I have intended to re-start this blog for a long time and am finally feeling like I'm in a space to derive some meaning from everything that has happened. Part of why I stopped was because it was so painful to even put down in writing what I have gone through in the last 5 months. To write it all down somehow makes it more real and I've gone through so many emotions that were too powerful to even try to articulate. I resisted blogging about the complications of my hip scope because it hurt too much to even acknowledge it to myself, as if somewhere I was/am accountable and responsible. But this is my life right now and trying to stay in the present is the only real way to perserve. I am going to get through this and come out on the other end a stronger, more resilient person.
This blog really isn't just about my hip. Its about my own unique experience with a serious and debilitating injury that has lasted far, far longer than I could have ever imagined and how I can learn to best cope in the face of such an adversity. I have wondered countless times whether I will ever really be able to walk again without pain and to take part in some of the activities that make me feel whole like hiking, ski touring in the backcountry and possibly even trail running. I've learned to accept, though, that my body will never be the same again.
To summarize as briefly as possible, beginning at around 7 weeks post-op it became very apparent that I was still having even more pain than before surgery. My hip would flare up for no apparent reason and it hurt to walk much of the time. Both of my PTs were concerned and urged me to go see my OS again before my 12 week check-up. After nearly a week of horrid aching pain during which time I mostly lay on the couch, I went to see Dr. S who did a full exam and concluded that the joint was extremely inflamed but that I had not re-torn my labrum or anything that would require additional surgery. He ordered me on a full month of home rest and advised me to do nothing but rest -- no walking, no PT, no stationary bike -- nothing. Just working from home and resting on the couch to try and get some of the inflammation to go down.
March and April of this year were possibly the hardest months of my life. I was in the most excruciating chronic pain that I could not even imagine someone could live this way for very long. I probably sound overly dramatic but I think my family, some close friends and certainly my husband and dogs know the extent of my pain. For those who have been spared the misery of joint pain, it is an awful, seering, deep ache which you cannot get away from and it often follows you through the night. I was on a high dosage of NSAIDs in addition to pain meds and I was still at a Level 7 pain much of the time. I would lie on the crouch in tears trying to concentrate on my work but doing a poor job of much besides feeling sorry for myself and crying to my mom on the phone. The link between chronic pain and depression is well-documented and in every way the two went/go hand in hand for me. The physical pain and feelings of hopelessness lead to depression and on a neuro-muscular level the depression makes the pain worse. The few times I tried to walk the dogs around the neighborhood I would hobble back to the house and spend the rest of the afternoon icing my hip. I was in a pretty bleak state and even dinners with friends, pedicures and saunas didn't do much to brighten my mood. Sometimes I felt like I was being punished -- for what I don't know -- that is a glimpse of the darkness of my state of mind during that time. Thank goodness for my dear accupuncturist who made changes in her schedule to fit me in even on a few sundays because accupuncture was the one single thing that would help with the pain...that and the few dozen bottles of wine I plowed through during that month...but that really isn't so funny.
After living this out for a month as ordered, we went back to Dr. S and all concluded that I needed a follow-up MRI. The MRI showed that the ligamentum teres (the ligament that connects the joint capsule to the femoral head) was completely ruptured. Somehow it was only partially repaired during surgery. Dr. S was not sure this was really the cause of my pain because it is largely believed to be a vestigial ligament we do not need after childhood. He kindly offered to get a 2nd opinion from the world's leading hip surgeon, Dr. Mark Phillipon, at Steadman Hawkins in Vail (and whose review I am still waiting for by the way!). The month of rest had reduced the pain down to a dull roar and I was ready to go back to work and to have the distraction of my job, my commute, my friends at work. We also agreed that I would try a PRP injection into the hip in the hope of stimulating some healing despite that these injections are still largely experimental.
Fast forward to May 15th when Dr. N (a radiologist at BCH specializing in muscular/skeletal imaging) spent over an hour with me looking at my hip via ultrasound and determining where to put the injection. I had already gone to Dr. N earlier in the spring for a PRP injection into my dreadful lateral epicondyle (IT band) which had been bothering me for more than a year due to the altered biomechanics of my hip. This time he injected the rectus femoris tendon (high quad)which is often injured during arthroscopy as well as the labrum itself. PRPs, by the way, are platelet rich plasma -- they take my blood, spin it in a centrifuge to extract the platelets and re-inject them into the injured site to trigger the body's natural inflammatory response to heal the injury. These have been used for years in the OR for abdominal wounds and such but only recently for ligament/tendon/joint injuries. Dr. N asked me whether I was a health care practitioner because I was so full of information and statistics. He also said I had one of the highest pain thresholds he had seen in a long time as he drove the 5-inch needle into my hip. Not so sure I want to be in that club but I appreciate the vote of confidence.
AMAZING stuff these PRPs. Within 10 days I was dramatically better. I could not believe it and I was thrilled to head off on our 5-day river trip down with 16 of good friends in a far better place than I had been in months. I was able to start swimming again which felt great on the joint and I even did a few hikes during the river trip with NO PAIN. Bumping all day through the rapids and getting in and out of the boat lifting heavy stuff - no problem. I laughed really hard and smiled alot on our trip - things I had not done in far too long. I had been nervous about the river trip for months as I pictured myself cramped in a raft in cold water with my hip nagging me all day but I was estatic with how well it all went. When I returned I felt relaxed and happy for the first time in months.
Where I am at today: The PRP has definitely helped tremendously but I'm still very up and down. I had some 'glory days' in which Brian and I were able to ride our bikes for over an hour during the lovely June twilight out and around El Dorado Springs and Sunshine Canyon. I'm still swimming 3-4 times per week and I've been really careful to work very gradually back up to my normal 3000 meter distance so as not to over-do it as is my tendency. I'm back to Dog Walk Wednesdays with my dear pals and our troop of 5 dogs and I have made around the little Shanahan loop at least 5 times. Just being able to be back out in my 'backyard' again as the wildflowers are blooming has done more for my head than any medication ever could. On a lot of days I still have a fair amount of pain -- some days its even hovered around a 5 and I've had to lay low and stay off my hip. But at least I'm active and able to get out of the house and enjoy some of the summer some of the time.
To end this first super-sized blog entry (they won't all be this long I promise) I thought I'd include some humor. Operating under complete and utter delusion after feeling good for about 5 days, I agreed to sign up for Bike to Work day with the crew biking in 35 miles from Boulder to our office. Predictably, my hip told me to fuck off the next day for even thinking such a thing. Yeah, that wasn't going to happen. That would be exactly the kind of pavlovian response that I need to re-condition.
