Tuesday, January 24, 2012

Fix my labrum

I decided my labrum need a blog of its own - you can follow my surgery and recovery at http://fixmylabrum.wordpress.com/.

I'm just over a week away from surgery, so this blog will be going on hiatus a bit while I sacrifice my fitness in the short term for a pain-free hip in the long term.

In the meantime, if you're looking for a worthwhile cause, head over to Rurally Screwed and donate to bring Solha the dog home from Afghanistan!

And, if you love gross medical stuff, IronMo is recently post-op and has posted really awesome pictures her surgeon took of her ankle all filleted open.

Saturday, January 14, 2012

One hip mama, part 4

In the previous post, I'd visited with Dr. D, the orthopedic surgeon.

At every step along the way, I keep expecting that somebody will say, "yeaaaaah, so, you're really fine. Quit whining." It's great to have a diagnosis and a treatment plan. But what I really want is for ice, Advil, and a reality check to cure me.

Because as Dr. D explained the surgery, the next logical step was to start asking questions about the recovery. The good news is that I can expect a full recovery. Better than full - I've had pain for so long, I've forgotten what it is to be pain free. I can't imagine not compensating for this. I am truly lopsided now. My right glute area is just a mess - it's almost constantly in spasm, and yet terrifically weak compared to my left side. My water bottle sloshes like crazy when I hold it in one hand, and not the other. Both Dr. K and Dr. D have done range of motion tests that just blow my mind. Having full ROM and no pain is going to be fantastic! But there's a price.

Two weeks on crutches. And since it's my right hip, two weeks of no driving as well. I have two little kids and a full time job. The Supportive Husband is, in fact, quite supportive, but he's a busy, self-employed professional. And is having surgery of his own two weeks before me. So I'll be calling in a lot of favors. I'm lucky that my parents are nearby, however, they'll be going out of the country just before I'm off crutches.

And being off crutches doesn't mean I'm home free. I have four more weeks of restricted activity. I'm supposed to avoid more than 90 degrees of flexion, so all the bending down to tie little shoes and zip little zippers is out. Once those initial six weeks are up, I'll start physical therapy. It looks like recovery will be a marathon, and not a sprint.

In actual running news, I've had a rough time keeping up with my 10 Miler buddies. With surgery looming, I'll admit to waning motivation. I won't be running the race, so without that carrot, I have a hard time getting out the door. I was felled by a stomach bug just after Christmas, and had a week where I couldn't eat and couldn't run. I'm still trying to get the mileage back up from that. But it behooves me to be in good physical shape going in to the surgery, so I'm doing my best to slog it out. 

Speaking of surgery, Iron Mo had surgery yesterday, and is blogging postoperatively. She had a big tear in a tendon that has vexed her for a couple of years now. Lucky her, she gets crutches for eight weeks! Best wishes to her for a speedy recovery.

Monday, January 02, 2012

One hip mama, part 3

In the previous post, I had been referred by Dr. K to an orthopedic surgeon, Dr. D.

On the advice of Dr. K, I stopped by the hospital to get a copy of my MRI. I had my laptop in the car, and took a quick peek before hitting the interstate. Despite the radiologist's report, I couldn't really tell what the tear looked like. But I could tell that I was not pregnant, but apparently I really had to pee!

I made my way to Richmond to meet with Dr. D,  the orthopedic surgeon. I had a brief freakout the morning before, as a quick perusal of the practice's website made no mention of Dr. D doing arthroscopic surgery. Open surgery, for a torn labrum like mine, is not an option. Arthroscopic is the only way to go. And ideally, your surgeon has done hundreds of these procedures. There's a learning curve.

And waiting in the waiting room didn't exactly get my hopes up. There were a lot of pretty decrepit people in there, pre- and post-hip replacement. I want to repair the labrum to avoid hip replacement! I'm in my 30's for pete's sake!

My confidence was not bolstered by the office person doing my intake. She asked me a little bit about my injury, which I really didn't care to discuss with the office assistant. She asked when my pain had gotten worse, and I said it hadn't. Then she had the nerve to ask, "then why are you here?" Um, like chronic pain isn't a good enough reason? Really? Nice. I clammed up and told her I'd discuss my diagnosis with a nurse or doctor.

I went back to the waiting room for the aged, and fidgeted. Finally, I was called back. And what a relief - the exam room was wallpapered with autographed posters of famous athletes thanking the practice for helping them. Yeah! As expected, they had not received a copy of my MRI, so I was happy to have brought my own. They also wanted an X-ray, which I hadn't brought, but this being an ortho practice, they had an X-ray machine in office, and my eggs got another healthy dose of radiation.

And finally, the long-awaited Dr. D! He was not the dumb jock I was dreading, but very personable and well-spoken. He gave me another quick hip anatomy lesson, confirmed that I have a tear, and that surgery is the only way to fix it for good.

I asked a ton of questions - I'm sure he was not expecting such an interrogation late on a Friday afternoon, but I had one shot to check him out before trusting him with my health and well-being, and I was going to get my money's worth out of my copay. I come from a medical family, so I was armed with lingo, jargon, and my natural distrust of orthopedic surgeons.

Long story short, the good Dr. D has done thousands of these procedures, and has had great results. His approach is not to just excise the torn part, but to actually reattach it to the underlying cartilage with little plastic anchors into my bone. Sign me up.

Only one problem - when can a busy working mom of two fit hip surgery into her schedule? And did I mention that The Supportive Husband needs to have two hernias repaired as well?

More to come...

Thursday, December 22, 2011

One hip mama, part 2

In a previous post I had an MRI and found out I had a torn labrum in my hip. Now is the time on the blog where we talk anatomy of the hip. Ball and socket, sound familiar? The socket is lined with cartilage, and there's a lip that extends out, that's the labrum. Mine has torn away from the underlying cartilage. I suspect that the amazing joint instability I had while pregnant with Sami caused the ball to catch on the labrum and, over time, cause a tear. The orthopedic surgeon blames my many years of dance class. Nobody, for the record, is blaming running for the injury. Oddly enough, running typically doesn't hurt - it might hurt after running, it hurts sometimes walking, and it hurts like all get out when I roll over in bed. The bigger issue is that it could get worse, and will likely lead to osteoarthritis, which is not good. So it behooves me to fix it sooner rather than later.

How do you fix a torn labrum? First, you try rest, physical therapy, and anti-inflammatories. Check, check, and check, and mine still hurts. In short, tears don't heal themselves. So you fix them. With surgery.

When my doctor first floated the word "surgery," I immediately burst out with "I HAVE A NATURAL DISTRUST OF ORTHOPEDIC SURGEONS!" With an anesthesiologist dad, an OR nurse mom, and my own stint working in a medical library, my impression of orthopedic surgeons has not always been the most favorable, though there are plenty of orthopods who defy the stereotypes. The problem is, orthopedic surgeons, the good ones, anyway, tend to be very specialized. So you have to hope that "the hip guy" happens to be the guy in the department with a sterling track record, and a great beside manner.

Lucky for me, my doctor also has a natural distrust of orthopedic surgeons, and found The Hip Guy in this area. He's not at my local hospital, but he's one of a handful of surgeons in the state with extensive experience in hip arthroscopy, so I made the long drive to Richmond to meet with Dr. D.

more to come....

Wednesday, November 30, 2011

One hip mama, part 1

So I've had hip troubles on and off since I was pregnant with Sami, who is now three. I've done a stint in PT that made a lot of difference, but the pain has never completely gone away. My wonderful new doc sent me for an Xray, which was negative for some bad stuff. Yay! But I then needed an MRI to rule in/out some other stuff. Boo.

The very exciting part about all this is that in order to get a good view of the joint, I needed to have an arthrogram - basically, an x-ray where they inject dye into your joint. This involves a long x-ray so the radiologist (a PA, actually) can visualize that the dye is going into the right space during the injection, and the space is all filled up. One nurse took my sworn statement that I wasn't pregnant (though I had already signed a waiver with another nurse before), and handed me off to another who got me positioned on a table under an x-ray machine. She made all kinds of jokes about not wanting to fry my eggs in case I wanted to have more kids as she swaddled me in lead. Then she realized that my arthrogram was for my hip, and not my shoulder, and unswaddled me, leaving my eggs to fry. Nice.*

The PA numbed me up good, and got started. Even with all the numbing, there is no way to disguise the fact that at stranger is injecting dye right in to your joint. Especially since you see it on an x-ray screen. It was over soon enough, and a nurse helped me hobble down the hall, into the elevator, up a floor, and down another hall to the MRI. Did I mention I was wearing a hospital gown for this whole journey? Fried eggs with a side of humiliation.

I was pleased to discover that I was waiting for the flagship MRI of the brand-new hospital - the 450. Its wide bore is suitable for bariatric and claustrophobic patients. What a relief, not to be in a tube that is barely bigger around than me. However, at the last moment, I was whisked down the hall to the mobile unit. Yes, I was getting an MRI in a trailer. My gown, drafty by nature, provided no protection against the cold breeze in the waiting area.

I rode the power liftgate up to the trailer, and asked the MRI tech how short a straw he had to draw to get this assignment. He said he actually liked being out there with no one to bother him, which made me feel like I should apologize for intruding on his solitude. He readied the machine and the computer while I locked up my purse and clothes.

And then in I went. Holy crap, I went waaaaay in, feet first. I had done some advanced googling to try to prepare myself for how far in I'd have to be. My expectations were way off. I'm only 5'2", so all those pictures of smiling, average-height patients in up to their chins weren't quite accurate for me. Basically, the top of my head was out, which might as well have been nothing. If I arched my neck and craned my head around, I could sort of see one wall, which had a mural of a mountain scene.

Moments later, the tech came bursting back in, shouting, "Ma'am, are you pregnant?" I had, within the past hour, discussed my very personal reproductive issues with a nurse upon check in, two different nurses and the PA prior to the arthrogram, and I had signed a waiver stating that no, I was not pregnant. So when the tech asked me that with panic in his voice, I wondered if he'd seen something on his screen that I should know about. Getting pregnant again is one of my deepest fears, so there I was, sure I was pregnant, trapped in a teeny, tiny, drafty tube. My panic level was off the charts and I deeply regretted not having asked for Ativan, or Valium, or Xanax, or at least a Bloody Mary.

I said no, and he hustled back out, leaving me and my adrenaline all by our lonesome to deal with my deepest fears. So, it was a super fun way to spend my lunch hour. Did I mention that the tech had had to rubber-band my feet together?

Once it was over, I headed back to work where I proceeded to have the most unproductive afternoon as my body processed all the excess adrenaline that I'd been pumping out during the scan.

My doctor called with the results a few days later...on a Sunday. It's never good when doctors call on a Sunday. Sure enough, I have a labral tear.

More on labral tears and their treatment coming in a future post....

*We're done having kids, so I'm not really worried about my eggs being fried, scrambled, or poached.

Thursday, November 24, 2011

Race report - Turkey Trot

It was a beautiful morning for a run - cool and sunny. I had decided a while ago that since I was in no danger of setting a PR today that I'd push Sami in the buggy. I haven't pushed any kid in a buggy for any real distance in months and months, so between that, the hilly course, and my general injury/fitness status, I knew today was going to be painful.

And the most painful part was the start. Oh, Turkey Trot, how I love you and hate you. Runners with strollers are asked to line up at the back with the walkers, which is ridiculous, as there is no longer a separate corral for walkers/baby joggers. It's just one big lump, and you kind of just end up where you end up. I ended up waaaay in the back, and spent the first mile trying desperately to move faster than a brisk walk. It's a Turkey TROT people, not a Turkey Lumber or a Turkey Stroll. TROT.

By the time I got out of the lump of slow, we were deep into the tough hills that make up more than half the course. I was too hot, out of breath, and Sami was saying "Can I get out yet? Can I get out yet? Can I get out yet? Can I get out yet?" etc. I had no rhythm, and my main focus was on making sure Sami didn't launch herself out of the buggy, since she now refuses to be buckled. I walked up a good portion of the hills.

The final hill tops out about a half-mile from the finish, and then it's a long, easy downhill. Wheeeeee!

I crossed the finish line at just under 40 minutes by their clock, and just over 38 minutes by mine, since it took that long for my part of the crowd to cross the start. I didn't feel particularly awesome about this, but when I sat down to fill out my race spreadsheet, wouldn't you know it was a huge PR for buggy-pushing. Huh, how about that. Two years ago I pushed Sami to a 42:28 in the Turkey Trot. I set a 4 minute buggy-pushing PR and I felt shitty about the race - that's how far my running and racing have come in the past two years.

So in feeling shitty about the race, I actually feel pretty good about my running overall. I'm clearly more fit than I give myself credit for. My expectations are higher for myself. If I can get my hip fixed up, I think my fastest years are still ahead of me, despite the fact that my late 30's are coming on with alarming speed.

So this year I am thankful that I am healthy, that I am fit and strong. I am thankful, oh so thankful, for the health of my kids and family. I am thankful that my biggest complaint is that my hip kinda sorta hurts, but that I can still PR on it. How lucky am I?

Happy Thanksgiving, readers! May the upcoming holiday season bring you health and happiness that lasts all year long.

Saturday, November 19, 2011

I'm awesome; it's the hills that suck

I've been reluctant to blog a lot lately - my awesome new doctor, though he fixed my foot, has been unable to fix my hip. So I've had an xray (looked fine) and am having an MRI in a couple weeks. Meanwhile, I'm paranoid about all the worst case scenarios, and feel really down about my running prospects this season. Last year was so spectacular that I feared I'd reached my peak, and so far this season has done nothing to dispell that.

Anyway, the doctor didn't tell me not to run, and truth be told my pain level has been pretty constant for the past year and a half, so I don't think I'm making it worse. In the absence of a diagnosis or treatment plan, I'm just trucking along.

This year's program is in a new location, since the UVa track is under construction. I'm hoping that it will be done soon and that the powers that be will continue to allow it to be used by the community, because the new location sucks. The high school track is fine, though it's just 6 lanes of asphalt, instead of 8 lanes of marshmallows. The surrounding neighborhoods are lovely - quiet, wooded streets and beautiful homes. But the hills are outrageous.

Yeah. So, not in the greatest shape, paranoid, and demotivated me is not having the best time on the Saturday runs. Thankfully, I have a great running buddy and the group in general has been fantastic.  I'll spend 5 miles kvetching to the crew, and then as soon as we're back to the parking lot, I'm all "Hey, that wasn't so bad!!" Running in a group is the only way I can do this.

Next up - the annual Turkey Trot, and then another weekend of sucking wind on crazy hills.