You Are Always on My Mind (24 Weeks + 5 Days)

When kids are little, people often talk about how old they are in terms of months. That seems to last until they are two, at which point they just become two, and not 24 months; then they are 'just turned two,' then 'almost 2 1/2,' then 'almost three.' In typing out that I'm almost 25 weeks post-surgery, it struck me that I should really be talking in terms of months and not weeks. It has been almost six months. Six months. Somehow that seems much longer than 25 weeks.

The past month has been rough. I had a sinus infection turned respiratory infection followed by a GI bug followed by the flu, and everyone else in my family also had the latter two, which was fun. Not. This basically kept my son out of daycare for two weeks, during the most hectic time of the year for both me and my husband. There is just nothing like your body ejecting anything and everything out both ends AND having to clean up after two kids doing the same AND THEN having to drag yourself into work because it's finals week. (I can teach with a cough, with a sore throat, with a fever, with a headache, with a blood clot, with a painful hip, and even while loopy on pain meds, but being in class with a GI bug is The. Worst.) Nevertheless, my husband and I rallied, and recovered soon enough to do a little bit of Christmas shopping the last two days before Christmas, and we had a lovely Christmas. I feel so lucky. I truly have a blessed life, which makes me feel bad when I do what I am about to do, which is complain.

In the midst of so many horrible things happening in the world, it seems sort of petty to still be pissing and moaning about my hips, yet I realized the other day that even nearly six months post-surgery, my hips are always on my mind. The first thing I do when I wake up in the morning is wiggle my legs around to see how my hip is feeling, and there really isn't anything I do during the day during which I do not think about my hip at least once while doing it - even if it is just trying to get into a comfortable position to sit and watch TV. And it is the worst at night, trying to get comfortable so I can go to sleep. Granted, I have trouble falling asleep in general, but the pain in my hips and especially my inability to lie on my side without pain just makes my insomnia worse (which is why I am writing this entry at 1:30 in the morning). I feel like the chronic pain is really taking a toll on me. It's not life-threatening or even life-altering, but it's always there and it's always on my mind and is somewhat exhausting, both physically and mentally. I've really tried to accept the pain for what it is, and that has actually helped, but I hate that it is always there, that it is something I have to think about 100 times a day, even if just for a few seconds. I am completely aware that this is a 'first world problem,' and while I'm thankful I don't have something more urgent to take my mind off of my painful hips, I'm also wishing they would feel better already. I mean jeez.

In more positive news:

1. The pain seems to be about the same no matter what I do, which is a good thing in a twisted sort of way. LOL. I figure if my hip hurts the same whether I'm lying down or sitting down or riding my bike, I might as well, like, do stuff, right? We had planned a ski trip, which was supposed to happen a week ago, and I was anxious to see how my hip would hold up. Unfortunately, we had to cancel the trip because of the flu, but hopefully we can squeeze in a make-up trip sometime within the next month. At any rate, I went skiing last spring, when my hip was at the height of its painfulness, and skiing honestly hurt less than walking, so I figure if I am going to be in pain, it might as well be while doing something fun.

2. The meloxicam definitely helps. I mentioned that I had stopped taking it for a brief period while I was taking so many other meds, and I noticed that my hip started to hurt a lot more. I started to take it again, then ran out. When I got the prescription refilled, I also dropped off the script for naproxen/Aleve that my orthopedist had suggested I try as an alternative to the other meds. I tried it for about a week and it didn't help nearly as much. While I really don't like having to take an anti-inflammatory regularly, I definitely feel better now that I started taking the meloxicam regularly again.

3. My left hip feels mostly better. Aside from the fact that I can't really lie on my left side and fall asleep, it doesn't bother me too much during the day. This is a small victory considering my left hip didn't hurt much at all until I started physical therapy, but... oh well. WCYD?

4. My leg feels pretty much entirely better, even when I squat down. I am hopeful this means that the blood clot is gone, because I would really love to get off the Xarelto in February, which is when I'm going to go in for another ultrasound.

I'm going in to see my orthopedist on January 8th, and I basically have zero expectations. I'm undecided on the path I want to take after he tells me to wait another few months, and everything will be okay. But, I still have a while to contemplate this. In the meantime, I still hold out hope for a less painful 2015. Happy New Year!

'Tis the Season (20 Weeks + 6 Days)

I mentioned in my last post that I've been ridiculously sick for two weeks now. I started taking an antibiotic on Wednesday and that has helped a lot, but I haven't had a good night's sleep in, like, forever due to incessant coughing. But that's not actually what I came here to write about.

My hips. are. killing. me.

And I'm really unhappy about this. In fact, I sort of want to cry. It's not the pain so much as the reality that is sinking in that I'm basically not any better off than I was before the surgery. I know I've had a lot of ups and downs since surgery, and I'm currently in a 'down,' but I also had a lot of ups and downs before surgery. And... the pain that I've been having for the past week is exactly the same as the pain I had before the surgery. And... my snapping hip has returned with a vengeance. WTF?

When I think about the fact that post-surgery I have had a cortisone injection and have regularly been taking either a pain killer or anti-inflammatory or both, it's actually possible that I'm worse off than before the surgery. Also, my left hip didn't hurt pre-surgery, nor did I have 'chronic thrombus.' So all in all, this is an epic fail. While I'm thankful that this is nothing life-threatening, and not even something that threatens my daily routine (unless you count extreme grouchiness due to chronic pain as a disruption), I'm starting to feel a little bit uneasy about all of this.

At this point, my uneasiness mostly centers around feelings of what do I do now? I'm obviously super duper anti-surgery at this point, but at the same time, I have this level of pain that OMGIcannotlivewith for another 40 years. I mean, it's the same pain I had that led me to have surgery in the first place. At the same time, PT hasn't helped and cortisone injections and cortisone patches haven't helped, so what can I do? If this is as good as it gets, that's, well... depressing.

I think a lot of things are contributing to my current levels of pain. One is that I stopped taking meloxicam again. When I started taking an antibiotic on Wednesday, along with cough medicine + Xarelto + Vitamin D, somehow it just seemed like too many pills. I started to feel like my mother-in-law, so I temporarily ditched the meloxicam. I understand there is absolutely no logic behind this, I'm just sort of phobic of pharmaceuticals in general. I guess the good news is that the meloxicam does seem to help, because both times I've stopped taking it, my hip pain gets worse. The bad news is that I feel like four months post-surgery, I should not be this reliant on medication to get me through the day, especially considering I've also had a cortisone injection that should be keeping the inflammation in check. Part of the reason I opted to have the surgery is so I wouldn't have to rely on pain medications and anti-inflammatories for the next 40 years. So while I do realize I could start taking meloxicam again, and that it would probably help, that doesn't fix the cause, just the symptoms. (And over break, I just finished reading The Story of the Human Body, so I'm very much into treating causes as opposed to managing symptoms.)

The other contributing factor to my pain is that I've been trying to do a lot of yard work this weekend. I normally take very good care of our yard, but I wasn't able to this summer. Our yard got very overgrown and slightly embarrassing. Since we had some warm weather over Thanksgiving break, I at least wanted to clean up all the dead vegetation and put the yard to sleep for winter in a proper manner. Unfortunately, the squatting down and bending over associated with yard work has resulted in ridiculous amounts of pain. I know my physical therapist would tell me not to do things that cause pain, but I really don't feel like squatting down to pull up crab grass or pick up leaves should be causing this much pain at this point. Again... WTF?

So here I am. And I have no idea what to do.

The Never-Ending Cough (20 Weeks + 2 Days)

Ever since my orthopedist told me to ditch the Xarelto, and I decided to ignore him, I've been meaning to schedule an actual follow-up appointment with my husband's PCP to, I don't know, discuss a plan? Although I informally consulted several other medical professionals regarding their thoughts on continuing Xarelto despite improvement in my DVT, and all agreed on a minimum of three months, I never got a formal opinion. I figured that at the very least, I would need my husband's doctor to write a script for my Xarelto, since I could hardly ask my orthopedist to renew it after he told me to stop taking it. I just hadn't gotten around to it yet, mostly because I'm not out of Xarelto yet. (Thank you, drug reps, for free samples. :))

However, I saw my husband's doctor this morning, because I have been hideously sick for 10 days now and finally realized that I was getting worse, not better. On Monday, after a week of constant nose blowing + the Xarelto, the blood vessels in my nose finally rebelled, causing The Mother Of All Nosebleeds, at least in my adult life. (I've had worse as a child; one time the bleeding required having all the blood sucked out of my nose and then having my nostril cauterized.) Anyway, my husband texted Dr. A last night to see if he was seeing patients today, and if so, if he could squeeze me in. Since my husband took the day off and the kids don't have school, we slept in this morning (although, due to my coughing, I'm not sure either one of us has actually slept for real in several days). We both 'woke up' around 7:30, at which point my husband checked his phone and told me Dr. A would see me 8:30. It turns out that Dr. A was not actually seeing patients today, but agreed to squeeze me in between paperwork. I only later found out that my husband's text was: My wife has a marriage-ending cough. Is there any way you can see her tomorrow? LOL.

Since Dr. A was doing me a huuuuuuge favor, I decided it would not be an appropriate time to bring up the blood clot. However, he brought it up on his own. (I used to see his PA, who has now moved, so he has all my records.) After diagnosing me with having 'The Crap,' he asked how my right leg was doing. I launched into an abridged version of the saga, and he reiterated that while he did not want to insult anyone, according to his training, I should be on Xarelto for six months, at which point we should do another ultrasound. He also thought that it might not be a bad idea to have a lab workup of my blood done, just to make sure I don't have any clotting disorders or anything funky, and we can also check cholesterol and all that fun stuff. Since I can't have that done while on Xarelto, we should schedule that for approximately two weeks after I stop taking it. That means sometime in February. He asked me if my orthopedist had told me why he thought it was a good idea for me to stop taking Xarelto and I told him I got the feeling my orthopedist just wanted me to go away already.

Finally, he asked me how my hip was, and I told him it felt pretty much the same as it did before the surgery, and added that I thought I might need a new orthopedist. He said labrums were notoriously finicky, then asked if I'd had an arthrogram of my hip, with contrast dye. I told him I hadn't, and he said in his experience, straight up MRIs weren't that useful for hips - and added, 'I don't mean any offense to anyone.' The funny thing is that it is his former PA, Sarah, who ordered the MRI, which I told him. I didn't say it in an obnoxious way, just an FYI way. He semi-frowned, then flipped through my records, and pulled up a page with a sticky note on it, and said, 'Yup, here it is.' Then he read the sticky note out loud to me - apparently a note he had written: Sarah - an MRI for a hip is of limited usefulness without contrast dye. LOL. OOPS. I do miss Sarah, though, even if she didn't order the dye.

At any rate, he was very prompt and very thorough, and spent about 20 minutes with me, which I really appreciate considering he was seeing me on a day when he wasn't even seeing patients, and I'm not even really his patient. I finally understood why my husband likes this guy so much. Yesterday, when I was at the pediatrician's with my daughter for her annual checkup, I was thinking how funny it is that almost all of our primary care providers are old-school doctors - as I've told my husband before, old white men. Ha. These are usually solo practitioners who still do things like give out their home phone numbers and do house calls. They don't have fancy patient portals, and when you pay them, you actually write a check out to them and send it to their physical address, and not some place in Phoenix or Chicago. I've calculated that our pediatrician must be almost the same age as my long-dead grandparents, and I dread the day when he retires (or dies), because he is just fabulous, and I love him. (The pediatrician we had before him was the same way, and he did retire.) I think part of why it's so hard for me to deal with orthopedists is because they are, like, the opposite of the old-school style I'm drawn to. It is the huge corporation versus the mom and pop corner store. Interestingly, our old pediatrician once saw me limping when I brought my daughter in and wanted to know what was wrong. At the time, I was having a lot knee pain, so he referred me to one of his orthopedist friends, a solo practitioner orthopedist. (You just don't see many of those anymore.) I remember being shocked when the orthopedist himself came out into the waiting room to get me - no nurse or MA, just him. He was fabulous, but unfortunately, like most other doctors of this type, he is retired. Now, don't get me wrong, I appreciate the modern techniques and know-how of the orthopedists in the Gigantic Orthopedic Conglomerates, and I understand that no one hopes for a long-term relationship with an orthopedist the way they might hope for a long-term relationship with a primary care provider. At the same time, I could not help but note the stark contrast between my time spent with Dr. A and the time spent with my orthopedist. While modern orthopedic techniques are indeed amazing, it seems like throwing in a little bit of old-fashioned medicine might go a long way.

Food for Thought (18 Weeks + 6 Days)

Like most of the country, we have been in a cold snap for the past week. And not just cold, but really cold, for here anyway. I've been worried about walking around on slippery sidewalks and just the cold weather in general. But... oddly enough, my hips seem to enjoy the cold weather. Maybe it's like they are being constantly iced, LOL. At any rate, they've actually been feeling quite good since I last wrote. Weird. But weird in a good way, right?

In other news, due to the cold weather, I've been spending more time on the Internet than usual, trolling random blogs related to random (and sometimes not so random) topics that are of interest to me. I'm in the midst of having what may or may not be an 'aha' moment, but is interesting to note regardless of whether it's relevant or not. In reading other hip blogs, I've noticed that several of them are by people who have hip problems due to Ehlers-Danlos syndrome (EDS), which is a connective tissue/collagen disorder. There are several types of EDS, of which the mildest is Type III - hypermobility syndrome. The reason this sticks in my mind is because my daughter has actually been diagnosed with EDS - Type III. It was a long time ago, and at the time, we had so many other things going on with her that I never really thought twice about it. In fact, I went back and read my journal from the visit that we had with the geneticist who diagnosed her, and I didn't even write about that diagnosis. And apparently we even had a follow-up with the doctor that I didn't even find worthy of a journal entry. However, a few days ago, I was cleaning out my file cabinet and came across a folder full of medical reports from when my daughter was young. The doctor wrote: Given N's personal and family history of hypermobility, I diagnosed her with Ehlers-Danlos syndrome type III, otherwise known as benign hypermobility syndrome. I believe this to be the cause of a significant portion of her motor development delay... I would like N to be seen by a pediatric neurologist to try to differentiate any hypotonia from her extreme joint hypermobility.

There are a couple reasons I didn't think much of the EDS diagnosis, one of those being that the doctor didn't make a big deal about it. The other reason is because I'm not sure I really believed her. EDS - Type III is inherited in an autosomal dominant manner, which means that either I or my husband would have to have it to pass it down. And since the question of whether either I or my husband had EDS didn't come up, I guess I just figured the doctor was just sort of making stuff up, ha ha. Now, I guess on some level I realize that you don't get to be a pediatric geneticist at a reputable research hospital if you are in the habit of making stuff up, but at the same time, there were many other concerns on the table at the time, obviously the least of which was EDS. At the same time, it's not as if I've had such awesome experiences with doctors that I believe everything they tell me, and in my experience, most people's understanding of basic science is so limited, it has made a lot of health care providers lazy about their medical knowledge, or at least how they convey that knowledge. Another consideration is that mutations can arise de novo (meaning neither my husband nor I would have to have the condition), and in fact my daughter does have a de novo chromosomal duplication. So that is always a possibility.

On the other hand, now that I think about it, it is absolutely not out of the question that I might also this condition. What actually got me thinking about it was the fact the one of the blogs I stumbled across was a teenage girl with hip pain. She had a couple of failed hip surgeries, which is what actually led to the diagnosis of EDS; because of EDS, her tendons and ligaments were too lax to keep the joint in place after surgery. It is also worth noting that because EDS is due to a collagen defect, and collagen is present throughout the body, EDS is associated with other issues, notably with the heart and the GI tract. My daughter does have some heart issues (which actually baffled the pediatric cardiologist we saw) and GI issues (which a pediatric gastroenterologist said 'to keep an eye on'), and I also have heart and GI issues I have never really pursued, just because these are hard things to pursue when you barely ever go to the doctor. LOL.

At any rate, it is some interesting food for thought.

* * * * *

FYI, here were my impressions after our first visit to the pediatric geneticist:

April 14, 2007

Our meeting with the pediatric geneticist was mostly, as I suspected it would be, uninformative. However, it was much less torturous than I expected it to be, which was a pleasant surprise. I've never been to a research hospital before, which I realize is a good thing, because most of the people there are in a sorry condition. (...)

I have to admit it was really nice, though. The waiting room was like no other waiting room I've ever been in. It was enormous, with lovely toys for kids of all ages. The only other people in the room were two grad students (I presume) trying to recruit children for a study on memory. Our appointment was at 1:00, and when the clock ticked past 1:00 and we still hadn't been called in, I was annoyed considering they had emphasized the importance of us getting there early. However, we got in around 1:10, which I suppose isn't too bad. (Our ped's view on making people wait for appointments is that it is a form of 'medical arrogance.')

At 1:10, a girl wearing jeans and a t-shirt took N in and did all the standard poking, prodding, and measuring, then we went and waited for Dr. K for another five minutes. I had no image in my mind of what a pediatric geneticist MD would be like, but I was still definitely surprised when the doctor came in. First of all, Dr. K was, like, my age (literally, as it turns out), and secondly, she was wearing a fancy Chinese-ish looking shirt and nice slacks.

And sandals. Which I wouldn't have noticed, because, after all, who notices a man's shoes? (from 'The Shawshank Redemption') But the first thing she did was apologize, saying she was feeling very self-conscious today. She went on to explain that she liked these sandals so much she bought them in both black and brown. It was dark when she got dressed, and she ended up with one black and one brown. Then she sat down on the examining table with her legs crossed, rummaged through a fancy, Chinese-ish looking handbag (she was not Chinese, but a white farm girl), and pulled out a piece of paper.

Then she commenced taking a family history, first from me, then from E. Mine took all of one minute. I told her I was healthy and had no problems other than having hemoglobin E. Then she asked about my family and I told her I had two brothers, but that we were not genetically related. And that was the end of that. Then it was E's turn. The abridged version of the medical problems in E's family took about 30 minutes. N was tearing around the room the whole time, going back and forth from me to E to me, climbing on the chairs, pulling at the blinds, playing with the sink, and pushing the doctor's chair all over. Finally she demanded to be picked up by Dr. K, which is completely different from how she is with [our normal ped] (screaming hysterically and clinging to me from the minute he walks in the door). Dr. K decided this would be a good time to start her examination.

The very first thing she noticed was her ears, which is funny because we've always joked about how her ears stick out, never realizing that there could be a medical significance. But apparently sticking out ears can be a sign of muscle weakness. Obviously some people's ears just stick out, but since neither mine nor E's do, N's ears are suspect. In fact, Dr. K said her ears are classic 'Charcot' ears, which I recognized as being 'Charcot-Marie-Tooth' disease, although I couldn't remember what it was. However, she didn't seem too concerned because apparently the rest of her did not look 'Charcot.' (Although, I have to say, once I got home and Googled Charcot-Marie-Tooth, I started to wonder.)

After further examination, she exclaimed that N was the most flexible human she had ever seen, which isn't surprising, because she's been practicing for, what, six months? LOL. We've always thought it's logical that N is flexible, because both E and I are extremely flexible, and so N is Ridiculously Flexible. Dr. K said the delays in her gross motor development could definitely be due to the extreme laxity in her joints, especially since her fine motor skills were on par with what they should be for an almost 17-month-old. She also said that her muscle tone was good, which it wouldn't be if she were hypotonic, noting that flexibility concerns the connective tissue, whereas hypotonia concerns the muscles. However, she couldn't rule out that there was something wrong with her muscularly because of her ears and her problems swallowing.

She said that N needed to be evaluated by a speech and swallowing specialist before she could make any decisions about what sort of testing, if any, we should have done. She said it could be that her swallowing problems were unrelated to the gross motor development delays; maybe they were neurological. She also said that even if she had no muscular problems, she could still benefit from physical therapy, so we should have a physical therapist work with her, too.

(...)

Overall it was a good appointment, even though it just confirmed some of the things that we've thought all along. We're going to get a PT referral from [our ped], then go back to see Dr. K in two months. At that point she'll decide if there any genetic tests we should have done. She said if she was going to have N poked, she wanted to make sure she got all the tests done that she wanted, and she didn't want to do tests just to do them, which I appreciate.

Mostly it's a relief, because I was kind of worried that a specialist might take one look at N and say, 'Oh yes, it's obviously such and such' (kind of like the Charcot ears, which would have never occurred to me). But she didn't. She didn't seem overly concerned, which is logical because I'm sure that she sees many kids in much worse shape than N, but still. She didn't seem to think she had any sort of alarming condition and didn't even bring up muscular dystrophy or spinal muscular atrophy, which are the things we were initially concerned about. In fact, she didn't even bat an eye at N's above normal CPK levels.

I'm sitting in a café right now; I'm supposed to be working on a take-home exam, but instead I just spent an hour writing this entry. Ironically, a woman who just had a baby came in. I heard her telling the girl behind the counter that the labor had been very difficult, she had ended up having an emergency hysterectomy, and her daughter (now seven weeks) was still in the hospital. However, she seemed so upbeat and factual about it as she recounted the story. Oh the trials of parenthood. You don't stay strong by choice, you stay strong because you have to.

The Weather Outside is Frightful (18 Weeks + 1 Day)

Just some facts, mostly for my own record:

• On Saturday, I rode my bike for the first time in over four months. It has been so long that I forgot which side the chain was on and rolled up my pant leg on the wrong side. I only rode about two miles total and walked about one mile total. My hip felt fine - or as fine as it ever feels.
• On Sunday, my hip started killing me - my muscles were super tight despite incessant stretching, and I also felt pain in the hip joint itself, especially when I made a concerted effort to stand with my weight distributed equally between both legs. I'm not sure if this was due to the bike riding (I can't think of why it would be) or just coincidence.
• This pain has not gone away.
• My back also hurts. A lot. I'm super bummed about this because one thing I noticed almost immediately after surgery was that my back felt really good. Of course, I wasn't walking at the time, but before surgery, as well as now, my back hurts even when I am just sitting or lying down.
• I started taking meloxicam again on Friday. I don't think it's helping. My orthopedist also gave me a script for naproxen along with the meloxicam. He said if the meloxicam didn't work then I should try the naproxen. Maybe I will.
• In trying to come up with explanations for why I suddenly feel so much worse, I've only come up with stopping the meloxicam and possibly the cortisone injection wearing off? Granted, I don't feel like the second cortisone injection actually helped, but maybe it did. Maybe I would have felt way worse without it, and now it's wearing off and I'm feeling, well, way worse.
• I fell down the stairs a few weeks ago. I mentioned that I have a fear of falling down stairs that isn't totally irrational, because I have actually fallen down stairs a few times, as have my kids. It was a pretty minor fall (hence why I never even wrote out it) - just the last two steps and I think I fell backwards. My quadriceps and my back were what hurt the next day, and the day after that, if I recall correctly. I sort of blew if off because I was actually on my way to my parents' house, and I was rushing - hence the fall. I didn't say anything to my mom about it because she is super annoying about how much she dislikes our house and how scary she thinks our stairs are, and I just didn't feel like listening to her go on and on about our stairs (not that I even disagree, but at a certain point you have to get over it). Anyway, I suppose it's possible the fall did some damage, although I doubt it. I feel like my hip should have started hurting sooner if that were the cause of my current pain, but what do I know. 
• It is snowing out. The sidewalks are very slippery. This is a little scary. 

I'm starting to lose hope that I'm actually getting better. It's not like all-out panic or anything, and like I've said, I've made friends with my pain. LOL. Nevertheless, it's somewhat deflating.

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!

Let it Go (13 Weeks + 4 Days)

For no particular reason, I'm having a good day. In fact, I saw my orthopedist this morning, and basically he was not helpful at all, yet I'm feeling a lot happier than I have in a while. Maybe it is the residual effects of book club, which seems to buoy my mood. Or maybe my orthopedist was more helpful than I give him credit for.

For one, he seemed much less rushed than usual, and took the time to really talk. So while I did tell him I had been feeling better over the past few days, I mentioned that I had clusters of good days and bad days, just like I did before the surgery. He seemed cautiously optimistic about the good days and did not dismiss the bad days. We then talked about various things.

• I explained the motions that really hurt - the combination of flexing my thigh and then putting weight down on it, which occurs when I walk and especially up and even down stairs. He asked if I could ride a bike and I said riding a bike was fine; it definitely seems to be weight-bearing that hurts. He said it was a good sign that riding a bike was okay, but quickly added, 'But I understand that walking is pretty important.' LOL. 
• I mentioned that the pain usually got progressively worse and was always the worst at the end of the day, especially the days when I teach. I finish my last class at 1:30, then mostly sit in my office for the rest of the afternoon. It's when I get up to go home that the pain is the worst - walking down endless flights of stairs to go to my car. He asked, 'What about when you get home?' I told him that when I get home, I lie on the couch and cover myself with ice and drink beer, which isn't exactly true, but he thought that was pretty funny. Ahhhh, yes, self-medication!
• Since he seemed to be in listening mode, I also told him that I had gone hiking a few weeks ago and had felt great and really thought I was getting better. Unfortunately, the pain returned after the weekend and after a day of work, and I told him AJ's theory of work being the problem. He did note that it was interesting that the pain came back so long after the actual hiking.
  
• He did a few tests and said that my strength was good and that I seemed to have full strength in my hip, so he didn't feel that it was a question of needing to strengthen anything. He also said that my range of motion without pain was much better than the last time, and that it did not appear that I had re-torn my labrum. I supposedly passed the labral impingement test, but we know how that goes.
• Speaking of which... he also repeated his blood clot test on me (Homan's test) although I don't trust him at all on that one! Fortunately, he ordered a repeat ultrasound so we can see where we stand with my DVT without having to rely on his examination skills (or lack thereof). I did tell him that while my leg was definitely better, I still had some pain when I tried to squat down. I told him I realized this when I tried to put air in my tires the other day, and I ended up crawling around on my hands and knees in front of the gas station.

Other interesting tidbits:

• While he was examining me, he asked how classes were going. (I'm always amazed he remembers that I teach.) I told him they were going well. He asked if it was midterm time yet, which is interesting, because I feel like a lot of people have asked me that recently, and I don't know anyone in my department who gives 'midterms' - a pretty standard biology course is three or four exams and a final. I told him I don't really give a 'midterm,' but the class had just had their first exam. He asked how they did and I said they did pretty well, that the average was around a 70%. His jaw dropped. Then he asked if I scaled that up at all. I said no, 70% was actually a pretty good average for the first test. He just stared at me with his mouth open, so I added that a lot of people score in the 30s and 40s, which has to mean they aren't even trying, so I never scale up based on the average. I added that I do bump up grades on occasion if I don't have enough As; I like to have at least 10% of the class have an A. He kept staring at me and said, '10%?!' Then he declared, 'I'm glad I didn't have you for biology - I might not be a doctor now!' HA HA! (Have I mentioned that I really value sense of humor?)
• Before I saw the doctor, I asked the medical assistant if I could get a copy of the surgery report. I added that I knew it was sort of awkward, but I felt like I might have to see a different doctor at some point and would like to have the report. She was understanding. She said she would print it off for me, but then she never came back. After I saw the doctor, I thought she might come back in with the orders for the ultrasound, and hoped I could ask her then, but unfortunately the doctor came back in himself with the orders, which meant that I had to ask him for the surgery report. I could have just ditched the idea at that point, especially since I felt like the visit went well, but. But. But. I asked him for the report and it ended up being fine, but... eh. On an amusing side note, I had to laugh at the very first sentence, This is a very pleasant 39-year-old female... Me? Pleasant? Even very pleasant? Did he just add that in there before giving me a copy? I didn't know they put notes about your personality in surgery reports. Besides, aren't most people pleasant when they are anesthetized? LOL.

So after all this... my doctor seemed a little stumped, just like I am. As he said, physical therapy doesn't seem to be helping and the cortisone injection didn't help, either. He contemplated the situation for a good while and then said, 'I'm thinking we should just... maybe... give it a rest.' I immediately understood, and agreed. Let it go. While this isn't exactly helpful, it sort of is. I was thinking about this before my appointment: What exactly is it that I want my doctor to say or do that would satisfy me? Yes, I suppose he could order more X-rays or another MRI, but I'm not sure that's really what I want right now. I sort of just want a break. I think this is what I was getting at about a week ago, when I wrote about just trying to accept my pain for what it is, and stop stressing about it so much. That actually helped me a little. And hearing this from my doctor validates it a little more.

It felt different than the other times when he just told me I needed more time. He didn't say that I was going to be fine, he just suggested trying to take it easy for a month, and after a month we would see where we were and re-evaluate. It is sort of ironic that not hearing him tell me that I was going to be fine made me feel better. I guess that made me feel like he was listening more carefully than before. He did say his usual hope was to have people back to normal after three months but that, of course, everyone is different.

So the plan is:

• Stop PT. Overall, it's just not helping and seems to be making everyone frustrated. (I stopped by the PT room after my appointment and both AJ and Beth agreed this might be a good thing.)
• Continue non-weight bearing or minimally weight-bearing activities that do not hurt, such as a stationary bike or elliptical. I'll have to work on this one - perhaps carve out some time to go to the Y.
• Continue taking meloxicam. It is probably helping a little bit, even if I don't notice any obvious benefits. He also suggested taking it in the morning, which I haven't been doing because I'm afraid of the side effects making me goofy. However, I've been taking it long enough now that I'm pretty sure it doesn't make me goofy.
• Get an ultrasound on my leg (which I scheduled for next Friday) and try to get off Xarelto sometime in the near future if the blood clot has resolved (fingers crossed).
• Avoid activities that cause pain. This is hard when walking is one of those things, but fortunately he did not mention the 'c' word. He did recommend perhaps not hiking for a while though. Ha. I need to try getting rest when I can to give my hip a chance to calm down. It's not as if I need bed rest or to go back to crutches, but... I just generally need to try to take it easy.

I'm surprisingly okay with this plan. I also feel as if somehow, in all of this, I was able to let go of some of my anger. I've been feeling a lot of frustration toward my orthopedist over the past few months, and I don't like feeling that way. I felt like he redeemed himself today, and I'm happy to be able to let go of my anger towards him. He truly is a super nice guy, and I do believe that he's trying to help me in the best way he knows how. He seemed concerned today, and ironically, that has renewed my faith in him.

So... onward.

Book Club Redux (13 Weeks + 3 Days)

I've mentioned that I'm in a book club, and I really look forward to my monthly book club meetings with fellow working moms, who also look forward to this one night a month where putting the kids to bed becomes the sole responsibility of the dad. As someone tonight said, 'It's really more like a drinking club with a book problem.' LOL.

Somehow book club seems to have fallen into the same schedule as my visits with the orthopedist: book club on Thursday night, orthopedist on Friday. At the last book club, I was also anticipating a meeting with my orthopedist the following day. Looking back, I think I've improved somewhat since the last book club. In fact, I'm having a fairly good hip week, and I'm sort of torn as to how to go about with my appointment tomorrow. On the one hand, I'm happy that I've been feeling better for the past few days. On the other hand, the few minutes that I get with my orthopedist every now and then are few and far between, and I feel like he should know about the horrendous pain I've been having for the past three weeks. I realize that perhaps I could actually be getting better (which would be awesome), but... what if I'm not? What if I'm just having a good few days, the same way I was having a good day when I saw him two weeks post surgery and he failed to diagnose my blood clot because I was having a good day?

I feel as if I tell my orthopedist that I've been feeling better, that is all he will hear. He will just take that as a sign that I'm getting better, and that will be the end of it. And while I HOPE that's the case, I don't want to waste my precious minutes (especially at approximately $80/minute) on him telling me that everything is going to be just fine.

Ah, dilemmas.

Baby Steps (12 Weeks + 4 Days)

So back to more practical matters.

Ever since the semester started, I've only been able to make it to PT once a week, even though my orthopedist was still recommending twice a week at my last visit. Honestly, I could make twice a week work, but with my old PT, AJ, it wasn't worth it. It wasn't worth the time or the money. Also, back in August, I mentioned to AJ that I would be cutting back to once a week once the semester started and he thought that was fine. At the time, he said I was doing great, and he actually thought that pretty soon I wouldn't need to come in at all.

Ha.

Several weeks ago, I wrote about how AJ broke up with me. For the past few weeks, I have been seeing Beth, who, despite being 'just' a PTA, is, like, 100x better than AJ. Okay so maybe not 100x, but at least 2 or 3 and maybe even 10. She's just a lot more hands on than AJ, which has actually been pretty helpful. At least, I leave PT with a sense of accomplishment rather than a feeling of extreme depression. I left PT yesterday feeling positive enough about PT that I actually made two appointments for next week.

Something I haven't discussed a lot recently is the pain in my left hip (the non-operated side). This is mostly because I sort of totally can't deal with this right now, so I've tried to block it out. Unfortunately, the pain has recently become un-ignorable because it is preventing me from comfortably sleeping on my left side, and since I can't sleep on my right side, either, this has led to a lot of sleepless nights, which reeeeaaaalllly gets to me. I can't stand not getting enough sleep - although it happens frequently, which probably goes a long way toward explaining my bad personality, lol. 

After a consultation with Dr. Google, I diagnosed myself with bursitis. (This doesn't take a rocket scientist.) And honestly, it doesn't seem to matter what any of any of this is, as non-surgical options for most conditions are the same: rest and ice. (And trust me, I'm 110% anti-surgery at this point.) Unfortunately, 'rest' in a lot of cases means crutches, just like AJ suggested, but let's not go there right now. However, one recommendation for bursitis is a cortisone injection into the bursa - LOL, sound familiar? The up side to this is that it is both diagnostic and therapeutic, just like a cortisone injection into the hip. If it takes away the pain, you know what you're dealing with; if it doesn't help, you can eliminate bursitis as a cause of pain. The down side is, of course, that as I've learned from experience, cortisone injections hurt like fucking hell and are also pretty pricey. Plus, the more I read about cortisone, the more I'm convinced that it's got to be really bad for you or at least not good for you, especially if you use it a lot; after all, it's a steroid. So I wasn't exactly jazzed about a cortisone injection; nonetheless, my left hip has become quite painful and I realize I will have to deal with it at some point.

Yesterday I mentioned to Beth that my left hip hurt quite a bit. She massaged it for a while and suggested that we try a cortisone patch, which basically delivers cortisone to a site without the need for an injection. Instead, the cortisone is delivered via iontophoresis, which is driven by a small battery in the patch. (I looked all of this up after the fact.) Although I've used patches for back pain before (which I'm pretty sure were just numbing/painkilling medications), the idea of the cortisone patch was new to me, and sort of exciting. A cortisone shot without the shot!

And... I have to say... two thumbs up for the cortisone patch. My left hip feels so much better today, I can't even tell you. The sort of funny thing is that I woke up and was like OMG my hip feels amazing! only to realize that my groin area was killing me. It was as if the pain just moved from my bursa into my groin. LOL. However, after a day full of activity, I'm pretty sure the current pain is actually just soreness from all the stuff I did in PT yesterday.

Beth also suggested trying a patch on my right side, and I figured why not. After all, what is one more dose of steroids in the large scheme of things? And as long as it doesn't involve a needle, it seems relatively free of risk. Basically the patch didn't do anything for my right side, but that is at least good information. So it's likely not bursitis on my right side. And actually, at my last appointment with my orthopedist, he did 'check' for bursitis, and he concluded that bursitis was not the problem. I say 'check' in quotes, because I have little faith in his physical examination skills, but I at least agree with him now. :) Unfortunately, when it comes to my right side, crossing bursitis off the list leaves me with much less palatable possibilities, which, in accordance with my last post, I am not going to worry about for the time being. I'm just happy to have some relief in my left hip.

Baby steps, baby steps. :)

Embrace your Pain (12 Weeks + 3 Days)

J'embrasse mon rival mais c'est pour l'étouffer.

(I embrace my rival, but it is to strangle him.)

Jean Racine (1639-1699)

* * * * *

One time in college, I set out to make an inspirational poster for one of my teammates. This was pre-Internet era, so inspirational quotes were not a Google stop away. I had two books of quotes, one of which was full of quotations from only French authors. Flipping through the book, I found the quote above. It didn't quite work for inspiring better diving, so after a lot of 'fiddling,' I finally came up with: Embrace your fears, and you will strangle them.

It is like our diving coach used to tell us: It is okay to have butterflies, you just have to make them fly in formation. 

I was once an accomplished athlete. My main sports were gymnastics, and later diving, both of which involve a significant amount of fear. I could have been so much better than I was, but unfortunately, fear always got the best of me. My physical abilities were always ten steps ahead of my mental abilities. The thing is that fear and anxiety are a cycle, just like pain is a cycle. Looking back, I think that I sometimes feared the horrible feeling of fear itself rather than the actual dive. I detested that feeling of shaking legs and standing on the end of the diving board full of self doubts, wondering if I actually had it in me to throw myself off the board, do two and a half flips, and override all human instinct and land on my head. When I managed to put these thoughts out of my head, the dive itself wasn't ever difficult for me.

With my current hip ordeal, I've been told I need to break the pain cycle, and I've tried so many things to do this. So far, these things haven't worked. Now I think I need to break the cycle of fear and anxiety and stress. I realized recently that my stress about my pain is worse than the pain itself, just as my fear of doing a back 2 1/2 in diving was worse than the worst thing that ever happened to me from actually doing it. I need a break from the stress. I need a break from worrying about the pain and a break from my constant appointments with Dr. Google and a break from wondering what is wrong with me and why I'm not better and why surgery didn't work and... and... and...

I have an appointment with my orthopedist next Friday, a week from tomorrow. Until then, I'm just going to accept the pain for what it is and do the best that I can with it. Because at this point, it is the stress about my pain that is killing me, not the pain itself. I am tough. I can deal with physical pain. It's the mental stuff that has always gotten the best of me. So I need to tend to the mental part of this.

Embrace your pain and you will strangle it.

Out of Words (11 Weeks + 5 Days)

I feel like I am running out of new words to express my frustrations, which is an odd feeling for me. I'm almost never at a loss for words when it comes to writing.

I suppose that I could write nothing at all, but... it is Saturday evening and I am home alone, with only college football on TV to keep me company. Also, as I have progressed through this hopefully soon to end adventure, I've realized how valuable it is for me to have a record of some of my experiences, as I was experiencing them. Of course, my hope is always that what I'm writing won't end up being significant, but so far I'm batting about 500. The leg pain I started to complaining about just a week after surgery turned out to be massive blood clot, which was finally diagnosed a month later. At that point, I stopped taking birth control and started taking Xarelto, which led to massive vaginal bleeding, which I freaked out about. Fortunately, that did turn out to be 'nothing' - if losing enough blood to soak through a super plus tampon and a pad in an hour for 48 hours counts as 'nothing.'

I'm now almost 12 weeks post-surgery, the point at which I was supposed to be all better, 'all better' meaning that I would have no restrictions on my activity, the point at which my surgeon said he had seen NHL hockey players start playing hockey again. Instead? I am feeling horrendous pain, the same, if not worse, than it was before the surgery. I also have a lot of pain in my left hip, which I've mostly been trying to ignore, because honestly, I can't deal with pain in another body part right now. (I warned you early - I have pretty much zero tolerance for stress.) However, I'm starting to get somewhat alarmed by the pain in my left hip, which is relentless and just won't let up.

I know that I supposedly need to be patient, but I am tired of being patient and tired of being a patient. Also, at my last visit with my orthopedist, he assured me it was very likely that I'd be feeling much better in a month. That was almost a month ago, and instead of feeling much better, I feel much worse. And this is after having a second cortisone shot a little over two weeks ago. This does not feel right to me. I realize that recovery from surgery is a process, and everyone is different, and yada yada yada, and just because NHL hockey players are able to play hockey within three months doesn't mean I should expect the same. At the same time, I don't feel like it's normal that I should be feeling worse than I did before surgery at this point. And I'm not asking to play hockey, just to be able to walk without severe pain.

I mentioned a few weeks ago that my therapist had suggested using crutches again, to give my hip a rest. At the time, I saw that as really going backwards, but recently I've become sort of desperate and decided to try this - at least when I'm alone. At this point, it is not muscle weakness or lack of range of motion that is my problem; it is the pain. I can do everything that is asked of me at PT; it just hurts like hell. So maybe a little rest when I can get it isn't a bad idea. With that in mind, I decided to really try to rest this weekend, since my husband took the kids out of town and I was by myself. It has been difficult to really adhere to using crutches to get around, but at the same time, the pain relief that the crutches afford makes it easier.

I was supposed to take an all-day class today that was cancelled. So... I went up to my office at the university and spent the day there. I could have worked from home, but over the past few years I've really tried to make a concerted effort to draw a line between my work life and my home life. I've been so successful that even when I'm all alone, it's hard for me to work from home, with the exception of answering e-mails and grading.

As I said earlier, I am super self-conscious about trudging around on crutches; for some reason this embarrasses me, a lot. However, I figured that I was fairly safe from embarrassment on a Saturday morning at the university, and was fairly determined to give my PT's 'resting when I can' idea a chance. Little did I know that so many of my colleagues work on Saturdays. LOL. Fortunately, everyone knows about my hip saga at this point, so it's not a hugely surprising thing for me to be using crutches to get around. (If I'm not crutching, I'm limping and constantly whining.) The sort of ironic part of this is that yesterday, I had to walk across campus to deliver exams to Disability Services for my students who need a test-taking accommodation. While I was dragging myself past my colleague's office, she asked me where I was headed, as if she knew I was going to Disability Services (work ESP, I guess). When I told her, she came out of her office and asked me if I could take her exams over for her as well. Then she asked me if I needed to borrow her cane. LOL. This woman is actually disabled herself; she was hit by a car while riding her bike to work, and now uses a cane to get from her car to her office. I declined, but apparently she was watching me as I made my precarious descent down the staircase just outside her office. She called after me, 'Seriously! I mean it! You can borrow my cane!' Today when I was sitting in my office, this same colleague passed by my office and commented on my crutches in a tsk tsk sort of way, as if my refusing the use of her cane yesterday caused my need for crutches today. Ha!

Here's where I could really use an awesome doctor or physical therapist. I feel like I'm stuck in this weird territory between needing to strengthen my hip and return to normal, and needing to rest my hip to not cause more pain and inflammation. Since I don't seem to be getting much guidance, I've been consulting Dr. Google again. After much consultation with Dr. Google,  I've come up with the following possible explanations for my continuing pain:

1. It is just typical post-surgery pain, and I need to give it more time. This would be the best explanation, though I find it hard to believe that all of this pain is just normal pain. During my last visit with the orthopedist, he commented that my labrum had obviously not healed yet, and that I needed to give it more time. Later I got to wondering about what traipsing around on a still-torn labrum was doing, considering the reason he told me I needed to be on crutches for an f-ing month was to let the labrum heal properly. I sent him an e-mail but never heard back from him.
2. I somehow tore the labrum again. Aside from falling the afternoon after surgery, I don't see when this could have happened. For once, I've been an extremely compliant patient throughout all of this.
3. I have tendonitis in my hip flexors and a lot of scar tissue that is causing the pain. This is what the therapist I've been working with has suggested. At my last appointment, she used the 'spatula' on me and commented on how much scar tissue I seemed to have. However, she did not think this would necessarily be causing the continued 'grinding' sensation I have in my hip joint. Nonetheless, I Googled treatment for hip flexor tendonitis, and non-surgical options include... rest... and ice. Check.
4. I have avascular necrosis (AVN), which is basically when the blood supply to the bone is interrupted, and the bone begins to die. Not to be a hypochondriac, but I'm sort of alarmed at how much of what I'm feeling seems to match up with the symptoms for this. Also, this condition is often associated with clotting that cuts off the blood supply to the bone. While I know enough about anatomy to understand that clots in veins are different from clots in arteries, I can't help but wonder if there could be some connection between DVT and AVN. All my literature searches on AVN tell me that most cases of AVN are idiopathic ( = no known cause), but it still makes me think... hmmmmm... Of course, I Googled treatment for AVN, and non-surgical options include... rest... and electrical stimulation. Check.

So... I have a plan of sorts. My next appointment with my orthopedist is on Friday, October 10th. If I'm not feeling much better by then, and if he tells me once again to be patient and wait it out, I'm going to get a second opinion. I'm also going to try to find a new physical therapist and perhaps see a pain doctor that my PA recommended to me initially. This is sort of tricky, and involves some level of confrontation that is difficult for me, but might be necessary, IMO. I've tried so hard to be positive about all of this, and I really like my surgeon, and don't want to be angry with him, but at the same time, I don't feel like he is helping me right now. And I really need help!

I think the other part of this that I'm struggling with right now is whether or not it was a good decision to have this surgery in the first place, considering that I'm now feeling worse than I was before the surgery, plus have been dealing with a potentially life-threatening blood clot. It doesn't help that I have my mom constantly reminding me that you should never see a doctor unless you will otherwise die (which is the attitude with which I was reared). However, I have to say that I'm not yet at a point of pure bitterness. I still don't regret my decision. While I'm disappointed in the outcome of the surgery, and how my surgeon has dealt with it, I still know that I had to give this surgery a chance. If I weren't here whining about how much my hip hurt post-surgery, I'd be here whining about how much my hip hurt because of a torn labrum and loose cartilage floating around in the joint, and you'd all be thinking that I should just have the surgery so I would shut up already.

And... to conclude, I'd like to say that I am still thankful every day that this is the biggest problem I have in my life right now. I realize it could be so much worse, and I am extremely grateful that it isn't.