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.

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