it's unlikely s/he could help me in the time period within which I am hoping to be helped ( = ASAP).

I remember an essay I was asked to write at some point in my education about how team captains for sports teams should be selected. I wrote an essay laying out the reasons I didn't believe in team captains, even though it wasn't really true. It just seemed like an easily defensible position, sort of like being pro-life, so I went with it. The response I got was that while my arguments were well laid out, wouldn't a team without a captain be like a ship without a sail? I had to agree.

And now... I feel like a ship without a sail, desperately in need of some guidance. (Any thoughts? Please share... here or on LJ...)

P.S. A few days ago, I wrote that I saw an anti-Xarelto ad on TV. While I was writing this entry, a similar ambulance chaser ad came on for anyone who has Smith & Nephew implants (which I do). So now I have two things working against me. Awesome!

10 Days and Going Strong (14 Weeks + 6 Days)

Despite the less-than-awesome news on the DVT front, my hip continues to feel really good. Considering I had been feeling good for a few days before my last visit to the orthopedist, I'm estimating that I've been feeling good for about ten days now. (But who's counting?) Today, I had one instance where I could feel the sharp pains trying to return for about five steps while taking my daughter shoe shopping, but... they went away.

I've been trying to think of the reasons I've been feeling so good, not so much because I care WHY I feel good, but because so far, every time I start to feel good it has been short-lived. So just in case the pain returns, here are some possible explanations for why I feel so good right now.

1. Maybe I'm finally healing. Obviously this would be the best option. :)
2. I stopped doing PT. I haven't been to PT in almost two weeks. And... I hate to say it, but not doing PT has helped way more than all the things I've tried in PT over the past two months or so, including the beloved massages. Granted, this could just be a coincidence if #1 is the case (fingers crossed), but nonetheless, I'm not missing PT at all. 
3. I started to take meloxicam in the morning instead of the night. Apparently dizziness is a possible side effect of meloxicam, so I was worried about the side effects it would have on me if I took it in the morning. Once I started taking it at night, I just never got out of that cycle until my orthopedist recommended taking it in the morning. Again, this could just be coincidence if #1 is the case (fingers crossed).
4. I never sleep on my left side without lying on a pillow. Every since my non-operated side started hurting, sleeping on my side has made it worse. Unfortunately, I often roll onto my side in my sleep and wake up this way. I used an extra pillow on and off since surgery, but lately I've been vigilant about making sure my extra pillow is in place before I fall asleep. This makes my sleeping situation look fairly ridiculous, since I also sleep with my right leg on a huge pillow. (Even if the DVT goes away, I think I'm going to have a hard time sleeping without the pillow.) However, it is good protection against my son, who has been coming into our room in the early morning and crawling in bed with us. It defines my territory. :)
5. I stopped stressing about the pain.
6. I've been much happier at work. Combined with #5, my mental state has been much better than it has been in the past.

At night, I continue to ice and stretch both hips religiously, and I'm thrilled this is keeping the pain away. Before, when I did this, I feel like it just got me back to my baseline after my pain increased to unacceptable levels during the day. I hope this means I've busted up this ridiculous pain cycle I seem to have been stuck in for the past two months. 

I know every time I post something like this, I have to post something a few days later retracting it. But since this is the longest stretch of time that I've gone with very little pain, I can only hope it's different this time. Hope is never a bad thing. :)

Blood Clots and Fried Green Tomatoes (14 Weeks + 1 Day)

I'm not going to lie, I'm not in the greatest mood right now. Although, I did just eat, so hopefully my mood will improve by the time I'm finished with this. :)

Anyway, I just got back from my 'stat' ultrasound, and as you may have guessed, it's not exactly the news I was hoping for. Apparently it's business blood clots as usual. I mean, I understand this might be something I have to deal with for six months or a year or even a lifetime in a worst case scenario, but I feel so much better than I did before, so I had imagined some major improvement in my situation. The tech did say it looked as if things had cleared up a little, but I can't rule out the possibility she was saying that just to make me feel better and to make herself feel better by not being the bearer of bad news. After all, none of this was an official diagnosis.

Apparently the back of my knee is still very clotted, which I hate to say I sort of knew, on some level. When my orthopedist did his blood clot test, which we know he sucks at and does not work on me, I didn't even try to exaggerate because I knew I was getting an ultrasound, which would tell the objective truth. (Plus, it really didn't hurt much at all.) However, then I reminded him that my blood clot went all the way up my thigh, too. So then he pushed on the back of my knee and asked if that hurt and I reflexively responded, 'OUCH! That does hurt!' He seemed somewhat taken aback, because I never scream like that. I was actually somewhat surprised myself by how much it hurt, but I guess my hope was that the pain was just from residual swelling. Ahhhh, denial.

In other news:

• My husband made crepes for breakfast this morning, and they were awful, or at least mine was. This is weird because he's quite a proficient (and pretty awesome) crepe-maker normally. The kids didn't complain, although they are not discriminating. Perhaps I just got the part of the batter that was not mixed well. At any rate, I could NOT eat my crepe and had to throw it away after my husband left to take my daughter to school.
• By around 10:45, I was starving, especially as my colleagues started warming up their lunches in the microwave, and all the yummy smells of frozen TV dinners wafted into my office. LOL.
• I left around 11:15 for my 11:45 check-in and 12:00 appointment, which was stupid. I'm so used to going to PT and to my orthopedist, which really is a good 30-40 minutes away, office to office. However, I quickly realized that the imaging place was actually only about five minutes from the university. Oops.
• I ran a quick errand and still arrived somewhat early. I got checked in immediately and then sat... and sat... and sat some more. I knew I was early, but eventually I checked the time and it was 12:23. 
• Eventually, I went in for the ultrasound and immediately saw the reason for the delay: it was a new tech. I was a little bummed out by this because the tech who did my last ultrasound was fabulous - very competent and readily shared information with me. Plus, you figure it's never a bad thing for a repeat ultrasound to be done by the same person. Fortunately, the new tech was being trained by the tech who did my original ultrasound, who remembered me from the last time. And since she was talking the new tech through the whole procedure, I sort of figured out what they were doing. (FYI: If they stop and take a picture and use their little tool to draw a line across a black circle, it's a blood clot. I know you were dying to know that, ha ha.)
• At any rate, the new tech was (understandably) sloooooooow, and the ultrasound took foreeeeeever, and I didn't get home until after 1:00, at which point I was very hungry and very grouchy.
• When I got home, I made fried green tomatoes, which I don't even really know to make. My husband erroneously told me it was going to freeze last night, so I went out and picked a bunch of tomatoes. It did not freeze, and now I have a bunch of green tomatoes in my kitchen. And since I've rarely met a fried food I couldn't eat, I figured what the heck. They weren't bad considering my total lack of direction.

And now... I am still somewhat grouchy, but at least not hungry anymore. :)

14 Weeks and Feeling Hopeful

It is hard to believe that I am 14 weeks post-surgery, but yet, here we are.

I am feeling really good right now. I don't even want to write this, because the last time I wrote that I was feeling great and speculated that I had finally turned the corner, my pain returned with a vengeance. However, I'm not actually that superstitious, so I'll just say it: I'm feeling really good right now! And even if my pain returns an hour after I write this, I'm still feeling good right now!

I mentioned that when I met with my orthopedist on Friday, he wrote orders for me to have a follow-up ultrasound for my DVT. I called right away to schedule it, because I am anxious about this, and I knew it might take a while to get an appointment given my fairly tight schedule. The imaging place had not received my orders yet, but since I had a copy of the orders, I was able to schedule an appointment anyway. I noticed as I was reading the orders that they just called for imaging of my calf and 'popliteal' (back of the knee), even though my original blood clot was also in my thigh. I immediately shot off an e-mail to my surgeon to make sure I could also get an ultrasound of my femoral vein and to make sure he had changed the orders (if necessary) before Friday.

Today, when I got out of class, I had a message on my cell phone (plus two messages on my home answering machine, which I discovered when I got home - WTF?). It was the imaging place, telling me to call them back immediately. Of course when I did, they asked how they could help me, and I was like... I don't know, YOU called ME. LOL. It turns out the orders were 'stat,' which apparently means my doctor wants the ultrasound ASAP. Honestly, I was fine doing it on Friday, which I tried to tell the woman on the phone, but apparently she was afraid I would die before Friday and they would get sued, so I agreed to go in tomorrow. Ha. I had to actually tell her that no, I could NOT go in today, and I was certain I'd be fine for a few more days. This is in stark contrast to when I called on Friday and basically had to fight to get an appointment for the following Friday. But really... what is a few more days in the large scheme of things? I mean, I'm sort of anxious about this, but it's not as I'm dyyyyyyiiiiiiiing.

At any rate, I am feeling hopeful. Although I know I still have swelling in my leg, it feels so much better than it did at the beginning of this ordeal. And unlike my hip pain, which comes and goes, my leg pain is consistently non-existent, except for when I squat down. I would love to be able to put this hiccup behind me. I realize that a clear ultrasound doesn't guarantee anything, but at the same time, it is a baby step, which seems to be what I'm resigned to these days. :)

It doesn't help that I was watching TV last night and an ad came on from one of those ambulance-chasing personal injury law firms. It started off: 'HAVE YOU OR A LOVED ONE TAKEN THE DRUG XARELTO AND SUFFERED FROM ANY OF THE FOLLOWING?' It then went on to explain all the horrible things that had happened to people taking Xarelto and urged us to contact them if we were interested in receiving compensation for our suffering. Needless to say, that didn't exactly inspire confidence, especially knowing that Xarelto is a relatively new drug and there aren't many (any?) data on its long-term safety.

Personally, aside from my initial bleeding, which could have happened on any anti-coagulant, I seem to have tolerated Xarelto fairly well. Nonetheless, I am anxious to be off of it, or to at least know I won't have to be a life-long taker of anticoagulants. Of course, almost every source I've read suggests being on an anticoagulant for a minimum of three months, and probably closer to six months considering the extent of my DVT. Regardless, having a clear ultrasound, or at least one showing improvement, would still give me a tremendous peace of mind.

Here's to hoping!