My Hip Really Hurts

Today at least, and yesterday and alot last week. There is absolutely no rhyme or reason to my hip pain except for maybe some strange cyclical phenomenon that I have yet to be able to identify in any meaningful way. I have good weeks in which I don't have to think about walking the dogs or sitting at my desk and there are other weeks where I wake up feeling sorry about the 10 minute walk around the pavement the dogs are going to get that morning. And then I sit at my disk all day and poke and prod my hip because its so pissy and wonder if I should get up and go to the gym to try and get some blood flowing or if its better to rest...I have no idea on that one. The ups and downs are what I've consistently written about in the last year and a half of this blog and are what need to stabilize or else. I can deal with a few days every month of pain but I generally do not have any pain-free days and the majority of days I have a fair amount of pain ~ its just that now 6 months after my last surgery my hip has "healed" enough to where I can push through pain to do some of the things I want to be doing. Not that pushing through pain is really any fun though, especially when its not "good pain". Its the bad kind of pain that means something is wrong and even if those neuron pathways and pain receptors have all gotten a little too sensitized in the last 2 years they are still there telling me that I'm not supposed to feel this way -- this isn't just old age or over-doing it or whatnot.

I had an interesting conversation with one of my PTs yesterday about the role of the nervous system in all of this after living in chronic pain for 2 years. He really believes that there is alot of re-training that needs to go on in order to de-sensitize my nervous system after prolonged periods of intense pain. I am going to do a little more work in this area for sure but I still whole-heartedly believe that once you remove the source of the pain and replace it with a healthy joint all those nervous system breachs are going to work themselves out over time. I know that people living in chronic pain have been able to help themselves with imagery, meditation, etc and that just in the way atheletes can use imagery to push their bodies to great lengths we can also use our mind to control and help alleviate chronic pain. I do know that when I get really down about being in pain it leads to a viscious cycle of depression, feeling over-whelmed and hopeless, exhaustion and more pain. I do know that when I have a really good few days and do something I haven't done in a long time the pain doesn't seem nearly as sharp and concerning. But this isn't rocket science here folks and as much as I'd like to believe I can focus my thought patterns better to decrease my perception of pain my mind also knows that I've got a hip with a lot of very damaged tissue that looks a bit like hamburger meat and may just not have any more life in it. I suppose I need to really endeavor to do EVERYTHING I can in the next 3 months to help my hip by strengthening the muscles around it as much as they will allow, rewarding it for good behavior and working on these nervous system issues. Then, I will really know that I gave it my best shot whatever happens.

I don't want another surgery. I really don't want another surgery. Not even a little. But as I've said ad nauseum I won't accept that this is as good as its going to be. I made a promise to my ginormous puppy that I wouldn't let another year go by without being able to really spend some quality time in the woods with him and I'm going to keep that promise whether or not it requires another surgery.

Following Up

Back to San Fran for a whirlwind day trip to see Sampson for my 5 month post-op follow-up appointment. That's a long way to go for a 30-minute appointment but I felt that in flying out to see my surgeon I was dutifully giving this last surgery my utmost effort and encouragement...even if Dr. Sampson's painstaking work ends up getting paved over this summer. We looked together at my recent x-rays and the pictures from my scope and discussed my expectations and timeline. He didn't really have anything especially novel to say that I didn't already know...my right hip is effed up pretty good and will require some significant cartilage re-growth to fill in the potholes of cartilage loss. I'm still fairly certain that re-growing cartilage via microfracture has a slim to none chance of actually working but I respect that Sampson believes otherwise. (I'm certainly not alone in this belief either as evidenced by the multitude of people with metal hips who previously endured microfracture surgery).

Dr. Sampson also asked if we could talk "bluntly" about my biological clock and getting pregnant with my crapped-out hips. I told him that while I did want to get pregnant I have been more concerned with making it a full week without painkillers and still feel like adding 25 lbs to my already-slight frame would be asking for trouble. He advocating getting knocked up now and then if my hip still isn't fixed post-baby I can consider more invasive options. Easy for him to say since he will never be sentenced to 9 months of hip pain without pharmaceuticals but I appreciate his sentiment. All in all, the best part of my 15 hour trip to the West Coast was walking through the leafy neighborhoods of San Francisco for a few hours and meeting up with an old friend from law school for some excellent Thai food (in Japantown).

As for my vacation to Costa Rica the hip actually cooperated decently well I'm sheepishly willing to admit. It has nothing to do with "happy hormones" as my mom calls them because I've been in horrendous pain on plenty of other vacations. I just think my hip is scared shitless to misbehave because it knows there is now a firm expiration date (August 4th at the moment).