Brought up about my foot as I had x-rays taken yesterday, all apparently normal and the fact I was to be sent for a bone scan to be sure.  Said I’d rather not have any more radiation and would prefer an MRI if it came to that.   That would mean I’d have to be referred to SportsMed for them to send me for an MRI as a GP can’t do this so I asked that even though a stress fx of a metatarsal might be beneath him, if he could possibly write the referral.  He pulled up my x-rays on the computer (I love how they can just log in and see everything!), zoomed in on the area in question and said without a doubt there is periosteal reaction indicating a stress fracture (March fracture – common injury in sodiers).  The radiologist’s report was indeed normal so he is writing to him to review it and submit a new report lol.  Hopefully won’t even need the MRI to confirm now.  So looks like I’ll be off to a podiatrist to sort out something for my shoe to help take the pressure off and try to avoid it getting worse and needing casting.

Had my physio appointment this afternoon.  She is still too scared to do anything aggressive given my history and seems afraid she’ll make things worse.  She thinks the latest snapping and tenderness might just be some inflammation from overdoing it at the gym a few weeks ago.  The plan of action is to avoid the hip machine at the gym for the time being, stretch the TFL/ITB at least 3 times a day and do some ultrasound treatments then reassess.  If this doesn’t help, last resort is back to the surgeon for possible steroid injection/scans/xrays.  B L A HHHHH for goodness sakes I thought I was done with all this crap.  I REALLY don’t want a steroid injection.  I have worked so hard at getting off all medications and had been successful for the past couple of months until yesterday’s little hiccup.  Feeling like life is once again on hold until good old leftie starts behaving…

Monday: morning physio at the gym, then the relaxation class which was really quite good, I will be going again tomorrow.  Worked 4 hours.

Tuesday: I worked a 9-hour split shift at work, went for a swim at lunch time and then a bike ride after dinner (the same route as Sunday). Then I remembered that I was supposed to do a gym session on my own before I met my physio next, which I thought was Thursday but upon checking discovered it was Wednesday, so didn’t have time to fit that in unless I wanted to do two sessions on Wednesday!

Wednesday: Physio was very happy with me doing a swim and bike ride on Tuesday so not worried about skipping the gym and we made some changes to my program, mainly just adding in some extra sets where things were a bit easy.  Told me to try a longer bike ride on the weekend.  Worked a 9-hour split shift.

Thursday: I slept in and had a day off exercise. Worked 6 hours.

Friday: I had an appointment with the psychologist who was very pleased with how things are going.  It’s amazing what a difference diminished pain levels coupled with a feeling of well deserved normalcy and harmony among peers can make to ones mood!  Worked 6 hours. Went to a fund-raising silent auction for my cousin’s rowing team.  Managed to buy myself a pair of awsome Roxy snowboarding boots…ummm, never been snowboarding in my life but they were a BARGAIN, winning bid of $80 and they are worth $350!  One guess at what I am going to do this winter…and if I don’t like it I can sell the boots lol.

Saturday: I biked to Nanna and Grandy’s  for scones and coffee then back home, a 22km round trip.  It was good having the break in between.  Came home and did some gardening/loading garden waste onto a trailer to take to the dump and felt pretty good afterwards.

Sunday (today): Sleep in, took half an hour to find clothes that fit, argh! Glad to be able to exercise again and ready to put in the hard yards!  Sushi for lunch at the mall, grocery shopping then off to the gym with hubby for an hour and a bit.  Managed to jog for my warm-up today (first time since surgery) with the treadmill set to intervals for 10 minutes.  NO pain on impact, a nice and very welcome surprise!  Did all my exercises then 5 minutes on the bike to finish off.
Yummy home-made Balinese curry for dinner at my inlaw’s and now a nice hot cuppa as I recline on the couch and blog

I am really pleased with the way things are going at the moment.  I feel like I’m finally getting somewhere.  The hardest part of my physical activity is the flexion exercise on the hip machine at the gym which still causes a reasonable amount of discomfort but I’m sure it will just take a little time to sort this out.
I am nearly off all medications.  Pain killers are stored in the cupboard (except for the emergency ones in my bag) and haven’t been touched at all during the week.

Life is good

]]> http://www.jessmcb.com/2010/02/21/phew/feed/ 2 http://www.jessmcb.com/2010/01/18/1-day-shy-of-10-weeks/ http://www.jessmcb.com/2010/01/18/1-day-shy-of-10-weeks/#comments Mon, 18 Jan 2010 02:15:01 +0000 Jess http://www.jessmcb.com/?p=1893 I had a great physio session today, a whole hour!  I am so lucky to have such a caring and hard-working team looking after me.

My strength and gait have both improved since my last assessment a couple of weeks ago and my ROM is improved after a bit of a warm up.  I still feel something in the joint interfering with flexion at about 70 degrees, but if I just push a little further I feel it move out of the way and I can flex to 90 degrees, maybe a rough patch of cartilage or something?

My physio had a closer look at my back today as I have had difficulty with the pelvic tilts due to low back pain.  I have had this for a while and it is most likely compensatory.  Standing straight it appears that my pelvis is ever so slightly crooked (with my arms hanging at my sides the gap between my body and right arm was larger than the gap on the left).  The pain was more pronounced while standing and bending (forwards and backwards) than while lying on my back doing bridge exercises (very similar movement) so it is apparently caused by compression which I have been told is easier to fix.  My physio did some stretches and then I got a nice massage.  My ROM was immediately improved, though by the time I cooled down and put my shoes back on I was feeling sore again bending over.  I was reassured this would wear off.

I have had a good couple of days pain-wise.  I am back on Diclofenac 75mg (Voltaren) twice a day and have not had to take any pain killers since Friday night.  The nausea from increasing another medication has settled thank goodness so I’m feeling a lot better today.  I even managed a pain-free 5 minutes on my bike this morning

Working 3 hours 5 days this week, starting tonight

]]> http://www.jessmcb.com/2010/01/18/1-day-shy-of-10-weeks/feed/ 0 http://www.jessmcb.com/2010/01/16/yay-its-the-weekend/ http://www.jessmcb.com/2010/01/16/yay-its-the-weekend/#comments Fri, 15 Jan 2010 23:31:20 +0000 Jess http://www.jessmcb.com/?p=1889 The Paradex seems to have worked last night.  It definitely helped with the pain I had, though it wasn’t unbearable  last night so it will be interesting to see how it works on 8+ pain God forbid that ever happens again.  As far as I remember I only woke up once at 1:10am and usually I’m not even asleep by then.
I did wake up nauseous this morning but I am putting that down to increasing another medication.

For some reason I am still feeling extremely tired, almost like I didn’t sleep at all.  Possibly still recovering from a bad week I guess, but have the weekend to rest so will make the most of it starting with a Nanna nap this afternoon lol

I txt Dad yesterday to see how he is as the last time I spoke to him (New Year’s Eve) he sounded like he was having a hard time and didn’t want us to visit.  I’ve been worried about him, but now he’s worried about me lol  He is going to visit next weekend which will be nice.

Now, what to do…take more? Get up and have a bath? Find a chainsaw?

Pain during the day is still predominantly muscular.  I can bend forwards now and reach my toes without a problem which has me feeling confident that the joint is good, but I am still having great difficulty lifting my leg up as to put on socks or get in the car etc.  The leg no longer gives way which is a welcomed improvement and the ‘penguin’ waddle has definitely lessened.  So overall I must be getting stronger, it’s just so gradual that it is sometimes not noticeable to me and I begin to think, what if this is as good as it gets?  Will I ever get back to long distance cycling? I have to remind myself that this will take time and to look at my progress thus far, though it is hard with no success story to compare myself to, just how long does it take?  Is my recovery on track?  Am I expecting too much too soon?  Nearly eight weeks post op I would have thought my muscles would be recovered by now.

Time for sleep attempt number two for the night.

]]> http://www.jessmcb.com/2010/01/04/another-sleepless-night/feed/ 6 http://www.jessmcb.com/2009/11/13/hip-arthroscopy-recovery-day-3/ http://www.jessmcb.com/2009/11/13/hip-arthroscopy-recovery-day-3/#comments Fri, 13 Nov 2009 05:54:21 +0000 Jess http://www.jessmcb.com/?p=1708 I’m still doing quite well.  Have not had to take pain meds since in the hospital, still just taking the Voltaren to help prevent heterotopic bone reformation.

Using one crutch inside, can go without for a few steps which surprises me and using two outside.  Went out to the mall to get some groceries earlier today, must have wiped me out as I spent three hours asleep on the couch this afternoon!  One cat seems to like sleeping on my hip so if I’m on my side she jumps onto it and I nearly hit the roof.

Trying to sleep on my back where possible as I woke up in the night pretty sore in my right bursa area, don’t want to cause further problems there.

Overall, still feeling positive

2 Days post op ~ can just see the old scars below the new ones

Am still struggling with the weight gain.  Decided I have to do something as lately I have all but neglected any form of exercise which is so easy to do as it makes such a HUGE difference to my pain level.  When not exercising I very rarely have to take pain killers unless I do something that aggravates the hip such as a busy day at work, long car ride or household chores.
I tried jogging, but could only manage one a week between the hip and muscles that are out of condition.  I got told off by a physio friend who suggested I walk instead of jogging which technically makes sense as it is less impact on the joints.  Oddly enough though, I actually find walking more bothersome that jogging, this completely boggles my mind.  The only thing I can come up with is maybe a longer stance phase during walking causes the irritation, though I have also noticed the stance phase of my left (affected) leg is shorter than my right (in other words my left leg will not extend as far as my right).

My lovely physio friend has also suggested some prehab exercises and has told me I have to get to the pool at least once a week.  This started OK, but after my first pool session on Monday I have been so sore and have been unable to go back yet.  Isn’t swimming supposed to be easy?  I only ever swim freestyle (front crawl) and do a couple of laps with a kick-board.  I only did half of my usual 1km swim and other than muscle fatigue from lack of practice thought I felt OK.

Bring on November 10!

]]> http://www.jessmcb.com/2009/10/08/prehab/feed/ 5 http://www.jessmcb.com/2009/08/12/hipscope-no2-on-the-cards/ http://www.jessmcb.com/2009/08/12/hipscope-no2-on-the-cards/#comments Wed, 12 Aug 2009 04:33:00 +0000 Jess http://www.jessmcb.com/?p=1299 I saw Mr Rietveld today.  He was bang on time and nice to talk to which was a relief.  He answered every single one of my questions and I don’t think he thought I was too crazy lol.

He never received the notes from Auckland (surprise, surprise).  So started by asking me what my symptoms are and how they started.  With the hip pain after competing in the duathlon and the fall off my bike happening fairly close together it is hard knowing what caused the tear in the first place and when asked how long it took for the symptoms to kick in I simply couldn’t remember (it was 3 and a half years ago) other than within a couple of days.

He first looked at the MRI-arthrogram from August and located the now quite obvious labral tear that was not found during hip scope #1.  This needs to be repaired.

Then had a look at the CT scan and immediately pointed out my problem on the first scan he looked at.  CAM impingement.  There is flattening of the head-neck junction anteriorly quite visible on the 3D model and on all of the radial scans.  My jaw practically dropped to the floor when he said this without any hesitation as after staring at my images for hours I practically knew this was the problem and he is the first to actually confirm it without a ‘maybe’.

I had a brief physical exam that once again involved that horrible impingement test.  It beats me why everyone wants to keep doing this if three people have already said it is positive.  I have a positive impingement test on my right side also, but I won’t go there…it’s not causing major problems.

So he gave me three options…you can guess what they are:

1)  Do nothing: reduce activity level, avoid squats etc.  Not really an option if the pain is there when you’re not doing anything and not really an option if you want to be active.

2)  Hip arthroscopy:  Minimally invasive surgery, repair tear and cam decompression.

3)  Open dislocation surgery:  As above but with large incision, hip dislocation and a horribly long and painful recovery.

We came to the conclusion that my best option is to go for the arthroscopic technique.  All of my impingement and labrum issues are anterior, there is no need to access the posterior joint and therefor no need for open surgery to avoid all those nasty blood vessels in that area.

The scope surgery will involve:
~ Two incisions.
~ Capsulotomy.
~ Labral tear repair (not debridement as in hip scope #1) – detachment of the labrum from the acetabulum, suturing the tear back together, resecting rim of the acetabulum 1-2mm to expose raw bone and reattaching the labrum with bone anchors.
~ Femoral osteoplasty to remove the prominent area of the femoral neck.

I have been told that recovery varies.  Hospital stay is likely to be two nights.  I could be on crutches two days, two weeks or longer (from what I’ve read on the forums, two weeks PWB with two crutches and four weeks with one crutch is typical).  There is to be no hip flexion above 100 degrees for the first six weeks post op to protect the labral repair.  Light swimming is permissible at three weeks post op with no pushing off the wall, physio and non-resistant stationary cycling can be started at six weeks.  I will be put on anti-inflammatories to stop bone regrowth and will need four to six weeks off work (this could be interesting).

So it’s the waiting game again now.  ACC has to approve surgery before I can book it.  This may take 2-4 weeks but I have a lot in my favour (my age, accident-related injury, the fact they’ve covered everything up to now and the fact that this is on-going from the original injury/surgery).  Mr Rietveld says it could go either way, but he will do all he can to get surgery approved as he feels it really should be.  He also said that if ACC declined, he would do as much as he can to help with an appeal which is fantastic!

The surgical waiting list is 4-6 weeks at the moment so I could be looking at a surgery date in as little as six weeks, fingers crossed.

I am nervous but so relieved that the problem has been recognised.  It is hard to believe even yourself now and then when symptoms come and go…one minute you are in agony and the next you feel completely normal…it really does your head in.

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