Tuesday, August 5, 2008

Hip, Hip ...

You thought I was going to say “hooray,” didn't you! Fooled you.

(Note that this post was originally published on my skating blog, tntsk8.blogspot.com)

I wasn’t going to post about this, but I’m hoping someone reading may have advice for me. My diagnosis today is acetabular dysplasia, a congenital hip deformity. (German Shepherds often have hip dysplasia, so let the dog comparisons begin.) In this abnormality, the socket of the hip does not surround the ball of the joint as it does in a normal hip; those with this condition inevitably have pain, which progressively worsens; they develop arthritis, and eventually need full hip replacement. The edge of the bone may more easily fracture since it is not stable.

Of all the sports to participate in, according to the doctor, skating is just about the worst. Running or other high-impact sports would be the only things that could be worse. The doctor, I must say, was pretty unsympathetic; even though I described how I participate in the sport of ice dancing and what that entails, he clearly thought that my skating was just any old activity because, let’s face it, I’m 45 years old and most people can’t picture us old farts skating any way other than round and round the rink for exercise. I described lifts, and ballroom dancing on ice, etc. but his answer was that I’d need to find a different activity, such as swimming, or no activity at all, which would be easier on my joints. He didn’t seem to understand that skating isn’t just going around in circles; skating is my one and only creative outlet. I've never found any other type of exercise I enjoy as much.

He gave me the name of a specialist and said good-bye.

I did some Internet research and it was then that I realized that for a skater, this was one of the worst possible diagnoses. There are many other career-ending diagnoses of course (knees, head trauma, backs) but this is right up there with the more commonly-seen injuries. The fact that I was born with this and skated for so many years without symptoms, all the while a ticking time bomb, makes this even more difficult to swallow. I will admit that I’ve shed some tears today in the bathroom at work and in my car.

The Internet says that once someone has pain from this condition, the arthritis sets in quickly, so surgery is indicated right away. As the condition worsens, the outcome of surgery is less and less likely to be positive. While there are many people who skate at a high level after hip replacement, I shudder to think of the many ways such a major surgery can go wrong, and that surgery won’t necessarily mean that I’ll be able to skate again at my current level – or walk for that matter. There are no guarantees.

I have always been healthy and never had surgery, so I’m also fearful of the process. Even giving blood is a trauma for me since I have rubbery veins, so the thought of being hospitalized for 5 days or more is truly frightening. I’d almost rather just let the arthritis take its toll, until I think of the true consequences of that. Doing nothing and continuing to skate until I can’t stand the pain any longer is an option, but then I may not be walking when I’m 50. Having surgery which isn’t successful seems like a worse option.

The internet shows that 17% of people having the surgery are able to function at the same level as before when it comes to “athletic activities”; another 37% are able to function well enough to “ambulate.” Those numbers seem particularly disturbing to me. Hip surgery is great when it allows an elderly person to continue functioning so they don’t have to be wheelchair bound. Hip surgery that means I won’t be able to skate any more does me no good at all, and seems like quite a trauma to put myself through.

An aside - this explains why I could never do a spread eagle or an Ina Bauer, despite being able to do Biellmans. Typically people with this type of dysplasia have very little hip turnout, and no amount of stretching can change that - it's just physically impossible for the hips to move that way. To think of all the time I wasted doing plies, pilates, and various other stretches to improve my turnout which never seemed to improve ... and to think of all the coaches who told me I was "just not trying hard enough" to do that Ina Bauer. Well, it's vindication all right, but somehow THAT doesn't feel very good right now.

I’m in a little bit of shock right now since this was not the diagnosis I was expecting (I was hoping more for "you pulled your groin, now rest and ice it for a month then you will be good as new"), but I need time to process this and figure out what I am going to do. Readers, I already know I have your empathy. If any of you have constructive advice, I could sure use some now.

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