Late September… Surgery…

I have been at ‘this’ for three years ; this referring to the time spent in meetings with my surgeon regarding surgery. As many of you are aware, he was the fourth and final surgeon that I met with that summer of 2009 and I ended up placing my trust in him. Over the years I have seen him for follow ups, tests and surgery more often than I have seen friends and family members so there is definitely a comfort level here. Regardless of this I still get nervous for appointments and the information that I know we are going to discuss.  Surgery, failures, improvements, setbacks, and the amount of time that we have left to go, the many things that I have yet to face are never easy conversations, no matter how many times I have been through them.

This past Friday I met with my surgeon for yet another follow up, well aware that the topic of conversation was going to be quite heavy; the surgery on my right hip, Today my hip sister Jess would be coming with me, although she would wait in the waiting room and not meet my surgeon until a few hours later when we had finished up. Shortly after arriving one of the nurses (who I get along with really well) came out saying “Emily oh Emily where are you?” and when she saw me gave me a little wave and came over to help me up. “How are you doing honey?” she asked. She told me about how she saw me on the list today for Dr. Kain and was so glad that she was going to get to see me. “Its always nice to see you cause we have all gotten to know you with how frequently you are in here” she said to me “we all can not wait for the day that you can come in and tell us that you are finally starting to do better and are on the upswing of all this.” Having nurses that know me by name and will say hi to me just passing in the halls makes coming to the hospital more of a comfort than anything else.

My surgeon and I discussed the upcoming surgery and the plan that is starting to take shape. We need to take as many precautions as possible to make sure that what is occurring with my left leg does not happen to the right. This means that we are going to have to start working with the anesthesiology team as well as working with neurology so that during surgery (amongst other precautions) we can monitor my nerves with electrophysiological monitoring. Say that one five times fast… Anyways, the question now is what exactly are we going to do for surgery? My surgeon started to think that we may be able to achieve the same relief for both pain and function with a femoral osteotomy (FO). The best way to explain this is they basically cut the femur and internally rotate it (essentially turning my foot in) and then when you turn my foot back to “normal” my hip now sits in the same turned out position that it does now. The only problem that I have with this is that even though turned out is more stable and comfortable I still cause myself pain in that position’ we want this surgery to address both the pain and dysfunction and not just one or the other. It was just a thought that he had, and will be considering as we move forward; I believe that he is still leaning towards an anteverted PAO which is manipulating the bony structure on the socket (acetabulum) side of things.

We discussed the two surgeries at length,, both the FO and the anteverted PAO and will continue to work on figuring out which will be the best choice. The advantage of the FO is that there is much less risk to the nerves, but we would also have to combine it with a surgical dislocation surgery. I am still not sure if this sounds to me like it is the way to go but I know that I can trust my surgeon enough to believe that he will have made the right decision by the time that I go in for surgery. He has made it clear to me as well that I have a say in all this with the knowledge that I have on this subject.

In terms of time frames, we are looking at late September and will hopefully have several possible dates soon. My surgeon and I did not even touch on the pre and post op details but agreed that we would talk about them next time and continue to work out those kinks up till surgery. Much of the post op detail is up in the air until after the surgery but it is important to have things in place for different probable outcomes. Our conversations went a lot further than I am going here but I think you get the gist of things.

We also went over strength and where I am improving in that aspect. He was very happy with how well I can straighten my leg now but concerned, that for some reason, my quad wont kick in for the last inch. My foot has gained a little more plantar flexion but dorsi flexion is still absent. He swears there is something going on with the peroneal nerve but nothing we’ve tested seems to show much. He is helping me to find additional neurologists in the area for second and third opinions on this matter. In PT I have been working on walking with one crutch on my left side supporting the right leg where my left is doing the majority of the work; I can only get a few steps but I showed him how this was going. He was pleased, and asked me to show him a four point gait as well. This uses two crutches and you walk opposite crutch to leg. Upon standing back he said that my left leg is definitely smaller and atrophied a bit. I cant stand on my right one facing straight forward as it gives way and he watched as this happened and as I had to turn my right leg out more and more to be able to stand at least semi steadily on it.

After watching me in the hallway with the many things he asked me to do, he had me step back into the room as thoughts and ideas were racing through his mind. He moved my right leg around more turned it out which causes pain in the back and then in which causes a more severe pain through my hip. I really don’t have much internal rotation on the right side. We finished up discussing the “plan” and where we are going from this point forward in terms of prepping for surgery. I said that it seems like it is so long away, the end of September. It just seems like forever. He chuckled and said Emily September is closer than you think, in fact its right around the corner. I think if surgery were any sooner neither of us would be prepared he said. As much as I wish it were tomorrow I know that he is correct in that statement.

That is where I stand regarding surgery and improvements on the left and with my surgeon. I am not sure how to hang in until this surgery, but I am going to do my best. It can’t come soon enough but it also is an event that evokes a lot of fear in me. I’ve always been nervous for surgery but this time I am scared along with many other emotions.

 

“Keep the faith it is the only way … Faith, well it’s faith in never giving up and always finding a way and constantly trying to do the right thing” 

– From A person who inspires me beyond what they know, in response to the fact that “September is a long way away”