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Hippy Chick- Surgeon Appt #1

Posted Nov 13 2009 10:01pm
A proud Mama shows off her hip x-rays!

My hip/leg feels good. My hip/leg hurts. Rather Rinse Repeat.

Over the last several months, I've seen Chiropractors, Family Practitioners, Sports Med Docs and PTs, Airrosti treatment experts, ART experts, massage therapists, etc. I've taken anti-inflammatories and had an MRA scan which confirmed what was suspected. I have a small labral tear in my hip joint accompanied by a 4 mm cyst. I'll also be honest. The only thing I haven't done is COMPLETELY STOP exercising. With that being said, I have cut back on intensity and mileage opting for more low impact choices like swimming , yoga, pilates and a little bit of running and riding.

While a hip scope is definitely the primary surgical treatment, I don't want to rush into this solution for many reasons. The biggest reason is the lack of longevity and research that supports a full recovery. In fact, trimming off some of the cartilage (if repair is not possible) only compromises the hip further for future arthritis. Quite frankly, this surgery is just too new to have long term results. Needless to say, I've sat on making any moves for months. In the meantime, I've met and spoke with some wonderful Austinites who have also been diagnosed and have recently had or are contemplating surgery for the same diagnosis. Results have been mixed quite frankly and a few of there surgeries are too recent to assess any real results. Time, patience and physical therapy will tell. All seem relieved that they went ahead with surgery instead of prolonging their pain.

Yesterday, I met with my first Orthopedic Surgeon. I delayed the surgeon appointment because I could predict what they would say. "Of course you need surgery!" All I know is that I can workout to a limit, but speed work and cycling makes my right leg go numb.
The appointment presented some good news and some "hurry up and wait" news. First of all, they got me back to the exam room on time (surprise, surprise!). I was quickly assessed by a tech and then they scheduled more x-rays of my hips. I had x-rays done at another doctor's office, but didn't think to have those with me. All I brought were my MRI films and CD. When the surgeon first came in, he was rather abrupt and I understood why some people may be put off by his bedside manner. He definitely wasn't the "warm and fuzzy" sympathy type and proceeded instead to get down to business by asking basic questions such as, "When did this happen?", "When did you first start noticing symptoms?", "Where is the pain and describe how it feels," etc. At first, I was a little nervous (felt like it was a verbal test), but he was asking the proper questions and followed up appropriately. I described my pain as I've been having it mostly....1.) Deep stabbing pain in the hip flexor/groin area that gets agitated when I run fast causing my leg to go "dead." 2.) Lower back pain that extends around the glute, sciatic, IT Band and down into my lower leg (usually when cycling).

After looking at the MRA films, he did concur and confirm that there was a small tear that was probably causing the hip flexor irritation. He definitely didn't make a big deal of either the tear or the cyst, indicating that they were both relatively small. He also brought in the X-rays that they had taken and had nothing but positive things to say about those pictures. My femoral head is perfectly shaped (hell yeah), the S-Curve on the femur looks good, spacing between then femur and the socket cartilage looked healthy and proportionate, no osteo-arthritis, etc.
He very confidently said that he did not see any signs of FAI, confirming what the Radiologist reported.My heart actually leapt with joy on this one because an impingement can complicate surgery and recovery time.

Femoral head (ball) in good shape, good spacing between femoral head and
acetabular, no impingement noted

We spoke about the surgery itself and he didn't want to rush into anything until we know for sure that the tear is the root cause of all of the other pain. For instance, a numb sciatic nerve is not necessarily a common symptom of the tear. In any event, we kept coming back to this lower back pain and sciatic/leg numbness. Bottom line, before we do anything with the tear, he ordered a lumbar spine MRI as well as a nerve conduction study on my leg to rule out any bulging or compressed discs in my back which might be putting pressure in the same area.

I guess in one respect I'm happy to know that my hips overall are in great shape. I had an image in my mind of a shredded socket that was beyond repair. Range of motion is good and the x-rays showed an otherwise normal hip area. No osteo-arthritis in the hips was detected.

Spread 'Em!

So, at this point, he said I can proceed with normal activity and exercise, as long as I'm not in debilitating pain. He didn't think I'm causing any more damage as long as I keep my distance and speed comfortable until we know more details. He also didn't rule out a cortisone shot to see if that helps too.

In summary, I respected his "let's rule out everything else" attitude before scheduling surgery for the tear. He definitely wasn't "knife happy." He spoke briefly to the fact that this diagnosis is "the new thing" and seems to be treated with a lot of haste, which is why some people aren't satisfied with the results. With that said, he sounded very knowledgeable about debridement (shaving the loose parts of the labrum) vs. repair. I didn't ask other specific surgical questions at this point figuring it best to wait and cross that bridge if and when we get to it.

So, there is my report on appointment #1. I'm not at all excited about a nerve conduction study (needles in nerves), but if it helps alleviate some pain in the long run, I'll go through it. It can't be worse than childbirth (so I'm told!)

Someday I will have "The Amazing Hip!"
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