2 weeks post hip arthroscopy (again)
The best perk of being a PT you ask? Most definitely... having PT friends. After a long day in clinic, Jackie (ahem... Dr. Piccone) worked some PT magic and finally got my muscles to chill the F out. Combo ultrasound + e-stim for the win! It provided a similar effect that dry needling would have (although not quite as specific or focused) and seriously helped get my spasms in check.
I always tell my patients that surgery is "elective trauma." And although those procedures are necessary to fix an underlying structural deficiency/injury, it always leaves you with collateral damage. In fact, you are often left MORE broken leaving the OR than you were when you went in. I am forever thankful for the skillful hands of Dr. Mei-Dan, but I know that it would all be for nothing without all the fabulous PT's in my life who have helped put me back together again (and again... and again... and again... and again... and again) after surgery. Both physically and mentally. So THANK YOU. I love you all and am so grateful to have had you by my side through all of this <3
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10 days post hip arthroscopy (again)
When I think about all of MY patients that I've treated following hip surgery and the goals/expectations I have for them 10 days post-operatively, it completely baffles me that I find it so incredibly difficult to allow myself the same patience. The following day was Friday and I was completely worn out. A lot of my friends were going out to celebrate the end of the work week and I found myself almost numb as I sunk into the couch. I didn't want to eat or read or watch TV. I didn't want to do any of my own rehab (which I hadn't done in 2 days because I was so tired and sore.) I just sat there until I fell asleep... sitting up. When I woke up I still felt so heavy and numb and I knew I needed to snap out of it. I needed to actually do something to make myself feel better. So, around 10 pm, I went to the gym and got on the stationary bike. Almost as soon as I made my first revolution, I broke out into tears. And instead of trying to stop them and put on a tough act like I always do, I just let them fall. I was in and out of tears nearly the entire time I was on the bike but, when I finished, I felt like this giant weight had been lifted off my shoulders and I could breathe again. These moments- the ones that break you down and test your resolve- are the moments that pave the way for true growth and change. They are not a sign of weakness, but rather, a signal of readiness to completely surrender to and accept the journey that you are on. So in other words my friends... let yourself have a good cry and then go kick some ass :) In addition to kicking some ass this next week, I plan to practice a bit more self love and patience- a life long skill that I think we all need to nurture more often than we probably do.
3 days post hip arthroscopy (again)
0 days post hip arthroscopy (again)
Day of Surgery
Once inside, Dr. Mei-Dan found an area of cartilage damage with underlying subchondral bone defect. He performed small micro fracture to promote cartilage healing and smoothed out the cartilage in the area. This defect was not picked up by any of my imaging studies and the only reason he found it was because he was "searching" for it based on my clinical presentation and a slight artifact on CT. He believes this defect is most likely the root cause behind all of my symptoms. However, just to be safe, he fixed all other structural abnormalities while he was in there since I have tended to be a bit of an enigma throughout all of this. Interestingly enough, he found that a portion of bone on the acetabulum (socket portion of joint) had actually grown under and around one of the previous anchors, leading to a protrusion of bone and labrum. This protrusion may have been acting like a pincer-type irritation of the surrounding tissues- but especially the labrum, as there was evidence of peripheral tearing/fraying. As such, the anchor was surgically removed from this site, the extra bone growth was shaved down and the labrum repaired. I also had a bursectomy of the iliopsoas bursa due to chronic inflammation and, to finish, he closed the anterior hip capsule and tightened this closure to make up for my inherent collagen laxity and to prevent me from over-stretching it (I was a dancer and figure skater... I can't help it!). All in all, he seemed quite pleased with how things went! So fingers crossed this is the last time this hip finds herself up on an operating table :)
10 months post core decompressionPart of my evaluation in Utah included a CT scan for 3D reconstruction of my hip. This is such amazing technology that allows surgeons the ability to see the bones of the body in their full and actual shape/orientation within the body. (Make sure to take a peek at the slideshow below!) This study, unfortunately, did not offer much diagnostic value for me. There were some signs of FAI, but this abnormality did not match my clinical presentation. Plus, FAI was previously resolved in the first surgery I had, which made this even more unlikely. Imaging can be a wonderful tool for diagnosing pathology that we are unable to see with the naked eye. HOWEVER, it is so important to correlate radiographic abnormalities with the patient's symptoms. Just because something is structurally abnormal, it does not necessarily indicate SYMPTOMATIC pathology. In my case, for example, if FAI was the driving factor behind my symptoms, I would expect the majority of my pain to be associated with sitting and squatting activities. My chief complaint, though, was pain with prolonged standing and walking- both of which are inconsistent with the diagnosis of FAI. Because of his mismatch between diagnostic imaging and clinical presentation, FAI should not be considered in the differential. As I was in the process of moving back to Colorado, I decided to continue this evaluation back home. Dr. Mei-Dan has been with me through all of these hip shenanigans and, at the end of the day, I wouldn't want anyone else operating on me. I forwarded him imaging done out in Utah and he placed orders for another MRI out in Colorado. Between these imaging studies, consideration of my past medical/surgical history and current symptom presentation, we came up with a few scenarios that may be contributing to my pain. However, because all of these imaging studies were only suggestive of various pathology (not conclusive or diagnostic), the upcoming hip scope is going to be somewhat of an "exploratory" procedure. Surgery set for September 25th... wish me luck! 9 months post core decompression
I was unable to be on my feet all day in clinic and it was incredibly distracting to me, which is not a good thing for any healthcare provider. As such, I elected for a single, never to be repeated ever again (in an effort to maintain good cartilage health) cortisone injection just to get me through my work day. I have received about 60-70% relief from this, which is great because I can at least do my job now, but I am still unable to do much for exercise. So until further notice... the pool is where you can find me...
8 months post-core decompressionI know it has been awhile since I've updated, perhaps because things have been so up and down with this pesky hip that I haven't known how to even put words to what has been going on. Even though the MRI came back clean for AVN, I've continued to have intermittent activity related pain. I ended my ski season early because I was having pretty significant night pain again... but with rest, things seemed to get better. I gradually resumed activity again and was able to get out and hike quite a bit. But then again, out of the clear blue sky, I began to develop significant activity related pain that would be much worse at night. This past weekend, I got so sore from just walking around the mall for a few hours- which makes absolutely no sense considering just 1 month ago I hiked Mount Olympus in Utah, which amounted to 3,000+ ft vertical gain in 3 miles, with little issue. During this time, I had a PRP injection to stimulate the body's own healing process. It seemed like this may have been helping a bit, although the true effects of it can take several weeks, so it's hard to really know. I of course have been diligently rehabbing and trying everything I know under the sun to assist my body in healing itself, but it just seems like it is going to continue being stubborn... 9 scars. 5 surgeries. 3 long years. These past few weeks I've had a hard time looking at these scars because my hip hasn't been feeling great... and that has made me feel angry that my body is failing me yet again.
As a PT, I hear this all too often from my patients as they work to overcome injuries... and Mr. H has been no exception over the long year we have been working together. He, too, has been working to overcome 3 brutal orthopedic surgeries over the last year. He has had an incredibly challenging time practicing patience and self love during his recovery. Today, after a particularly difficult session, he looked at me and said, "You know, I am so thankful to have had you by my side through all of this. Even through all the ups and the downs, I am not angry at myself anymore and I have you to thank for that. You have helped me be thankful for this body and all the things it can do right now and for all the things it will be able to do when we're finished here." Those moments when the patient becomes the therapist- little did he know that his words were exactly what I needed to hear today. Mr. H... thank YOU for the much needed reminder to be grateful for this warrior body and to trust that it will continue fighting for me just as it has done so all along! 20 weeks post decompressionGUYS. I can't believe it... MY FEMUR ISN'T DYING ANYMORE! I am over the moon with excitement! Even more so, I know that all the hassle of driving to Idaho every week for hyperbaric treatment (HBOT) was totally worth it. It just goes to show that, regardless of what insurance companies or other people may tell you, you must always advocate for yourself. Ahhh and just look at those scans! 14 weeks post core decompression
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