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.

Obviously work is the problem. (11 Weeks + 3 Days)

The good news: My leg feels a lot better, which I hope means my blood clot is gone, or at least going away. Aside from remembering to take my Xarelto every morning, I rarely think about DVT anymore.

The bad news: My hip pain is back. With a vengeance. Ugh. No matter how many people tell me I just have to be patient, it just doesn't feel right. I feel like it is way too long after surgery to still be feeling this much pain.

Today at PT, I was explaining to AJ how I went hiking over the weekend and felt great, but that the pain returned midday on Monday, after my first class. He replied definitively, 'I know what the problem is!' Even though he has never even really tried to give me an explanation for any of the problems I've presented to him over the past 10 weeks, I was actually stupid enough to believe him. LOL. After all, even my new therapist - who is actually a PT Assistant - suggested maybe it had something to do with hiking and then sitting in a car for so long. My own idea is that it is the effects of the cortisone wearing off already.

However, AJ went on to say, 'Obviously work is the problem!'

I had to laugh at that one. He may be on to something. But I'll save that discussion for my other blog.

Just for the record, my current pain is very specific. It is the combination of flexing my hip, bending my leg, and putting weight on it, that is killing me. Examples of activities that require this combination of motions: going up stairs, going down stairs, getting into my car, sitting down, standing up, and bending over. Interestingly enough, I was able to do a fair amount of exercises at PT today without much pain because none of them required all three of these motions together.

I know I sound like a broken record, but ohmygosh when is this going to end?!

Light at the End of the Tunnel? (10 Weeks + 6 Days)

I took a long weekend and went on a fall getaway, and it was fabulous to be out of Internet and cell phone range and breathe some fresh, mountain air. The weather was spectacular, the colors weren't quite at their peak of spectacular but were fairly spectacular nonetheless, and my hip was... spectacular. I'm afraid to even type it. Ha. And I'm afraid to even wonder, but yet can't help wondering: Have I finally turned the corner? Am I finally approaching the end of the tunnel?

It was a fun-filled weekend, full of moderate levels of activity and (drum roll, please) hiking. I have not gone hiking since, well, the last time I went hiking. LOL. But the last time I went hiking, it did not end well; in fact, extreme pain after going on a short hike with a bunch of a little kids is what pushed me in the direction of surgery. I am happy to say that it was a totally different story this time! The first day of the trip, I went on a very level hike on a well-established path, about four miles round-trip, and felt virtually no pain. The second day, I went on another hike, about the same distance, with a lot more ups and downs and uneven terrain, and felt a little bit of discomfort here and there, but basically no major pain. I was also without my new best friend, Mr. Ice Bag, for the whole weekend, and I actually feel really good right now.

In less spectacular news, I've noticed some small things here and there that I hope are signs of progress. For one, I can now squat down, which I haven't been able to do for a long time. It still hurts some, but the fact that I can do it at all means that the swelling in my leg has gone down, which hopefully means my DVT is resolving. Also, since the surgery, I haven't been able to stand with my legs together without extreme pain, but I noticed this evening that I can now do this. It still hurts a little, but it is nothing like it was before. Hopefully this is a sign of healing.

At this point, it is tempting to speculate what all of this might mean as far as my recovery, but I think I'll just sit back and enjoy it instead. It is what it is. :)

Breaking Up is Hard to Do (10 Weeks + 1 Day)

I realize that my incessant whining is probably pretty tiresome at this point - I'm even tired of listening to myself - but I know that I have crossed some sort of threshold when there is zero charge for my latest visit to the orthopedist, and even my physical therapist has given up on me. Okay, so the latter is not exactly true, but I did see a different therapist today (and quite frankly, it was awesome).

The sort of funny/sad part about this is that my whining is not nearly what it could have been. When I last saw my therapist on Thursday, I was feeling okay. However, I apparently had a terrible reaction to the cortisone injection that I got last Wednesday. Although the injection itself didn't hurt as much as it did the first time, the post-injection elation was pretty short, and not only that, I was in horrific pain on Friday and Saturday. On Friday, I could not walk without extreme pain, and since I was home alone with my son for most of the day, I decided to save myself the agony of limping around all day and just use a crutch. But only me and my son knew about this; it was our little secret. After a heavy duty pain pill on Friday night, I was feeling a little better by Saturday, and since my husband was around, I was able to take it pretty easy.

Dr. Google told me that I was likely experiencing a 'cortisone flare,' which is when the steroid crystallizes in the joint and causes intense pain. I knew this was a possibility after consulting Dr. Google prior to my first injection, but it wasn't really on my mind since it didn't happen the first time. Fortunately, I was back to normal, or at least 'normal' on Sunday, and by Monday I felt pretty good. So WHATEVER it was on Friday and Saturday, it is now gone, thank God.

Anyway.

I've been planning on going out of town this week/weekend with my parents and my son for a long time. It is my dad's birthday, and my parents originally invited the whole family, but my husband and daughter are going on a trip, so it is just me and my son. As I've been quite busy, the trip sort of snuck up on me, plus I did not realize that we were leaving on Thursday instead of Friday. To make a long story short, I had to rearrange my schedule for the week sort of last-minute, including PT, which I've been going to on Thursday afternoons. My orthopedist has recommended continuing PT twice a week, but since I started back to work, I just can't seem to fit it into my schedule twice a week, plus it's not so awesome that I'm that motivated to make it fit into my schedule. I could have just cancelled PT this week, but... it seemed like a long time to go without it. So I moved my appointment to today, Tuesday, instead.

Now, for reasons I won't go into here, I've been doing some 'research' on physical therapy places in town, and it has made me realize that the clinic I am going to is sort of the 'big box store' version of PT clinics: limited one-on-one time with an actual therapist and a lot of time with aides. Other PT clinics boast that you will never spend time with 'unskilled' aides or assistants, and your whole appointment will be one-on-one with your PT. I'm not exactly sure how I feel about this. I mean I GET why this is a good thing, but I've mentioned I'm not crazy about my therapist, and the thought of spending 45 minutes with him one-on-one sort of gives me the heebie jeebies. LOL. I actually enjoy some of the aides quite a bit, and most of them are perfectly capable of hooking me up to the electrical stim machine. (Hell, I'm capable of hooking myself up by now.) And it was because of an 'unskilled' PT assistant that my blood clot was finally diagnosed after I spent a month whining about how much my leg hurt, including to both my orthopedist and physical therapist. Nevertheless, I am sort of confused about how appointments work and how patients are distributed amongst the physical therapists at the clinic I'm currently going to. My therapist often has, like, three or even four people he is trying to take care of at once, which can get frustrating. Meanwhile, it seems as if most of the other therapists aren't nearly as busy. I don't know if there is some pecking order as far as who gets to see patients or what, but it's not as if I requested my therapist in the first place, so if he's that booked, why didn't they just put me with someone else from the beginning?

At any rate, I was sort of annoyed this morning when AJ came out into the waiting room and there were two of us booked for the same time, plus two people already inside he was also working with. I realize that I changed my appointment at the last minute, but if he was busy, they should have just told me so, and I would have just cancelled. (Again: Big Box Store. Appointments = Money.) However, after AJ got one of the other guys going, he came back out and sat down next to me. He looked like a boyfriend getting ready to dump his girlfriend. LOL. He sort of sheepishly said that there were some 'scheduling issues' and that he had a proposal. He seemed a little nervous, so I was thinking he was going to ask me to, like, jump out the window or something, haha. He then went on to say that my issues at this point were mostly soft tissue issues and that one of the other therapists had an open schedule right now and could work with me one-on-one for the whole time today, and would take me into a more private place to be able to do a little more than out in the open. (It is hard to work on hips in a clinic with an open floor plan; I've had to plan my wardrobe around this.) Then he added, 'And actually, she's a lot better than I am with soft tissue,' and went on to say that he had already filled her in on my history. It was as if he were giving me a sales pitch. LOL. The smart aleck in me had a hard time resisting saying something along the lines of, 'You mean you are breaking up with me?!' but since I'm not sure he has the greatest sense of humor, I just agreed. The funny thing is that it's not as if I even like him that much, so... I honestly didn't really care. I do have issues with change, which is probably why I've stuck with him for so long, but it's not as if I minded the idea of working with someone else.

So... my appointment was with Beth today, and she was A-M-A-Z-I-N-G. She told me that unfortunately, the private treatment room in the PT clinic was currently being used for storage, and took me into the casting room in the orthopedic area. She then massaged my hip, thigh, and back for a good 20-30 minutes, which was reeeealllly good in that semi-painful type of way. But AJ was right; she was A LOT better than he is. HA! And she was very pleasant, too, which was a pleasant surprise. (She just never struck me as pleasant before, but after today I feel she is probably a lot like me - not super outgoing or overly friendly on a superficial level, but perfectly lovely on a personal level.) Of course, in my mind, there is basically no amount of unpleasantness that can't be overcome by a good massage, but it is icing on the cake to be able to have a good conversation while you are simultaneously getting massive pain relief.

When I left PT today, it was a bit awkward because I soooo wanted to complete the break up with AJ, but I felt like I needed his permission. LOL. I quickly debriefed with him and told him that Beth had been extremely helpful. I then said that I was going to make an appointment for next week on my way out and wondered if he thought it would be a good idea for me to see Beth again. He pretended to hesitate and then said he thought it would be a good idea, that he thought this might be helpful for me.

I skipped all the way out. And I thought that maybe, after all, I can fit PT in twice a week like my orthopedist recommended. :)

A Man and a Trash Can (9 Weeks + 4 Days)

I think that I am officially starting to lose it. Yesterday afternoon I was running some errands and there was a man at the shopping center digging through the trash trying to find aluminum cans. I tried to ignore this as I dodged into the liquor store to buy some beer (OMG I was really in need of a beer), but inside the store I started crying, which is sort of ridiculous considering this isn't the first time I've seen someone digging through the trash looking for aluminum cans. In fact, many people who live on my street specifically leave their aluminum cans in a separate bag for the dumpster divers who scavenge our alley every day, going through the recycling bins looking for aluminum cans to take to the recycling center. I would do the same, except I never buy anything in aluminum cans after reading The Story of Stuff, which includes a chapter on how much energy and how many resources it takes to produce an aluminum can. The author of that book suggests renaming aluminum cans platinum cans because they might as well be. But I digress.

I came out of the liquor store and the man was gone. Out of sight, out of mind. Or not so much. I promptly spotted him about 50 yards up, going through another trash can. I got into the car and started digging through the my wallet to try to get some cash to give him, which is admittedly kind of awkward, because it wasn't like he was asking for money. At the same time, you have to figure an old man going through trash cans could probably make good use out of some cash. I've only given money to people who weren't asking one other time - about 14 years ago, my husband and I were walking down the street in the bitter cold, and there was a couple sitting outside of a restaurant with a bunch of change spread out all over the bench, counting it. It was a sight I won't ever forget. I wanted to give them some money, but I felt too awkward, so I made my husband go back and give them $20. He said the woman actually started crying.

I had this in my mind as I looked for some money and tried to figure out how I was going to make my delivery. But by the time I figured it all out, the man was gone. I drove all around the shopping center and I couldn't find him. How fast could an old man dragging all of his stuff actually move?! Did I imagine this? By the time I realized that he really had disappeared, and was nowhere to be found, I was practically bawling, and semi-hysterical. WTF?

I. am. losing. it. On the one hand, I think my pain is really taking a toll on me. I am constantly in a bad mood, overly emotional, and generally just don't feel like myself. On the other hand, I feel bad that I am like this over a little bit of stinking hip pain, when there are so many other worse fates I could have met. So on top of the constant pain, I have constant guilt. It is the recovering Catholic in me.

OMGthishastostop!

Prior to my hysterics, I had gone to physical therapy, and I think I felt worse after it was over. I also realized at that point that the cortisone shot basically did nothing for me, and was feeling sort of depressed or at least super 'woe is me' as I drove back from PT and swung by the school to pick my daughter up. As I walked around the school yard trying to find her, the mother of one of my daughter's classmates commented that I was limping. Yeah? No shit? LOL. I mentioned that I had had hip surgery over the summer and apparently wasn't recovering. This woman is an occupational therapist, and she said, sympathetically, that she worked with people who have chronic pain every day, and she couldn't imagine what it was like. She said almost all of them have depression in addition to chronic pain because mentally it takes such a toll on you. I said that my whole hip ordeal was really giving me a lot more sympathy for people who have chronic pain, especially when I consider what my pain has done to me even though it's just in one part of my body and has only been an issue for about a year. I guess if anything good comes out of this, it is my increased level of sympathy/empathy.

In less emo news, I woke up this morning to a throbbing hip and had a revelation. Both my therapist and orthopedist commented on how tight all my muscles are, and my therapist has been working on stretching and massaging my psoas and IT band during PT. I also stretch constantly throughout the day, just like I did before the surgery, because it's what allows me to, like, walk. And I work on loosening my muscles with a rolling pin, a therapy ball, and a foam roller (which my orthopedist suggested trying at our last appointment). Considering I am very flexible naturally, there is no reason I should be this tight. However, I did realize that due to my blood clot (oh yeah, remember that?), I have been sitting with my leg propped up and sleeping with it elevated (I've finally learned how to sleep this way!), which basically re-shortens all those hip flexors that I work so hard keep stretched out. I mentioned this revelation to my husband, who reassured me that tight hip flexors were better than pulmonary embolism or even permanent repercussions from DVT. Ha.

My therapist also told me that I might want to consider using a crutch or a cane again. Ugh. He mentioned, 'I know you don't want to do this at school, but maybe around the house.' So he does know me a little by now. LOL. Although he didn't think I was damaging my labrum by walking around, it just might help reduce some of the pain and therefore inflammation and make me more comfortable. I repeat: ugh. I don't think I actually responded when he told me this, and he didn't say anything more. So yeah. No comment.

I realize that sometimes you have to go backwards to eventually go forwards, but Jesus Christ, how far backwards am I actually going to have to go? And when do I get to start going forward again?

Cortisone Redux (9 Weeks + 2 Days)

The good news: My hip feels GREAT right now.

The bad news: I know from past experience that this is not the cortisone working its magic, but the short-lived numbing agent that is also in the shot.

I'll be sure to enjoy the next 12-18 hours to the fullest!

Surprisingly, the injection wasn't nearly as bad as the first time. Not NEARLY! It actually wasn't bad at all. The funny thing is that while I was waiting for the injection, the doctor popped his head in and said that he was going to look at my X-rays and would be right back. I remember from the last time that he wasn't able to pull up my X-rays (and am not sure why it's necessary), and that must have been the case again, because he came in and asked, 'We've injected you before, right?' I said yes, and must have made a horrible face, because later he said, 'You've already had one of these, so you know it's not your favorite thing.' I told him I was reeeaaaaally not looking forward to it, but at least this time I was prepared for how bad it was going to hurt.

He asked how long the cortisone had helped last time, and I said I wasn't sure because I had had surgery about a month afterward. We then talked briefly about the surgery. I told him that it had been nine weeks and I was still feeling pretty awful. He asked what my doctor thought was going on and I said I had no idea what he thought. He contemplated this for a brief moment and then said, 'Well, I'm sure he's just as unhappy as you are about the fact that the recovery isn't going well.' Uhhhhh, I seriously doubt that! But I refrained from commenting, and just said that I knew it must be bad if I was agreeing to another cortisone injection. He said that he had had his hip injected a few times, so he understood. Then he added that the first time he felt stinging and burning all the way down his leg, but that the second time he just felt uncomfortable pressure in his groin area. Then he fired up the ultrasound and remarked that it looked like I had quite a bit of fluid in the joint. Then in went the needle. I was bracing myself for the worst, but it turned out that it would be exactly the same for me as it was for him. The first time I felt stinging and burning all the way down my leg, but this time I just felt uncomfortable pressure in my groin area, which was NOTHING compared to the first time. It also seemed much faster than the first time, and it turns out that it was.

When he was finished, I told him that it wasn't nearly as bad as I was expecting; it was nowhere as bad as the first time. He said maybe he was getting better at doing the injections. Ha. I told him that the first time I couldn't believe how long 30 seconds was, and he said he had been able to do it much faster this time; it was only about 15 seconds. So it wasn't just my imagination. All in all, I was pleasantly surprised.

Even better, I hardly had to wait at all. According to the Internet, and a colleague who sees this doctor as her regular orthopedist for a different hip problem, the wait time for the doctor is usually pretty horrendous. I guess I've just been lucky both times I've seen him. I at least felt fairly confident today because my original appointment was at 4:15 but got moved up to 2:00 because the doctor had to leave early for some reason. I figured if HE had somewhere to go, he would try harder to stay on schedule. LOL.

Anyway, I guess now I'll just wait and see, and be sure to enjoy the numbing agent while it lasts. I'm looking forward to at least getting a good night's sleep. :)

At least I'm not dead (9 Weeks + 1 Day)

Some perspective: My husband is flying out tonight to go to the funeral of a dear friend, who unexpectedly dropped dead on Friday, at the age of 37. He leaves behind four children and a pregnant wife. Although I could not sleep last night because my hips were throbbing, and I'm feeling increasing frustration toward my surgeon and about my situation in general, I do realize that it could be much, much worse. In the large scheme of things that life can throw at you, this is extremely minor. I'm grateful that this frustration is the biggest annoyance in my life right now.

That said, I am simultaneously dreading and looking forward to my cortisone injection tomorrow. Dreading - because now that I already have one cortisone shot under my belt, I know that they Hurt. Like. Hell. Looking forward to - because now that I already have one cortisone shot under my belt, I know that they can offer significant pain relief. And I reeeeaaaaaallly need that pain relief right now. I feel as if my pain levels have slowly but steadily been increasing over the past week, which, quite frankly, sucks. I have actually been using a crutch to get around the house this morning because it helps my hip not hurt so much and I feel like there is no point in pushing through the pain. I've been pushing through it for the past few weeks, which has been making it worse, not better.

At this point, I've pinned all of my hopes on the cortisone injection. But I have been losing some sleep over the anticipation of it. I remember when my daughter was born, even after all my birthing classes, I had such horrible back labor that I said yes to the epidural faster than you can say 'natural birthing classes.' Unfortunately, the one anesthesiologist in town was tied up at the time, so I went for several hours without it. Eventually my OB/GYN arrived at the hospital and gave me an intrathecal injection. A few minutes after the injection, my blood pressure dropped and my daughter's heart rate fell to 40 BPM. Even though I wasn't fully dilated, my OB/GYN had to vacuum her out because her life was in danger. Fast forward six years to my son's birth. Because of my previous experience with the intrathecal, I was dead set against any injections. Dead set. At the same time, I recalled the excruciating pain that led me to beg for an injection, even though I had been fairly set against it. The anticipation of the pain I was going to experience, along with the knowledge that I would absolutely not have an epidural, led to many sleepless nights before the delivery. Fortunately, my son was born six weeks early, so that saved me from six weeks of sleeplessness, lol. Just as I got through my son's birth, I will get through the injection. I just hope that being prepared for the pain might make it easier the second time around.

I am also curious to see how much it helps this time. I remember the first time, I felt absolutely amazing the morning after the injection. Apparently this was due to the numbing agent in the injection, and not the cortisone. Unfortunately, the effect of the numbing agent was short-lived, but the doctor said the fact that it provided so much relief was good information, because it confirmed that the pain was coming from inside the hip joint, and not from somewhere else. This also helped confirm that I would likely benefit from surgery to fix my labrum. So now I have mixed feelings about the injection. On the one hand, if I feel awesome the day after the injection, it will be nice to feel pain free. On the other hand, I don't like the idea that even after surgery I could be having that much pain coming from inside my joint. I know that my muscles all around my hip are also 'angry' (to use my surgeon's words), but it's hard for me to tell how much of pain is coming from the muscles and how much of the pain is coming from the hip joint. In a way, I'd feel better if I knew the pain were coming from my muscles rather than my hip joint, but this would also mean that the cortisone injection won't really help, which would suck. I'm trying to decide if this is a lose-lose or a win-win situation, ha ha. In the interest of staying positive, I will try to see this as win-win, but ask me again tomorrow. :)

Visit with the Orthopedist (8 Weeks + 4 Days)

I saw my orthopedist this morning. Honestly, I didn't have any expectations for what he might be able to do for me. Thinking about it rationally, I don't even know what he could say to make me feel any better. At the same time, I sort of feel like he should know about my pain, you know?

Given this mindset, it was actually a pretty good appointment - better than I was expecting. And unlike last time, I was very calm and did not cry at all. :) The doctor poked around a bit and did a few 'tests,' although I have to say that his examination skills seem to be a little lacking. It reminds me of a time I had to take a practical for a sports medicine class; all the coaches in the athletic department were mock patients with pretend injuries and we were supposed to figure out what was wrong with them. The feedback I got from the practical was, 'It was as if you were afraid to touch anyone.' That about sums it up. So I understand that the art of physical examination is harder than one might think.

Anyway. He did not think that my continued pain, which is identical to my pain pre-surgery, was necessarily a sign of the surgery not working or the labrum somehow being re-torn. Rather, he just said that the labrum had obviously not yet healed completely. I mean, who are we kidding? Of course he's going to say that. I have my doubts, but really, what can you do? The only way to confirm this one way or the other is to have another MRI, and it's a little early for that. While I do feel frustrated by having this much pain almost nine weeks post-surgery, it's not out of the realm of normal. Plus, I've had some complications along the way. The doctor said that he often saw people who weren't feeling very good two months out but then felt much better three months out. Again, of course he had to say that, but my guess is it might actually be true. I just hope I end up being one of those people.

He said my strength was very good, but that all the muscles around my hip, including my hip flexors, IT band, and muscles in my back were super tight, which I knew. Duh. Although, I believe his exact words were actually, 'Your muscles are really angry right now.' LOL. (Meanwhile, I'm thinking, Yeah, and my muscles aren't the only part of me that are angry.) He asked whether I was taking an anti-inflammatory, and I told him I had to ditch the diclofenac because it upset my stomach too much. His assistant had also suggested trying Aleve, but I just hadn't gotten to the store to buy any yet. He said he would give me a prescription for another anti-inflammatory, meloxicam, and if that didn't work I could try prescription-strength Aleve/naproxen. He said he really didn't want to go the route of a muscle relaxant because in his experience those just made people sleepy. I agreed, and shared my experience with a muscle relaxant with him, and added that I had no desire to ever take a muscle relaxant again for as long as I live. So we agree on something! :)

Then he said something I might want to consider is trying a cortisone injection. Aaaaaaagh!! I had a cortisone injection before, and it was awful. (See: http://39andhip.blogspot.com/2014/07/the-cortisone-injection.html) But, I have to admit that it did help, which I told him. It just didn't help enough. However, it's possible that in conjunction with the surgery, it might be helpful. And as he explained, I could just be stuck in some sort of vicious pain cycle, and this might help break me out of it and calm my muscles down. Fair enough. I mean, the bummer of this is that I went the surgery route precisely because I didn't want to have to go the cortisone injection route for many more years to come, but... I understand how a cortisone injection might be a logical thing to do at this point. And given that I'm fairly desperate right now, I agreed to it, and made an appointment for next Wednesday. I am 100% dreading it, but if it helps it will really be worth it. And what I really, really, really need right now, more than anything, is some hope.

So here's to hoping.

Book Club (8 Weeks + 3 Days)

Tonight was my monthly book club meeting, which is an event that I really look forward to. As I was walking over to my friend's house, I could not help but think of the last book club meeting, four weeks ago. I had had PT in the afternoon and was scheduled for an ultrasound the next morning, which I recounted to everyone at book club with casual amusement. At the time, I really thought everything was okay. (See: http://39andhip.blogspot.com/2014/08/post-surgery-4-weeks-3-days-6-days-uirtw.html)

It was sort of depressing to realize that things haven't changed much since four weeks ago. Four weeks ago, I struggled with pain as I walked five blocks to book club. Tonight I struggled with pain as I walked one block to book club. Just as I had PT four weeks ago, I had PT today. Four weeks ago, I wasn't able to do much at PT due to pain, which led the PT assistant to try massage to help my pain level, which eventually led to discovery of my blood clot. Today during PT, I wasn't able to do much due to pain, and my PT did massage. Déjà vu all over again.

I guess the sort of good news about this is that I do have an appointment with my orthopedist tomorrow. I know I've said that I don't feel like he can help me at this point, but I am trying to keep an open mind, seeing as how I have no other options. I was originally supposed to see him next Friday, but apparently my semi-hysterical e-mail last night prompted someone on staff to call me today and tell me that he had time to see me tomorrow. Ironically, I was actually at physical therapy, 20 feet away, when they called me, and then when I called back after I got home two hours later, they gave me the usual runaround. Fortunately, I'm pretty experienced with the runaround and realize that being pissy with front office people never gets you anywhere. Eventually, I managed to get an appointment tomorrow, which can't hurt. If nothing else, it will give me an outlet for complaining that is not my husband.

At this point, my expectations are pretty nonexistent, so anything at all helpful would be a pleasant surprise. Anything not helpful will not make me happy, but won't be a surprise. Maybe that's a bad attitude, but it's where I am mentally right now. When I was logging in via the patient portal, I noticed that my appointment was classified as a 20 minute re-check. 20 minutes? You've got to be kidding me. The only time I've ever gotten 20 minutes from my orthopedist was during surgery, and even then it was only an hour. At any rate, I'll let you know how it turns out.

Roller Coaster (8 Weeks + 2 Days)

I feel as if I am on some insane roller coaster ride, which I at least know is not uncommon, from reading other people's hip surgery blogs. The irony is that I've seen enough terrible things happen that I really don't take much for granted. I thank the powers that be every day for my children and for their health and for my health and for the jobs that my husband and I have that keep a roof over our heads and on and on. Yet even after reading a bunch of hip blogs, most of which were pretty much hip horror stories, I really didn't think that would be me. I worry about all sorts of things - like my kids being snatched off the playground or having a fatal allergic reaction, and ever since a friend of mine and her three kids died after being swept away by a flash flood and drowning, I worry about us being swept away by a flash flood and drowning. And considering that a few days before surgery I found out that one of my daughter's classmate's mom died during routine surgery, it did cross my mind to worry that I might actually die. But once I woke up from surgery and realized I wasn't dead, it never occurred to me I might be one of those people who didn't actually benefit from surgery, who might have to go on and have more and more surgeries, who kept a blog that lasted for five years when it should have only lasted for five months. I mean, I'm not saying I'm there yet, but over the past few days I've been having to come to terms with the possibility that this surgery didn't actually do anything for me. Because for the past few days, I have been feeling, well, exactly like I did before the surgery - the only difference being that now, in addition to hip pain, I also have a massive blood clot. Awesome.

At any rate, in case you couldn't tell, I'm in a lot of pain right now, and I am extremely unhappy about it. I know that it is possible I am feeling a lot of pain because over the past two weeks I have not only returned to work, but also tried to return to normal by doing a lot of 'normal' stuff. For example, I spent all of Monday - in honor of 'Labor Day' - working in the yard. Admittedly, this included taking a tumble off of my husband's camping stool that I was trying to use to weed, seeing as how I can still not squat down, and maybe that has something to do with my current pain, but still. It has been over eight weeks since the surgery and my gut is telling me that I shouldn't be having this much pain over eight weeks post-surgery. I also feel like my hip should be healed to the point where a little stress here and there should not result in agony. It's not as if I crashed on my bike, which despite all my temptations, I have still not tried to ride. But then again, what do I know?

I just sent an e-mail to my orthopedist telling him some of these frustrations, but I guess part of why I feel so discouraged is because I have no faith that he can do anything about it. I have no faith that anyone can do anything for me right now. I've sort of talked myself into having a good relationship with my physical therapist, and I appreciate a lot of what he has done for me, but at the same time, he's not extremely helpful with anything that pushes the limits of his rather small comfort zone. He just tells me to talk to my doctor about it. I also don't feel as if he has any sort of long-term plan for my rehab; it seems to be a lot of day-to-day improvisation. It's an unsettling feeling to know that no one is going to help you. I could completely handle the pain right now if I had faith that there was something that could be done for it, or there were at least some plan.

If I sound very bitter... well, I'm not. Not exactly, anyway. I actually really like my doctor, and his medical assistant is super sweet, which is what makes some of this frustration even more difficult for me to handle. I do actually want to feel ANGRY over a lot of this, but... I understand. I touched on this a little on my other blog, where I wrote about the similarities between my job and my orthopedist's job. When I decided to have this surgery, I had full faith in the surgeon - otherwise I'm sure I wouldn't have gone through with the surgery. I still believe he is pretty brilliant, and a very competent surgeon. Unfortunately, things haven't gone as planned, and he seems to be a little lacking in the area of 'when things don't go as planned.' Maybe this is lack of experience or something else, but whatever it is, I can relate. I'm sure he sees a ton of patients every week, just as I have a ton of students every semester. By necessity, I teach with a 'one size fits all' mentality. Medicine, in my experience, is also like this - not because practitioners don't realize that one size doesn't actually fit all, but because they don't have time for the outliers. As much as I tell students to come see me if they need help, I honestly don't know how much help I can give them if they just don't get it. I try, just as my orthopedist tries and my PT tries, but at times I fail. I can go on living with myself because I figure that what I do works for probably 70-ish % of my students, and WOULD work for another 20-ish % if they did their part, and thus, I'm only failing to meet the needs of 10-ish %. It's not a bad statistic from my point of view, it just sucks if you're in that small minority. And I seem to be in my orthopedist's minority of 'people he cannot deal with.' Like I've said before, karma is a bitch.