day 11 after pain test

Yesterday was my first pain free day since they injected the Kenalog. Don't think that means that I went for a run and did everything I wanted. Very much the opposite - I sat or was reclined most of the day. I played video games, watched tv, napped. But I also did the dishes and cooked a big breakfast for us and our house guests.

And by pain free, I mean I had no sharp pains the entire day. Nothing that made me hold my breath and try to recover gracefully. It still aches and hurts a little, and other body parts - who have been working overtime compensating for my left hip - ache most of the time. In the last few days, it's been especially my right hamstring and left glutes, along with the ever present interior left hip/groin pain.

Saturday we took our friend's cousin's boat out, and they were kind enough not to drive quickly, which made the ride bearable pain wise for me. It was nice to float in the lake with a beer and friends.

I did attempt a grocery store run last Thursday, and it was awful. Started out ok, but I got slower and slower (someone on a walker actually lapped me) and my hip hurt more and more as I tried to finish gathering everything on my list. I also felt like I lost some sensation the more I walked, which has happened on multiple days lately. I'm hoping that sensation goes away since I'm going to need to walk a lot in Italy.

Two more active release appointments this week on Tuesday and Thursday.

6 days post arthogram and pain test

It's been 6 days since the arthogram and pain test. While it's certainly not a fun experience, it was needed testing, so I'm glad I did it.

Day of (7/12): 

Signed all my paperwork at the front desk, more paperwork with the nurse. Then I popped a pain pill I had leftover and they wheeled me off for some xrays. Then it was on to the arthogram. I greatly appreciated the doc at this place, he was much gentler and seemed in less of a hurry than the guy I've previously used in Austin. He put in the Kenalog, Lidocane, and dye.

My hip felt full and my leg felt wobbly and weak, but when he was done with me I was in less pain than when I'd come in. Which was a pleasant surprise. MRI was boring, as expected, but went by quickly. And they pumped music from my phone into headphones for me, which was a plus. Overall, I can't say enough good things about the staff at the Memorial Hermann Outpatient Imaging clinic. They were awesome. I felt comfortable and well looked after, and it was obvious they knew what they were doing.

I kept up with pain meds until the evening when I decided I didn't want to take anymore. Big mistake. Once the Lidocane had worn off, I was a very unhappy camper. Pain level was high enough that I couldn't sleep, even with Ambien.

Next day (7/13):

Mom drove me back to Austin in my car. Took my pain pills like a good girl, and the pain level was tolerable. Right before we pulled into my driveway, Dr A's office called with the results of the MRI. Fastest. Results. Ever.

Yes to FAI, but hopeful that we won't have to tackle that surgery right now. Pain is probably coming from labral tear. Waiting on Kenalog to kick in (takes 7 - 10 days) to see if it relieves pain. They didn't see the femoral head stress fracture on the MRI that Dr L was worried about. Scheduled for a follow up in Houston August 6, and we'll likely go ahead and set a surgery date then. I feel pretty comfortable with Dr A, so Chris (my husband) and I are thinking we'll let Dr A do the repair.

Following days:

I've been pretty uncomfortable since I got home, though the pain has definitely gone down and I don't find myself needing even my 800 of Ibprofen most days.

Monday (7/16), I saw an Active Release Therapy (ART) Chiropractor who does a lot of work on hips. Expensive for a short session, but willing to try it for a little bit to see if it helps. Have another appointment scheduled for Thursday of this week.

Yesterday (7/17) , I got the munchies around 4 pm and figured it was just boredom because of sitting. Then I got a headache and became dizzy and a bit agitated. A few hours later, my hip started to feel oddly loose and my entire leg felt weird, almost in an it's not attached to my body kind of way. It definitely felt really weak. However, I could take tiny strides instead of hobbling. Thought maybe the Kenalog was starting to work. By 9 pm I was super flushed and sweating. By 11, I was freezing. By 12, I was exhausted and hoping I didn't need medical attention...but I was going to try to sleep.

Slept for almost 10 hours. Woke up because I was done sleeping and not because of hip pain. Strange sensation. I haven't gone nuts walking around or anything today, but I have been able to do the necessary things with very little pain. Headache and dizziness are back again. Called my mom to ask about that (she's a nurse). She suggested snacking on carbs. That does the trick for a few hours, so I guess I'll be snacking more than I'm used to.

If I understand this correctly, the relief of pain using the Kenalog means soft tissue damage, which should mean that repairing the labral tear should alleviate my pain. So maybe we can put off or avoid this open surgery with bone shaving stuff...at least for now.

2 days and 2 more appointments

Yesterday at 10 am I got a phone call from Dr L's office. They have a loooooooong wait and I'd been trying to get in. They had an opening at 3 pm and wanted to know if I could be there.

I threw clothes in a bag, drove around picking up medical records, and hauled to Houston. Made my appointment with five minutes to spare, too.

Today, I had an appointment with someone who specializes in hips and sees FAI cases, Dr A.

Dr L doesn't believe in FAI and thinks I have a possible stress fracture of the femur. He does agree, however, that my measurements and exam indicate that I have FAI if he believed in it. He wants an MRI (no contrast) to look for a fracture and amount of fluid in my hip.

Dr A looked over an old MRI and my xrays and says he's pretty confident I have FAI and he thinks I also have a labral tear. He's also cautious about the possible fracture Dr L noticed. He ordered an MRI with arthogram, some sort of radioactive dye (starts with a K) and a pain test (which while it sounds bad, should help with pain in the long run). I opted to go through wve ith Dr A's plan for now, since it covers everything I'm concerned about (except hip fluid level). It looks at enough stuff that I think we can get a pretty good idea of what's going on in my hip.

So that's where I am as of today. Still a little confused about what's going on with my hip, but at least it looks like I'm heading to a real diagnosis soonish. I am not looking forward to the MRI since the arthogram laid me out for a few days last time. Oh well - no pain, no gain.

MRI w/ arthrogram, radioactive dye, and a pain test scheduled for 3 pm tomorrow.

Independence Day wrap up

I survived the 4th. We were supposed to go to two parties - one a BBQ at 3, and then a dinner and fireworks viewing at 6. By 2 my back and hip were hurting quite a bit, so I stretched out and took a nap hoping it would help. It helped a little, but more time being still would have been nice.

So off we went to dinner, where we met up with Ultimate friends. Fun stuff, and I was able to find seating in the apartment and upstairs on the rooftop deck. We had one friend there who was 16 days post op on ACL repair, and another friend who is having foot surgery in 2 weeks. Ultimate folks are a lively but broken crowd.

After fireworks we needed to stay put for a while as there was a lot of traffic downtown. No use getting in the car to go nowhere. I stretched out on the couch, which helped, but by the time we went home I was in a pretty considerable amount of pain. Unfortunately for me, being unable to go to a friends house pain free pretty much means no floating the river tomorrow. Lamesauce.

Happy 4th!

[4th of July parade rolled right in front of my house]

Six days after my exam with the hip specialist, I'm finally not waking up with a lot of pain. I'm hoping this trend continues.

I posted to some FAI support groups online. I have been asking what tricks people have found to cut down on pain while waiting for surgery, what they wished they knew going in, what was helpful during recovery, etc. I'll compile a good list of tips (and a list of support groups I found) once I feel like I have enough data. For now, this is what I've found:

• Sitting on our comfy couch at a non-90 degree angle is my best bet if I want to sit for a long time. I look like a fool slouching all the time, but it works. Laying down helps too, so I sneak in some naps.

• NSAIDs aren't helping at all any more. I was taking 800mg of Ibprofen three times daily. It upset my stomach and didn't help with pain (big clue to the doc that this had nothing to do with swelling).

•  If I'm not having a lot of pain, walking is something I can do - if I walk slowly. Walking faster means a longer stride for me. And longer stride means more pain.

A friend suggested I try hot baths (and maybe even epsom salts). I'll try whatever, so I'll see how that does over the next few days.

We had some great invitations to celebrate the 4th with friends. Chris and I picked 2 parties with my hip in mind - limited number of people, seating for me, Chris is able to either park very close or drop me off and come back quickly.

I hate picking things with my hip in mind, but it's my best chance to have a fun day if I engineer hip success. Of course, the best way to not have pain would be to stay on my trusty couch. But I refuse to let my hip completely control my life.

The plan for now through October

As there's no way I can have surgery until the end of October, I chatted with Dr M about my plan for now.

• Physical Therapy - 6 weeks of this, twice a week. Going to use the therapist I've been using as she's awesome.

• Active Release Therapy (ART), and sports chiropractor (he has worked in orthopedics before) - as often as this doctor says I need to come in. His first appointment was July 16th, so I'm not looking forward to my 2 week waiting period :/

Between these two things, we are hoping to manage my pain level to get me through October. My fingers are crossed, but I've already done 6 weeks of PT as part of Dr D's conservative approach, so I'm not expecting miracles. I've been trying very hard not to rely on painkillers and intend on continuing that trend.

In the meantime, I'm posting to boards to find pain relief ideas from people who have dealt with this before. Maybe there's some sort of trick I'm missing.

I'm also canvassing for friends or friends of friends who have or have had AFI. I'm asking tons of questions to better understand what they went through and what I have in front of me.

If you've gone through this, any tips? Anything you wished you had known before surgery?

About

Some patient stats, for good measure - so you have an idea of where I'm coming from (and how my experience may or may not relate to yours).

• Female
• 28 years old
• Active lifestyle
• In decent shape
• Play Floorball, Ultimate, and Golf
• Also enjoy Zumba and Turbo Kickboxing classes at the gym
• Running for the sake of running is off the table (boring)
• Knee injury and surgery in 2006; completely recovered
• 2 cats who can miraculously step directly on the part of my hip that hurts the most without trying
• Husband who is also injured and going stir crazy

Sitting is driving me crazy. I miss sports, chasing discs and floorballs, and my teammates.

6/28/12 - diagnosis

At the end of March, I played in a 2 day Ultimate tournament. Played in would be an overstatement...I subbed in only when I was absolutely needed. It was muddy and I had a bad feeling about running in that much mud.

Last year I had some hip flexor issues, and what we assumed was a labrum tear, left hip. MRI with arthogram (Oct 2011) turned up a whole bunch of nothing. I did some active release therapy, physical therapy, and started running again. By the time I signed up for that tournament in March I was back to playing pickup and feeling pretty good about returning to club level play for Centex.

By Monday morning, I knew that even limited play time had been a bad idea. So in early April, I grabbed an appointment with a new orthopedic clinic closer to my home. I had an appointment with Dr D. He thought labrum tear on examination, but decided on the conservative route of physical therapy, steroid dose pack, and LOTS of anti-inflammatories (800mg ibprofen 3x daily). 6 weeks later I wasn't getting any relief. At my recheck he punted me to a hip specialist, Dr M.

Dr M appears to be the Dougie Houser of the office. Youngest doctor there and very smart. He looked at old films and MRI and ordered some new films. And by the time I left that afternoon, I had a diagnosis.

FAI or Femoroacetabular impingement, specifically CAM. And global overgrowth of the labrum.

Basically, the femoral head (top part of your hip) needs to be shaved down since it's too large/misshapen. In addition, the labrum, which is the lining of the hip joint is overgrown. So they would need to cut that back too.

Some cases can be done arthroscopically, but Dr M thinks mine would need to be done open. More scars, yay.

Obviously I'm not jumping into this without another opinion. I plan on researching who the best guy is in Houston and seeing him for another opinion. In addition, I'll be getting another MRI with an arthogram probably at the end of August (to look to see what else might be going on in my hip).

For now, it's nice to have explanations as to why I was also having TFL pain, hamstring insertion pain, etc.

I have a bunch of things to do and places to see before I can have this surgery, though, so we are looking at the end of October or early November before I go through with it. I've spent the better part of three days researching FAI and surgical options. While I've found plenty of medical journals, I haven't found many first hand accounts, so I intend to put mine out there. If for no other reason than someday, someone will be googling FAI and might come across this. Maybe it will answer questions or quiet their fears, and if so, keeping this blog is totally worth it.