Wednesday, May 25, 2011

My Hip Journey

It started in May 2010. That little twinge of pain. A little stiffness when I first stood up. The pain of walking for the first few blocks. It was weird but it wasn't alarming. I was in Europe at the time I first started noticing things were off so I figured it was just a matter of walking more than usual and having a slight strain in the hip. But then it didn't go away. It would hurt horribly when I would run and then worse when I didn't. I remember very clearly walking to Safeco Field with my nephew and feeling like a knife was stabbing me in the front of my leg.

Something was wrong.

My mom had suggested I try her chiropractor and see if he could help me. After a summer of discomfort that was increasing I decided it was time to go see a doctor. Because I'm cheap and I figured with my mom's "free appointment" it would be less expensive to go to the chiropractor I went in to see him. His first thought was things were a bit odd because the pain was in the front of my leg. Usually, hip pain comes from the sacroiliac which would manifest itself in your lower back. My pain was almost exclusively in the direct front of my left leg. He took a bunch of x-rays and said to come back in a day or two. Before I was even back to the office he called me and let me know something was amiss and he needed me to come back the next day as early as possible.

My mind immediately went to cancer. When I got there he showed me the strange way my body was shaped. There was no tumor. No cancer. Just a weird body. Duh. I could have told him that. I've known my hips were uneven since I was in Junior High. I've had a sway in my back that is ridiculous for longer than that. My toes curl under in a way I can't control which evidently is from having short ligaments in the back of my legs and bottom of my feet. I could have told him I was weird shaped. It didn't take a medical degree to see that.

What concerned him though was the cloudiness he was seeing in my hip joint. That I didn't understand or know about previously. He wanted to take further pictures so he did and told me to come back again the next day.

The following day he explained to me that the cloudiness in my joint were actually cysts that had developed because of the sharp angle of my hip. He told me this was above his pay grade (my words not his) and sent me to get better pictures and to a specialist in odd hips. I'm thankful for his quick recognition of the fact that what I had was not a chiropractic issue and his referral to Dr. Lovell who is one of the top rated doctors for my type of issue. When I saw him in October I was told by his assistant, for the first time, that a full hip replacement was necessary.

What!? I'm 33 years old. I'm active. I'm not in THAT much pain. What do you mean, full replacement? But they were adamant. It was my only option at this point. The bone had died. I had no space left in my joint leaving the ball and socket bone on bone, he was surprised to see me as mobile as I was.

That diagnosis was devastating to me and to my too mom I think. We both drove pretty quietly back to her car. It didn't seem like it could be real. In my mind they had the wrong x-rays. I was getting a second opinion.

The second opinion though was more of the same. By the end of October I knew surgery was inevitable. The second doctor gave me advice to put it off as long as I could. He suggested I stay away from doctors. He gave me a prescription to an arthritis medication and suggested I take it as necessary along with Tylenol. The best thing to do was to put it off and get as old as possible before I had to do anything about it.

The hip replacement would end my ability to run and jump. This was a limitation I wasn't very willing to put my arms around. The new joint would be good and pain free but it would be not as strong as a real joint and it would wear out. A second replacement was inevitable. If I limited my activity level it might postpone the second or third replacement but future surgery was a reality. I was depressed. I was depressed and my pain steadily increased.

I told myself I could put the surgery off for years and that maybe the technology would improve in the meantime. I would stay away from doctors and I would show them, just like I showed the doctors who told me I shouldn't be walking around on my previously broken and damaged ankle. I am nowhere close to surgery on that joint and they had told me years ago that I shouldn't put it off. I was determined to do the same thing with my hip. I couldn't ignore the change in my walking pattern that eventually turned into a constant limp and I couldn't ignore the knife like pain that began to be ever more prevalent in my left leg.

Finally, the end of May I took Moxie for a hike. It was steeper than I expected and by the end of the hike Moxie was so hot I was practically carrying her and I wasn't sure my hip would get me back to the car. It scared me as I thought about having to be helped off the Butte and I knew I couldn't put the surgery off any longer. In one afternoon I went from thinking I was hopefully another five years off from surgery to thinking it couldn't wait another month. The next Monday I scheduled a second appointment with Dr. Lovell. He couldn't see me until the beginning of August but I knew I wanted to meet with him instead of his assistant if he was going to be the one cutting on me (a terrifying enough thought without knowing the surgeon).

In the meantime, I had a life to live. My prescription had run out so I went to my primary doctor and she renewed my prescription and agreed with my assessment of surgery being necessary sooner rather than later. My summer has been filled with weddings - eight between Memorial Day and Labor Day this year. The first one was in Seattle and I had a chance to go to a baseball game with Pete during the weekend I was over there. He mentioned to me an advertisement he had seen for a "new" hip replacement that allows people to remain active and lead their same lives as before. I listened but didn't really think anything of it. Then my mom told me she had seen the same thing. If my mom and Pete were both telling me about it, two people I love and respect very much, I figured it was worth looking into. My mom emailed me a link she had found with information about it and I did some research. It turns out it wasn't a full replacement of the hip. Instead it was a resurfacing of the existing joint, putting space back and limiting the bone on bone situation that occurs when a joint "wears out". There were some limitations in the candidates however. The most alarming to me was that it was not a good surgery for someone who was in their childbearing years. I don't know that I will ever have children but I also don't know that I'm at a place in my life where I can make that forever decision.

I decided it wasn't fair to just decide outright that I wasn't a candidate without at least discussing things with a doctor. I wasn't sure if there was a local doctor who would do the surgery but I decided it was worth looking into. There were in fact two doctors in Seattle who were authorized and trained in the resurfacing. One was at the UW Hospital and one was at Swedish. That's an easy decision for me. I've always thought Swedish was one of the best hospitals in Seattle and I didn't like the idea of med students being involved in my surgery so I made an appointment with Dr. Pritchett. He was able to get me in within a few weeks.

I was super nervous about the appointment. I didn't want to get my hopes up but I also was feeling as though this might be such an amazing answer for me. To make a long story short, Kathy, my Godmom went with me to the appointment and we both really liked Dr. Pritchett. He told me I was a candidate - despite the fact Dr. Lovell had said the bone was dead, which Dr. Pritchett saw but didn't see as a concern and that the surgery had changed so there were no longer necessary concerns over having children after the operation. It was a two week recovery vs. two months and once I healed I would not feel like I had ever had a hip surgery. No one would be able to tell (unlike with a replacement where some form of my limp would likely remain) and while I shouldn't go out and become a marathon runner my limitations would be few. He said I would feel as though I could run marathons but the resurfacing would likely wear out more quickly if I did. The wearing out of the resurfacing would lead to either another resurfacing or a full replacement at that time. I'm not anxious for more surgery or pain so I think I'll remain at the finish line cheering on all of you crazy runners. I can still coach basketball in comfort and should be able to run on occasion if the spirit moves me - which it usually doesn't honestly. I'll stick to my bike and the elliptical.

There is a higher failure rate in the resurfacing procedure than in the replacement (5% vs 0%) but I would say a 5% risk is worth taking. Plus if the resurfacing doesn't work I will still be able to get a replacement. The opposite is not true.

My surgery is scheduled for September 19th. I have those weddings to get through remember? I'm still meeting with Dr. Lovell in early August and if he sets off alarm bells things might change but at this point I'm very willing to take the risk and see where it leads me.

This journey has been a very isolating time. It has made me have a deeper appreciation for the people I know who are in chronic pain. It's impossible for your peers to understand the sadness and frustration that comes with that feeling and feeling as though you have limitations where others don't. That's a feeling I didn't understand until I've lived it. My heart now goes out to you and I apologize for not having more compassion for you before now.

Thank you to everyone who has supported me as I've gone through this.

My pre-op appointment is on Friday. I'll try to do a better job of documenting what's going on than I have recently. Maybe it will give someone else who is feeling alone in their situation feel like there is actually someone else who gets it.

If you are a praying person - please remember me on September 19th and the days leading up to that day as I'm incredibly scared for the procedure and the healing time to follow.

That's all for now,
The Future Bionic Woman