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…

Overall Mr. R. is pleased with my progress which made my day.  I had been worried that it was going a bit slow but he assured me that it is still early days.

The swelling could hang around for another couple of months but he didn’t seem concerned about it.   In the past week I’ve had a little snapping on the outside of my hip when i straighten up from bending over which I never had before.  This apparently is due to the IT band.  I guess while the swelling is still present this is a little irritated but he told me that as my gluts etc. get stronger this should improve.  Come on buns of steel!

The residual pain and limited flexion is due to scar tissue from the capsulotomy.  He wants me to push through this pain now, taking pain killers as needed (and assured me I won’t do any damage) to break down the scar tissue and prevent more forming.  If this doesn’t get better he said he can do a steroid injection to help things along.  I have a follow up appointment in six weeks time so it could be a long six weeks!  Not at all keen on the injection though, remembering the flare it caused in my wrist.

I have the OK to get a pool/gym program so his secretary is going to send a letter of approval to ACC and they will fund it!
I have no limitations, just have to use common sense with lifting etc. and avoid twisting while lifting.

So I’m a happy chicky right now.  Pleased I can push things a little without worrying it will be doing any damage.  Mr R says that he can’t guarantee it will ever be 100% again, but it is already better than pre op and I am certainly heading that way

]]> http://www.jessmcb.com/2010/01/27/11-weeks-post-op-check-no-pain-no-gain/feed/ 5 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/2009/08/01/pet-expo/ http://www.jessmcb.com/2009/08/01/pet-expo/#comments Sat, 01 Aug 2009 11:14:43 +0000 Jess http://www.jessmcb.com/?p=1283

Boy, what an insane day today!  One of my colleagues and I are helping out with the Dunkleys Pet Expo this weekend.  We didn’t really know what we’d be doing until we got there.

We ended up working with VCA (Veterinary Companies of Australia) and we sold a tonne of product!  From urine and stain remover to shampoo and guaranteed indestructible toys.  Altogether a very successful first day and it was great to catch up with some old friends too.
I never gave any thought to how long I’d be standing in one place though…10am-5pm in practically the same spot absolutely wiped me out.  I spend 6 hours a day on my feet at work normally, but it is different when you are running around doing things…surgery or going upstairs to tend to the cattery, then back to reception etc.  I took some magic white pills with my lunch which helped to get me through the afternoon…tomorrow I think I’ll take some for breakfast too as we’ll be working the same hours.

I’ve been going to the gym a couple of times a week and try to swim once a week too.  I have been finding it hard to get motivated lately.  I did go for my first bike ride in nearly four months last Sunday and although I felt OK during the ride, just a little unconditioned, I felt awful afterward and was very sore…won’t be doing that again for a while.  I’ve been getting the catching sensation in my hip again recently and also pinching in my groin on weight-bearing…the pinching is a new thing so I’m not sure if it is due to increased activity and inflammation, or whether my tear has gotten bigger.  It is the same pinching I get with the anterior impingement test (flexion, adduction and internal rotation) and like the other problems comes and goes randomly. Ten days now until I see John Rietveld and I’m anxious to see what he says.  I am working next weekend with a full cattery so get a short week and am also going to a fluff-themed party on Saturday night so I think the week will go fast!

Oh, we are now officially house-hunting again!  Thanks to extremely generous family members we are fortunate enough to have the opportunity to move out of our crappy, leaky house and start a-fresh.  Though we probably won’t be able to get rid of this place we will hopefully be able to repair what is needed and rent it out for a few years.

TV3 News Report

It’s also been a bad week, pain-wise for me.  Possibly because of the rain, possibly not, who knows?  I’ve had awful groin pain even when just lying on the couch (as I normally do to limit hip flexion).  I have been having trouble sleeping and getting comfortable in bed but am not sure if this is the reason I’ve been waking up in the wee hours of the morning recently.  One night this week I must have slept with my knee flexed, I woke up twice during the night with my knee painfully locked in a flexed position, probably not related to the hip but has never happened before so I don’t know…thankfully it hasn’t happened again so I’m not worried about it being a problem.

I had a huge ‘pop’ in my hip at lunchtime today while leaning forward and to my left while sitting at the dinner table, forcing my hip into internal rotation.  Not the best thing to do while sitting but for some reason this is one position I still forget not to do until it’s too late and for that I have been sore all afternoon.

I am still battling with ACC to get my flights to Auckland paid for.  I have sent them all my notes and they have info from my GP and surgeon, but now want to know who said I should go to Australia and who referred me to Haemish Crawford.  Well it was Mr Armour who said he could refer me to someone in Australia if I could afford to go, but it was through corresponding with the Australian surgeon and eventually trying to sort out a 3D CT scan at Ascott Radiology in Auckland that I got in contact with the head radiologist who suggested I see Haemish Crawford.  I organised the appointment and referral myself.  I’m beginning to think it will be easier to just pay for the flights myself…so long as they pay for the appointment.

We are having car trouble again!  After Hamish spending $900 on his car a few weeks ago (ignition and electrics) he has sprung two leaks in or around the radiator and it requires another $700 spent on it for a new one!  This time we have decided that enough is enough, the car is old and not worth much so we are looking to purchase a new vehicle.

The lawyer has been paid this week, so everything should start moving soon!

Hope everyone is keeping wrapped up warm!
TTFN

My right hip (good side) has been showing similar signs to my affected left side.  No catching yet so hopefully no tear there.  It’s just been getting that stabbing ache right in the groin.  I’ve also been getting a very sore lower back in a place where I cannot figure out how to stretch it, it feels almost like it needs to ‘crack’, like it is out of line or something and I have been getting that nerve pain, (sciatic??) at the lower lateral buttock on both sides.  Both hips pop and snap like crazy, this is always in the groin, never over the greater trochanter but a lot of the time this is not painful.  The odd occasion it feels like it will pop, but as I continue moving it just jams and THAT is what HURTS!

I did manage a bike ride with Claire today and a couple of jogs last week, of course there are consequences but with my appointment in Auckland coming up next month, I am also deliberately trying to stir things up a wee bit.  There’s nothing worse than going to a doctor for a problem and having them look for symptoms that aren’t there on that particular day!

I am in the process of finding out whether ACC will pay for flights and the appointment.  There is question as to whether the specialist I am to see is the ‘nearest place of treatment’.  Although there is another specialist here in Christchurch, his experience is also limited to the same treatment that my current surgeon can offer.  Not only am I not prepared to have an open surgery and take a step or three backwards with either of them, from talking to some patients of the other ChCh surgeon, he comes across as particularly arrogant and not at all interested in helping anyone post-operatively.  I’m sorry, but bedside manner and feeling comfortable with a doctor is VERY high on my priority list.  If a doctor was the best in his field but cold as stone, I would not even consider being their patient.

So it was suggested that this specialist in Auckland may have the arthroscopic skills necessary to help me and I’m hoping he is NICE and that ACC will help me out with the finances.  I finally have a very nice case manager who I have explained everything to and she is going to do everything she can to help me.  I am going to fax her my clinical notes tomorrow to help them with their decision.  The only other thing that is against me is that the FAI needs addressing as well as the new labral tear.  ACC should cover the tear treatment, but because nobody knows the true origin of FAI and it is an anatomical problem, they may not cover it.  I am in contact with people who have treatment approved and other people that have had it denied so it could go either way.  There is no point though in repairing the tear and not the impingement because I will just end up in the same situation that I am in now.  If the arthroscopy can be done to address the impingement and reduce the risk of further labral tears and joint degeneration I will totally go for it.  More-so for the long-term effects than pain relief right now.

There is also the question of when we decide to start a family.  Is this condition going to affect pregnancy in any way?  Such as increased pain/joint damage from hormones, pelvis moving, weight gain etc. and also child-birth.  When we have kids, I’d like to have a natural childbirth, natural as in vaginal (I’m sure drugs will be involved at some stage, I’m not going THAT natural lol), not a c-section if possible.   If I don’t address the impingement, will this be possible or will the extreme flexion just tear the hell out of my hips and c-section be my only option?  If I have an epidural I may not even realise it is happening. Do I get this fixed before or after having kids?

There are so many questions and it is so unfortunate that the surgeons here just don’t have the skills to fix this problem without slicing a 10-inch scar into the side of your leg.  The technology is out there and some of the best surgeons in the world performing hip scopes are just across the ditch (Australia for those non-kiwis).  They are learning but it is going to take some time for them to gain experience and confidence in the procedure.  I’m not in a hurry to have surgery, I know my joint is not beyond repair at the moment and I am relatively pain-free compared to others with the same condition.  My main concern is joint preservation and childbearing as lets face it, I’m at that age and it is an important issue to me.  If it is suggested to me that I wait, then fine, I’m happy with that, I just want to make sure I do the right thing and in the right order

Thank you for the emails this week.  It is great to see people out there getting something positive from my blog!  I will reply to you ASAP, sorry for the delay.

I am pleased to say the pain in my right hip joint only lasted the day, phew!  It did have me worried…just couldn’t deal with that right now, one is bad hip is more than enough thank-you.

I will be checking emails and blogs while on holiday, so you won’t miss me too much.  Hopefully will get some fun pics to post too

I don’t know if it is the rain, the amount of swimming I have been doing or what, but today has been pretty unfair painwise.  Not only do I ache in the usual places, but this morning my ‘good hip’ was giving me strife.  Every step I took I had a jab in the front centre of the hip while weight-bearing.  I had to resort to taking pain killers at work, which I try really hard to avoid as I feel a little uneasy taking opioids while looking after patients, calculating drugs etc. but since I have never noticed any ill-effects from taking  them myself , the fact I find pain screws my mind more than a couple of pain killers do and we had no surgery  or any in-patients today, I gave in.   I hope this is a temporary thing as I really do not have the energy or patience to start going through all this on the other side.

]]> http://www.jessmcb.com/2008/08/26/bad-day-bad-mood/feed/ 5 http://www.jessmcb.com/2008/07/27/i-have-to-tri/ http://www.jessmcb.com/2008/07/27/i-have-to-tri/#comments Sun, 27 Jul 2008 07:58:12 +0000 Jess http://www.jessmcb.com/?p=335 On Tuesday I ran a personal best of 7.5km.  It doesn’t sound like much, but it was 53 minutes of continual running for me (I am a slow runner).  Surprisingly it didn’t hurt that much, usually I get a lot of lateral pain after about 3km and limp home but this run felt so easy.  I have noticed muscles all around my hip tighten as I run.  I cannot control it no matter how much I try, it is like I am clenching every muscle to keep things in place, this of course makes running very tricky and tiring.  I have had a lot of anterior clicking this week which may or may not be related and doesn’t really cause any pain, just feels and sounds gross.
I attended a veterinary dentistry seminar on Friday and had to sit for 5 out of the 6 hours I was there.  That along with the torrential rain we have had the past three days has caused me more grief than the running ever did!
It is that bloody nagging ache that does my head in.  It sits there in the background every day, with the odd occurrance when it gets stronger, in waves, washes right over the groin area at random times, even when I’m not doing anything, only a slight move and it takes my breath away.  I try not to take painkillers unless I really need to, I don’t like them and they don’t like me.  For that intense pain, I’m not sure the medication I have actually does the job, but because it can be so random it is hard to tell.
Last time I went to my GP I asked for something that would work faster than the 30mg Codeine I have so I can just take it when I really need it as the Codeine takes forever to make a noticeable difference on pain levels and taking Panadol regularly makes me sick.  She gave me Codalgin (Panadeine) which is just 500mg Paracetamol combined with 8mg Codeine.  That kind of defeated the purpose I could have done that on my own with the 30mg Codeine, sigh.
The first triathlons of the season (PhysioMed Women’s Series) start in exactly 10 weeks with nice easy super short distances.  Plenty of time to get prepared and back on track.  Still not sure about the South Island Tri. which is on 22nd Nov as the distances might be a wee bit far for me, but we will see.

Well, Thursday this week will be the one year anniversary of my L hip-scope. I don’t really feel that I’ve come a long way in that year. To this day I have no catching in my joint, which I am thrilled about, but that is about all that has changed. I still get the ache, the clunks and do the “bum shuffle” (as Hamish calls it) a lot. I have the most trouble with sitting for any length of time, but standing in ouane place for a long time is painful too. As long as I keep moving I am OK. I thought the rest with having my wrist surgery would be good for my hip, but it was actually the opposite. I am just starting to ride my bike again (post wrist surgery) with small rides (10-35km) to build up some of the muscle that has wasted from five weeks of sitting on my butt. I went for a proper swim today too and it was really good, I’m surprised at how much fitness I still have and managed 1km with no trouble at all.
Seeing another friend go through major hip surgery this week, I am even more determined to avoid it myself and hopefully by keeping active I can at least avoid it for a few years yet.

TIMELINE:~

March 2006: Bad hip pain after participating in a duathlon. X-rays rule out stress fx.
October 2006: Fell off bike onto left hip on the road. Dx Trochanteric Bursitis, ultrasound negative, rx physio.
November 2006: Physio suspects Labral Tear and sends me to SportsMed for second opinion.
December 2006: MRI arthrogram L Hip.
January 2007: MRI results show focal anterior labral tear and probable superior labral tear. No definite osseous predisposing factors for Femoroacetabular Impingement.
May 2007: Booked arthroscopic surgery for labral debridement after waiting four months for ACC to make a decision.
June 2007: L hip arthroscopy, debride fibrillated labral tear. Surgeon~Mr Paul Armour at Southern Cross Hospital.
October 2007: Continued pain, revisit surgeon. Rx NSAIDs and come back at nine months post op.
March 2008: Nine month post op recheck. NSAIDs do diddly squat. OS tells me I have a mild bony abnormality that could be contributing to my pain but there is nothing short of major surgery he can do for me. There is the option of travelling to Australia for FAI arthroscopy which is still about two years away from being done in NZ. I say I’ll live with it until I can’t for fear of making an OK situation worse.
June 2008: One year post op and barely a scar to show for it. Relatively active and pain manageable with pain meds when needed.

So, that’s where I’m up to. The saga is far from over but at least for now I am comfortable and can manage the pain. I will not let irreversible damage set in before I do anything more, but for now I am happy to just wait things out and make the most of what I can do physically.