Thursday, December 18, 2014

H.O. and Hardware Removal

***Please excuse any typos - I'm still under the influence of anesthesia!

Today's follow-up surgery was so different rom my prior hip surgeries.  After experiencing the mother of all hip surgeries twice, I figured this one would be significantly easier and it was.

Unlike the PAOs, where Perry and I stayed in a hotel in Tacoma 3 hours from our house and had to be at the hospital at 5:30 AM, today's surgery was at noon.  I slept in my own bed last night and we took our time going to the hospital around 9:00 AM after a full night's sleep.

This surgery was outpatient - once I was stable in the recovery room I was allowed to go home.  I'm sitting on my recliner at home right now. My pain is well controlled.

I was not very nervous for this one, which is unusual for me. I did know that this would be a much simpler surgery but I'm always nervous around doctors and hospitals.

Dr. Santore was able to successfully remove all of the H.O ("a massive amount," as he told me) and put my rectus femoris tendon and muscle back together.  He also moved some bone that wasn't showing on the x-ray, outside of the rectus femoris, which was preventing external rotation. I am beyond excited that I now have better internal rotation as well as unexpectedly-better external rotation.

He re-used my original scar which is great.  He was also going to remove as many screws as he could easily reach, but when he tried to remove the first one it broke off so they are staying. Dr. Mayo countersinks screws, and it has been five years,  so we knew this could be an issue.  The screws don't really bother me other than a little sensitivity with cold weather but it's always good to NOT have metal in your body if you have the choice.  Oh well!

At least now I have 12 and a half screws instead of 13!

I'm tired from the anesthetic so signing off now.

Thursday, November 6, 2014

Act Two

On a whim, I decided to see the best PAO guy here in my new home of San Diego just to be sure everything was still hunky dory after five years.  Dr. Santore is just as legendary in the PAO community as Dr. Mayo, and deserves that reputation.  As a result of my consultation, I will be having HO removal surgery on December 18th, making for a HO HO HO merrrrrrry Christmas.

For those not in the know, HO stands for heterotropic ossification.  That's basically bone growing where it shouldn't be.  This occurred not long after my LPAO and I've known about it and dealt with it for a long time.  In my case, the tendon connecting my rectus femoris muscle (AKA one of the quadriceps muscles) to the hip area has ossified, or turned to bone. The amount of bone on the x-ray looks like, on a scale of "not much" to "OMG that's a whole lot o' bone in your hip," more on the OMG side.  It is a couple of inches long and looks like a claw on the x-ray, right at the front crease of my hip where it bends.  Which makes bending difficult.  I've had to sit down to put on my shoes and socks on the left side since my PAO, and pants are also difficult. Bending forward to tie skates is difficult.  Doing anything that requires my hip to bend more than 90 degrees is impossible as the HO bone just blocks the movement.

I wanted Dr. Santore to tell me if removing it would give me better ROM and he thinks it will.  To prevent re-growth, he will treat me with a strong NSAID after surgery (some docs use radiation but I'm glad he does not as that comes with its own complications).  I'm a little nervous about this since I have to GIVE BLOOD (I have the veins from hell) during the preop and Dr. Santore said it was possible that I'd lose strength while gaining ROM.  Possible, but unlikely.

This is an outpatient procedure and compared to my PAOs should be a piece of cake. I'll be on crutches as needed, more for comfort than anything, but can bear weight right away. I don't think I'll need the heavy-duty narcotic pain killers this time.  And, if all goes well, I'll be hitting the gym for rehab around the first of the year.

Other than that, Dr. Santore said that my hips were holding up well.  The joint space and cartilage are good.  PAOs are performing as designed.  All good.

He did say that nowadays they don't put the hip so deeply in the socket in the back (we're talking the crease of my butt if you're trying to picture this).  Evidently PAOs have changed a lot in 5 years.  Hearing this, I realize this is why my ROM is so limited when I try to do good extension to the back as I skate. I just can't. My hip joint prevents it.  I have been stretching and trying hard to get that extension to be better for FIVE YEARS without realizing that my hip socket's new location is limiting the ability to get to where I used to be.  I always thought I was just inflexible because my soft tissues had been disturbed by the surgery, which is probably also true, but not causing this particular problem.

This is a bit disheartening.  In fact, I was really upset by it at first.  It means I will never, ever have that beautiful and graceful extension I used to have when I skate.  My free legs will always be twisted to the side, no matter what I do.  If I'd had my PAOs later, I might not have had to give that up.  Sigh.  I know I should be grateful for what medical science has done for me but damn it, I wish Dr. Mayo had explained to me how limiting that was going to be -- perhaps he and I could have worked out a deal.  Give me a little more ROM, and I promise not to abuse my new joints.  Something like that.  Because obviously they do PAOs that way NOW.  OK, I'm rambling on. It's done.

I will keep y'all updated on the HO HO HO since I know this is a common occurrence and many hippies will want the full story.  For now, over and out.

Wednesday, July 9, 2014

Five Year Hippiversary


It seems I only update this blog now on my hippiversary. That's good news -- because my hips are no longer a big deal. In other good news, not much has changed since my last report a year or so ago, or the report before that.

I have been walking as much as I can, and I can easily do 3 - 4 miles at a good pace. I'm not race walking and I'm certainly not jogging, but I am able to do more than I could in the past because I've worked at it. I still may get sore if I walk a long way on hard surfaces, but it's not the kind of soreness I experienced before my PAOs. I still don't think walking is the best exercise for me or for many post-PAO patients. However, I enjoy it and now that I've moved to San Diego where it's sunny one of the joys of my existence is walking on the beach and around my neighborhood. So, I've worked to build up those walking muscles. It can be done.

Due to an ankle injury, I haven't been able to skate since October. I thought my hips would be the end of my skating and I see the irony in knowing that I was able to come back from the PAOs -- not to my prior skating level, admittedly -- but I was able to work on international dances again. It took a sprained ankle, not a broken pelvis, to end my skating career. Beware the sprained ankle, readers! If your hips are unstable you may be more likely to roll your ankle. A high ankle sprain is not something to take lightly, and can lead to further problems such as Sinus Tarsi Syndrome (which I now have) if not allowed to properly heal. Anything called a "syndrome" is generally bad news when it comes to your anatomy. Consider yourself warned.

I still lurk on several PAO and hip dysplasia forums, and refer people to my blog when they ask. I know based on traffic reports that a lot of people from all over the world still read this blog. I'm always happy to answer questions from fellow hippies. If this chronicle has been helpful to you then it has served its purpose.

Peace out!  Terri