Finally...PAO date set!

I am LONG overdue for an update so I will try to make it short and sweet.

After having my labrum repaired last June, the pain in my hip never improved. I was finally able to get an MRI (of both hips since the right one has started to become symptomatic) in April. The scans showed a labral tear in the right hip (the one that started to show symptoms, but still remained my "good" hip) and 'no evidence' of re-tear in the left hip. However, the one labral tear was enough to get me a referral from my family doctor to the hip dysplasia specialist that I've been trying to go see for 9 months now -- Dr. Ira Zaltz in Royal Oak, MI. After last year's scope (with another ortho) failed, I began doing research on hip dysplasia and who specializes in it. I was lucky enough to find Dr. Zaltz, who is well-versed in hip dysplasia as well as the surgery to address it...and he was only an hour away from home!

My appointment with him was on May 18th and went exactly as I expected. He looked over my MRIs and did his own set of x-rays. He told me I do have bilateral hip dysplasia and that the left (the one I had repaired last year and that is the most painful) is worse than the right. He said I have minimal arthritis and said that I was a reasonable candidate for a periacetabular osteotomy (PAO). He did caution that since I had the repair on my labrum done last year and that had failed, that my cartilage would not be as hearty as it would've had I not had the scope done, however, he thinks the PAO should help my pain and put off the need for a total hip replacement for a long time.

He seemed surprised that I had so few questions and was ready to go ahead and set my surgery date that day. I explained to him that I have done tons of research since my scope last year and had already made the decision that this was the route I would need to go. So the appointment ended up setting up a date pre-op for a CT scan (done at his hospital, Beaumont Royal Oak, his preferred place because he likes the equipment used there) as well as a surgery date, pre-op and first post-op appt.

CT Scan @ Beaumont - July 12 - 12:30pm
Pre-Op Appt. - July 31 - 1:45pm
Surgery - August 8 - will get time the night before
First Post-Op Appt. - August 28 - 1:15pm

Now I'm just finishing up work - my last day before surgery is Friday, August 4. I think I've got all the things I need for post-op, including Mobilegs Ultra crutches, shower chair, ice machine, toilet seat riser, etc. I'm just ready to get this behind me and start recovery already!

Surgery Day

Well today is the day of my surgery. I didn't really have time to be nervous since I just scheduled it yesterday. It was supposed to be August 30, but yesterday (June 14) I got a call that there was a cancellation but it just happened to be June 15, the next day. I freaked out a little at first, but figured I'd rather just go ahead and get it over with. I talked with work and family and agreed to go in for surgery the next day.

So, I got up fairly early as I had to be at the surgery center in Novi by 730am. Doug and Mom went with me, and we took my father in law's van as I figured it would be easier to get in and out of afterwards.

They get me set up in pre-op fairly quickly, and Doug and Mom talked to me for almost an hour straight until it was time to go back. This was good because it kept my mind off of the surgery. Just before, Dr. Farjo came in and marked the correct hip. Off we went. I remember there being 6-8 people in there setting up...and was only awake for about 30 seconds before they put me under.

I was later told by my husband that surgery only took about 45 minutes, which is pretty fast for all the work I had done - labral tear repair with one anchor, femoroplasty and shaving of bone spurs, bursectomy and IT band release.

I woke up in awful pain but my nurse was so amazing. She was very soothing, kept telling me to take big breaths. She kept trying to give me morphine, but it just wasn't helping. I've had this issue before...it really doesn't work for me. So finally she gave me dilaudid, which finally started to ease the pain. I fell asleep for a few minutes, then woke up again feeling at least a little better. They gave me some water and animal crackers to make sure I could eat and drink without getting sick. Luckily I never had issues with nausea. I was then allowed to get dressed - I brought a heavy sweatshirt long nightgown, which was good because the bandage was so big, I don't think I would've been able to wear pants over it. With help from mom, I finally got dressed and seated in the wheelchair while Doug went to get the van. Getting in the van was easier than I thought it would be, I guess because the pain meds were still working so well. Half the drive home was great - I felt OK. But after about 30 minutes or so, I was ready to be home. Pain was coming on stronger, and I wouldn't wait to crawl into my own bed.

Once I got home, my mom went to pick up my pain meds from the drug store. Then finally arrived home and I took some. I don't remember most of the rest of the day as I was in and out of sleep. I do remember peeing a lot due to all the fluids I'd been given, which seemed like torture because I kept having to get out of bed and use crutches to get to the bathroom. I couldn't even lift my operative leg without help.

By the next day, the pain meds just were not keeping up with my pain and I was unable to move my leg without excruciating pain, so I called the surgeon and my mom was able to drive down there to pick up a stronger dose. I started taking those when she returned and that helped a ton. I took them every 4 hours even through the night for a while. I had to stay ahead of the pain and make sure not to miss a dose.

The next several days were a blur. I had my ice machine on constantly, pain meds in at all times, drifted in and out of sleep and watched the Olympic trials. I would return at 1 week post op to have stitches removed.

Here are some pics from my surgery:

After bone shaving (femoroplasty)

Inflammation inside the hip joint (before it was removed)

Tear repaired

gigantic hip pad

Hip Diagnosis

I realize that my blogging has really been lacking lately. I mean, really lacking. As in my last post was February and now it's June and a lot has happened since then.

I continued with PT February thru April hoping that it would help. But nothing changed. So finally early May I decided it was time for an MRI. So I scheduled it for a Friday afternoon and waited. On Monday, I was surprised to get a call that they wanted me to come back in because the first set of images weren't conclusive enough. So, I went back in that day and scheduled a follow-up with my primary care doctor a couple days later.

The time finally came and I was so nervous....yet excited to find out what was finally wrong.

As suspected, full thickness labral tear of the hip. Great.

I spent the next several days doing a lot of research on surgeons has hip arthroscopy to repair labral tears isn't too common. There are only a few orthopedic surgeons in the entire US that have done enough of these to have perfected the skill. I finally came across Dr. Laith Farjo of Advanced Orthropedia Specialists in Brighton, Michigan, only about an hour from where I live. I called and earliest appointment was June 13, which I didn't really like, but didn't have much choice.

Appointment day finally came and they did an x-ray that morning so the surgeon could look at that as well as the MRI I had already had.

I saw the PA, Chris, first. He did a lot of movements to see what kind of pain I got with each one. He then went over my x-ray with me and showed me that I had a bit of both types of impingements - CAM and pincer - which they could fix with bone shaving. Finally, the surgeon came in and discussed what would be done during surgery. Labral repair, femoroplasty (bone shaving to prevent tear from happening again), bursectomy (remove inflammed bursa) and IT band release (to prevent friction on the trochanteric part of the femur). I agreed and went to the front to set up surgery with the office coordinator. She said the first date she had was August 30 (almost 10 weeks  out)...I reluctantly took it and she said I was at the top of the cancellation list...and people frequently cancel. So I left the office with my fingers crossed.

Here are a few images of the procedures I will have done:

I will report back after surgery!