Wednesday, May 18, 2016

What's wrong with Brea's hip anyway?

With such a huge outpouring of love and support, I feel obligated to explain to each and every one of my well-wishers, food bringers, and company keepers why I just had surgery (again) on my right hip.

There are some explanations of my first surgery elsewhere in this blog, but I'm fresh from more than a week on narcotics and still laying on my back most of every day; I don't have the energy to find the entries and link them.   This is going to be as quick as I can - before I fall asleep unexpectedly or have to do more physical therapy or something.

I hurt my hip running, but it wasn't because of running - it was because the head of my femur wasn't smooth.  It was like a square peg in a round hole.  The hole is the socket side of the joint, called the acetabulum.  This was due to the way my bones formed and I could have done it hiking, biking, dancing, or virtually any other way I had chosen to be active.  This condition where the two bones don't fit together correctly is called femoroacetabular impingement (FAI).  All the beating of that square peg in that round hole tore the cartilage that lines my socket (acetabulum).  That cartilage is called the labrum.

So.  I had this tear.  And it hurt like hell.  So the surgeon repaired it; he sewed it up and anchored it to the acetabulum.  And then he shaved the edges off my square peg of a femoral head.  All better.  Physical therapy and get back to running!

Except that's not how things worked out.  In the winter and spring of 2014/2015 I went back to my surgeon and he got me back into physical therapy for one last-ditch effort to get back to running.  So in late April 2015, I broke up with running.  I didn't want to keep doing something that was causing me pain.

Weeks later, still always having a bit of a nagging pain that I figured was my hip recovering from trying to run, we flew from Seattle to New York to Dublin.

By the time we arrived in Dublin my hip was screaming.  I spent a lot of time in bed while my husband explored.  It was miserable.  We'd spent a year planning and saving for that trip, and I was in excruciating pain.  I found a few things that helped, but the pain I experienced whenever I sat for more than about an hour was obviously not liveable. 

Back to the surgeon, who said "I can re-scope you...or you can try physical therapy again."  Back to PT.  I failed PT.  Even the car ride there (45-50 minutes) irritated my hip!

My surgeon did an injection to confirm the pain was coming from my hip (spoiler:  it was), and I decided to have a repeat scope (arthroscopy - they take a little camera and a little set of tools into your...well, your dislocated hip...I try not to think about this part too much).

All we knew was going to happen was that they would tighten up/repair my joint capsule, which is now done routinely but wasn't done in my surgery in 2012.  The thought was that the instability created by my looser joint capsule could have led to micro-tears and, hence, pain.

The surgeon was also going to check the 2012 repair, look for additional tears (because if they were near the 2012 repair they'd be difficult to see), possibly shave off another bumpy edge on my femur, and check out some other stuff.

All we know for sure now is that something looked pretty ugly in there.  I don't know for sure yet what happened, though I think it's most likely the 2012 repair just failed.  In any case, my surgeon decided to do a reconstruction (which is more involved than a repair).  I got a donor graft.  I'm sure at my post-surgical appointment on Friday my surgeon will explain all as he goes over the photos and videos (which we've already seen because we have our own copy at home!  Crazy?  Maybe.).

Today is the first day I've been totally off narcotics.  The last week has been up and down and strange.  I'm still processing some feelings about having a donor graft.  We didn't even fully realize this was the case until we saw a card in my discharge paperwork telling me where to send a letter thanking the donor's loved ones and letting them know that, in death, their loved one's tissue has allowed me to do x, y, and z. Kind of heavy. 

After two surgeries and what that means for my family, and now having a donor graft, I feel like I need to be a good steward of my hip and this tissue.  As everything feels more like my own body again, I'll have to wrestle with how active I want to be and in what ways.  I expect I'll be more of a cross-trainer than anything else now.  Hiking, biking, rowing, running, plyometrics, HIIT, weightlifting, yoga, etc. I'll do it all.  But I know I'll miss long-distance running.  I'll have to chase the runner's high some other way.
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