The ugly

When I started this blog I promised the good, the bad, and the ugly.  Well here comes some bad and ugly.  I want to be truthful and helpful to people who might be heading toward this surgery.  I tell my students all of the time that if I taught them that life is full of rainbows and butterflies and nothing bad will ever happen or tempt them then I would be the worst teacher in the world because I would be setting them up for failure.  Here is my reality, no rainbows and butterflies in this post...

 I had my first kick in the pants of reality this weekend.  I had two big outings that really pushed me and set me back.  I attended a charity basketball game on Friday night, then a bridal shower on Saturday afternoon, and the combination led to a meltdown Saturday night. My pain was up significantly and I was tired, so naturally I threw a pity party for one.  It was the first day where I felt like I had major hip surgery.  I didn't want to paste on a smile anymore and say everything was okay because I honestly didn't feel like it was.    Thankfully Gabe was here to calm me down and reassure me that everything is going to be okay.  He's been such a trooper during all of this, I don't know where I would be without him.

I have come to accept there will be bumps in the road, today was the first one and I am sure there will be many to come. Hoping tomorrow brings less pain and more smiles.

Peace out sutures!

I can't believe it has been one week since my surgery.  It feels like it is going by fast, hopefully I don't jinx myself by saying that!  Today I met with Dr. Edwards for the first time since October.  He was trilled to hear my positive review of Nashville and took a look at my pictures from surgery.  I was happy to hear him say that with the microfracture and labral tear I will hopefully heal stronger with all of the blow flow going into the joint.  The nice part about the therapists and doctors being in the same building is we could just walk next door to talk to Curt about therapy.  I won't have to go see Dr. Edwards until after my next trip to Nashville in June.  Curt will keep him updated as we go and consult as needed.  

In other news, I got my sutures out today! They put steri-strips over my incisions and those will fall off in two weeks or so.  With all my icing, I still have a significant amount of bruising around my incisions. They said that was normal and it would probably be worse if I weren't icing as much as I am.  Here is an updated picture after the sutures out:

I promise I have taken a shower (several!) since I have been home. Dr. Byrd's initials just won't wash off!

Physical Therapy Day 1

I had my first PT appointment today. I am doing my therapy here in Columbus at the Ohio Therapy Institute.  It's connected to my orthopedists office which is great because the doctors and therapists work together just like Dr. Byrd's office in Nashville.  My therapist is Curt and he is awesome.  I met with him before my surgery to do some at home therapy to strengthen before surgery.  Today we pretty much went through what my surgery was like, and the protocol that the therapy team in Nashville sent home with me.  I am SO lucky to be working with the Ohio Therapy Institute not only for the great people but also for their equipment.  They have a therapy pool as well as treadmill that you can use in the water that is a dream for patients like me that are non-weight bearing.  My first 8 weeks of therapy will be in the pool.  I am happy to have had this surgery right as pools are about to open.  This will be a HUGE advantage for me because I can do my home therapy in the pool too.  Overall today was super successful and I am confident in my recovery path ahead!

Game Ready

If I had to give anyone going into this surgery any advice at all, it would be to invest in the Game Ready icing machine.  This thing has been my crutch through out my recovery thus far.  Dr. Byrd's office gives you this as an option, but it beats ice packs any day.  How it works is you rent this to bring home with you for two weeks. It was $300 for the two weeks, and insurance will not cover it.  I have known so many people with knee replacements and different types of surgeries that have used similar machines, so I knew it would be worth the price.  I honestly do not know what I would have done the first ten hours without it.  It helps numb any pain, and I really think that I have done so well (with very minimal pain medicine which is important to me) so far with my recovery because of it.

Here's out it works:

This is the machine it self, you fill it with water and ice and it circulates the ice water.

Here is where the ice goes:

Here is the hip adapter (aka my ice pants!)  It kind of fits like a diaper the hose connects to the machine to circulate the cold water.  It also inflates to create a cold compression. It will not go below 32 degrees, but circulates the ice cold water which helps numb a lot of my pain. It has several settings, but my setting is to have it on for 30 minutes and off for 30 minutes. 

My schedule right now pretty much revolves around this device. I wake up in the morning usually to some significant pain (I take one pain pill at night around 11PM, and I pretty much wake up like clock work at 6AM in pain).  I put this on when I first wake up to numb the pain, and then try to go back to sleep for a little bit.   I get up and do my first round of therapy in the morning, spend the day sitting in the game ready, get up and sit at the table for dinner, therapy round number 2, and then spend the rest of the night in the machine before bed.  For the first few weeks it is really important for me to stay off my feet as much as possible.  I will post more about my room set-up advice in another post! I learned in the hotel not to sleep in this bad boy.  I woke up freezing cold in the middle of the night and at that point I need help getting in and out of it.  Now I am pretty good at getting myself in and out, I just need help getting it filled with ice and turning it on.

The final thing that I would advise is using a theraband to help keep your feet together.  They advised me after surgery to limit the external rotation of my hip.  When you lay down and relax your legs and feet they naturally rotate outwards.  This isn't good for the hip joint after the surgery.  Erica gave me a theraband to put around my toes while I'm laying down to prevent this rotation for happening.  It's not tight, but it allows me to relax my legs without worrying about the rotation.

It was easy to bring from Nashville to Columbus in this carrying case.  It has tons of padding so we actually just checked it and got it at baggage claim. No damage!

Tomorrow is my first day of PT! More to come...

The diagnoses & therapy

First off if you are not the medical type and pictures of surgery gross you out, you might want to skip this post :)

The only information that we knew for sure going into surgery is that my labrum would need repaired.  From there it was a guessing game until Dr. Byrd got in there to see what what going on.  I was hopeful that would be all that he found, but unfortunately it turned out to be a lot worse than I even thought.  

First off here is the tear in my labrum:

The left is how they entered the joint and the right is the actual tear.

The next picture is of the significant damage to my articular cartilage.  This caused them to do a procedure called a microfracture.  On the left you can see the damage to the cartiliage.  From there they drill into it to promote blood flow to the area.  The body will form whats called micro cartilage.  This isn't as strong as the articular cartilage but it helps reduce the chance of arthritis down the road.

The need for this procedure has been down for the count longer than I expected.  Instead of the hopeful 4 weeks on crutches with weight bearing, I am now on crutches for at least 8 weeks with minimal weight bearing.  I can only put 30lbs of pressure on my foot as I walk with crutches.  That pretty much means I can graze my heel and toe to the ground with my crutches but that's about it.

The final part to my surgery was to grind down the head of my femur to help with the FAI.  Smoothing out the bone will help prevent tears in the future. The left is the before, the right is the after.

I didn't quite process this information until I met with Dr. Byrd on Thursday.  As he was talking me through what they did and why, he just kept shaking his head saying "I don't know how you were moving around, this was significant damage."  In a way it made me feel tough, but in another way it made me scared for the recovery ahead.  I know I am in good hands and if I listen to the doc and therapist (stop laughing the people that know me too well) that I will recover just fine.  It's just going to take patience, some more patience, with a side of patience.

I ended up with 5 incision holes, on Thursday they took the big bandage off and now I just keep band aids on them until I get them out next week.  Here is the hip post-op:

I met with the physical therapist Erica on Thursday after seeing Dr. Byrd. She gave me a set of 12 exercises to do twice a day, on top of the therapy I will do with my PT at home twice a week.  It felt good to get my legs moving, but I was extra cautious so I was glad I worked with her.  She taught me to stop BEFORE the pain, which is tricky to figure out.  The first rep you almost have to find where that pain starts and then stop short of it.  It's different for each exercise and each day.  I can tell I am getting more range of motion with each day that I do the exercises which is good.  I have my first PT in Columbus on Monday.  Overall I left Nashville feeling prepared for the journey ahead.  Everyone in Dr. Byrd's office was so nice and helpful, I definitely made the right choice.

Surgery Day

Surgery day!  My surgery was scheduled for 12:30, which means I needed to be there at 10:30.  I wasn't allowed to eat after midnight, but I could have water up until 8:30 which was a life saver.  We got all checked at the Baptist Surgical Plaza at Baptist Hospital.

And of course I had to take my last picture on two legs for a while...

We waited until about 11:00AM and finally got called back.  They wouldn't let Gabe come back at first, which made me nervous, but the nurse assured me he would be able to come back shortly.  I got changed into a gown and took a boat load of pills everything from a blood pressure medicine to keep me heart ready steady during surgery to anti nausea medicine for post surgery.  Then I met with the anesthesiologist who was super nice.  He went over the whole process with me and it wasn't until then that I realized that I would be intubated for surgery.  It freaked me out a little bit, but I knew I was in good hands.  Gabe was then allowed to come back to find me lookin' pretty sweet in my surgical gown... Dr. Byrd came down to check in and initial the leg he was going to operate on.

I just realized I think I have my thumbs up in every single picture we took along this process, what a nerd.  Anyway from there we waited... and waited... and waited.  The nurse came in to let us know that Dr. Byrd had a difficult surgery before mine and it was taking longer than they thought.  I just tried to relax and close my eyes but my nerves were definitely kicking in.  I had decided pre-surgery that I was going to rent an icing machine called a GameReady device (I will go into detail about this awesome investment later!).  The guy needed to show Gabe how to use it, so around 2:00pm he headed out to meet with him and kissed me goodbye.  About 15 minutes after the nurse came down to let me know the room was ready and it was time to go to surgery.  My last two memories are looking at the clock to see it was 2:15, and then having them move me from the bed I was on to the table in the surgery room.  From there I don't remember anything until the recovery room.  Gabe said that Dr. Byrd came out to talk with him about 4:15PM, but he wasn't allowed to come see me in recovery until about 5:15PM.  Dr. Byrd explained to Gabe exactly what he found and how he fixed it. He said everything went smoothly, but there was significantly more damage than they originally thought (I'll go into detail later).  He was surprised that I had tolerated walking around on it for so long.  That's the one thing about chronic pain, you just get used to it.

The first memory out of surgery is that my throat was very very very dry.  I just kept asking for something to drink but all they would give me were ice chips because they were afraid of me throwing up.  Gabe was finally allowed to come back and see me, boy was I glad to see him.  We sat in recovery for another hour and they came to check on my pain level.  Apparently I was doing better than a lot of other people in recovery because they said I was looking good and would be able to leave shortly.  My pain level was pretty high at that point, but I knew once I got back to the hotel and got some food in me I could take my pain pills. 

The nurse went over all of the details with Gabe and then we got dressed and loaded into the car.  The ride home was rough, but luckily it was only about a 10 minute ride from the hospital to our hotel.  Gabe got the wheelchair from the hotel and we made it up in the room.  I began to eat crackers and drink some water so I could take a pain pill.  I wanted to start with one to see how I did.  Coming into this process I was nervous about taking pain pills.  I usually don't react well to them, and I worry about addiction and dependency.  My pain Wednesday night was probably some of the worst pain I had ever been in.  Gabe was awesome.  Refilling my ice machine every few hours, making sure I had everything I needed. I wouldn't have gotten through that first ten hours without him, I am so thankful for him and everything that he continues to do for me.  About an hour after my first pain pill I decided to take another one.  My pain was pretty severe and I wasn't doing well.  It was hard to get comfortable laying on my back and trying to keep my leg supported so I wouldn't use any of the muscles in my leg.

For those of you who might be heading on the road to surgery here is my best advice. The first ten hours are the WORST.  It is painful, uncomfortable, and you will think it will never end but it will.  I woke up the next morning and while I was still in pain it was no where near the pain in the first ten hours.  I woke up a few times during the night, mostly to go to the bathroom.  You will definitely need help doing this the first night. My hip was in a huge bandage and it was too hard to do on my own.  You definitely want to have someone close by that first night.  I will update about my follow-up appointment on Thursday next...

Greetings from Music City...

First off, my thoughts & prayers go out to everyone in Boston and all the members of my running family.  I heard the news just an hour before we boarded our flight to Nashville, and sitting in the airport was a different experience.  The only noise to be heard was the overhead announcements and the two TVs in our terminal.  People got off flights unaware of what had gone on.  People were hugging, calling others, shielding their children from the screens.  Columbus Airport did a fantastic job responding. There were security guards at every terminal and even in the jetway as we boarded the planes.  The same was seen when we arrived in Nashville.  While it was scary to leave home hours after a terrorist attack in our country, I felt safe the entire time and I am thankful for that.

Our first stop today: 

I finally got to meet Dr. Byrd today!  On my previous trip I had met with his nurse practitioner so I was excited to meet with him today.  He was so nice and genuine, I feel like I am in great hands.  He talked through my procedure and what I could expect.  He just had a great way of making me feel at ease which was great timing as my nerves are starting to kick in full blast. He was honest in that we really won't know what my recovery will be like until they go in and see what the damage is.  If the torn labrum is all they need to repair he said I could be off crutches as early as 4 weeks!   He decided that since it had been so long since I had any imaging done that he would like another MRI done before surgery.  He sent me over to the next stop of the day for a CT scan and MRI of my hip.

Next stop...

We arrived at the Centennial Medical Center imaging tower to find a long registration line!  Everyone here was super helpful and oh so nice.  That's one of the many things that I love about Tennessee, everyone is so nice and have such great manners!  Plus I love that everyone calls me 'sweetie' and 'darlin', gosh I love the south!  My first stop was for a CT scan of my hip. This was an open machine and only lasted about 10 minutes.  The worst part about this was the way they had to position me for the imaging.  Laying on my back with my toes pointed in and then they rubber band them together to make sure they can fully see the hip joint.  This was extremely uncomfortable and put a lot of strain on my hip that I am not used to.  

I returned to the waiting room to wait for my MRI.  Eventually I got called back for my 40 minute MRI.  As soon as I entered the room I began to panic. It was a closed MRI.  The only time I have ever had a closed MRI I had a Valium before to help with my claustrophobia.  I didn't have much time to react so I just went with it.  I quickly asked if I would have to go all the way in the tube and the nice nurse told me yes.  He must have seen the panic in my face because he automatically asked if I wanted ear plugs and a wash cloth to put over my eyes which I immediately took him up on.  I laid down on the table and out came the big rubber band to go around my feet again.  40 minutes of this? I began to sweat, more.  From there they put a metal cage type looking thing over my hips to keep me flat on the table.  Enter a claustrophobic nightmare.  I was proud of myself for facing my fear and getting through it, but left with white knuckles and pit stains. Literally.

After that we went over to our favorite restaurant in Nashville for lunch...

Yummy food that hit the spot since we were at Centennial for 3 hours!  From there we to fill my prescriptions and went back to the hotel.

Tomorrow is the day! I will keep you all posted. I will try to at least post a picture tomorrow, not sure how coherent I will be to write much.  Next time on this blog I will have a fixed hip! Stay tuned...

Life post cortisone

After the numbing medicine wore off, I was pretty sore for about three days after my shot.  From there I started to notice a difference in my pain level.  Going up stairs wasn't as hard as it was before, and I had a little more pep in my step.  I met with my physical therapist in Columbus, and he put me on an at home therapy plan to gain some strength back before surgery.  Everything was slated as "could be tolerated" as far as the exercises went.  For about a week I was really pushing myself to try and get in shape. It was a nice week while it lasted, but the cortisone quickly wore off for me.  They were hopeful it might last a few months, but it just depends on the person, and for me it was a rather quick fix.  I was also prescribed Celebrex, which I continue to take for an anti-inflammatory.  I still have daily pain, but it is much worse when I don't take it.

From there I had a choice. I still had four months before surgery, and I was going crazy not doing anything.  I started using the elipitical at the gym and walking on the treadmill.  I started going back to Jazzercise class and just doing what I could.  I stopped when I had pain and started to get in tune with my body.  I found a good balance on what I could tolerate and what I couldn't.  I was just happy to be moving again.

Fast forward four months and I am packing up my bags to head to Nashville tomorrow.  I got the clearance from my insurance company two weeks ago that they would cover my surgery and was put on Dr. Byrd's schedule six months and two days after I first went to see Dr. Edwards.   Since my diagnoses I have met several people with the same problem I have (yes I know A-Rod and Lady Gaga have also been making this surgery famous!).  I plan to blog my entire experience so that it might help someone else going through this. I will keep you posted with the good, bad and the ugly.  I haven't had any imaging done since my MRI in October, so what they will find has happened since then will be interesting!

Here we go...

Hello Nashville!

In an effort to conserve sick days at school for surgery, I scheduled my appointment in Nashville with a 24 hour turn around.  It was a quick trip, but from the moment I stepped off the plane, I knew I loved Nashville.  While we didn't have much time to explore the city, it was a great chance to get acquainted with my medical team.

Dr. Byrd's office is on the campus of Vanderbilt University.  He has a state of the art facility with an adjoining physical therapy center.  Everyone in his office was so welcoming from the moment we walked in.  Everyone was so genuine, from the receptionist to the x-ray tech (who was from that state up north and wasn't a huge fan of my OSU gear!).  I met with Beth first and then headed to physical therapy for an evaluation with Erica. 

I was embarrassed by my lack of strength.  I had gone from a healthy runner at a healthy body weight, to someone who couldn't do a set of ten leg lifts without taking a break because of the pain.  At this point I had gained about 25 pounds since July.  I was unable to workout at the level that I previously did, and when I did workout at all I paid for it for the next three days. My stress eating had not been helping my cause over the past 5 months either.

After my evaluation I headed back to get my shot of cortisone.  I opted not to look at the needle, which was a good choice based on the look on Gabe's face.  That sucker was about the length of a number 2 pencil and a half.  They numbed me up, laid me on the table with the following instructions. "Don't move and don't scream."  Easier said than done.  Once it was over I was told to walk around for about 10 minutes and they would come back to check on me.

I couldn't put my finger on it but something was not right. It just didn't feel normal.  When Beth came back in and asked how I was doing I was honest and said "It just feels weird, something isn't right."  She went on with a list of questions, and finally asked what I was feeling, to which I answered "Nothing, I can't feel anything, it's weird." She immediately started laughing.  The humor I was struggling to find, but she told me that I wasn't feeling anything because there was no pain there.  This is what it felt like not to have any hip pain. When normal people walk they don't "feel" anything in their hips, I had been walking around for so long feeling something with each step, my body didn't remember what it felt like to feel normal.  She quickly told me that it would wear off in about 2 hours because it was just the numbing medicine for the shot.  Let me tell you, it was the best two hours of my life in the past six months! She assured me that this was the feeling I would have after surgery, no pain and back to normal.  I can't wait to get back to that feeling.  The countdown was on.

Jumping through hoops

Once I got my diagnoses I came home and did what most people do. Googled it.  I started with the buzz words that Dr. Edwards mentioned, "labrum", "FAI", "Dr. Byrd".  As I started reading about all of this a sense of peace came over me.  I finally had an answer.  I wasn't going crazy, and I wasn't going to be in pain forever, there was an answer.  Reading through Dr. Byrd's resume I knew I was going to be in good hands.  Hip arthroscopy isn't as common as it is with knees and ankles.  There are two main doctors that have been on the cutting edge of this procedure, one in Colorado and one in Tennessee. I spoke with Dr. Byrd's office the next week and was told I would hear back in a few weeks about surgery, but they most likely would be able to schedule me in early January.

In the few weeks in between I was researching and googling everything that I could.  I wanted to try and find the cause of this problem and the root of it was femoroacetabular impingement (FAI).  Basically it's a problem in the way the hip socket is formed.  Your hip is a ball and socket joint with the head of your femur (leg bone) and pelvic bone.  In my case, the head of my femur isn't perfectly round which causes a problem in the joint that puts me at a higher risk for tears in the labrum.

Two weeks later I got a call from Beth, Dr. Byrd's nurse practitioner.  She explained in full detail what my next steps would be and exactly how they would go about treating it.  Then she dropped the bomb.  Because of my insurance, I would have to show that I have done six months of preventative rehab before insurance would cover my surgery.  She went on to tell me that since I hadn't sought medical treatment until October, that I wouldn't be eligible for surgery until April.  I immediately had flashbacks of those workouts I did in pain and regretted every single one of them.  Why hadn't I listened to my body? Why was I so stubborn? I should have gone to the doctor right when it happened.  I immediately put all the blame on myself.

Beth was awesome, she talked me through my options, and has been a great resource through this whole process.  I opted to go to Nashville to Dr. Byrd's office to get a shot of cortisone and to meet with their physical therapists. I was hopeful that this would help manage my pain and get me strong and ready for surgery in April. In early January Gabe and I headed to Nashville.

From the beginning...

You probably came across this blog for one of two reasons.  One being that we are friends and you want to keep tabs on my recovery.  The other is because you googled "torn labrum", "hip pain", or "FAI" because you have hip issues and are having trouble finding resources.  Whatever your reason might be, I am glad you are here.  I should begin by telling you how I ended up here, four days away from major hip surgery 377 miles away from home.  My background as a multi-sport athlete led me to my fair share of injuries along the way.  I can't help but wonder if my lack of taking care of myself as a teenager is now catching up with me. I had my share of ankle and knee injuries over the years, but never any issues with my hips.

My passion for running started in 2008 when I ran my first half marathon.  I ran one the next year and was hooked. In July of 2012 I was in the midst of training for a Ragnar race.  This is a team relay race where you run from one city to another.  I was slated to run a relay from Miami to Key West in January of 2013 with a group of runner friends. This race was totally what I needed to challenge myself and get out of my comfort zone.  I started training pretty heavily over the summer to get myself in shape to run my 3 legs of a combined 17 miles.  I was up for the challenge and feeling good training wise.  

As my training progressed I was balancing running with weight training.  I was in the gym working out one day in late July when I started to feel a pain in my hip while doing lunges.  As I typically do, I ignored it and kept going.  Two days later I was bending down getting laundry out of the dryer and as a stood up I felt an intense pain in my right hip.  It was so bad that I literally dropped everything in my hands in fell to the ground.  It took a good 5 minutes to pick myself up off the floor, drag myself to the couch to try to figure out what the heck was going on.  The pain eventually went away and I was sure that I pulled a muscle in my thigh and it would be okay.  I went with that notion for the remainder of the summer as I continued to run and weight train.  I started noticing a "catching" sensation from time to time, but ignored it and trained on.

As school started I noticed more pain on a consistent basis.  I teach health & physical education, and coach two middle school sports, so as school started my activity level increased.  With that increase there was also a rise in my hip pain.  It got so bad when I was coaching volleyball that my hip was catching every time I stood up from the bench during a game. I would hobble and limp up to the huddle looking like a 80 year old woman.  I started to think maybe this wasn't muscular.  My boyfriend, Gabe, told me that he would not put a ring on my finger until I went to the doctor to get this figured out.  He hated seeing me in pain and was done putting up with my stubborn ways.  I began to think this wasn't going to go away.It was keeping me from living my normal life, I was struggling to get work outs in without paying for it the next day.  I began to become discouraged that I couldn't do the things I wanted to do.

My next step was to go to my chiropractor.  Now I know what some of you might be thinking, a chiropractor??  I was non-believer until about three years ago when I hurt my back.  My mom is a massage therapist, and when she couldn't fix me she sent me to a chiropractor.  Dr. Pettay is awesome.  He wants to fix you and never see you again.  I have never had to go for multiple adjustments and he is very open and honest in his approach.  I was beginning to think that maybe my hip was out of place and maybe an adjustment would help.  So I went in and that was not the right move. I yelped in pain during the adjustment and he quickly sent me to my orthopedist. Something else was going on.

I went to see Dr. Edwards on October 17, 2012, almost three months to the date of the beginning of my hip pain.  I started with an x-ray, and he told me that he was pretty sure I tore my labrum, the cartilage in my hip joint.  I needed to get an MRI to see what was going on for sure.  I had an MRI two days later that confirmed what he thought, the majority of my labrum was torn and a cyst had formed in my hip joint.  This explain the "catching" sensation I was feeling.  I was happy to have an answer but nervous to hear my treatment options.  After much discussion it was decided that I would go to Nashville, TN to have arthroscopic hip surgery with Dr. Thomas Byrd.

Note: Ten days later on October 28 (after seeing multiple doctors) Gabe followed through on his promise and proposed! :)