Tuesday, July 31, 2018

Tuesday, July 31, 2018 -- Mattie died 463 weeks ago today.

Tonight's picture was taken in August of 2008. Mattie was outside in the Hospital commons area showing his cousins this amazing rock garden. I am not sure it was actually a garden, but let's put it this way..... there were a lot of stones surrounding the periphery of the medical library and all of them caught Mattie's attention. He loved to go look at the stones and I must say on two occasions, we left the garden with  stones in tow. You can see in this photo, Mattie was picking up stones and checking them out. One day during Mattie's treatment, and it was a very bad day, we went outside and Mattie came back to his room with a very large stone. Most of the time I was able to convince Mattie not to take a stone, but that day, if the stone brought him happiness, it was coming with us! This stone remains in our front hallway today, as we use it to prop our door on warm weather days. 


Quote of the day: I have learned now that while those who speak about one's miseries usually hurt, those who keep silence hurt more. ~ C. S. Lewis


I would imagine that the average person who interacts with me isn't aware of my chronic daily pain. Not just one pain, I have several. For 16 years, I haven't known a day without some sort of headache. I marvel at people who tell me they have never had a headache! That is pain number one. Then pain number two is from fibromyalgia, which is basically over active nerves that produce pain in the neck, back, arms and legs. If those two aren't bad enough, now I add pain number three..... I have a torn labrum. 

Peter went with me today to the orthopedic surgeon's office. The doctor I was referred to is considered the guru in labrum tears in Washington, DC. He performs about 8 surgeries on the labrum weekly. In any case, my appointment was for 3:30pm. When I arrived the receptionist told me they tried to call me but couldn't get a hold of me. They said the doctor was running late. So I asked what number they called, and of course they did not have my correct call phone number. Problem number one! Problem two was that the office staff did not manage expectations for patients in the waiting area.

When I asked the receptionist what late means.... I said late like my urologist which translates into 2-3 hours late, or 30-40 minutes late. She responded.... NO not hours, but maybe 40 minutes at most. Needless to say we waited over two hours. But we weren't the only ones. We started talking to other patients in the waiting area and befriended two. We shared stories, pains, and frustrations together, as well as questions we all wanted to ask the doctor. They were not happy waiting either and frankly we felt this wasn't managed well by the staff who did not level set our expectations from the beginning. Why tell us 40 minutes, when they knew it would be hours?!

Needless to say I went back up to talk with the staff two hours into waiting and told them I wasn't the only unhappy patient. Literally they left patients alone for so long that we formed a support group with each other. The staff got what I was saying and the next patient called back was me. I hate to say this but in healthcare, the loudest voice gets the most attention. It shouldn't be this way, but it is!

Fortunately the doctor was nice. Harried but nice. He explained that I have a significant labrum tear, in which the entire cartilage would need to be replaced. It gets replaced with an animal cartilage, not something synthetic. However, he feels that surgery should always be the last resort. Therefore I will continue on anti-inflammatory meds and do physical therapy two times a week for 12 weeks. He actually wanted to give me a cortisone injection in the hip today, but I said no. Given that I am going back to Los Angeles next week, I do not want to be deviating from my current med routine. So I will begin this regimen in late August and see him in September, for a cortisone shot. 

The doctor is uncertain how I got this, but believes it has been brewing for years given the calcifications that are growing around the tears. With that said, the goal is to reduce the inflammation. He thinks that if that gets reduced my pain will be less. He says that people can live with torn labrums, without having surgery. But the question is can I get to that point where the inflammation gets significantly reduced? Time will tell. I also asked him whether more activity can further the tear. The answer was yes. So until I am stabilized I can not do zumba and any high impact activities. Things I like to do and that help with fibromyalgia pain.  

So what's a labrum tear? 

A hip labral tear involves the ring of cartilage (labrum) that follows the outside rim of the socket of your hip joint. In addition to cushioning the hip joint, the labrum acts like a rubber seal or gasket to help hold the ball at the top of your thighbone securely within your hip socket.

Athletes who participate in such sports as ice hockey, soccer, football, golf and ballet are at higher risk of developing a hip labral tear. 

Symptoms

• A locking, clicking or catching sensation in your hip joint
• Pain in your hip or groin
• Stiffness or limited range of motion in your hip joint

Treatment

Treatment choices will depend on the severity of your symptoms. Some people recover with conservative treatments in a few weeks, while others may require arthroscopic surgery to repair or remove the torn portion of the labrum.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), can relieve pain and reduce inflammation. Pain can also be controlled temporarily with an injection of corticosteroids into the joint.

Therapy

A physical therapist can teach you exercises to maximize hip range of motion and hip strength and stability. Therapists can also analyze the movements you perform that put stress on your hip joint and help you avoid these forces.

Surgical and other procedures

If conservative treatments don't relieve your symptoms, your doctor may recommend arthroscopic surgery — in which a fiber-optic camera and surgical tools are inserted via small incisions in your skin.