First Visit with the Orthopedist

I finally went to see an orthopedist on 5/22/14, nearly seven months after the pain started. My PA recommended me to a specific doctor within a group of orthopedists, probably based on how needy/picky/easily freaked out I am; of course I Googled him and was at least satisfied with his credentials on paper, ha ha. However, when I called to make an appointment, appointment woman suggested switching me to a different doctor who specializes in hips. Being that I am paranoid, I figured she was switching me to the least busy doctor, who in my mind was probably the worst. I looked the new guy up and saw that he specializes in hip replacements, so I figured either everyone knew something I didn't or the guy was going to push hip replacement on me. (Clearly there is some leftover trauma from my trip to the orthopedist 15 years ago.) I felt really uneasy and stressed out about the whole thing, which again, was for no particular reason except my insanely miniscule level of tolerance for stress.

Fortunately, it wasn't that bad. In fact, it was just about the best news I could have hoped for at the time. The doctor was actually very nice and took the time to thoroughly explain things. He told me that aside from the torn labrum, my hip actually looked pretty good - no signs of arthritis or instability or imminent oh-my-god-your-hip-is-going-to-break danger. He also did a few tests and mentioned that I had very good range of motion (which I should, because I stretch religiously, about 10 times a day, because it's the only thing that keeps me in motion). What that meant was that we could proceed with just treating the symptoms - i.e., the pain - and there was no immediate need to treat the cause of the pain - i.e., fix the labrum with surgery. Of course, if treating the pain didn't work, I should obviously consider the surgery, but he wasn't like OMG YOU NEED A TOTAL HIP REPLACEMENT RIGHT HERE RIGHT NOW OR YOU ARE GOING TO DIIIIIIEEEEE! In fact, he basically told me that since my hip looked pretty good, the course of treatment should be what I felt was right based on how much pain I could tolerate for how long, how much it was affecting my lifestyle, and so on. He said that if the pain could be managed, it was quite possible I might never need surgery. (!!!) He did mention my shallow hip sockets but didn't seem to think it was a problem, it was just something to make a note of.

I agreed to get a cortisone injection to see if that helped. On a side note, it's worth mentioning that I had just gotten back from a three-day trip to Mexico and had two days at home before heading out on a 10-day vacation with my family. Plane travel was horrid for my hip, and I was really hurting at that point. I was hoping I might be able to get some quick relief before going on vacation, but given my tight time frame, that was hoping for a lot. Apparently they don't just plunge a needle into your hip (which to be honest I was sort of dreading); they actually numb you up and use ultrasound to deliver the cortisone a precise spot, and there is actual skill involved, especially when the injection is into a joint. (I read this on the Internet after my appointment.) So the injection required an appointment with a doctor who specializes in doing injections - one who doesn't work on Fridays. At least the vacation was a sit-on-the-beach type vacation and not one with a lot of activity planned.

The doctor told me to keep a pain journal before and after the injection so we could try to accurately assess how much it helped, or didn't help. He said that if it didn't help, he was going to have me see another doctor in the practice, one who specializes in hip arthroscopy. Then he actually introduced me to that doctor, probably because he could tell I was freaking out. The other doctor seemed very nice, too, although I'm pretty sure he was half my age. Okay, so obviously not literally, ha ha, but he was young - like, as young as an orthopedist can be - which made me feel old. They both mentioned that even if the injection helped, but didn't last long enough, I might want to consider surgery. I asked what 'long enough' was, and they said that was up to me - to consider how much it helped, how inconvenient getting the injection was, etc. (At that point I was thinking how bad can an injection be? Little did I know.)
 
I was slightly wary of the injection because my uncle actually died of a massive heart attack right after getting a cortisone injection, but rationally I know that's a personal anecdote and not a scientific reason to fear something. (Nevertheless, someone has to be the statistical anomaly, and it sucks if it's you.) Also, I got home and of course Googled cortisone injections, and read that there was a possibility it could make the pain worse. Apparently there is a possible side effect that involves the injection crystallizing and causing severe pain, so although I was worried about my pain level on vacation, I also thought maybe it was good not to have the injection the day before leaving the state. I also stumbled upon a message board with all sorts of cortisone injection horror stories, but I always view message boards in sort of the same way I view things like RateMyProfessors.com; they only tell a fraction of a story.

I left the appointment feeling very optimistic. I was thrilled at the prospect that an injection might help for several months or even a year or maybe even indefinitely, if it could reduce the inflammation to a point where it didn't return for a very long time. Apparently long-term relief is a realistic possibility, so my fingers and toes and eyes and everything that can cross were crossed. After all, it was likely I'd had a torn labrum for over a decade, yet it wasn't always that painful. Most of all, I really appreciated that it was all presented to me as MY DECISION, what /I/ was okay with. Also, knowing that aside from the tear in my cartilage, I was more or less healthy and wasn't doing any major damage by walking around, even as much as it hurt, was a huge relief. It made the pain much easier to deal with.