So I now know for sure I have a labral tear in my hip along with the arthritis. A labral tear is a tear in the soft cartilage of the joint. Used to be much more common in shoulders but now it's becoming very common in the hip. I think it's because they have better tools to diagnose it. My doctor says I have options. Live with it and do nothing or arthroscopic surgery to fix it.
I decide to live with it even though I can't run anymore it's not limiting anything else and it's not that painful at the moment. I first felt the pain in my hip in November of 2007. After all the tests to figure out what the problem was it was well into December. As the days went by my hip did get worse. I started feeling it catch on the torn cartilage and that is not pleasant. It was my busy season so I did live with it for a few months. I asked my doctor for his referral to someone who does this surgery. Again, at the time there were very few doctors that even did the surgery. Luckily I found a really good doctor in Miami. I would have gone wherever I needed to for a well qualified doctor. I had found a couple that had done one or two but that is not enough for me. This doctor originally trained under a Canadian doctor that pioneered the technique and had done thousands. Of course I talked to his nurses and physical therapy staff beforehand too. It's amazing what they will tell you, they are a great source of information.
My doctor said that I had some bone spurs and lots of arthritis he could clean up while he was in there. He would repair the tear, clean off the head of the humerus and poke small holes to stimulate blood flow to grow a different type of cartilage. You can't regrow the original, but this was supposed to be better than nothing. It was arthroscopic so minimally invasive and an out patient procedure. I would have to be on crutches for a while. I decided to go ahead with it.
The surgery itself was no big deal. Three tiny scars on my upper thigh and in and out the same day. Rehab was another matter. Not much pain but I could not put any weight on it at all. None. They were very adamant about it. For five weeks. Crutches for 5 weeks. And you get to use the automatic joint movement machine they use for knee replacements. You get to set it to a certain range of motion for your leg and you get to lay there while it goes up and down in slow motions for 30 minutes to an hour once or twice a day. After so many days you get to increase your range of motion. It was incredibly boring so I got a lot of reading and napping done.
If you've ever been on crutches you know how much fun that is. Everything you do takes three times as long. Luckily I could drive myself around after the first week. So I went to physical therapy three times a week, along with the leg machine at home and all the exercises I did at home my physical therapist gave me. All very tedious and boring because I could not put any weight on my hip. All my exercises were done laying down, for five weeks. Ironically I was the Fitness Director at one of the local country clubs. And I was still training clients. How does it look to have your trainer come in on crutches? Or to see your Fitness Director hobbling around on crutches? You really have to keep your sense of humor. As with anything you get through it and it could always be worse.
One of the happiest days of my life was when the doctors said I could get rid of the crutches. Although my physical therapist said not so fast. I could get rid of one of them. I had to use one for a week and then wean myself off the one so many hours a day over the second week. I did what he said, he knows his stuff. After you go through any surgery do what your physical therapist tells you. Make sure he's good though. I have had some that just followed a cookie cutter outline and it didn't really apply to my circumstances. You want one that takes your specifics into consideration, what kind of shape are you in, pain, range of motion, so many other things. You want to get the best results possible from your surgery so do what your physical therapist tells you. It's hard, you may feel like you can do more or your are bored. Don't do it unless you talk to them first. I always asked for more and when can I do certain things.
I had a friend of mine go through the same thing. She was younger and didn't have arthritis but had the labral tear. Had the surgery and then didn't listen to her physical therapist and did too much and the wrong things. She had a lot of pain and was slow in recovering. You don't want to undo what you just had the surgery for. I can't say it enough. Find a good physical therapist and then do what they say. It's ok to question them, they usually have good reasons. It's ok to tell them you want more. Just make sure you listen to what they say.
The surgery did help, my hip did not catch anymore and it did feel better. Unfortunately is didn't cure it, I still had arthritis. My doctor did say it wouldn't fix everything but might put off a hip replacement 5-10 years. Still couldn't run, I mean I could but it didn't feel good so I didn't. I took up swimming instead. Life throws you curve balls it's how you deal with it that matters. I wasn't happy about giving up running. Even if running wasn't my favorite thing no one likes it when something is dictated to you and it's not your choice. That's the tough part. I did shed a tear or two over it but then moved on. Turns out I love swimming! It's amazing what good things come out of bad situations if you keep an open mind and try.
Saturday, February 19, 2011
Saturday, February 12, 2011
How it all started - A pain in the hip
It's funny, after I started having problems with my hip, and even more so later when I had to have a double hip replacement, I can't tell you how many people asked me if it was because I was so active or from running. You have to stop and really think about that question. Because if that were the case than almost everyone I know would need a hip replacement at a young age. I am an active person but I am in no way what I consider as active as athletes are or anyone who runs marathons or competes in major triathlons. In fact I never even ran until about 6 years ago, and I only started because I signed up for a sprint triathlon. About 2 months before the race I figured I should start running. Needless to say I wasn't a very fast runner by race time but I finished my first triathlon at the age of 46. Then I swore I would never do another one.
I even told my husband that there was no way I would ever say I liked running. I did kind of keep it up and much to my amazement actually looked forward to certain aspects of running. I am lucky to live next to the beach in Florida so I would get up and run at sunrise. I would run along the water where the sand is harder packed but it's a challenge. You never knew what you would see, baby turtles hatching, sharks in the surf, crabs on the beach and sometimes some amazing shells, just to name a few things. The sunrises were always beautiful and it was a great way to start the day. And being Florida I could do this pretty much year round, I love where I live.
One of the other things I grew to love about running was that when I traveled I would scout out places to run. One time in Lime Rock, Connecticut, next to the race track there, is an offroad trail my husband found. Lots of elevation changes and beautiful scenery. My husband is a sports car endurance race car driver and we often ran the race tracks he competed on, always fun. My husband races all over the world and I found some amazing places to run in France, along the river in parks. So when I had to give up running I actually missed it.
I am a Personal Trainer and I used to be the Fitness Director as well at a local country club. I don't usually teach group classes but for Thanksgiving one year I did a boot camp that morning. My hips had always ached after running but I took Advil and it wasn't that bad. After I did the high energy boot camp my right hip really hurt and didn't get better. In fact got worse with time and I had to stop running. So off to the orthopedic doctor I go.
Right off the bat he tells me I may have osteoporosis, a fracture, or a labral tear. I, of course, tell him that none of those options are probable, he's crazy. He kept asking if I'd been in an accident or had some incident that might cause the fracture or labral tear. I had not even fallen so it just couldn't be those two issues. I had a bone scan and my bones where great. X-rays didn't show anything, some arthritis but nothing major. I go for an MRI and it doesn't show anything. All of this takes time, it's not like you schedule all the tests in one day. You do one of the tests then schedule back with the doctor, schedule the next test, schedule back with the doctor. All along he kept asking if I felt something catching or could hear any clicking. At the time I didn't so I was very skeptical about what he was suggesting. If he hadn't come highly recommended by multiple people I would have gone elsewhere.
I had made friends with a physical therapist, Rett, that had worked on my husband years ago. Rett is one of the best I believe in the country. So I introduced myself so I could ask him questions about clients and also refer clients to him. I won't refer people to anyone I don't know or who I don't think is one of the best in their field. Rett had recommended this doctor highly so I stuck it out. Looking back I laugh because I really though he was so far off the mark but from day one he had it pegged exactly what it was.
Finally he sent me for an MRI with contrast. So fun, they stick a ginormous needle in your hip joint and inject dye. It wasn't the worst thing in the world but not fun. Then they do the MRI. Well son of a gun! It showed clear as day a labral tear in my hip joint. At the time this was relatively rare unless you had been in a car accident or older. Labral tears in the shoulder were very common, specially with baseball players and other athletes. My doctor says my options are arthroscopic surgery or live with it. I decided to live with it, which lasted all of 3 months. I started limping and it started catching.
A labral tear is in the soft cartilage of your joint, doesn't matter if it's the shoulder or hip it's the same thing. The cartilage tears and you have a piece of bone sticking up which will then catch as the joint is used. Obviously not good in the hip as you use your hips to walk, sit and just about everything you do in life. Long story short, I had osteoarthritis in my hip which produced bone spurs and when I moved a certain way with force it tore my cartilage. Of course I tried to ignore it, isn't that always the first recourse to problems? As I said, that didn't last long as it just kept getting worse.
In my next post I'll talk about the next part of the journey. It's all a process and I've learned you better be proactive about it if you want the best results. No hiding under a rock! No matter how much you would like to :) It's your life, make it the best it can be.
I even told my husband that there was no way I would ever say I liked running. I did kind of keep it up and much to my amazement actually looked forward to certain aspects of running. I am lucky to live next to the beach in Florida so I would get up and run at sunrise. I would run along the water where the sand is harder packed but it's a challenge. You never knew what you would see, baby turtles hatching, sharks in the surf, crabs on the beach and sometimes some amazing shells, just to name a few things. The sunrises were always beautiful and it was a great way to start the day. And being Florida I could do this pretty much year round, I love where I live.
One of the other things I grew to love about running was that when I traveled I would scout out places to run. One time in Lime Rock, Connecticut, next to the race track there, is an offroad trail my husband found. Lots of elevation changes and beautiful scenery. My husband is a sports car endurance race car driver and we often ran the race tracks he competed on, always fun. My husband races all over the world and I found some amazing places to run in France, along the river in parks. So when I had to give up running I actually missed it.
I am a Personal Trainer and I used to be the Fitness Director as well at a local country club. I don't usually teach group classes but for Thanksgiving one year I did a boot camp that morning. My hips had always ached after running but I took Advil and it wasn't that bad. After I did the high energy boot camp my right hip really hurt and didn't get better. In fact got worse with time and I had to stop running. So off to the orthopedic doctor I go.
Right off the bat he tells me I may have osteoporosis, a fracture, or a labral tear. I, of course, tell him that none of those options are probable, he's crazy. He kept asking if I'd been in an accident or had some incident that might cause the fracture or labral tear. I had not even fallen so it just couldn't be those two issues. I had a bone scan and my bones where great. X-rays didn't show anything, some arthritis but nothing major. I go for an MRI and it doesn't show anything. All of this takes time, it's not like you schedule all the tests in one day. You do one of the tests then schedule back with the doctor, schedule the next test, schedule back with the doctor. All along he kept asking if I felt something catching or could hear any clicking. At the time I didn't so I was very skeptical about what he was suggesting. If he hadn't come highly recommended by multiple people I would have gone elsewhere.
I had made friends with a physical therapist, Rett, that had worked on my husband years ago. Rett is one of the best I believe in the country. So I introduced myself so I could ask him questions about clients and also refer clients to him. I won't refer people to anyone I don't know or who I don't think is one of the best in their field. Rett had recommended this doctor highly so I stuck it out. Looking back I laugh because I really though he was so far off the mark but from day one he had it pegged exactly what it was.
Finally he sent me for an MRI with contrast. So fun, they stick a ginormous needle in your hip joint and inject dye. It wasn't the worst thing in the world but not fun. Then they do the MRI. Well son of a gun! It showed clear as day a labral tear in my hip joint. At the time this was relatively rare unless you had been in a car accident or older. Labral tears in the shoulder were very common, specially with baseball players and other athletes. My doctor says my options are arthroscopic surgery or live with it. I decided to live with it, which lasted all of 3 months. I started limping and it started catching.
A labral tear is in the soft cartilage of your joint, doesn't matter if it's the shoulder or hip it's the same thing. The cartilage tears and you have a piece of bone sticking up which will then catch as the joint is used. Obviously not good in the hip as you use your hips to walk, sit and just about everything you do in life. Long story short, I had osteoarthritis in my hip which produced bone spurs and when I moved a certain way with force it tore my cartilage. Of course I tried to ignore it, isn't that always the first recourse to problems? As I said, that didn't last long as it just kept getting worse.
In my next post I'll talk about the next part of the journey. It's all a process and I've learned you better be proactive about it if you want the best results. No hiding under a rock! No matter how much you would like to :) It's your life, make it the best it can be.
Thursday, February 3, 2011
Hip Replacement - What you need to know before and after
Arthritis, what a pain, literally. Lucky me I inherited osteoarthritis. I knew I had it in my left shoulder which I discovered in my mid-40's. So far a cortisone shot has helped with that. Then at the age of 49 I had a pain in my hip that caused me to start limping and stopped me from running. I went to an orthopedic doctor who immediately said it was probably a torn labrum (lining inside your joint) or osteoporosis. I pretty much told him he was crazy I was too young and had never been in an accident which, at the time, was usually the way you tore a hip labrum. Shoulder labral tears are much more common. So after a drawn out process of denial and MRI's it was confirmed that I had a labral tear and arthritis in both hips. Well you have options, do nothing and live with it or hip resurfacing. The do nothing option stinks because you can't walk right, it hurts all the time, you baby the injured side and compensate which in the long run will lead to back problems and other issues. Basically a labral tear is a tear in your cartilage and it catches on the hip femur bone. Not fun and painful. So, two years later I decided to get the hip resurfacing. Again, at the time, there were not many doctors that did it. It's done othroscopically as an inpatient procedure, not a big deal but you have to be on crutches for 5 weeks! No pressure on that leg for at least 5 weeks! Now that was inconvenient. What hey basically do is scrape off the bad cartilage of the femur and poke holes in it to stimulate blood flow to grow back what it can, it's not the same as the original catilage but better than nothing. The doctor did tell me that this would not fix the problem but would put off hip replacement for a while and I should be able to walk better and should take care of the cartilage tear that was catching.
Now let me back up a bit. When I found out I had a labral tear of the hip I tried to find out everything I could about it. I asked physical therapists, friends, doctors, you name it I did it. I searched the internet, whatever I could do to get information. You are in charge of your health, don't let someone else make the decisions, get informed before making your own decision. I've found that nurses, aides and physical therapists and athletes are a valuable and reliable source of information and referrals. I then got referrals of doctors that did the procedure, there were not that many. It's a hard thing to diagnose in the hip. Luckily with technology it's easier now. I found a doctor in Miami that was an expert on it. Made an appointment and went down and interviewed him about the procedure. Then did more research on the procedure. What to expect for the operation, recovery and after. Do your homework!!! I know it's tedious and time consuming but this is your life and body, no one else is going to care as much as you do and you have to live with it. I can't stress that enough. Don't be afraid to ask people questions and ask a lot of people too. So fully prepared I had the operation.
The operation itself was really a non-event. Woke up fairly alert and not a lot of pain. My husband drove me home (2 hours north) and by the time I got home I needed some pain killers, still not awful. The hardest part is you can not put any weight on that hip for at least 5 weeks :( that's rough but doable. You figure it out. Rehab is tedious, you are put on a leg movement machine like knee replacement patients get and you have to do that every day for what seems like forever. After a couple weeks you can go to physical therapy but it's all very basic exercises, isometric for the leg that's operated on because you can't put any weight on it. Finally after 5 weeks my doctor said I could walk on it and could get rid of the crutches. Yea!!! But, my physical therapist said not so fast. He said I could get rid of one of my crutches and over the week work my way up to getting rid of it completely.
Here is the second most important thing you need to do besides your homework. Find the absolute best physical therapist you can. They will make all the difference from a bad or basic recovery to a phenomenal recovery. And then listen to them and do what they say! I know sometimes I told my physical therapist to hurry it up or I could do more or you have to be kidding, surely there is more I can do. But he had his reasons and they were all sound and I was very glad I listened. Don't mess up what you had fixed, do what your physical therapist says! I know people who haven't and they end up worse than before their surgery, longer rehab, or they never get full range of motion back. So why would you not listen to them. I asked people to recommend a good physical therapist and then talked with the people that had used him.
I'm lucky, the owner of our local running store/triathlon is an amazing athlete and knows lots of people that have orthopedic issues and therefore uses lots of doctors and physical therapists. She always has excellent recommendations and has been very helpful to me. I also ask around the local gyms. Once I find some good referrals I make an appointment with them and interview them. What's their education and background. How familiar are they with my problem. I've never had anyone get upset with me about it. Years later they do tease me about it but usually anyone that is good appreciates the questions. If they have a problem with you asking you don't want them.
So, had the hip resurfacing on my right hip. Both hips had lots of arthritis but for whatever reason my right hip always hurt more and it was the one with the labral tear. It did get better after the surgery but never back to what I thought it would. Couldn't run so I started swimming and biking more. LOVE the swimming, wow does it burn the calories. Plus I like the water so it was a no brainer for me. I'm a personal trainer (so imagine hobbling around on crutches for 5 weeks while training clients, such fun) and I continued with training clients and teaching spin classes. I also did a couple triathlons, although I had someone else do the running, I did the swim and he bike. Still fun and it gave me goals to help keep me in shape.
I did everything I could to strengthen my hips and legs. I still had arthritis and boy can it ache in the cold weather. Good thing I live in Florida. Everyone tells you to put off hip replacement for as long as you can, specially since I'm young. And yes I consider myself young :) Just the thought of having a hip replaced was huge to me. To replace an entire joint in your body, how bizarre. I didn't want to get rid of my body parts, it feels final and like the beginning of the end. I found it strange to even think about. I am an active person and hate limitations. But, I do understand that if life throws something at you which changes what you can and can't do, figure it out. Everyone thought for sure I'd get depressed or fat because I couldn't be as active. I have to say I shed a few tears over not being able to run on the beach in the mornings or when I travel. Who likes to be told they can't do something. But you get over it if you are smart. What are your options, keep crying about it and get depressed and fat or do something else. I wish I had taken up swimming years ago. I like it better than running.
Enough for now, I'll continue in my next entry. So far, if nothing else remember these three things:
1) Do your homework on what your problem is
2) Get lots of referrals for the doctor
3) Get lots of referrals for a good physical therapist
Ask lots of questions and then ask them is there anything I forgot to ask?
You can do it! Whatever it is you can get through it.
Now let me back up a bit. When I found out I had a labral tear of the hip I tried to find out everything I could about it. I asked physical therapists, friends, doctors, you name it I did it. I searched the internet, whatever I could do to get information. You are in charge of your health, don't let someone else make the decisions, get informed before making your own decision. I've found that nurses, aides and physical therapists and athletes are a valuable and reliable source of information and referrals. I then got referrals of doctors that did the procedure, there were not that many. It's a hard thing to diagnose in the hip. Luckily with technology it's easier now. I found a doctor in Miami that was an expert on it. Made an appointment and went down and interviewed him about the procedure. Then did more research on the procedure. What to expect for the operation, recovery and after. Do your homework!!! I know it's tedious and time consuming but this is your life and body, no one else is going to care as much as you do and you have to live with it. I can't stress that enough. Don't be afraid to ask people questions and ask a lot of people too. So fully prepared I had the operation.
The operation itself was really a non-event. Woke up fairly alert and not a lot of pain. My husband drove me home (2 hours north) and by the time I got home I needed some pain killers, still not awful. The hardest part is you can not put any weight on that hip for at least 5 weeks :( that's rough but doable. You figure it out. Rehab is tedious, you are put on a leg movement machine like knee replacement patients get and you have to do that every day for what seems like forever. After a couple weeks you can go to physical therapy but it's all very basic exercises, isometric for the leg that's operated on because you can't put any weight on it. Finally after 5 weeks my doctor said I could walk on it and could get rid of the crutches. Yea!!! But, my physical therapist said not so fast. He said I could get rid of one of my crutches and over the week work my way up to getting rid of it completely.
Here is the second most important thing you need to do besides your homework. Find the absolute best physical therapist you can. They will make all the difference from a bad or basic recovery to a phenomenal recovery. And then listen to them and do what they say! I know sometimes I told my physical therapist to hurry it up or I could do more or you have to be kidding, surely there is more I can do. But he had his reasons and they were all sound and I was very glad I listened. Don't mess up what you had fixed, do what your physical therapist says! I know people who haven't and they end up worse than before their surgery, longer rehab, or they never get full range of motion back. So why would you not listen to them. I asked people to recommend a good physical therapist and then talked with the people that had used him.
I'm lucky, the owner of our local running store/triathlon is an amazing athlete and knows lots of people that have orthopedic issues and therefore uses lots of doctors and physical therapists. She always has excellent recommendations and has been very helpful to me. I also ask around the local gyms. Once I find some good referrals I make an appointment with them and interview them. What's their education and background. How familiar are they with my problem. I've never had anyone get upset with me about it. Years later they do tease me about it but usually anyone that is good appreciates the questions. If they have a problem with you asking you don't want them.
So, had the hip resurfacing on my right hip. Both hips had lots of arthritis but for whatever reason my right hip always hurt more and it was the one with the labral tear. It did get better after the surgery but never back to what I thought it would. Couldn't run so I started swimming and biking more. LOVE the swimming, wow does it burn the calories. Plus I like the water so it was a no brainer for me. I'm a personal trainer (so imagine hobbling around on crutches for 5 weeks while training clients, such fun) and I continued with training clients and teaching spin classes. I also did a couple triathlons, although I had someone else do the running, I did the swim and he bike. Still fun and it gave me goals to help keep me in shape.
I did everything I could to strengthen my hips and legs. I still had arthritis and boy can it ache in the cold weather. Good thing I live in Florida. Everyone tells you to put off hip replacement for as long as you can, specially since I'm young. And yes I consider myself young :) Just the thought of having a hip replaced was huge to me. To replace an entire joint in your body, how bizarre. I didn't want to get rid of my body parts, it feels final and like the beginning of the end. I found it strange to even think about. I am an active person and hate limitations. But, I do understand that if life throws something at you which changes what you can and can't do, figure it out. Everyone thought for sure I'd get depressed or fat because I couldn't be as active. I have to say I shed a few tears over not being able to run on the beach in the mornings or when I travel. Who likes to be told they can't do something. But you get over it if you are smart. What are your options, keep crying about it and get depressed and fat or do something else. I wish I had taken up swimming years ago. I like it better than running.
Enough for now, I'll continue in my next entry. So far, if nothing else remember these three things:
1) Do your homework on what your problem is
2) Get lots of referrals for the doctor
3) Get lots of referrals for a good physical therapist
Ask lots of questions and then ask them is there anything I forgot to ask?
You can do it! Whatever it is you can get through it.
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