Walking is so basic. It seems so easy. It's great exercise. It's good for you. Almost anyone can do it!
My stepdaughter Ashley is here visiting from Colorado, on break from college. Yesterday my mother and I showed her some of the highlights of Portland - the Rose Garden, the Japanese Garden, and shopping on NW 23rd. I walked A LOT, more than I have since diagnosis, and didn't really make any accommodations except taking the shuttle up the hill to the Japanese Garden. Today I feel like somebody stood on my pelvis and took a baseball bat to my back, hips, and legs.
My 70-year-old mother accompanied us and wasn't even tired at the end of the day, while I was firmly planted on a chair complaining of how sore my legs were. That's right, me, the athlete.
We are supposed to be going downtown tomorrow and to the beach the following day, both walking-intensive activities. The wheelchair idea is sounding better and better. Wheelchair on sand at the beach? Probably not going to happen. I just need to get through this week and then it's only 4 more weeks until surgery. I can spend the weekend recovering from all of this walking.
I am now 100% convinced that I do need this surgery.
Showing posts with label Why PAO?. Show all posts
Showing posts with label Why PAO?. Show all posts
Wednesday, June 3, 2009
Tuesday, May 26, 2009
Doubt
The following is something I posted to the Hipwomen Yahoo group in response to T*****, who was questioning having such major surgery with so little pain. I wanted to re-post it here for my friends and family, some of whom have asked me the same question. Terri
T*****:
My PAO is scheduled for July and I ponder the same thing on days when I don't have hip pain, which are frequent. But then I realize how much I am limiting myself in order to be pain-free. I was out today on a beautiful spring day, driving with my husband, and saw people hiking. I realized that I hadn't gone for a hike or even a pleasant walk around the neighborhood since diagnosis last August. I have mostly avoided walking except for what is necessary to get around.
I think of how active I used to be just a year ago, and even though I don't have severe pain yet, I realize that in order to be that active again I have to do this. I backed off on things so gradually that I hardly realized that I wasn't doing much walking until I saw others hiking. I live in the middle of a forest with trails everywhere, and so I see a lot of hikers now that the weather is nice!
Before diagnosis I managed my condition by ignoring it. I had a little pain, some limitation of flexibility and lots of stiffness after exercise. I chalked this up to being "out of shape," which I wasn't. I thought it was what happened to people over 40 who liked to be active, until I realized that nobody else my age or older was walking bent over or having trouble standing up after exercise.
My surgeon said that if I didn't have the surgery, I would only be able to "manage" the condition by sitting on the couch and doing nothing, and eventually sitting would be painful too. That was not acceptable to me. He said eventually I wouldn't be able to walk at all because the pain would be so great.
Although I'm in the age range where a THR makes sense (I'm 46), I have almost no arthritis and he was pretty clear that PAO was the better option since it will preserve my own joint. If I did nothing my arthritis would get bad and I would no longer have the PAO option - only a THR/Resurf would be available if I waited. I didn't like that very much - I'd rather keep my own hip as long as possible. Since you are much younger than I, you probably have a much better chance of success with a PAO if your doctor recommends it. But you can't wait too long or you'll lose that opportunity.
I know that was sort of long-winded. I want you to know that many of us question this surgery on our good days. I just have to look at all of the things I've given up to keep my pain level manageable to know that I need to do this. Everyone has to make the decision that is right for them.
T*****:
My PAO is scheduled for July and I ponder the same thing on days when I don't have hip pain, which are frequent. But then I realize how much I am limiting myself in order to be pain-free. I was out today on a beautiful spring day, driving with my husband, and saw people hiking. I realized that I hadn't gone for a hike or even a pleasant walk around the neighborhood since diagnosis last August. I have mostly avoided walking except for what is necessary to get around.
I think of how active I used to be just a year ago, and even though I don't have severe pain yet, I realize that in order to be that active again I have to do this. I backed off on things so gradually that I hardly realized that I wasn't doing much walking until I saw others hiking. I live in the middle of a forest with trails everywhere, and so I see a lot of hikers now that the weather is nice!
Before diagnosis I managed my condition by ignoring it. I had a little pain, some limitation of flexibility and lots of stiffness after exercise. I chalked this up to being "out of shape," which I wasn't. I thought it was what happened to people over 40 who liked to be active, until I realized that nobody else my age or older was walking bent over or having trouble standing up after exercise.
My surgeon said that if I didn't have the surgery, I would only be able to "manage" the condition by sitting on the couch and doing nothing, and eventually sitting would be painful too. That was not acceptable to me. He said eventually I wouldn't be able to walk at all because the pain would be so great.
Although I'm in the age range where a THR makes sense (I'm 46), I have almost no arthritis and he was pretty clear that PAO was the better option since it will preserve my own joint. If I did nothing my arthritis would get bad and I would no longer have the PAO option - only a THR/Resurf would be available if I waited. I didn't like that very much - I'd rather keep my own hip as long as possible. Since you are much younger than I, you probably have a much better chance of success with a PAO if your doctor recommends it. But you can't wait too long or you'll lose that opportunity.
I know that was sort of long-winded. I want you to know that many of us question this surgery on our good days. I just have to look at all of the things I've given up to keep my pain level manageable to know that I need to do this. Everyone has to make the decision that is right for them.
Tuesday, May 12, 2009
Around Anchorage
Last October, exhibiting the "Old Normal" - disco pants and all!
I spent the weekend in Anchorage, which is a 6 hour plane ride (plus a layover in Seattle and a one-hour time change) from Portland. Because of the distance from the lower 48, it's not the type of place you normally go for just a weekend, but I was asked to come up and judge some skating tests and always love going to Alaska, so I said yes.
I again found myself bumped to the front of the security line just because I have a cane. Again, I didn't argue with this; I suppose it's one of the only perqs for those with hip dysplasia and other disabilities. I felt kind of silly since I still envision myself as I was 9 months ago - healthy and young - and figured everyone in line saw the sham.
That was before I caught sight of myself reflected in the glass-lined walkway as I made my way through security. Who is that old, stooped over woman, shuffling along? Not an athlete or dancer with good posture and a spring in her step. That's the person I am inside my head, but the mirror told me the truth. I have certainly aged since August.
Once in Anchorage I did my judging and then went sightseeing with one of the coaches, her dad, and the other judges. Thankfully we were driven in a van and only got out to walk around when we got to our destination, where we had dinner and then came home. Quite the sedentary sightseeing, and so different from what I used to do.
I did do a lot more walking than usual though, and probably walked faster than my "new normal" pace. On Sunday morning I walked "around" the lake which was near the hotel. The old me would have done exactly that. The new me walked "around" -- meaning "near," not "on the perimeter of" -- the lake. That means I went from the hotel lobby to the lake, walked about a block along the shore, then turned around and came back. That was my limit. I was sore when I arrived home at midnight Sunday.
I hope that my future state "new new normal" after surgery is somewhat closer to the old normal, although I fear I will never really be "normal" again. It would also be nice to feel my age again, and not like this androgynous, clunky, staggering, shuffling elderly lady I've become. I hope to hold myself tall and walk like a dancer or an athlete again. I hope to some day really be able to walk "around" the lake; hell, I'd like to be able to walk all around Anchorage. I hope some day to be "around" normal.
Sunday, December 7, 2008
Thank you, Dr. Tennant
I re-read my very first couple of posts here today. Yes, I'm talking about those shocked and angry posts that I wrote post diagnosis. At the time I was pissed off about how the orthopedist, Dr. Tennant, gave me the bad news. I was particularly peeved that he had told me I had to quit skating, as if he were telling a diabetic to lay off the candy. I was angry that he assumed skating was a trivial part of my life. I was angry that he thought swimming or elliptical training could take the place of skating for me since they all were "exercise." I was angry that he didn't react with any empathy to my distress over this catastrophic new state of affairs in my life. I was angry at his monotone delivery. I was angry that he had no other answers for me.
Well, I am still skating of course (shhhh, don't tell). I am not jumping and never will again, but my primary focus has been ice dancing, not freestyle, so really it's no great loss. The fact that I took up jumping again on a whim a few weeks before my diagnosis tells me that flirting with freestyle probably exacerbated my condition. But that realization isn't what's prompting me to post today.
I have read so many accounts of people with hip dysplasia being misdiagnosed. This seems odd to me since even I can now look at x-rays and diagnose hip dysplasia. OK, I'll admit that I'm no expert, but it seems pretty obvious to me. As poor as his bedside manner was, I have to thank Dr. Tennant for correctly diagnosing me, for knowing about PAO (it amazes me how many orthopedists have never heard of PAO) and for referring me to one of the best specialists in the country for hip dysplasia and PAO. I realize now that I could have been misdiagnosed, given bad advice, subjected to surgeries which would not have done any good, or perhaps told that nothing at all could be done.
Had I been told nothing could be done, I may have waited years until my arthritis progressed to the point that nothing really could have been done. As it is, my dysplasia is severe but my arthritis is mild. I am the kind of person that PAO is most likely to help.
Dr. Tennant, I didn't like you very much in August. I guess I wanted to shoot the messenger, and I will say your delivery leaves something to be desired. I have to thank you though for pointing me in the right direction. The alternatives would have been far worse.
Well, I am still skating of course (shhhh, don't tell). I am not jumping and never will again, but my primary focus has been ice dancing, not freestyle, so really it's no great loss. The fact that I took up jumping again on a whim a few weeks before my diagnosis tells me that flirting with freestyle probably exacerbated my condition. But that realization isn't what's prompting me to post today.
I have read so many accounts of people with hip dysplasia being misdiagnosed. This seems odd to me since even I can now look at x-rays and diagnose hip dysplasia. OK, I'll admit that I'm no expert, but it seems pretty obvious to me. As poor as his bedside manner was, I have to thank Dr. Tennant for correctly diagnosing me, for knowing about PAO (it amazes me how many orthopedists have never heard of PAO) and for referring me to one of the best specialists in the country for hip dysplasia and PAO. I realize now that I could have been misdiagnosed, given bad advice, subjected to surgeries which would not have done any good, or perhaps told that nothing at all could be done.
Had I been told nothing could be done, I may have waited years until my arthritis progressed to the point that nothing really could have been done. As it is, my dysplasia is severe but my arthritis is mild. I am the kind of person that PAO is most likely to help.
Dr. Tennant, I didn't like you very much in August. I guess I wanted to shoot the messenger, and I will say your delivery leaves something to be desired. I have to thank you though for pointing me in the right direction. The alternatives would have been far worse.
Saturday, November 29, 2008
I’m over 40 … and my timing stinks
A new study was published which concludes that the outcome of PAO for patients over 40 is “not as good as” the outcome of total hip replacements. While it doesn’t say the outcome with PAO is “bad,” for an insurance company this is denial fodder worth its weight in gold.
Thanks guys, please kick me while I’m down.
As of November 1st, my insurance company, along with most others, has unilaterally decided not to pay for PAOs. This probably means that they WILL pay for some, if you make a really great case on appeal, but that by and large they consider this rare operation, which has helped women for 30 years, to be “investigational.” Not enough large studies have been done. Hmmm, how many is “enough”? There are quite a few small studies that I’ve read, but how can anyone do a large study when this surgery is so rare? This isn’t like diabetes or heart disease – run of the mill maladies which every Tom, Dick and Harry seems to have nowadays. And oh, by the way, Tom, Dick and Harry probably don’t have hip dysplasia because the vast majority of people with this condition are WOMEN. We all know what whiners women are … with their subjective complaints and all. Those women, they want special, expensive surgery for all their silly little problems … we big insurers need to let them know that we know what’s best for them!
Believe me, if I could have a total hip replacement or resurfacing instead of a PAO I’d be overjoyed. Recovery time for THR is short, and one is only in the hospital for a couple of days. I’d be walking and full weight bearing the day after surgery, and probably skating again within months. Not that THR is a cakewalk, but compared to PAO it’s “hip surgery lite.”
The problem is that my dysplasia is on the severe side, and it’s coupled with severe anteversion. THRs are not designed for people built like me. They, and their cousin the hip resurfacing, are designed for people whose hips are fairly normal in mechanical construction, with perhaps small abnormalities, but which are diseased or worn out. While there is a “dysplasia cap” available for hip resurfacing, again, it is not designed for severe cases. Two experts have now told me that my best course of action is PAO, based on the severity of my mechanical imbalance and the fact that my hip joint is basically healthy. Why would I remove and replace a healthy joint! Why would anyone do that? It seems obvious to me that correcting the structural imbalance, preserving the joint, and avoiding multiple revision surgeries is my best course of action. I’m seeking a third opinion. How many expert opinions do I need to override Aetna’s blanket policy?
I will add that I am not your typical 45 year old. I like to think that I am in better physical shape than most. I am not overweight. I am very muscular. I have exercised all my life. What about the over 40 patients in the new study? How many of them were like me? Is the only thing we have in common that we are "middle aged"? Yes, I am over 40, but my life isn’t over yet. I’m not ready to take up knitting or lawn bowling. MY PERFECTLY HEALTHY HIP JOINT SPACES DO NOT NEED TO BE REPLACED … that is not my problem, oh stupid insurance company flunkie reading my file. What I need is better femoral coverage. Isn’t the solution obvious?
Thanks guys, please kick me while I’m down.
As of November 1st, my insurance company, along with most others, has unilaterally decided not to pay for PAOs. This probably means that they WILL pay for some, if you make a really great case on appeal, but that by and large they consider this rare operation, which has helped women for 30 years, to be “investigational.” Not enough large studies have been done. Hmmm, how many is “enough”? There are quite a few small studies that I’ve read, but how can anyone do a large study when this surgery is so rare? This isn’t like diabetes or heart disease – run of the mill maladies which every Tom, Dick and Harry seems to have nowadays. And oh, by the way, Tom, Dick and Harry probably don’t have hip dysplasia because the vast majority of people with this condition are WOMEN. We all know what whiners women are … with their subjective complaints and all. Those women, they want special, expensive surgery for all their silly little problems … we big insurers need to let them know that we know what’s best for them!
Believe me, if I could have a total hip replacement or resurfacing instead of a PAO I’d be overjoyed. Recovery time for THR is short, and one is only in the hospital for a couple of days. I’d be walking and full weight bearing the day after surgery, and probably skating again within months. Not that THR is a cakewalk, but compared to PAO it’s “hip surgery lite.”
The problem is that my dysplasia is on the severe side, and it’s coupled with severe anteversion. THRs are not designed for people built like me. They, and their cousin the hip resurfacing, are designed for people whose hips are fairly normal in mechanical construction, with perhaps small abnormalities, but which are diseased or worn out. While there is a “dysplasia cap” available for hip resurfacing, again, it is not designed for severe cases. Two experts have now told me that my best course of action is PAO, based on the severity of my mechanical imbalance and the fact that my hip joint is basically healthy. Why would I remove and replace a healthy joint! Why would anyone do that? It seems obvious to me that correcting the structural imbalance, preserving the joint, and avoiding multiple revision surgeries is my best course of action. I’m seeking a third opinion. How many expert opinions do I need to override Aetna’s blanket policy?
I will add that I am not your typical 45 year old. I like to think that I am in better physical shape than most. I am not overweight. I am very muscular. I have exercised all my life. What about the over 40 patients in the new study? How many of them were like me? Is the only thing we have in common that we are "middle aged"? Yes, I am over 40, but my life isn’t over yet. I’m not ready to take up knitting or lawn bowling. MY PERFECTLY HEALTHY HIP JOINT SPACES DO NOT NEED TO BE REPLACED … that is not my problem, oh stupid insurance company flunkie reading my file. What I need is better femoral coverage. Isn’t the solution obvious?
Thursday, October 30, 2008
PAO
I finally got in to see the specialist today, after a 3 month wait. He specializes in people with my deformity, acetabular dysplasia, and he does a lot of pelvic reconstruction from trauma. He is very well regarded.
He told me that I was a good candidate for periacetabular osteotomy (PAO), and that a hip replacement or resurfacing would not work well because my hip sockets are so shallow. An artificial hip would probably fail fairly soon since there would be poor structure to hold it in place.
They took more x-rays and also did a CT scan to determine whether my legs were the same length and how much my femurs were misshapen. At the end of the day (and, with 4 hours of drive time, we are talking ALL DAY), it turns out that I have multiple problems. Very severe dysplasia, meaning very shallow hip sockets. Not a mild case. This had not been evident from the first films. I have stage 1 arthritis in both hips which, once pain is present, usually quickly degrades to stages 2, 3, and 4. Also, my femurs turn inward ("anteversion"), which I knew, but mine do so in the extreme, meaning my femurs are actually twisted. So that entails another surgery, where they break the femur and insert a plate. The PAO means they cut my pelvis up and reposition it, inserting screws. Some day I'll have a fully metallic pelvis - TSA will love me.
The upside is decrease in pain (although I may still have some residual pain), a more stable hip and leg structure, a slowdown or stop to the arthritis, and potentially no need for future hip replacement. If I do need future hip replacement, my bone structure will be much more amenable, meaning less likely to fail, after PAO.
Downside is that I may have less range of motion, although the femur revision may give me some more turnout. Normal turnout is 30 degrees, and I have less than 5 degrees - "essentially zero" as the doctor put it. I do have excellent "turn in," which is ever so ugly in skating. All of this means it didn't matter how many plies I did, I would never ever ever ever ever ever ever be able to do an Ina Bauer. The rhumba choctaw? Impossible for someone built like me (yet I do it ... my way). All the coaches and ballet teachers who said I just wasn't trying hard enough ... well, you know the gesture. I'm too emotionally drained to get upset about it again.
Another downside is that I will be in the hospital for 5 - 7 days, non-weight bearing for 8 weeks post surgery, and unable to skate for 6 months, at which time they will do the other hip! So this is really 4 surgeries and 2 hospitalizations and a year off the ice in total. The thought of getting my strength, stamina, flexibility, balance and skill back in my late 40's after going through something like that boggles my mind right now. I know it's possible, but will I just give up and take up golf? It's entirely possible.
Finally, my insurance doesn't pay for this. The total cost PER SURGERY is roughly $150,000. That's right, them's a lot of zeroes. And then multiply that times two. And oh yeah, will the insurance company pay for the special hospital bed I need at my home for a month, and the physical therapy, when they don't even cover the surgery? I'm thinking not so much. The doctor's billing assistant said they are working to get this covered and if I wait until next summer (which I have to do anyway), they may have made progress.
I could have raided my 401(k) or my home equity at one point, but in this economy that's just not an option. How to pay for it is a big question, but I have time to ponder that as they can't even schedule me until next summer. I am tentatively penciled in for July, pending the funding issue.
A year off the ice is an awful reality to face. I'm not ready for that. I am still improving as a skater! I am still competing! I am still testing international dances! I am not ready to quit and not ready to have a forced hiatus which I'll need to fight back from.
Hip replacement has a much shorter down time and is paid for by my insurance. But, if I trust what I heard today, it won't be very successful for me. It sounds like my options are limited.
Meanwhile I will continue skating until the pain gets too hard to bear. Right now it is pretty constant, but sleeping is the worst. Skating isn't as painful as sitting. Maybe I will get some crutches so I can keep the weight off it all the time except for that hour or so when I'm on the ice. No cross training as I can't risk it. But I vow to get through this competitive season - I've made a commitment to Tim which I think I can keep -- and then take the next step.
He told me that I was a good candidate for periacetabular osteotomy (PAO), and that a hip replacement or resurfacing would not work well because my hip sockets are so shallow. An artificial hip would probably fail fairly soon since there would be poor structure to hold it in place.
They took more x-rays and also did a CT scan to determine whether my legs were the same length and how much my femurs were misshapen. At the end of the day (and, with 4 hours of drive time, we are talking ALL DAY), it turns out that I have multiple problems. Very severe dysplasia, meaning very shallow hip sockets. Not a mild case. This had not been evident from the first films. I have stage 1 arthritis in both hips which, once pain is present, usually quickly degrades to stages 2, 3, and 4. Also, my femurs turn inward ("anteversion"), which I knew, but mine do so in the extreme, meaning my femurs are actually twisted. So that entails another surgery, where they break the femur and insert a plate. The PAO means they cut my pelvis up and reposition it, inserting screws. Some day I'll have a fully metallic pelvis - TSA will love me.
The upside is decrease in pain (although I may still have some residual pain), a more stable hip and leg structure, a slowdown or stop to the arthritis, and potentially no need for future hip replacement. If I do need future hip replacement, my bone structure will be much more amenable, meaning less likely to fail, after PAO.
Downside is that I may have less range of motion, although the femur revision may give me some more turnout. Normal turnout is 30 degrees, and I have less than 5 degrees - "essentially zero" as the doctor put it. I do have excellent "turn in," which is ever so ugly in skating. All of this means it didn't matter how many plies I did, I would never ever ever ever ever ever ever be able to do an Ina Bauer. The rhumba choctaw? Impossible for someone built like me (yet I do it ... my way). All the coaches and ballet teachers who said I just wasn't trying hard enough ... well, you know the gesture. I'm too emotionally drained to get upset about it again.
Another downside is that I will be in the hospital for 5 - 7 days, non-weight bearing for 8 weeks post surgery, and unable to skate for 6 months, at which time they will do the other hip! So this is really 4 surgeries and 2 hospitalizations and a year off the ice in total. The thought of getting my strength, stamina, flexibility, balance and skill back in my late 40's after going through something like that boggles my mind right now. I know it's possible, but will I just give up and take up golf? It's entirely possible.
Finally, my insurance doesn't pay for this. The total cost PER SURGERY is roughly $150,000. That's right, them's a lot of zeroes. And then multiply that times two. And oh yeah, will the insurance company pay for the special hospital bed I need at my home for a month, and the physical therapy, when they don't even cover the surgery? I'm thinking not so much. The doctor's billing assistant said they are working to get this covered and if I wait until next summer (which I have to do anyway), they may have made progress.
I could have raided my 401(k) or my home equity at one point, but in this economy that's just not an option. How to pay for it is a big question, but I have time to ponder that as they can't even schedule me until next summer. I am tentatively penciled in for July, pending the funding issue.
A year off the ice is an awful reality to face. I'm not ready for that. I am still improving as a skater! I am still competing! I am still testing international dances! I am not ready to quit and not ready to have a forced hiatus which I'll need to fight back from.
Hip replacement has a much shorter down time and is paid for by my insurance. But, if I trust what I heard today, it won't be very successful for me. It sounds like my options are limited.
Meanwhile I will continue skating until the pain gets too hard to bear. Right now it is pretty constant, but sleeping is the worst. Skating isn't as painful as sitting. Maybe I will get some crutches so I can keep the weight off it all the time except for that hour or so when I'm on the ice. No cross training as I can't risk it. But I vow to get through this competitive season - I've made a commitment to Tim which I think I can keep -- and then take the next step.
Monday, August 25, 2008
Speak softly and carry a big stick
My new sidekick: A wooden cane that my grandparents brought back from Mexico 30 years ago. It was in my parents' basement so I borrowed it for a test run.
Some problems with carrying a cane:
1. It's hard to carry other things since you only have one hand free! I must get a backpack since I carry a lot of stuff most days.
2. It's unwieldy. I have already wacked two people with it and not on purpose. It falls down when I lean it up against things. It's easy to trip over if I leave it lying around.
3. It's heavy.
4. It attracts attention. OK, look, I know I could mitigate this issue by getting something plainer; my cane has intricate carvings painted in bright colors. But my grandfather used this cane for years and it has sentimental value. Plus I'm cheap. Why buy a cane when I already have one?
I now have some level of pain pretty much all the time. If I sit for long periods of time my hips start to ache. When I first get up, I'm too stiff to move for a few moments. I can still sleep but only on my back. This doesn't hurt my hips but it does hurt my back. I figure eventually it will hurt my hips too, it's just a matter of time. I can't lie on either of my sides.
Walking hurts, although after I get going it hurts less.
Skating hurts.
Standing, sitting and lying down all hurt most of the time.
It's a tolerable hurt right now -- a dull ache and not a sharp pain. I am not taking pain medications until I have to. I'm not big on meds. NSAIDS can cause kidney damage and I'd rather have some pain now than kidney disease later. If I have to start popping an Advil now and then I will, but I want to delay that as long as possible. I want to know how bad it is, not mask it.
I am hoping that the pain will be tolerable through this skating season. I can then do something about it. I have an appointment with the periacetabular osteotomy guy Oct. 30 (I still can't believe the lead times for doctors). PAO does not sound promising, however. It sounds horribly painful with a long recovery time. A week in the hospital, and no weight bearing for months. The pain is akin to a broken pelvis, because that's what they do, break your pelvis. Hip replacement/resurfacing sounds less painful with a much shorter recovery time. However, the life span of those methods is limited (10 years? 20? who knows really) and the PAO may postpone the need for them -- or eliminate the need for them altogether.
When I read about the limitations post-surgery, PAO also sounds worse. I can't skate if I'm constantly thinking about what I can't do. I don't want to skate if my toes turn in and my extensions look like shit. I have worked all of my skating life to fight my lack of turnout and now I am at the point where my legline looks decent. To give all that up now just because I'm in some pain sounds silly. But if the pain increases it probably won't be so silly any more.
That's PAO though. Hip resurfacing will allow me some turnout; perhaps more than I have now. It's just the limited lifespan that worries me. I plan to live a long time and don't like the sound of 2 revisions in my future. But it seems multiple surgeries of some sort are inevitable. It's just a question of what. And when.
Some problems with carrying a cane:
1. It's hard to carry other things since you only have one hand free! I must get a backpack since I carry a lot of stuff most days.
2. It's unwieldy. I have already wacked two people with it and not on purpose. It falls down when I lean it up against things. It's easy to trip over if I leave it lying around.
3. It's heavy.
4. It attracts attention. OK, look, I know I could mitigate this issue by getting something plainer; my cane has intricate carvings painted in bright colors. But my grandfather used this cane for years and it has sentimental value. Plus I'm cheap. Why buy a cane when I already have one?
I now have some level of pain pretty much all the time. If I sit for long periods of time my hips start to ache. When I first get up, I'm too stiff to move for a few moments. I can still sleep but only on my back. This doesn't hurt my hips but it does hurt my back. I figure eventually it will hurt my hips too, it's just a matter of time. I can't lie on either of my sides.
Walking hurts, although after I get going it hurts less.
Skating hurts.
Standing, sitting and lying down all hurt most of the time.
It's a tolerable hurt right now -- a dull ache and not a sharp pain. I am not taking pain medications until I have to. I'm not big on meds. NSAIDS can cause kidney damage and I'd rather have some pain now than kidney disease later. If I have to start popping an Advil now and then I will, but I want to delay that as long as possible. I want to know how bad it is, not mask it.
I am hoping that the pain will be tolerable through this skating season. I can then do something about it. I have an appointment with the periacetabular osteotomy guy Oct. 30 (I still can't believe the lead times for doctors). PAO does not sound promising, however. It sounds horribly painful with a long recovery time. A week in the hospital, and no weight bearing for months. The pain is akin to a broken pelvis, because that's what they do, break your pelvis. Hip replacement/resurfacing sounds less painful with a much shorter recovery time. However, the life span of those methods is limited (10 years? 20? who knows really) and the PAO may postpone the need for them -- or eliminate the need for them altogether.
When I read about the limitations post-surgery, PAO also sounds worse. I can't skate if I'm constantly thinking about what I can't do. I don't want to skate if my toes turn in and my extensions look like shit. I have worked all of my skating life to fight my lack of turnout and now I am at the point where my legline looks decent. To give all that up now just because I'm in some pain sounds silly. But if the pain increases it probably won't be so silly any more.
That's PAO though. Hip resurfacing will allow me some turnout; perhaps more than I have now. It's just the limited lifespan that worries me. I plan to live a long time and don't like the sound of 2 revisions in my future. But it seems multiple surgeries of some sort are inevitable. It's just a question of what. And when.
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