And so it begins...

Yeah, so I know in the song the girl dies, but hip-puns seem de riguer in this business and I love the Roots, so fuck it, The Hipnotic it is!

Oh and hi, welcome to my blog. :) I never really thought I'd have such a thing, but with all the craziness of this year it seemed to make sense. Following several months of increasingly persistent pain in my left hip, I was diagnosed in April 2008 (at the age of 28) with bilateral hip dysplasia. If you google this you will learn lots about dogs and babies, neither of which I, you know, am. But essentially the socket of my hip joint is too shallow, which leads to easy dislocation and the aforementioned pain. By April I was to the point where I was unable to walk without a limp on the left side, especially after getting up from sitting for more than half an hour or so, and waking up in the morning was excruciating.

Thankfully my diagnosis came quickly, after only one set of x-rays, and Dr. Crose, my excellent primary physician, hooked me right up with a physical therapist, Susan Stephen, who is phenomenal. Susan started me with simple exercises to do with a couple balls and therapy bands. From the very first time I did them I felt a huge difference, especially on my left side, where I had lost an incredible range of motion without even realizing it. Weeks of twinges, pangs and pins & needles ensued as I worked to regain even semi-normal function, though all this was nothing compared to the searing lower back pain I began to experience from basically realigning my entire midsection.

Here enter ultrasound massage and Kinesio Tape, my new best friends (along with Susan, my trusty PT), which somehow got me through to pool therapy, which I started in June. The pool... oh, the pool is an experience wholly unto itself. I have seen more, bigger and older boobs in the past 3 months than I'd seen in my entire life previously. I've also experienced the strange sensation of sweating in a pool, which is to be expected when the air temperature is 90 degrees and the water temperature is... 90 degrees! I shudder to think of the toxins I've sweat out onto the poor unsuspecting octagenarians, though I'm pretty sure the (literally) stinking chlorine's killed them off right quick. Uhhh... right, but all that aside the pool is amazing - I'd be miles away from where I am now in terms of strength and endurance without it.

So I've been chugging along well with everything I'm supposed to be doing - taking my piddly daily ibuprofen (since my condition is constantly deteriorating, they don't like to put you on pain meds until they absolutely have to), being mindful of my movements, rocking PT and continuing to lose weight (25 pounds and counting!) - but I'm not getting better. And I've come to terms (sort of!) with the fact that, regardless of how strong or stable I feel, I won't really get "better" without surgery. Here enter Dr. Young-Jo Kim of Boston Children's Hospital, one of only a handful of surgeons on the Eastern Seaboard that performs Periacetabular Osteotomies, the surgery recommended to me by Dr. Bean, the orthopedist at Central Vermont Medical Center responsible for my initial diagnosis. When I saw him he said "I don't know of anyone who does this surgery, but you may be able to talk someone at Dartmouth into giving it a try." Ah, thanks but no thanks dude! And off to Boston I went (4 months later - Dr. Kim's a busy man!).

This past Friday was my first trip to Boston Children's in Waltham, a mere three miles (or 25 driving minutes) from my dear friend Jon Kemp. After some last-minute roadside finagling with insurance (which I could author quite the rant on, given the chance) I went in for my very first MRI. Let me begin by saying that, like many people, I'm terrified of hospitals, mostly because I think of them as a place people go to die, not to get well, but it hadn't occurred to me that, because of its target population, Boston Children's would be a very different hospital experience. More colorful, more friendly, more cutie babies (occassionally screaming) out and about, and sweet fish tanks in the waiting area! Of course it also didn't occur to me that I'd be the oldest "kid" in the place (reading my Harper's with Dora the Explorer on the giant flatscreen), but because they have such a prestigious hip team, everybody pretty much knew what my problem was (at least medically! [haha]) as soon as I walked in the door.

The MRI... well, I was completely freaked out by the prospect of it, but I was totally wrong. Probably the worst part was the injection of the contrast, which produces a very bizarre vein-expanding sensation in one's arm. Here I am today, 5 days later, and my arm STILL hurts! The tech didn't mention that, but I'm assuming it's normal, or at least normal for someone as hypersensitive as I am. I chose earplugs over music for the MRI experience, figuring it'd be more zen, and that the noise of the machine would overpower the music anyhow, which I'm sure it would have. They got me to the point where my nose was in line with the edge of the machine and I could see the cool skylight above me and said "Are you okay there? That's where you're going to be." and I'm thinking "Oh, cool, I'm cool!" as my heart goes "THUMPTHUMPTHUMPTHUMPTHUMP!" And of course they lied to me because 10 minutes later the machine goes "CA-CHUNK-CHUNK!" (it does a lot of that sort of thing) and I slide another 6 inches into the damn thing. I opened my eyes and found myself looking at the inside of the tube. Then I closed my eyes. :)

I can't really explain the sensation of lying perfectly still for 40 minutes while your body feels like it's being pulled through a vibrating microwave. I went on some sort of Internal Fantastic Voyage (probably good prep for my upcoming days in a morphine-induced haze) and felt SO bizarre when I finally got off the table. It wasn't as claustrophobic, nor as uncomfortable as I'd anticipated, and it had an odd brainwipe aftereffect I still find puzzling. I volunteered for a research study on PAOs that will necessitate at least another couple MRIs, though, so I'll have plenty of time for further reflection on the experience.

After a long long wait for my appointment with Dr. Kim (note to self: schedule for Monday mornings, NOT Friday afternoons!) I was taken into the exam room and met Erin Dawicki, Dr. Kim's kind and capable Physician's Assitant. We did the usual intake chat-and-evaluate (which is usually when I realize how truly fucked my left hip is - 10 stinking degrees of rotation!) before being joined by the big man, Dr. Kim. I definitely appreciate his friendly approach to this not-so-friendly procedure, and he laughs when I make a funny, so he's already cool in my book. He confirms for me (then Erin re-confirms) what I've secretly known all along: that I've got a "choice" between a) having this crazy invasive LONNNG-recovery surgery that will likely give me 20 years of normal hip function or b) waiting until the pain is too great to bear, which may happen as soon as 3-5 years from now and also means the cartilage is shot for a PAO and my only option is a total hip replacement (THR - so many acronyms!), which will reduce my mobility and need to be RE-replaced at least once or twice in my lifetime. So... kind of a no-brainer there.

This handy link gives you a good clear cringe-inducing overview of the PAO procedure. Blegh - gives me the willies just looking at it! But that's what I'm doing, dammit, come the end of school. Not that I relish the thought of limping along at this pace for the next 9 months, but I even LESS relish (there's some good grammar for ya) being on crutches for 3 months of the Vermont winter. So I wait, and in the meantime will likely drive everyone (or at least my mom) completely insane with my obsessive preparations. Last night she said "Don't be so worried about it!" and I said "I'm not worried about it, I'm organizing!" which is like maybe 65% true. She told me she could organize it in 5 minutes, which is like maybe 85% true. :)

There are a whole bunch of blogs of ladies who've been PAOed, all of which I've been reading voraciously to try to get a sense of what to expect in terms of recovery. It ain't pretty. After a 5-7 day stay in the hospital post-op I'll likely come home on a walker while working my damndest to get on crutches. I'll be crutching for... 2 months maybe? before downgrading to one crutch and then a cane. So be on the lookout for sweet canes! Oh, and "home" post-op will be my folks' house, which can be made relatively handicapped-accessible, unlike my apartment. So, yeah, I'll be at the mercy of my mom, for better or worse. And, at least at first, for going to the bathroom and showers. :( When I was telling Andrew and Jon about it (and many thanks for letting me vent, boys!) Jon said "So wait, you want us to come up to Vermont in June and kill you?" hahaha It's funny... because it's true. At this point I'm not even freaked about the pain (because what's the point?) but I'm very anxious about the complete and utter loss of independence.

Oh, and my right leg developed a new pain after I saw Dr. Kim, which is just great. Though also dysplastic, rightie's been largely asymptomatic (aside from mad sciatica issues) and Dr. Kim doesn't feel it will worsen significantly even with bearing the brunt of my weight throughout next summer or that it will need to be PAOed as well. As he said "We only operate on the hip that hurts", which sounded great to me... until my right hip started hurting. Still, I know I pushed myself too far Sunday at the ENORMOUS Brimfield Flea Market with the Kemp boys, and I'm hoping this is just an aftereffect. We shall see.

Dear lord this is a lengthy ramble. The first of many to come, I'm sure!