It's almost hard for me to remember now, how many nights over the last two years I have cried myself to sleep. What chronic pain does to the mind and the heart of a person. Today it's sunny and I can go anywhere, do anything I want to do. Going to wait a couple of months to run, but I'm happy about that one!
The kids are turning 2 and 4 this week. My hip pain presented with the first pregnancy, but became absolutely unbearable with the second. My husband would roll me over in bed, help me dress myself. There were days I literally crawled on the floor, or drug myself with my arms because I was unable to walk. Dark days.
Caring for a newborn baby and a highly active two year old while in disabling pain, not fun. So began a year of for doctors, three surgeons, PT, rationing anti-inflammatories and trying every alternative remedy I could dig up. I learned a lot about myself and more than I'd ever like to know about pain. I also learned about the power of faith, prayer, love and friends who show up at your doorstep with a hot meal when you can't care for your own family.
I put surgery off for a year. I still stand by my decision and think everyone who is not a professional athelete should give this time. The surgery doesn't have a very high success rate, it is a long hard recovery and if you have a family to care for, well you're not going to be able to. 6 to 8 weeks on crutches for a labral tear. But when I felt like there was no option left I made the decision and had the surgery 10 days later. Oh, and did I mention a few insurance companies still consider it to be experimental, so the unlucky (me) pay out of pocket.
I was shocked to hear I had developed stage 3 osteoarthritis. No wonder I hurt all the time! You can dig through the old posts to hear about the surgery and recovery process, but the short version is I'm almost 100% recovered. Actually I think my hip is better than it's ever been in my life.
It took about 3 months of PT to be strong enough to slowly return to cardio activities. By the 4th month I was back in spin class, dancing, and doing at least 30 min on eliptical machine. The first few weeks back I was weak and would have a lot of pain for about 48 hours afterwards, but my therapist said it was to be expected and we monitored the length of pain. Like she said, after about 4 or 5 times my hip got used to the activity and the pain was gone.
I used to cry in spin class, pilates or yoga because of the fear I would lose this part of my life forever. Now I cry in spin class, pilates and yoga when I feel the inner strength, and think of how grateful I am to be there now. It's given me such a new perspective and motivation. I am in a very good place, but it was absolute hell getting here. And still my advice regarding the surgery decision is to weigh your risk vs benefit. Don't simply think about the surgery, but what you will do afterwards. Be sure your surgeon has a game plan for your recovery in place and that you know what it is!! This procedure doesn't end when you wake up from the sedation.
Good luck to all of you. And for those who have been so kind and supportive it really has meant a lot to me!! I am so thankful we can share our stories together, the good and the bad.
love,
Vanessa:)
Hip CLUNK and the pain is gone?
10 hours ago
19 comments:
I still stand by my decision and think everyone who is not a professional athelete should give this time. The surgery doesn't have a very high success rate, it is a long hard recovery and if you have a family to care for, well you're not going to be able to. 6 to 8 weeks on crutches for a labral tear.
I'm fascinated by this part, because it is so very different from my own experience. I am not a professional athlete by any means - just a keen one - but arthroscopy was presented to me as the only available option. Indeed, I was told that I could expect hip replacements within 5-10yrs if I didn't have it done, and the sooner the better to prevent further damage to the joints. I was also informed that it has a 5% chance of failure. Because I had extensive (partly open) bone work, I was on crutches for a week, but a girl on my ward who had just the labral work was told 2-3 days, and then only as needed. I'm just over 7wks post-op now, and dying for the surgeon to clear me to train again.
This isn't a criticism of your statement/recommendation at all - I'm just stunned that we have such different experiences on either side of the Atlantic. I wonder what it is that US surgeons do differently to UK ones, and whether your joints will survive longer than mine due to the different approach. I hope you will update in a few months, once you are back to your running - I'll be interested to hear how you are doing!
Hi Briony,
The approach is definately different, not only in the US, but surgeon to surgeon. The labral repair, using anchors to reattach the labrum takes 4 to 6 weeks to heal at the repair site. Compression and external rotation can easily compromise the repair during this time, making the repair vulnerable. I guess the surgeon I used doesn't see the sense in risking that repair. It's worth being conservative to me, because I won't have to second guess myself now if something had gone wrong.
Also probably different is we started PT the day after surgery and continued weekly to almost 4 months post-op. I know without a doubt this was key to my recovery because the weeks or days I slacked off my pain level increased and my range of motion decreased.
Most insurance companies and studies cite arthroscopic surgery to treat FAI as having an 85% success rate here.
Thanks for posting,
Vanessa
oh, by the way Briony. My surgeon and I are conservative. The first two I saw said this was the only option. My point is, it probably is your only option if you are hoping to get back to training or being a highly active person.
Not everyone is. If you have no interest in returning to a highly active lifestyle surgery may very well not be your only option. Rather, it might be a risk (expenisive one) NOT worth taking. Unfortunately too many surgeons rush their patients to this decision and trust me, I've recieved countless emails of heartwrenching stories of surgeries gone wrong, it happens too often.
Thanks for that insight. As I said, I wasn't trying to question your judgement at all - it is clear to see how much research you have done! I'm just stunned by the differences. From what you have said, I think the answer is that you had labral *repair*. I had labral debridement - repair is not given as an option here, unless it is a very substantial tear. Unfortunately, this leaves me with less cartilage in my hip - if I had had the choice, I would have gone for the repair instead of the debridement, without question.
My physio was nowhere near as intensive as yours: I saw them one week post-op, then two weeks and five weeks. They had no protocols for this type of surgery, and were using info for hip replacement, which was more conservative than my surgeon would have liked (eg no stretching for 12wks). I saw my surgeon's registrar this evening for my follow-up (7wks) and he has cleared me to do whatever I like - skating included. My range of motion is stiff and limited, and I'm sure that with better physio, I would be closer to my normal mobility by now.
Briony,
It doesn't seem that aggressive PT is the norm, but with those surgeons who have studied under both Byrd & Phillipon and others I'm sure it is. I wish that more people were getting that aspect of the care & the follow-up. Having that relationship with my PT was vital to my confidence too! Having someone who could see and take notes on my progress was a great thing!
And I think you're right, debridement is not as long on crutches or recovery. It also seems most surgeons do not do the repair.
And, at 7 weeks I was stiff & still had pretty limited range of motion, don't worry it will come. Actually between 7-9 weeks i hit a wall and kind of had to push through it. Stretching made a great difference!
Here's one that is great if you don't already know it:
Lying on your stomach, bend the knee of post-op leg then let the weight of your foot (slowly) fall out to the side, keeping your knee bent at a 90 degree angle. If you're tight this will be an uncomfortable, yet relieving stretch. Spend some time going from external to internal. This mimics a stretch they do at my PT visits. I use it several times a day and no longer feel much of a stretch at all.
Good luck,
Vanessa
Vanessa,
I can't thank you enough for your blogs. I know I say it every time, but it is so important for us who are scheduled to have surgery to hear of someone who was in such debilitating pain come out better on the other side.
You are so fortunate to be near Dr. Byrd. It seems like everyone who sees him has success. Are there actually some non-success stories when it comes to Dr. Byrd? I know he's in the top three for this surgery, but I've never read anyone who has a had a negative experience with him. Do you know what his personal success/failure rates are?
Hi Kate,
Good question. I have no idea what his stats are, but I'm sure there is a way to find that info. I can tell you that I have met people in therapy who have had an unsuccessful surgery and have had to repeat the procedure. I'm not sure if the first were performed by him or not. I do know of one patient here in town who has not had great results.
Dr. Byrd was very clear with me that there were no guarantees with the surgery and that some do not get better afterwards, but that he would do his best and we would hopefully see great results and we did. Unfortunately that's not always the story.
I don't know of anyone who has been unhappy with him as a surgeon, except for having to wait too long to get an appointment, needing to send so much medical history to his office and there have been a few who have been angry that he wouldn't schedule surgery right away.
-Vanessa
Hey I'm UK I was 6 - 8 weeks crutches because of the bone work. Also had labrum reattached with anchors. PT here bit half hearted and uncoordinated, offered 6 week course ad of course 6 months post op am still in weekly pt as I have not got much better, some improvements but nothing to write home about. I had it 6 years before spotted, dunno if that's why? They say I have muscle and tendon adaptation which is difficult to sort... perhaps bad luck, I had Schilders in Bingley, Yorkshire.
Hey ho, I say it if it hurts to the point that you would face surgery, go for it.. it has a strong chance of working, but agree with Vanessa that its a nightmare if you have rug rats too. Post OP is sooo much harder than the op.
XX Good luck all and well done Vanessa!
Hey venessa, so glad things are going well for you. I am now in those dark days you talked about. i have been in severe pain since december of 09. I will most like;y have to have open surgery to correct my hip impingement and i think a few other issues because i have cerebral palsy as well. i have not heard on the date yet but did talk to the ortho again and he was surprised to hear that i had heard nothing. I am getting so nervous and the daye is not even set yet. i am so glad for your blog. It has been a great thing because i know that I am not alone in this good luck to you and your family and keep up the improvement. kepp us all postend on how things are going we all need a positive in our lives especially when the pain get us down.
dear Vanessa:
I have been following you as I am the same afraid to just do the arthroscopy. I just got through with 2 months PT, A.R.T. therapy and bike, etc. Some help, but not "fixed". The next step is a cortisone injection in hip to be sure it is the hip joint. Any reason NOT to get that? Thank you so much!
Lisa
Lisa,
I had the injections in the joints and psoas on both sides almost two months ago. I flared up for about two weeks after the injections, but have had pretty decent relief since then. I would try it. I believe mine are starting to wear off a bit, but I don't know if I could have functioned the past two months without them.
I say go for the cortisone injections! I got great relief for several months. Unfortunately, like Kate I did get a terrible flare up in my psoas after one of them, but mine only lasted 2 days. It's certainly worth it and your surgeon can order a contrast dye MR-Arthrogram in the meantime.
Good luck,
Vanessa
I had an MRA in May 2008, It is probably too old now. I have such buttock pain, sometimes a sciatic flare, this pain seems worse than the groin pain. Did you also have that pain, was your pain achey? I am afraid I waited too long, I am 45.
Lisa
jenny,
Hang in there, I know it's tough. It's very difficult, especially to have additional challenges to deal with. Please keep us posted when you get a date! And it is nice to have others here who understand and can relate.
take care,
Vanessa
Lisa,
I did have that pain at times, usually that was where my pain would start but always settled in the deep groin achiness. The most common, clearest indication of FAI pain is the achy joint. Did you mention what your MRI showed? Although MRI often does not catch FAI, it's difficult to see into the hip through imaging sometimes scope is the only way to see.
As for the age, only from what I've read of other people's experiences I wouldn't say you've waited too long, although some surgeons would prefer to do this procedure on people thirties and below. However, there have been posters on this blog at 50+. Maybe it will depend on the surgeon you meet with.
The age thing is for two reasons:
1) A hip replacement would be ideal, but they don't last that long. So the closer you get to an age where hip replacement is a possibility, the less your OS and insurance company is going to want you to do the FAI procedures.
2)The hip deteriorates naturally. Of course 45 is still young, but the idea is at some point there would be significant deterioration anyway.
I say if you get the procedure and it buys you 10 good years it's worth it. Then you can think about replacement if need be. But it sounds like from your symptoms, you could be dealing with something else, easier to treat. Let's keep our fingers crossed for you it's not FAI!!
Good luck,
Vanessa:)
Vanessa:
I was told pelvic floor stuff like you in the beginning. Obturator internally was pretty bad and when she examined me flared me up. My MRA did show labral detachment, cyst probably from tear, etc. some loss of retroversion, couple other stuff I would have to look. I did see FAI specialist and he thinks pathology in hip is issue. I think I will go to Rush University in Chicago nearby for 2nd opinion. Dr. Shane Nho does hip arthroscopy and trained at HSS in New York. Before I inject more stuff in my already sore hip. My two lidocaine injections went badly, major flare when wore off. Thank you Vanessa for all your answers! You are the best! By the way, I have family in Gadsden too!
Lisa
Lisa, that's funny you have family in Gasden! Not exactly the big city:)
Keep us posted as things go along! Good luck to you,
Vanessa
hey everyone im paul and 26 years old I just had surgery six weeks ago. I had the labrum debridement because it was to far gone to repair, this was caused from a bump that I had on the head of my femur that also had to be removed along with a large chondral lesion. I really want to start pt but my insurance is too expensive, i was wondering what exercises i should do and how often, basically any advice would be greatly appreciated. Thanks
Vanessa,
Dr. Byrd performed my surgery on 2/22/2010 and I am amazed that I have had NO pain post-op. He cleaned up the labrum and shaved both bones to correct FAI. First, we agreed to try PT and an injection to see if that would correct the issues and pain in my hip. After 8 weeks of PT and a second injection under x-ray, with no relief, we both agreed that surgery was the best option. So far so good, and I know that Dr. Byrd was the right person to perform my surgery. I am luck that I live in Nashville and was able to get in to see him.
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