Cry Cry Cry (8 Months + 5 Days)

I was listening to Johnny Cash's song Cry Cry Cry on the way to my appointment with my orthopedist, and that's exactly what I wanted to do. I don't think it was necessarily even about my hips, but more general stress about a lot of different stuff. My hips certainly aren't helping, but I can't blame everything on them, either. My kids have the flu, and in addition to the usual challenges that having sick kids and a job poses, my husband and I are both running on about four hours of sleep. So, the fact that I wanted to burst into tears even before my appointment might be more of an indication of my general state of mind than anything else.

I'm not sure if I am just so tired I couldn't fully function during the appointment, or if I'm just out of words. I felt like I just sat there the whole time and stared off into space and nodded my head. Obviously I have a lot going on in my mind at any given time, and some of it is stuff I would hope to be able to discuss with my orthopedist. Yet, I said virtually nothing, probably because I was too tired and knew it wouldn't make a difference. Sweet surrender.

So apparently there is still a tear in my labrum. I am unsure whether it is a new tear or part of the old tear or what. My orthopedist only seemed to care about the fact that the area where he had repaired the labrum was intact and the anchor was still in the bone. At the last appointment, he seemed most worried about the possibility that the anchor had come out, which in a weird sort of way might have been the best thing. Based on what Dr. Google told me, surgery to remove a loose anchor wouldn't be a huge deal and could offer significant pain relief. But that's not what it is, so it doesn't matter.

Since I didn't feel like my orthopedist was offering me any useful information, and mostly seemed intent on convincing me that it wasn't his fault that my hip still hurts (not that I'm even blaming him), I asked his MA for a copy of the report so I could read it myself. It says:

(T)here appears to be a recurrent tear of the anterosuperior labrum, across the labral base. (...) The tear is positioned just posterior to the acetabular anchor, involving the anterior aspect of the superior labrum and the superior aspect of the anterior labrum. (...) The superior labrum is relatively large, potentially hypertrophied due to the relatively poor coverage of the superior femoral head by the relatively small acetabulum. (...)

IMPRESSION: Recurrent right acetabular labral tear at the junction between anterior and superior labrum. The tear passes beneath labral base, just posterior to the labral anchor.

Honestly, I don't know what I think about any of this. I don't have any energy to even think about what I think about it. I'm so tired of thinking about it.

In other news:

• The report also states: 'A large-field-of-view coronal sequence shows a large myometrial mass that measures approximately 5 cm in diameter, is very similar to the prior study, and is likely to represent a uterine fibroid.' Good to know. LOL. Honestly, when I started to read the report and it was talking about uterine fibroids, I thought I had the wrong report. I would hope that if this were a significant finding, someone would have mentioned it to me by now; nonetheless, I consulted Dr. Google about uterine fibroids, just to make sure. Apparently they are 'normal' and don't usually cause any symptoms, and I don't have any of the possible symptoms listed, so it's just one of those things.
• Ever since my arthrogram, my left hip has been hurting a lot. I know that it is 'just' trochanteric bursitis, and that it comes and goes, and is probably related to how my right hip is feeling and how much I am limping. I'm not usually too concerned about it because I have my right hip to worry about and I can't worry about two hips at once. (Remember, I have a ridiculously low stress threshold.) However, it has been very painful for about a week, to the extent that I have been icing it many times a day to try to manage the pain. And, it actually hurts worse than my other hip at this point, which has not been the case in a long time. Dr. Google told me the best treatment for severe bursitis was a cortisone injection, and my orthopedist agreed. He said that unlike the cortisone injection into the joint, it was no big deal to inject the bursa, and there were usually very good results. I said I didn't feel like an injection was necessary just yet but would consider it if this episode didn't resolve itself like the other ones have. At any rate, he told me that pain in my bursa was 'a much better problem' than pain in my hip joint; he had definite solutions for bursitis (and I totally believe him, because every time he has told me everything is going to be awesome, he has been right </sarcasm>). He prescribed a cream (another one!) for it, one that I could pick up at a local pharmacy, and said that if it wasn't better in six weeks I should come back and have a cortisone injection.
• I also have a touch of bursitis on my right side, although it's not nearly as bad as on my left side. The doctor did say that if I had the right side injected as well, he would recommend doing one side at a time. So apparently it's not a completely painless procedure.
• Whatever. I have no plans for injections anywhere in my near future. (I'll wait until I'm in complete agony. LOL.)
• The doctor also mentioned that he thought physical therapy could help the bursitis, 'if you're up for it.' I said I felt like PT is what started the bursitis in the first place, to which he replied, 'Okay, never mind.' I said that in the past, these 'flares' usually calmed down on their own, though I was starting to worry that the current one was my left hip starting to go downhill. His reply: 'No, that's not allowed.' If only it were that easy.
• Speaking of PT, on the way out I popped in to say hello to my physical therapist. We had a cordial conversation and he said he was sorry he didn't have any ideas to help me. Then he mentioned that there were huge changes in the future, as their practice was 'partnering' with (i.e., getting bought by) a major healthcare system. Interesting. And sad. I mentioned in a previous post that I've always been drawn to small practices, and oftentimes, solo practitioners. It is sort of depressing to me that even this major orthopedic group is being bought out, as the group in its current state is already really big and impersonal.
• Also sort of on the subject of PT, last night in my EMT class, we practiced applying traction splints for broken femurs (which is something we will be tested on but never use in real life, according to our instructors). However, when it was my turn to be the fake patient and have the traction splint applied to me, it felt so good I actually volunteered to be the fake patient a second time. I've had my leg pulled on a few times before in PT, so maybe there is something to it.
• I mentioned that I still hadn't received the pain cream we had talked about. The MA gave me a number to call, and I actually did. Apparently my insurance doesn't cover snake oil produced at sketchy compounding pharmacies in Southern Mississippi, so they never sent it. (You'd think they could have just told me that a month ago.) I'm not opposed to paying for things out of pocket, depending on how much I think they will help and how expensive they are, but based on my experiences with this pharmacy thus far, there is no way I am going to give money to this place and just trust that they are going to send the cream to me. Plus, $1 per gram is pretty expensive for something I have my doubts about. So, whatever.
• As a courtesy, I sent an e-mail via the patient portal with a snake oil update, and briefly described my negative experience with this pharmacy. Both the doctor and the MA told me they had actually switched pharmacies because the previous pharmacy was so sketchy and they had soooo many problems, so I thought they should know this one sucks, too. To my surprise, I got a response within a hour from a different MA than the usual one, who said that she spoke to my doctor, who said he could prescribe the same medication in pill form if I wanted. I'm still sort of contemplating this. What type of medication are we talking about here?
• Even though my PCP is now taking care of my DVT (supposedly), I still had the ultrasound results sent to my orthopedist, since he was the one who set off this whole thing to begin with. When he first came into the room, he started talking to me about my DVT, and how it might be a lifelong condition, etc., etc. He was saying all of this as he was reading the report from my ultrasound, which he then then left for me. It was only after the appointment was over when I read the report myself that I realized that he was looking at the report from October. Needless to say, this didn't exactly inspire confidence.

It's ironic that after overthinking all of this for way too long, I truly don't want to think about any of this right now. After laying out all my plans for X, Y, and Z scenarios, now... I'm not sure what I think. I need to sit on everything for a few days. And get some sleep.

Three (8 Months + 3 Days)

Three.

That's how many new doctors I need.

I need:

1. an orthopedist
2. a primary care provider, and
3. an OB/GYN

I guess ideally #2 and #3 could be one person all wrapped up in one, like my old PA was. It's not as if I'm usually that needy. I typically only need antibiotics once or twice a year, plus I go in for my annual well-woman check up, mostly so I can get a prescription for birth control. I haven't gone in this year because I don't have a provider I would let touch me down yonder, and I'm not currently taking birth control due to my DVT.

Unfortunately, I'm needier now than I've ever been in my adult life, and I feel like I need a 'go to' person. I really, really miss my PA. I had a third ultrasound for my DVT over a week and a half ago, and I've been not-so-patiently waiting for my current doctor to get back to me with the official results. I haven't been taking Xarelto for the past few weeks because I was instructed to stop taking it five days before my arthrogram, which meant I was supposed to stop taking it on Thursday, 2/26.* Conveniently, I was also running out of pills around the same time, and I didn't renew the prescription because I was having an ultrasound on 2/27, and I hoped it would be good news, and that it would be a good time to ditch the Xarelto altogether.

* According to my doctor, I didn't actually need to stop taking Xarelto for five days prior to the arthrogram; this was more for other anticoagulants such as Coumadin. He was supposed to look this up and get back to me, but of course he never did.

I waited impatiently for almost a week before trying to follow up with my doctor about the ultrasound results. Based on what the tech had told me, I felt pretty good, and I really try to give people time and not hold everyone to my personal standard of timeliness, which is apparently abnormal. But eventually I called the office on Thursday of last week. It had been almost a week and I mean, geez, I just don't feel like a two-minute phone call with the results of an ultrasound is asking that much (but apparently it is, because it was a big deal for my orthopedist as well). I left a message with the front desk, but no one got back to me, so after giving them the weekend, I called again yesterday morning, which was a Monday. I didn't get a response all day, nor one today (Tuesday), so I enlisted my husband, who has a texting relationship with this doctor. FINALLY, the guy got back to me, about an hour ago. And...

... apparently the clot is still not f-ing gone, and he is recommending another three f-ing months of Xarelto, and another ultrasound in three f-ing months. Sorry, that is a lot of f-ings in one sentence but I'm feeling just a little ticked off right now. I'm feeling irritated over the f-ing doctor, over the f-ing blood clot, and over the fact that my f-ing hips are still f-ing killing me.

And speaking of my hips, this week is passing soooooo slowly I can't stand it. I have consulted Dr. Google numerous times this week about various scenarios, and each time I have had to cut myself off and remind myself that I had the f-ing arthrogram done so that I could put all of this guess work to a rest. I just hope that when I go in for my appointment on Thursday my doctor has read the results of the f-ing arthrogram.

And while I am pissing and moaning about doctors, let me just be a pathetic whiner for a little bit longer. Before the arthrogram, the imaging place wanted a report from my first MRI, as well as the surgery report, which they said would help the radiologist interpret the results (which yeah, makes sense). They thought they could get the results of my first MRI (which they did), but that I should provide the surgery report. So, I sent an e-mail via the patient portal requesting the report, and never heard back. Of course. A few days later, I called and left a message requesting that the report be sent, and I filled out some paperwork requesting the release of the report, but apparently it never got sent, because when I went to check in for the arthrogram, they didn't have it. I gave them my copy of the report, which I had requested way back when, when I first started having my doubts about my orthopedist. However, this was just a printed version and it cut off about 1" on the right margin, so 3-4 words of every line are missing and you have to sort of fill in the blanks. But, it was better than nothing. Even /I/ got gist of the report, missing words and all. BUT STILL, is it asking too much to send an f-ing report to an f-ing radiologist? I mean, isn't the whole idea of the 'information age' that stuff like this is not a big deal?! I live in a reasonably sized town with a metropolitan area of over 500,000 people, and my orthopedist is part of a reputable orthopedic group with a ton of resources for patient portals, support staff, and all the bells and whistles of modern medicine. (I have more sympathy for my PCP, who is a struggling solo practitioner whose PA just left him.)

And... remember that snake oil/pain cream I discussed with my orthopedist over two months ago? Still nothing. After my last visit with my orthopedist in February, his MA made a big deal about me not getting the cream and told me to hound them until I did. I didn't. Because: a) I just wasn't sure it would help and didn't care that much; and b) Why should I have to hound someone to get something they told me they would take care of? Like... I tell my students to let me know if they have a problem or don't understand something, but I don't say, 'Hound me until you learn something.' WTF?

Okay.

I need to quit. This is unproductive bitching, and I'm guessing that after my 'F/U' I'm going to have a lot more to bitch about. Just a hunch.

MR Arthrogram (Almost 8 Months)

Well, that was unpleasant. I knew it would be, and was prepared for it, but it was still unpleasant. I guess I was hoping it would be better than I was expecting. It wasn't. But, it wasn't worse than I thought it would be, either. It was pretty much what I had prepared for.

It didn't help that I stayed up way too late last night and didn't get to sleep until around 2 AM. I am taking a night class that goes from 6-10 PM, and after psyching up to stay awake through four hours of lecture, I have a hard time winding down. So, I was reeaaallly tired this morning. I practically sleep-talked my way through my morning class, and took off immediately afterward to get to my 11:15 appointment.

Before the MRI, I went in to get the contrast dye (gadolinium) injected. Getting the dye injected was about like getting a cortisone injection. I would say it was somewhere in between the first cortisone injection I had, which was horrid, and the second one, which wasn't nearly as bad. The injection was done by a radiologist, with the help of a tech. Before injecting the dye, the doctor injected an anesthetic, which was actually the most painful part, but apparently makes the injection of the actual dye hurt less. Both the tech and the doctor told me the dye would make my hip feel 'full' because they were adding between 10 and 15 CCs. (Ultimately I think they added 11.) 'Full' is a good way of describing it. It didn't exactly hurt, but it was extremely uncomfortable - sort of how your arm is uncomfortable when you're having your blood pressure taken, only the feeling lasted for over an hour.

After the injection, the radiologist took a few X-rays to make sure the dye was in the joint. For one of the X-rays, I had to do 'frog legs' and that... hurt. Like a mother. First off, my leg felt so weird I didn't feel like I could move it. When I finally did, rotating it outward caused a massive amount of pain. I must have made a face because the doctor asked if my hip always hurt when I rotated it like that, and I said that was pretty much the case. It reminded me of the time I had to get X-rays of my elbow because it was totally swollen and I couldn't straighten my arm. The X-ray tech told me I had to straighten my arm to so she could get a good picture but it was like, 'Helloooo, that's why I am here - because I can't straighten my arm!'

On a funny side note, when I was going over the information with the tech before the injection, I noticed they had listed my birthday as being in 1940. LOL. I told her I was definitely not THAT old. I crossed it off and changed it to 1974. She said they must have been looking at my age when they wrote that. Then the doctor came in and looked at the paper and said, 'Is that right? Were you really born in 1974?!' I said yes. Then he asked, 'So that makes you how old?!' I replied that I was 40. Then he said, 'That's what I thought, but before I saw this I thought you were, like, 18.' I told him that apparently 40 is so old I'm not even offended when people say things like that. Ha.

I must have really been limping when we went downstairs for the MRI because the tech asked me if I needed a wheelchair. LOL. I had a short wait in the waiting room with a woman who was drinking barium and apparently having a very hard time with it. She asked me if I had ever had to drink barium before. Yup, been there, done that, in high school. I'm not sure which is worse, having dye injected or having to drink barium. Barium is seriously so gross it makes you want to throw up, and a lot of times the reason you're drinking it in the first place is because you've been throwing up constantly. I told her I had had to drink barium before and agreed it was awful. I decided maybe having the contrast medium injected wasn't as bad as having to drink it. Plus, when the barium passes through you, it's not pleasant. I'll leave it at that. 

Eventually I went in for the MRI, and aside from being very painful, it was pretty uneventful. My hip was pretty much throbbing at that point, and lying down on my back is very painful. At first I was in such an uncomfortable position I had no idea how I was going to make it through 45 minutes, but then the techs at least put a pillow under my legs so my hips were not hyperextended (which really hurts me). Then they taped my feet together so it would be easier for me to hold still. And in I went. It was louder than I remember. And longer. The last time I had an MRI, I remember telling them to play classic rock, and I had to listen to '80s music the whole time. This time I also requested classic rock, and it seemed like true classic rock, although I could honestly not really hear much at all. I also remember last time thinking the time passed pretty quickly, but maybe that's because I fell asleep. This time I felt like the MRI would never end, but maybe that's because I was so uncomfortable (which is probably why I couldn't fall asleep). In the end, the tech told me I had done a great job holding still, and that they were able to get some great pictures. She said it so many times it made me wonder what most people do during the MRI. It's not as if you really have the choice to wiggle around. Since she kept going on and on about all the great pictures they had gotten, I asked her if she saw anything interesting. She promptly replied, 'Unfortunately, even if I did, I'm not allowed to say anything.' Darn. A by-the-books tech.

When I left, I was in an extreme amount of pain, but the pain wore off after about an hour. I feel pretty good now, although I am supposed to 'limit my activity' for the next 24 hours, whatever that means. Anyway, the arthrogram is done, and I'm glad I had it done because no matter what, it will help me make some decisions as I try to get through this mess. I have an F/U with my orthopedist next week, and until then, I'm just not going to think about it.

A Farewell to Clots (7 Months + 20 Days)

Since I've been considering the possibility that I need a new orthopedist (and not necessarily the one the my current orthopedist recommends), I've been asking around about orthopedists. One of my friends, who had hip arthroscopy a few months after I did, said that she liked her doctor 'just fine.' It wasn't exactly a rousing endorsement, except then she added that she had only seen him a few times, followed by, 'You know, my hip really doesn't hurt at all anymore.' Then it struck me that I should not be shopping around for an orthopedist that I like; I should be shopping around for one with whom I will not need to have a long-term relationship. LOL.

I thought of this because I just got back from my third ultrasound for my DVT, and I realized I was becoming a regular at the imaging place. Although it is very lovely and the staff are very nice and I've had nothing but really good experiences with the techs, I don't think it's a good place to be a regular. Ha. My appointment was at 2:45, and they asked me to be there at 2:30, so of course I was there by 2:25. I hadn't even finished filling out the forms they gave me when I was called back to do my registration. Then the woman registering me informed me that I didn't need to do any of the paperwork because I had done it recently, and if they ever tried to give it to me again (i.e., when I go back on Tuesday), I should just tell them I've already done it. So 'registration' took all of two minutes, and I was back in the ultrasound room by 2:35 and back in my car before 3:00. In and out.

A fast ultrasound is a good ultrasound. This much I know. If it takes a long time, it means they are stopping a lot and taking pictures of your blood clots and drawing a line across them to show the diameter. It was a different tech this time, and unlike the one I've had before, she did not have the screen turned on that allows you to see what she was doing, but I could tell by how quickly she was going that she was probably not finding anything exciting (exciting being bad in this case). In the end, she told me that things looked much better than before. Hurray. I asked if she saw any blood clots at all and she sort of hesitated, then said, 'Well, I think once you have them...' She sort of trailed off, so I finished for her, '... then you have them forever?' (I had read this was a possibility.) She said, 'I think sometimes they never clear off the edges...' but then seemed uncomfortable stepping out of her circle of approved dialogue, so I didn't push any more. I guess I will just have to wait and see what the much smarter doctors have to say about it. (That's sarcasm, by the way.) But I feel confident. My leg really doesn't bother me at all anymore, and I've never felt misguided by an ultrasound tech before (and I've had a lot of ultrasounds).

The only bad thing about the ultrasound was that she asked me to rotate my leg, and when I did this, my hip immediately began to throb. I tried to roll my whole body a little, and basically just ended up getting goop all over my other leg. So the ultrasound itself was quite painful, and I'm slightly alarmed about how much that little bit of external rotation hurt me. But I will wait until Tuesday to worry about that. In the mean time, I am going to throw back some meloxicam and go skiing this weekend.

DVT, Xarelto, and Arthrograms (7 Months + 17 Days)

We finally got a piece of the snow that has been afflicting various parts of the nation. As a result, I went sledding with my kids over the weekend and destroyed my back. It was that falling over, I-think-I-might-throw-up-or-faint-or-both type of pain that struck all at once when I was lifting my son up at the park. My husband suggested dropping me off at the ER on the way home, but I resisted, and when we got home, I threw back one of the hydrocodone pills in my stockpile - either from surgery or from my trip to the ER for DVT. I can't quite remember. That was on Sunday. On Monday, we had a snow day, thank God. Even the university was closed, but if it hadn't been, I would have considered canceling class anyway, because I was dyyyyyyyyying. And I never cancel class. At least, in six years of full-time teaching, during which there have been many crises, including my kids being hospitalized for various reasons, I've never canceled class. But it was bad.

I called my husband's doctor* on Sunday night and left a message asking if I could get in to see him on Monday. I have no idea what I thought he could do for me, but I figured considering the state I was in, I had to do... something. Unfortunately, in my pain-induced stupor, I apparently asked them to call me back at my parents' phone number. LOL. (I've done this before; I actually wrote my mom's work number on a letter of recommendation I wrote. After all, I never call myself, so it's the numbers that I call frequently that are stuck in my head.) When they didn't call back on Monday, I just assumed they were closed because of the snow, but apparently they weren't closed, and they did call me back... and they left a message on my parents' answering machine, which my mom informed me of late on Monday when she got back from work and discovered this weird message on her answering machine. Oops. So I'm an idiot. I immediately called back and they told me that I could get in on Tuesday (today), so I took the appointment.

* I guess he is my doctor now, too, I just haven't fully accepted this.

Fortunately, the hydrocodone was a miracle drug, and whatever was up with my back was temporary, because by Monday evening, I was actually feeling much better, which led me to believe that whatever I had did not involve any bones or cartilage moving out of place. Nonetheless, I decided to keep the appointment, because I've been meaning to follow up with this doc regarding my DVT. It's just that I haven't, because... because I'm me, and dealing with my hip is pretty much all I can handle. One medical thing at a time. Though, I have to say that all of this is really giving me a lot of sympathy/empathy for people who have or have family members who have conditions requiring constant attention. Like... I have a fairly flexible job, and so does my husband, yet scheduling appointments and medical procedures is a real challenge between my work schedule and his work schedule and our kids' school and daycare schedules. Ahhhhhh!

Anyway, I saw the doctor today, and based on a few tests, he said he was sure the back issue was just a muscle spasm and not a disc issue, and I actually believed him. He showed me a few stretches to do for my back, and I couldn't do some of them because it hurt my hip. Then I mentioned that I have a history of back problems, and I normally stretch my back religiously. However, I hadn't done so in a while because of my hip issues, and that could be why I'm having back issues. Ugh, I can't win.

And speaking of my hip, I told him I was scheduled to have an arthrogram on March 3rd, and one of the things they had told me was that I needed to stop taking Xarelto five days before the arthrogram (which I don't get, but whatever). At some point during our appointment, he whipped out his cell phone and seemed to be barely listening to me while fiddling with his cell phone, and all the while I was thinking WTF?! But it turned out he was consulting Dr. Google about the whole Xarelto/arthrogram thing, hahaha. So even doctors consult Dr. Google. He then said he thought that it was standard to stop something like Coumadin five days before an arthrogram, but that he didn't feel it should be the same with Xarelto. I told him the woman on the phone just asked me if I was on a blood thinner, and when I said yes, she hadn't asked me which one; she just told me to stop taking it five days before the arthrogram and to consult my doctor about an appropriate 'replacement.' He said he thought it was different for different medications; however, he would 'research' it more and call me back later with a better answer. Honestly, that made me feel good about him. As an educator, my students are constantly asking me questions, and sometimes I don't have a good answer for them. But I'm always willing to admit when I don't know something, and I then research it and answer them later.

At any rate, I have some selfish motives behind wanting to get off Xarelto. A few days ago, I took my last pill from my prescription, and seeing as how I feel like I should be at the end of my Xarelto days, I didn't refill it, because a) I am lazy, and b) I am cheap, and Xarelto is expensive. Which I know is horrible, and makes me one of those terrible and not compliant patients; at the same time, I have reasons to truly believe it is okay for me to stop taking Xarelto without risking dying of pulmonary embolism. One reason is that my orthopedist actually told me I could stop taking it back in October. Granted, I didn't totally believe him, which is why I sought other opinions and continued to take the medication until now. Nonetheless, I have to think that if one medical professional told me it was okay to stop the medication four months ago, then it shouldn't be life-threatening for me to stop it now.

It just seems to me like a good time to come off the Xarelto; as I discussed with the doctor, I'd like to stop taking it before the arthrogram and just never take it again. Ideally, I'd like to keep taking it until I'm sure my DVT has resolved, but I don't want the refill the entire prescription for 3-4 days when I'm really hoping, hoping, hoping I don't need it anymore. And even if I DO, I just don't feel like I'm high enough risk that missing a few days will kill me. (If it does, I will stand corrected, and will be sure to refill the prescription in my afterlife.) In the end, although I didn't exactly tell him I would not be taking Xarelto for a few days, he agreed that at this point I was 'low risk,' considering this incidence of DVT was my first ever, and that there was a definitive cause behind the DVT in the first place (the surgery).

The sort of funny thing is that he asked me about my family history, and whether there was any family history of blood clots or miscarriage or infertility. I told him I was adopted and have no family history, although I had had a miscarriage. Then later it occurred to me that obviously my biological mom was more fertile than she wanted to be, so it was unlikely she had any issues with fertility. LOL.

The end result of all this is that I'm going to get a 'STAT' ultrasound on Friday to (hopefully) confirm that my DVT is no longer an issue, and that I can rest assured that I don't need to take the Xarelto anymore. I'm hoping, hoping, hoping this turns out well, because this is one thing I'd really like off my mind. The more I think about things and let reality set in, the more I feel like there is still something wrong with my hip. While I hope I am wrong in thinking this, I need to prepare for the possibility that I am not. And if that is the case, I just can't be dealing with a freaking blood clot on top of my hip. Jeez. This is something I'd really like off my mind, once and for all.

Here's to the power of positive thinking.

Ailment du Jour (7 Months + 12 Days)

One of my dear college friends just sent me a message about a mutual acquaintance, who is apparently experiencing very similar hip issues, and just had a second surgery. Interestingly, this woman was also diagnosed with Ehlers-Danlos syndrome, which is something that my daughter supposedly has, which would mean that I might also have it. I wrote about this here: http://39andhip.blogspot.com/2014/11/food-for-thought-18-weeks-6-days.html.

While I was contemplating this, I realized that there are a lot of people out there who have hip problems, and while it's good to not be alone, OMG, having surgery to repair a torn labrum is right up there with being on the autism spectrum, having ADHD, or being gluten intolerant. It's that common now. It's trendy! And cool!

Okay, so I'm being purposely flippant. Sort of. Since I had this realization, I keep thinking of my poor dad, who was diagnosed as having Celiac Disease a few years ago, in his mid-60s. This was the worst type of punishment for my dad, who has always been an amazing baker and has always enjoyed flour-y, gluten-rich baked goods. I wish I could trade places with my dad, as I've never been a baked goods gal. I do realize that there is gluten in many, many things other than bread and pastries (even in soy sauce, wtf?), but I still think it would be much easier for me to be gluten-free than it is for my dad. Fortunately, there are many gluten-free options available now. While my dad appreciates this, he hates the idea that people might think he insists on gluten-free food because he is part of the anti-gluten movement and will not eat gluten because it is now very trendy to not eat gluten.

And to empathize with my dad, I hate the idea that people might think I am having hip problems because pretty much every middle-aged woman has hip problems and it is now very trendy to have hip problems and to have hip surgery to correct aforementioned hip problems. It's practically like having a Botox injection or dying your hair.

Call me cynical, but I'm currently reading a great book called Cancer: The Emperor of All Maladies. And while it is very fascinating to read about cancer, it also provides a very interesting perspective on the history of medicine. In reading about some of the procedures that used to be performed a few hundred years ago, I find myself grateful for modern medicine. (Surgery before anesthesia... who would agree to that?!*) At the same time, I realize that someday the procedures we go through now will be looked upon with the same scorn by future generations. I can just see this era written up in medical journals: 'In the early 2000's, it was very common for women to have hip surgery that ultimately ended up doing nothing, or inflicting more pain than the torn cartilage itself.'

* In fact, this is a big reason why Charles Darwin chose not to pursue a career in medicine; he found surgery in the days before anesthesia to be horrific.

With that said, I saw my orthopedist on Tuesday, even though I never got the snake oil cream that was supposed to be sent to me. You know it's bad when you go to your orthopedist and you get VIP treatment. His assistant was super apologetic about me not getting the cream, and my orthopedist went on and on about compounding pharmacies and how super shady they are and... and... and... whatever. I told them it wasn't a big deal just because I felt like this was beyond cream. Like... I'm willing to try the cream, but at the same time I want to move forward with other possibilities.

Fortunately, my orthopedist brought up the suggestion of the arthrogram before I even mentioned it. He agreed that regardless of what I decide in the future, it would be good to know what's going on for sure. I asked him what he thought could be a cause for the continued pain, if not normal, post-surgery pain. He said it was most likely that my labrum just never healed, for whatever reason. Then he said that sometimes the anchor used during surgery could come out, but that was unlikely without a traumatic event. Then he told me about a patient he had who fell after surgery, which made her anchor come out. This was interesting, because after multiple consultations with Dr. Google, I was aware it was actually possible for the anchor to come out, and I kept thinking back to the day of surgery, when I fell. It seemed unlikely to me that the fall did anything considering my hip didn't hurt for a long time after that, but now I wonder. I also wonder because I read the surgery report, and apparently during the surgery, my orthopedist tried to insert a second pin, but it wouldn't stay in, so he ended up not putting it in. That's not exactly encouraging. It's all... food for thought.

So the plan is: arthrogram on March 3rd followed by 'F/U' with my ortho sometime after then. (It cracks me up that 'F/U' in medical speak is 'follow up.') I was actually impressed that he recommended me getting my arthrogram at a place other than the one associated with their practice, telling me this other place had the best MRI machine and best radiologist. He also brought up the possibility of me seeing a different orthopedist again. (He is sooooo trying to get rid of me, lol.) However, we will discuss that at my F/U appointment once we have the results of the arthrogram.

And so it continues.

A Slow News Day (7 Months)

You know how when you watch the local news, and the lead story is about a lost dog or a fender bender, and you think to yourself, 'Wow, it must be a slow news day!' Well, it's a slow news day here. There is not much news on the hip front, which could be either good or bad, I suppose. I choose good. And even though I really don't have a lot to say, I thought I should write a seven-month update.

After my last visit to the orthopedist a month ago, we had settled on... lotion. I was skeptical, but figured what the heck, right? Supposedly this magic cream ( = a sophisticated snake oil?) was to be mailed to me? Nothing. Finally, last Friday, I inquired about this via e-mail, and I also asked for a refill for my meloxicam prescription. Every time I try to stop taking it, I can definitely feel it. My orthopedist's assistant got back to me on Monday telling me she had ordered the snake oil, and gave me a number to call to find out where it was. I didn't, just because. Because last week was insanely busy, and because it doesn't matter. In my heart, I know this is beyond snake oil. She also told me she would check with my doctor about refilling the meloxicam when he got back into the office on Tuesday. I waited all week and finally sent a follow-up e-mail on Friday. She called me within an hour to tell me she was faxing the request to my pharmacy. She seemed annoyed. Geez, woman, sorry to be such an inconvenience.

Anyway. I'm supposed to see my orthopedist in a week and half to talk about how the snake oil is or is not helping me, and even though I have not actually tried the snake oil, I'm going to keep the appointment, because I have a plan laid out in my head. The plan is:

• I'm going to ask to have an arthrogram. I feel as if I need to know what's going on, regardless of whether or not I'd agree to another surgery. To be honest, at this point, my level of discomfort is enough that I cannot completely rule out the possibility that I might seriously need to consider another Something Major that is beyond snake oil and needles. Even if it's not right away, I need to be able to prepare mentally for various possibilities, especially since I'm foreseeing some major changes in my future, and any long periods of being on crutches need to be worked into my plans. (I am a planner.)
• If the arthrogram shows something significant - i.e., something requiring surgery to fix - I think I am going to shop around for a new orthopedist, or at least get second and third opinions about the best course of action.  
• If the arthrogram shows that everything is splendid - i.e., the pain I'm feeling is really just normal, post-surgery pain - I think I am going to try physical therapy again, and I am definitely going to shop around for a GOOD physical therapist. I think I will also try some massage therapy, because my muscles feel really tight. Of course, I know now that the muscle pain could be the pain from inside the joint manifesting itself as muscle pain, which is why I think it would be helpful to get an arthrogram and at least know what I'm dealing with.
• And on the topic of massage, also in my plan is to follow up with my primary care doctor for my DVT. It has been six months since I started taking Xarelto, and the blood clot should be cleared up by now. I need to get an ultrasound to (hopefully) confirm this. I should definitely not have any massage therapy until I am sure the blood clot is gone.

Other random thoughts:

• I have gone skiing several times this winter, and my hip has held its own. This is nothing to get majorly excited about, as I actually went skiing last winter, too, at the height of my pain (pre-cortisone shot and pre-surgery) and my hip held its own. Nevertheless, I'm grateful to be able to ski. For a while, I was so nervous about falling that I spent way too much time worrying about how a fall might affect my hip, and I couldn't relax and just ski. But eventually I took a spill while cutting through some trees, and it turned out to be a good thing, because I wiped out and came out with my hip intact. I realized that while my hip does still hurt me, it's not, like, completely unstable and falling apart on me. That's always a good thing. :)
• The last time I went skiing, I definitely felt a lot of pain afterwards, more than the first couple of times, and enough to sort of freak me out. After a little break, I am going to go again tomorrow. I am a little nervous, but at the same time I sort of figure that no matter what I do, my hip hurts, so why not live a little?
• So while skiing doesn't really bother my hip, walking does. And that is slightly inconvenient. LOL.
• I'm also taking an EMT class right now, and there have been a couple times when I've had MAJOR PAIN from deep within my hip joint that really doesn't sit well with me. This came after trying to run and after doing various types of patient lifting.
• This is actually a concern because I am hoping to be become a certified EMT in May and get a job doing something EMT-related over the summer, which is part of the reason I feel like I really need to know what's going on with my hip, so I can plan accordingly.
• Going from standing to sitting and going up stairs are still my major nemeses. I limp. A lot. So much that pretty much every one of my colleagues has commented on it in the past month.
• Also, trying to find a comfortable position for sleeping is still a challenge, as I cannot lie on either side comfortably. I've actually gone back to lying on my back with my legs elevated, which I had sort of abandoned once my DVT seemed to be getting better. But now I realize I slept like that for so long I'm used to it.

I feel... blah about all of this. On the one hand, I don't have a lot of time to worry about my hip, and that's a good thing. On the other hand, the pain is something that is always with me, always on my mind. I have to think it is taking a toll on me both mentally and physically. I also don't like the idea that this blog is turning into one of these Internet horror story blogs that I was so convinced would never be me. But if there's one thing I've learned from reading aforementioned Internet horror story blogs, it's that attitude makes the biggest difference of all. So while I try to go forward in dealing constructively with some real issues of chronic pain and the various frustrations associated with that pain, I am really trying to focus on the fact that I have an awesome life. I am truly grateful for that.