Saturday, July 7, 2012

How it all started....

First I would like to point out the reasons I am writing this blog....
  1. Create awareness about femoroacetabular impingement.
  2. There aren't many Canadian "hip chicks" out there. Finding the right hip surgeon in Canada who can diagnose and treat FAI is difficult.
  3. I had a left scope done 05/04/11 and am scheduled for a left Open Surgical Dislocation and Debridement (Open SDD) on 07/24/12. I've found loads of info, blogs and experiences about scopes and PAOs, but not a whole lot about open FAI surgeries. Since I don't have dysplasia or any known version issues,  I want to share my story for others who are facing a similar diagnosis..these hip conditions are so rare that having online sources of information can really help with the process. it goes....

It's funny how things turn out...looking back I don't know what was worse for my health...smoking or running....

I quit smoking about 6-7 years ago and decided to take up running. It was always something I wanted to do, but being a smoker, it seemed silly to even bother exercising, let alone running! 

When I finally kicked the habit I hit the pavement.

I absolutely loved running....

One day, nearly 4 years ago, I woke up with the most excruciating pain in my left hip. It was funny because there was no trauma, no fall and in fact I hadn't even ran the night before. You know when you hit your funny bone and it catches your breath for a brief moment? Well, every time I tried to move my leg, my breath would catch. And that wasn't even me putting weight on it! It was nothing I'd ever felt before. Assuming it was one of those strange "random pains" that would eventually go away, I went on with my day.

That day turned into two days, which turned into two weeks, which turned into....well you get the picture.

After approximately four weeks, I went into my family doctor. At that point I just knew there was something horribly wrong. I asked her for an xray and a MRI. She smiled and gave my an anti-inflamm and told me it was a muscle off I went.

Another four weeks or so goes by...pain not letting I go again to doc...

By this point I am certain she thinks I am crazy hypochondriac trying to get pain meds...I ask again for xray and an MRI....she declines the MRI but agrees to the xray. She also tells me to go try physio. 

So...the process begins...I start physio while I wait for the xray results. When the results came back...she called me in....she says, "You have impingement doesn't looks serious and I am sure it's nothing. I have never heard of it before so I deferred to a colleague/mentor....he said one of his patients had it they had to get it surgically corrected. I highly doubt you're a candidate for surgery but he suggested I refer you to an ortho." I asked about a MRI...she said "No...let's not do that yet...the ortho will do that if he feels it's necessary." WHAT?!?! SERIOUSLY?

So...I continue with therapy....and I am referred to a surgeon. Bare in mind, I'm in Canada, so things take FOREVER. And at this point, I am very uneducated about this so called "impingement syndrome". So...not knowing any better...I wait patiently for my surgeon's appointment (only 4 months away! No big deal!).

So I wait...and continue with with PT...after 3 months of treatment we weren't getting anywhere. Lucky for me there was an amazing sports injury doc who came to the clinic once per month...Dr Levy. Since my PT wasn't getting any real results she suggested I see him. 

Up until this point, the focus was only on my left hip...well wouldn't you know it...the day before my appointment with Dr Levy, my right hip started to hurt! Okay...was it in my head? Was I over compensating? What are the chances I have this in both my hips? I mean, I do like to do things the hard way...but come on! During our first appointment I told him the results of my xray and brought him a copy. He did a quick exam and said said he was certain I had "femoroacetabular impingement" and that it could be surgically corrected. So I asked him what the chances were I had this in both of my hips. He said it's very common that people have the issue bilaterally, he did the FAI exam (trying to catch/impinge the bones) and ordered me a MRI for my right hip too.

He also said he had some good news...he knew the perfect surgeon who could help me. I told him I had an appointment lined up with and ortho for the following week and that I didn't want to "rock the boat" and p%ss anyone off. I was worried that I was finally getting somewhere and if I started doctor choosing I would step on someone's toes. (Looking back, I realize what stupid logic that was.) I told him thank you for the offer, however I will finish the process with this doc. He told me to call him once I saw the surgeon.

So...I finally met the first surgeon....Dr Armstrong....well although it was lovely meeting him, it was a HUGE waste of time. He described a hip joint to me and then...he broke the news..."Yes you do have a definite problem but I don't do hips." WHAT?!? YOU DON'T DO HIPS!! ARE YOU KIDDING ME? I was so frustrated because I waited months to see him. He did however send me for a MRI (okay maybe not a total waste of time) and said he knows the best "hip guy" around..Dr Ginty. we are getting somewhere!

So I call Dr Levy...tell him the news and he asked me if I wanted a referral to his surgeon. I said no, I was referred to Dr Ginty and was scheduled for a MRI. He said no problem...we can chat again once your results come back from both your MRIs.

So I wait patiently for my appointment with the "hip guy" prob...only 5-6 months. At this point who cares how much time it's taking...I mean I am only big deal that I can't walk without pain. 

Both MRIs came back and confirmed I had bilateral FAI with labral this point I still wasn't  told which type of FAI I had.

The big day finally arrives. I go to my appointment with Dr Ginty and describe my pain to him and gave him the result of my MRI and xrays. He asked me about my symptoms so I described the pain I felt...he looked very skeptical and told me "that is an awful lot of pain and it doesn't really make sense". Well no sh%$$#! It doesn't make sense to me either given I'm not 80. So he asks me to meet him at the hospital for an appointment. He wants to inject the labrum with freezing to see if that resolves any of my pain.

Perfect...I go to the appointment and he injects the labrum using a long needed aided by an xray machine. Then he asks me to go for a long walk to see if I feel any different....sure difference.

I go back to him and he said given the issues didn't resolve with the freezing, there really wasn't anything he could do for me. Frustrated beyond belief, I asked him what my options were. He said with him, there was none. ARGH!!! So I leave surgeon number two's end in sight to this whole mess...months after it all started.

Thankfully I had Dr Levy to fall back on! I booked an appointment with him and approximately two years after this whole mess started, I saw him for a second time. He referred me to the surgeon he was suggesting all along...Dr Wong. I finally got in to see Dr Wong about 6 months after the referall.... immediately he put me at ease and confirmed this was definitely NOT in my head and he could surgically correct this for me. 

I almost started to cry and wanted to hug him. We were finally getting somewhere! He also diagnosed me with having CAM FAI and labral tears. I had surgery on May 4, 2011 in Hamilton with Dr Wong and the team. I was a bit nervous given my wedding was only four months away following the surgery, but I was reassured I'd walk down the isle without a limp! (Which for the most part I did!)

The surgery appeared to be successful and I was even given a video of it! How cool is that? His intention was to correct CAM FAI and labral tears. The recovery went fairly well...I will write another post about my experience with the scope.

Following the weeks and months into my recovery, I really felt like there were more underlying issues. I had several followups, however I was told it was probably soft tissue/tendinitis etc. Realizing this wasn't getting any better and wanting to plan a family soon, I decided to get a second opinion.

It was actually on the Hip Chicks forum that I met someone who suggested I try Dr Kuzyk at Mt Sinai. Apparently there was a Young Adult's Hip Clinic and they specialize in the preservation and reconstruction of young hips! YIPPPEEE!

I got a referall and less that two weeks later I had my appointment. Now we are talking! He performed a thorough exam and more imaging. The results showed pincer impingement, abnormally deep hip joints, labral tears and damage to the cartilage. I am not sure if the CAM lesion came back or not (I forgot to ask and I didn't request a copy of the results).

He said in his opinon based on the fact that I have pincer impingement, my best bet would be open surgical dislocation and debridement surgery (open SDD). This is due to the fact that where my impingement is located, it would be very difficult to reach it via scope.

So...on July 24, 2012 (nearly 4 years after this process began) I am finally scheduled for an open SDD.

So...stay tuned for my experience with the surgery and recovery.

I am really nervous...yet in many ways very excited. Let's hope this works and I can move forward with my life!