But, I'm glad I kept the appointment. Of course, my hip felt pretty good the past few days. Fortunately, it felt terrible when I woke up, so I was able to describe the pain better to my orthopedist. (Thank you, four-hour night class that I sat through last night, for bringing the pain back.)
My orthopedist really didn't have any earthshattering ideas or insights, but I didn't expect that he would. We had a nice conversation, though. I sent both him and my physical therapist a Christmas card in December, thanking them for trying to help me, and apologizing for being difficult. I told them that despite everything, I knew they were really trying to help me (and I truly do believe that). He very genuinely thanked me for the card, then commented that my kids were super cute, and said that he enjoyed the newsletter, haha. I was never much of a Christmas newsletter person until I realized how much I enjoy reading other people's once-a-year newsletters, even if I barely know them. I probably wouldn't have sent one to my health care providers except there was nowhere to write on the card, so I needed paper to write on. I really didn't think he would read it, though! At any rate, I think the note of reconciliation went a long way, because we spent a good 20 minutes talking about... stuff. He did not seem hurried or impatient as he has in the past, and really listened and responded - that old-fashioned medicine I was talking about a few weeks ago. Some of our conversation was small talk but most of it was addressing the question of What should we do now?
Options:
- Get an MR arthrogram to see what's going on. However, as he pointed out, 'It would probably not change how we go about treating the pain because I'm guessing I can't talk you into letting me go back in and scope your hip again.' I didn't even need to say anything. I think I just smiled because it shows that he knows me fairly well at this point. The thing is that I am somewhat curious to see if something is wrong, or if this really is just residual pain from surgery that for some reason is lasting a freakishly long time. In my gut, I am pretty certain this pain is not normal, but he is right; there is no way I am having another surgery anytime in the near future. And since Christmas always results in a few months of really high credit card bills, and it's a new year, which means having to pay our deductible for health insurance, I'm not crazy about the arthrogram from a money point of view. (Also, it sounds pretty unpleasant, TBH. An injection followed by an hour in the teeny, noisy, tube. Awesome.) So that option is off the table for the time being.
- Go see another doctor. Yes, he actually suggested this. Ha. I honestly didn't feel like he was doing it in a trying to get rid of me type of way; it's just that it seems like he's out of ideas, and thought it might be helpful to have a 'second set of eyes.' I really think he's just trying to do the right thing for me. He said he has a friend who also does hips, who is in a different practice, to whom he could refer me. It's not out of the question, but it's also not on my immediate 'to do' list, either. I think I've had more visits to the doctor in the past year than in the rest of my adult life combined, and I'm not super anxious to add another one to the list.
- Try a topical cream pain killer. That's about all that's left to try in the way of medication, so what the heck, right? I did get some relief from the patches I tried in physical therapy, so... whatever. At this point, I'd be okay with just the placebo effect. LOL. So I agreed to try the cream and revisit him in six weeks. It sounds like sort of an ordeal to actually get the stuff, but an ordeal that apparently I don't have to deal with.
- The return of my snapping hip. It seems like my iliopsoas is acting out. This was after a conversation about how I stopped teaching anatomy labs because cadavers are too stinky, and swapped stories about being stinky after working with cadavers, so he knows I know my muscles and that he can use their real names with me.
- The bursitis I have in both my hips. It's a low priority. I really only notice it when I'm trying to fall asleep because it is painful to lie on either side. But it is worth noting that it is still there.
- Cortisone injections. He mentioned something about them, and I reminded him that the last one didn't help at all. Then I asked him if he had ever had one. He said no, but that he had given a lot of them. I informed him that they hurt. like. hell. and he seemed surprised. He must have done all of his injections on really stoic patients because it's hard for me to believe no one ever mentioned the extreme unpleasantness of them before. As the saying goes, you learn something new every day.
- My left hip. He was doing his labral impingement test on me and using my left hip to show me how in a normal hip, certain motions shouldn't hurt. As he was manipulating my hip to do said motions, I think I must have winced in pain. Then I told him I really scared I had the same issues in my left hip, but I couldn't even think about that right now. He was very respectful of that and put my leg down and said he didn't want to go looking for trouble. Ha. Maybe if I ever have that MR arthrogram, I'll see if I can have both hips and my left knee done all at the same time and just get it all over with at once.
- The motions that cause pain. I mentioned that my major frustrations at this point are going up stairs, hip flexion in general (which is exacerbated by stairs), and going from sitting to standing. If I've been sitting at my desk for even just a few minutes, I'm back to having to stretch for a good minute before I can walk. That said, there is not a single motion in particular that seems to trigger the sharp pain; that seems to come at random times.
- Limping. He noted that I limp. I told him I don't even notice that I do it anymore, but the idea that I do embarrasses me. I don't think I do it all the time, but definitely after I've been sitting and then stand up and try to walk (which is exactly what happened after I waited for about ten minutes for him, then talked to him for about five minutes, then stood up and tried to walk over to the examination table). He agreed that I'm too young for this.
- Generally, the ups and downs of all of this. I told him I have good spells where I think this is finally over, but then I start to go downhill again. His response: 'I don't want you to be like a sine curve.' (The real question is: Is he super geeky or does he just think I'm super geeky and hence trying to communicate with me in geek language?)
- My scars. Six months out, my scars still bother me. They don't really hurt, but they itch. I've consulted Dr. Google about this, and I think it's keloid scarring. (Interestingly, this is also common in people with Ehler's-Danlos syndrome, which my daughter supposedly has, which would make it likely that either I or my husband have it, too.) I wanted to have him take a look at my scars just to see what he thought, but I forgot. Maybe it was 'on purpose,' though, as it's weird to have to semi-undress for this.
- My back pain. One of the most amazing things after surgery was that for a while my back didn't hurt. It was the first time in decades that this particular pain went away, which was both unexpected and extremely awesome. It never really occurred to me that fixing my hip pain might make my back feel better, too, so this was just bonus material. Even though I was on crutches, I had virtually no pain. That pain is back now, though, and I can't help but think it must be related to something bad going on with my hip. It's not an urgent issue, nonetheless, it is worth noting.
Nevertheless, I consulted Dr. Google about dry needling, and there does seem to be some science behind it. It's not snake oil. Basically it seems to trigger the inflammatory response in order to promote healing, which seems to go against traditional treatments of, you know, taking anti-inflammatories. LOL. So perhaps I'll give the lotion a try, and if I still feel like I'm drowning after that, I'll jump onto the needle boat. And while I'm speaking about desperate, another option that occurred to me in writing all of this is massage therapy. However, I want to wait to make sure my blood clot is cleared up 100% before going this route. Hopefully this will happen in February. Fingers crossed.
All in all, it was a good day. As I've mentioned before, sometimes I want to be really mad at my orthopedist and my therapist, but then I go in and see they are people, just like me. And just like I do my best at my job, they are doing their best at their jobs. Unfortunately, as I know, sometimes your best just isn't enough. Nonetheless, it is helpful to be face-to-face with my orthopedist, who honestly seems like one of the super nicest people I know (and definitely the super nicest orthopedist I've ever met). Maybe he has a ways to go in terms of his medicine, but it's impossible for me to be angry with him when I see him in person. And that's a good thing, because I definitely don't have the time or energy to be angry.
