Saturday, November 27, 2010

The path to being pain-free (part 2)

After the wake up call from my physical therapist I knew it was time to see an orthopedic surgeon—the one type of doc I feared most because “surgeon” implies surgery. And who wants that unless you are Heidi Montag.

From all I had read about hip pain and the solutions, the most critical element lingering in my mind was that of one’s doctor selection. Anything requiring entry into the hip joint (either a needle or a knife) requires a very skilled doctor. The path to the hip joint is an exact one and if the entry isn’t just right there is a risk of nerve damage. I wasn’t about to take any chances on this so I did my homework before making an appointment with anyone.

Well it turned out that the orthopedic surgeon my physical therapist had recommended was highly qualified, extremely competent and had numerous testimonials to boot. After meeting with him, I just “knew” that if I could be fixed, he would be the one who could do it. The first thing he needed was an MRI arthrogram to determine exactly what was going on.

This is basically a joint imaging procedure where a special type of X-ray technology, called fluoroscopy, is used to take pictures of the joint after a contrast material has been injected into it. Along with an MRI, this allows the radiologist to see the soft tissue structure of the joint.

I was also injected with lidocaine to numb the hip joint. This was an additional test to help determine the source of the pain. The whole procedure was a bit nerve racking but nothing too horrible to endure. I did notice that while my hip joint was numb I was missing some of the pain I normally had, which was a good indicator that the trouble lay within the joint.

After all tests were complete, the doc told me I had a degenerative labrum (a piece of connective tissue around the rim of the hip socket) and an internal snapping hip (a tendon was catching). Post surgery would reveal more, including a tear and an extra piece of cartilage floating in the labrum.

Although it seems I’m kind of young to be having such problems with my hip, I found out from my doctor that I was genetically predisposed to problems in that hip socket because I had a deep socket. Why couldn’t I have been born with deep pockets instead?

Anyway, that combined with my activities and delay in handling the problem resulted in this chronic situation. The biggest lesson I’ve learned from all this is you’ve got to act quickly and get proper medical attention when you hurt. It’s fine to try natural remedies, but when they fail, or don't work quickly enough, it’s time to move on.

So what were my options? 1. Cortisone treatments; 2. Hip arthroscopy; or 3. Joint replacement.

From what I read about cortisone it seemed only to be a temporary treatment and I was "done" trying things. I wanted more predictable results. With the hip arthroscopy the doc thought I'd have about an 80% chance of full recovery of the hip joint. The risk was that degenerative labrums aren't that easy to repair and a hip arthroscopy is more effective when there is no degeneration present.

I wasn’t about to go through door number three. I wouldn’t even consider that one unless I was 80-years old.

I chose the hip arthroscopy. Although it's a minimally invasive surgery, it's still surgery with all the risks. And it needed to be done in a hospital, my least favorite place in the world. Uggghhh.

The time had come, like it or not, for me to face my fear. Part 3 will delineate that experience.

Tuesday, November 16, 2010

The path to being pain-free (part 1)

Just one month ago I had a hip arthroscopy (a minimally invasive hip surgery) and I thought it would be good to write about the whole ordeal. Although I had been avoiding it for two years, I finally came to the realization that surgery was the answer for handling my chronic pain.

Being indoctrinated in the “natural” approaches to wellness, I had always considered surgery to be a last resort. But by reading the stories of others on the internet, I opened up to the idea. Their stories helped me to get an idea of what the process would be like and how it could potentially help me.

The documentation of my experience is mostly for me like a diary entry, but by being on a public blog, it can serve to shed light on the process and basically just share with others who may have similar problems and may still in the decision-making phase of what to do.

My pain started two years ago while I was increasing my athletic activities. At the time, I was doing CrossFit, was training for a marathon, and had just gotten into adventure racing. I was also taking some kick boxing classes at a boxing gym. When they offered a new course in Capoeira (an Afro-Brazlian art form combining martial arts and dance), I jumped at the chance. It was so beautiful to watch I just had to try it.

One day in my Capoeira class, my knee just completely gave out on me while kicking. It was the strangest thing. One minute I'm kicking and the next minute I can't even put weight on the leg. There was no snapping or anything out of the ordinary. It just turned to rubber. At the time my only thought was I didn't feel the instructor warmed us up enough, or at least like we normally did.

After that day, nothing was the same for me. I started having trouble running due to a new pain in my right ankle; I couldn't lift the weight I was previously lifting in my CrossFit classes due to increasing hip and back pain; and I wasn't able to jump like I used to due to this new unstable feeling with my right knee. At the time, I had no idea that all these pains were related. I knew something was wrong, but basically I tried to ignore it, thinking it would all just go away.

It didn’t.

Reluctantly I had to start decreasing my activity level. I kept on my CrossFit classes for awhile, going less often, but eventually the weights became too painful and I stopped altogether. I wasn't ready to give up running though. It was too much a part of me. And as long as I didn't go too far or too often it seemed ok. At first I could run 10 miles without hurting, but over time the pain started kicking in at shorter distances. Next, I could only go 8 miles then 5, then 3, 2, then hurting even after only 1 mile. I'd try again every month or so just to see if taking a break had helped. But no, it hurt every time I ran.

During this time I also sought medical attention from various types of doctors. Being more of a natural-approach type of person—along with having a general disgust at the medical profession for mostly treating with drugs instead of finding the root of the problem—I went to chiropractors, physical therapists, an acupuncturist, a medical doctor who treated with prolotherapy, and a sports therapist who specialized in Active Release Technique (ART). I even got trained in self-treatment of trigger point therapy, which has a similar objective of ART—releasing muscle tension.

ART turned out to be the most helpful because at the time I saw the doc, all the muscles around the hip, groin, buttocks and thigh were extremely tight and in constant pain. The procedure is quite painful because the practitioner has to dig into the muscles at a very deep level, but it does get the muscle to release the tightness. I used to call it my torture treatment. Although this gave me temporary relief by relaxing the muscles there was still continuing pain that I just couldn't get rid of. The pain I had felt like it was just too deep for anything to get to.

All I could do was cut back on my activities. So over the past two years I went from a training maniac to couch potato. Even my favorite sport of snowboarding—which didn’t engage the pain as much as other activities—suffered because my legs weren’t as strong as before and I tired more easily.

My journey with this hip problem has been quite frustrating. All the doctors I saw had different ideas of what was going on, and none of them up to this point had really helped me. Over time my frustration turned to apathy. I started to think I would never get to do fun stuff again without pain. To top things off, my boyfriend at the time broke up with me “over my hip” (what a loser, I know). But it did act as a catalyst for me to seriously solve this problem, so for that I'm grateful.

Shortly after that I got heavy into research and read up on hip pain. I learned that by not exercising I could create even more trouble. One popular book recommended pool exercises. So I tried that. Even that hurt.

Being almost at my wit’s end I called the closest physical therapy office with the word “sports” in their name and made an appointment. I was determined to get a customized exercise program no matter what the cost. I didn’t care anymore.

When I went in for my appointment the therapist asked me a lot of questions and moved my leg around a lot asking if this or that hurts. He seemed very knowledgeable and competent. No other doctor I had seen had moved my leg around as much as he had. Suddenly I felt a tiny bit of hope that he might actually be able to help me…

So I asked him if he could prepare a customized exercise program for me.

He flatly refused.


He told me straight up that I needed to see an orthopedic surgeon as soon as possible to find out what was really going on before I did anything. He was dead serious and it kind of shook me up. But I really respected him for that. I felt like this was the first person I had seen that really had a clue. And although I could tell he had his suspicions of what might be wrong with my hip, he refused to guess.

Damn, you gotta admire that!

Stay tuned for part two.

Friday, May 21, 2010

The Beginning of a New Adventure

For the longest time I've wanted to learn to ride a motorcycle, but was always too busy doing other things. It just kept getting put on the back burner. Well, as you can see from the photo above, that all has changed. Necessity played a part in that I needed another outlet for my energy. Since I am no longer training for adventure racing and haven't been able to exercise like I used to due to injuries, riding a motorcycle has become one my outlets and is a way to extrovert my attention away from the internal dialog of daily life. It's not quite the same as running in the mountains trying to avoid snakes and mountain lions, but there is a certain "danger" associated with it which is what I like.

Every day I ride I know going in that this could be the day I die. There are so many additional hazards that you don't have to think about when you are in a car: oil, water, dirt, hitting a turn too hot, tires locking up, dogs chasing you, and so on. The biggest issue, of course, is that cars just don't see you, so you have to be super alert and drive very defensively, especially nowadays with so many people using their cell phones and texting while driving. Yes, I saw you doing that. We can see a lot from a bike.

I've accepted the risks associated with riding a motorcycle. The fun and freedom outweigh these risks and makes me feel alive.

Learning to ride the motorcycle wasn't easy. I dropped it a couple times going less than 5 mph and got freaked out. It turns out that knees and pavement don't go together very well. There's some pain involved! Handling a 300 lbs motorized machine takes some skill. Thankfully I didn't give up. I continued to work on those skills.

Now I ride the bike as much as I possibly can, eager to get more experience. The first few months were kind of terrifying. I'd want to ride, but was scared all at the same time. My desire to ride though overcame the fear. Each day it seems to get better. Finally, I stopped thinking about dying and just today I started thinking how natural it is starting to feel. I even did my first "white lining" at 80mph and didn't get nervous.

The feeling of riding a bike is amazing and makes you feel so alive. I finally understand how dogs feel when they stick their heads out the window. It's a very happy place. And the thrill you get when zipping through traffic is indescribable. As long as I can get the bike in between the cars I can get to the front of the line every time, all the while thinking "Ha ha you suckas!"

Seeing the looks on people's faces is kinda cool too when they recognize you are a girl. Gotta love that! :-)