Cry Cry Cry (8 Months + 5 Days)

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

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

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

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

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

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

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

In other news:

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

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

A Slow News Day (7 Months)

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

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

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

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

Other random thoughts:

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

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

Lotions and Needles (6 Months + 1 Day)

In celebration of being six months post-surgery, I got to see my orthopedist today. LOL. I'm super duper stressed about work right now because I'm in a huge time crunch trying to prepare for the upcoming semester. Being sick and dealing with sick kids for over a month in November and December really put me behind where I need to be right now. Admittedly, I've also had a hard time focusing over the past 48 hours, with my mind wandering to the horrific events in Paris, which hit closer to home than other horrific events. As I was driving to my appointment, 20 minutes away, in bad weather, I was thinking to myself WHY AM I DOING THIS?! Nothing ever comes of these appointments, but yet I continue to go (and then complain that nothing comes of them).

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.

Other things we talked about, in no particular order:

• 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?)

Things I forgot to talk about:

• 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.

On the way out, I popped into the PT room to say hello to my therapist, who also very genuinely thanked me for the Christmas card. We chatted a little bit, and he asked if I would consider a therapy where I got needles stuck into me. OMG are we grasping at straws or what?! Lotions and needles. This is what it has come to. I'm pretty sure I raised my eyebrows at him. He then went on to explain that this 'dry needling' was sort of a Western form of acupuncture: 'In acupuncture, you stick needles in the shoulder to try to help the hip; in dry needling, you stick needles in the hip to try to help the hip.' LOL. To be honest, I'm not sure how psyched I am about Western medicine right about now. At any rate, he wasn't pushy; he told me to 'look it up' and see what I thought, and let him know if I wanted to give it a try. I did tell him I'd probably try just about anything at this point. At the same time, I'm reminding myself of my students who come grubbing for points at the end of the semester. This all seems so... desperate.

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.

'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 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!

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. :)

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. :)