Wednesday, November 14, 2012

Still Broken - 5 months Post-op & CT scan results

5 months ago I woke up with the anxiety, fear and hope that I was beginning the ending of almost a year’s worth pain and extremely limited mobility/quality of life.

I was wheeled in to an operating room and 7 hours later I woke to what I was told was a very successful surgery. My labrum had been detached which was more severe than expected the repair went well. I was told I had good joint space and that the reshaping of my femoral head & neck was smooth. I was also told that my acetabulum was now structurally sound. The periactetabular osteotomy or PAO looked great. I had seven screws holding my “new” hip together as I re-learned how to move it. Initially, things appeared to be going well and the more detailed history can be read below. There were some complications that seemed mild and some typical trip-ups along the way of recovery which was starting to seem slower than some of my new “hippie” friends. I asked questions and I followed my “rules.” After 8 weeks (the typical initial recovery) I went in for a follow-up appt. A set of x-rays determined that my cuts appeared to be healing but “not quite there yet.” And I was told I needed another 2 weeks on crutches. I was cleared after that and started physical therapy.

Which brings me where I am today. Thought the next 2.5 months of PT and beginning to bear weight I continued to have a significant amount of pain.  Which after pushing my me and therapist resulted in the last two blog entries discussing some more imaging results of a MR-Arthrogram (MRI with contrast) and a CT.

As I was driving home two weeks ago, Dr. Prevost called me to give the results of the CT scan. He said that after reading the radiologist’s report and thoroughly reviewing the images himself he agreed with that fact one of the breaks in my pelvis was not healing. This is considered delayed or non-union. He used the term non-union as he talked with me and went on to explain that it is very rare (occurs in about 1% of PAO surgeries), he has never physically seen it and he didn’t know what to do about it (if anything). He wanted to send the images down to Dr. Mayo immediately and talk with him regarding next steps.  “The next decisions will be Dr. Mayo’s,” he said. He also said that it would cause significant pain but he still wasn’t sure what they would do (bone graft, plate & screws), if anything because often they won’t do anything for about a year to be sure the bones are not healing.

There has been several brief conversations emailed back and forth with Kenda, Dr. Mayo’s PA-C and as far as I know, he has the images and is going to be contacting me. I don’t know when.

I am having a hard time dealing this emotionally right now. Other things have been mentioned as possibilities for my pain like, issues with the labral repair or a new tear, the PSOA tendon and just plain old slow recovery. I KNOW something is not right. This pain started from the labral tear – I was told that repairing the labrum would not fix the problem because of the structure of my bones. I was told that they wouldn’t even consider fixing just the labrum and I need the PAO. I went for it, not expecting for a miracle but hoping that in 3-6 months post-op I would be A LOT better than I was at that time. Well I am not. I feel as though I have recovered surgically from one of the most invasive orthopedic surgeries out there but I am still in an amount of daily CONSTANT pain that is comparable (and only slightly different) then pre-op and now the left side is hurting. Leftie was worse off according to imaging a year ago and that scares me too.

So here I am. 5 months post-op and 16 months post-injury. I still struggle with sleeping, walking up stairs, sitting,getting up from a seated position, getting into bed and several other minor moves. I am still in pain that requires pain medication daily. Waiting to hear back from Dr. Mayo and hoping that my next steps… will eventually be pain-free and that my pelvis will no longer be.
X-ray from September Photobucket
3D Image from CT showing Fracture of the Superior Pubic Ramis Photobucket 3D Image from CT showing a small heterotrophic ossification HO (bone forming in the muscle) Photobucket