Again, overall, its a lot better than I thought it would be. My hip feels stiff, and my leg is starting to wear off the nerve blocker. I still have the air/water pads on which I had to change the ice about every 6 or 8 hours, as long as the water was cold in the machine it was fine. The compression on my calves felt good, and believe it or not, the compression on my hip feels good too.
My leg has about 2 liters of water in it from the surgery, so it looks and feels huge. It actually feels like a water balloon. I should absorb or urinate out the extra water in 2 days or so.
I just got back from my first Physical Therapy appointment, less than 24 hours after my surgery. Getting in and out of the car is somewhat difficult, but ok with help. We didn't do much which is what I expected. They gave me 3 exercises to do 3 times a day at home. Foot tilts and pelvic raises basically. Nothing extreme. It hurts to sit in a chair straight up (my top and bottom half at 90 degree angle) and I was noticing some more tenderness/pain in my groin area when I first got there. If I slouch even a little bit, then its ok. I really was scared to death about sitting on a toilet, even to the point I bought one of those 4 inch raised toilet seats the day before my surgery. I haven't had a bowl movement yet and i probably wouldn't NEED it, but I'm still glad I got it because it will help. We didn't do enough movement at therapy to cause any pain and for the first month I'll only be in therapy for one time a week.
Now as I write this I'm at home back in my CPM machine and wrapped up in my ice/compression wraps. My doctors assistant called earlier to check up on me and let me know that it is normal for the swelling to increase tomorrow or the next day.
Walking with crutches seems pretty easy, though its awkward because of the hip brace sticking out so far. I have noticed the brace really is for aesthetics as it doesn't prevent much movement, if any. The doctor even said it's more of a reminder for me and others that I've had surgery and don't do anything crazy.
About to finish of the night. I haven't been all that tired, not bored yet, and my 2 yr old has been awesome and super careful around me so I'm glad for that, and I can't forget about my wife who is catering to my every need (even more than before the surgery). My mom is also our sitter so when my wife returns to work I will still have plenty of help. I'm blessed to have my family around to help, I really couldn't imagine having to do this alone... It would be impossible.
Before I actually go to sleep I'll do my PT exercises one more time, another 30 minutes on the CPM, then off to bed!
Friday, March 21, 2014
6. The Surgery
Keep in mind this was my first surgery ever, though I've been put under before, I've never been cut open.
Surgery was scheduled in the afternoon. Its about a 2 hour drive so the drive home was what worried me, but I figured i'd be knocked out for most of it. On the way there we stopped and purchased a walker, the kind with wheels, just to help me around the house after the first couple days. I mostly wanted this because it had a little chair on it and a basket.... its not easy to carry things when on crutches.
We got to the surgery center about 30 minutes early but they got us started right way. This was a surgery center in an office building so needless to say I wasn't used to that. The nurses reassured me it was more efficient than a hospital, and I guess I had no issues to complain of. They took me back to the pre-op/post-op room (Emergency Room setting) and I got into my gown and the doctor came out to mark my leg. Gave me a quick synopsis and off he went. The anesthesiologist was next, put her mark on my leg, and she stayed around a bit. She asked if I wanted the nerve blocker for my leg... Of course i wanted it!! It took about 30 minutes to set in, but when it did, my leg felt like it weighed 100 pounds when I tried to lift it.
Another nurse came over to check the paperwork or do whatever, she lifted my gown and saw the markings. She then read the procedures to me to make sure they were doing the right things. I had to have a little fun..... When she read off "Right Hip...", I said no no no, its my left hip. The look on her face was priceless. I quickly told her I was only joking. The other nurses chuckled so it was all in good fun.
There was a 12 year old girl next to me who just had the same surgery and she wasn't crying or anything so that was a little sign of hope that it wasn't too bad. She was talking and everything and went home before I went in for surgery.
My family came back to see me briefly and off I went into the operating room. I was nervous but I didn't have the nervous breakdown I expected. I honestly think it had a lot to do with Dr. Birmingham making it seem like not such a big deal. This is where choosing your doctor is important, if you have a bad gut feeling about a doctor, GET A DIFFERENT ONE, and don't worry about making one doctor feel bad. They have a million more patients where you came from, so do it for yourself!! The anesthesiologist told me goodnight and I was out. Next thing I knew my family was standing over me and said, "About time you woke up, you've been sleeping forever."
One of my biggest fears was waking up in excruciating pain, which honestly wasn't really the case at all. It felt weird, but I didn't even really say "ow." It was stiff of course and couldn't move it because of the nerve blocker. The nurse brought me some graham crackers and I remember saying "before you told me you had cookies, what are these?" She laughed and got me some cookies. Just before leaving she asked if I wanted anything, water, apple juice, grape juice, etc... I asked for apple juice, she handed me a water.... I wasn't really thirsty so it matter either way. That would have been the only problem I had, which isn't a problem at all, but I said this would be an unbiased blog, so there it is.
I went home and i immediately wanted to get started on my CPM machine to get my leg moving. The 2 hour ride wasn't bad, but we had to stop at Walgreens to fill my scripts, so that was an extra 30 minutes and my leg was starting to get really really stiff. I put my cold therapy machine on and jumped into the CPM machine (figuratively speaking of course) and it felt good. I was to use the CPM for 3 - 6 hours a day, about an hour at a time. The water therapy was as needed and air compression was anytime I was sitting for a long time, especially at night.
After an hour in the CPM, it was placed on the floor. I started my pill regiment and kept the cold water/air on all night. Overall it was going a lot better than i thought up to this point.
Surgery was scheduled in the afternoon. Its about a 2 hour drive so the drive home was what worried me, but I figured i'd be knocked out for most of it. On the way there we stopped and purchased a walker, the kind with wheels, just to help me around the house after the first couple days. I mostly wanted this because it had a little chair on it and a basket.... its not easy to carry things when on crutches.
We got to the surgery center about 30 minutes early but they got us started right way. This was a surgery center in an office building so needless to say I wasn't used to that. The nurses reassured me it was more efficient than a hospital, and I guess I had no issues to complain of. They took me back to the pre-op/post-op room (Emergency Room setting) and I got into my gown and the doctor came out to mark my leg. Gave me a quick synopsis and off he went. The anesthesiologist was next, put her mark on my leg, and she stayed around a bit. She asked if I wanted the nerve blocker for my leg... Of course i wanted it!! It took about 30 minutes to set in, but when it did, my leg felt like it weighed 100 pounds when I tried to lift it.
Another nurse came over to check the paperwork or do whatever, she lifted my gown and saw the markings. She then read the procedures to me to make sure they were doing the right things. I had to have a little fun..... When she read off "Right Hip...", I said no no no, its my left hip. The look on her face was priceless. I quickly told her I was only joking. The other nurses chuckled so it was all in good fun.
There was a 12 year old girl next to me who just had the same surgery and she wasn't crying or anything so that was a little sign of hope that it wasn't too bad. She was talking and everything and went home before I went in for surgery.
My family came back to see me briefly and off I went into the operating room. I was nervous but I didn't have the nervous breakdown I expected. I honestly think it had a lot to do with Dr. Birmingham making it seem like not such a big deal. This is where choosing your doctor is important, if you have a bad gut feeling about a doctor, GET A DIFFERENT ONE, and don't worry about making one doctor feel bad. They have a million more patients where you came from, so do it for yourself!! The anesthesiologist told me goodnight and I was out. Next thing I knew my family was standing over me and said, "About time you woke up, you've been sleeping forever."
One of my biggest fears was waking up in excruciating pain, which honestly wasn't really the case at all. It felt weird, but I didn't even really say "ow." It was stiff of course and couldn't move it because of the nerve blocker. The nurse brought me some graham crackers and I remember saying "before you told me you had cookies, what are these?" She laughed and got me some cookies. Just before leaving she asked if I wanted anything, water, apple juice, grape juice, etc... I asked for apple juice, she handed me a water.... I wasn't really thirsty so it matter either way. That would have been the only problem I had, which isn't a problem at all, but I said this would be an unbiased blog, so there it is.
I went home and i immediately wanted to get started on my CPM machine to get my leg moving. The 2 hour ride wasn't bad, but we had to stop at Walgreens to fill my scripts, so that was an extra 30 minutes and my leg was starting to get really really stiff. I put my cold therapy machine on and jumped into the CPM machine (figuratively speaking of course) and it felt good. I was to use the CPM for 3 - 6 hours a day, about an hour at a time. The water therapy was as needed and air compression was anytime I was sitting for a long time, especially at night.
After an hour in the CPM, it was placed on the floor. I started my pill regiment and kept the cold water/air on all night. Overall it was going a lot better than i thought up to this point.
5. Pre-Surgery
My surgery was scheduled on a Thursday. The Tuesday prior is when i scheduled the medical equipment people to come out to my home and give me the items my doctor ordered.
He ordered: Crutches, CPM machine (continuous passive motion), a "game ready" cold water therapy machine, and a hip brace. The doctor told me that generally insurance won't cover the cold water therapy machine. When the equipment company called the first time, I asked them the same question and they said sometimes insurance won't cover it but they would let me know. So the day before my appointment to have the equipment dropped off I called my insurance company. They said everything was approved except the Water Therapy machine. They also warned me that some companies may get "shady" when dropping off the items...
So they arrived and as the woman was setting up the cold water machine I asked her if Insurance had agreed to cover everything. She said that they should because they said that they would. I then said, "Good, I just wanted to make sure that I would not be paying anything." She said, "Well they said they should, but worse case we would give you at the patient cost of $325." I thought this was very shady indeed. That being said, I anticipate paying the $325 because i'd rather have the machine than not, but I will give it a slight fight when the bill comes (since my paperwork said patient responsibility was $0.) But that will be when the time comes, for now, i'm glad I have it. This water therapy machine (Cothera V Pulse) is also a Compression machine to prevent blood clots from sitting around so long, so I'm very glad I have it..... (and while writing this the day after surgery, I'M SUPER GLAD I HAVE IT!!!!)
She set up the CPM machine which was pretty simple. The water machine has 3 wraps. One for my hip which has water and air, and one for each calf with only air. (Air = compression). While i have help at home, when she was putting all this stuff on me, all i could think was, "There is no way in hell I will be able to do all this after surgery." It wasn't that it was difficult, just that I would have to bending down and I thought I wouldn't be able to bend at all... (now, after the surgery, if I had to do it myself I could, but until I HAVE TO do it alone, i'll use my helpers!)
He ordered: Crutches, CPM machine (continuous passive motion), a "game ready" cold water therapy machine, and a hip brace. The doctor told me that generally insurance won't cover the cold water therapy machine. When the equipment company called the first time, I asked them the same question and they said sometimes insurance won't cover it but they would let me know. So the day before my appointment to have the equipment dropped off I called my insurance company. They said everything was approved except the Water Therapy machine. They also warned me that some companies may get "shady" when dropping off the items...
So they arrived and as the woman was setting up the cold water machine I asked her if Insurance had agreed to cover everything. She said that they should because they said that they would. I then said, "Good, I just wanted to make sure that I would not be paying anything." She said, "Well they said they should, but worse case we would give you at the patient cost of $325." I thought this was very shady indeed. That being said, I anticipate paying the $325 because i'd rather have the machine than not, but I will give it a slight fight when the bill comes (since my paperwork said patient responsibility was $0.) But that will be when the time comes, for now, i'm glad I have it. This water therapy machine (Cothera V Pulse) is also a Compression machine to prevent blood clots from sitting around so long, so I'm very glad I have it..... (and while writing this the day after surgery, I'M SUPER GLAD I HAVE IT!!!!)
She set up the CPM machine which was pretty simple. The water machine has 3 wraps. One for my hip which has water and air, and one for each calf with only air. (Air = compression). While i have help at home, when she was putting all this stuff on me, all i could think was, "There is no way in hell I will be able to do all this after surgery." It wasn't that it was difficult, just that I would have to bending down and I thought I wouldn't be able to bend at all... (now, after the surgery, if I had to do it myself I could, but until I HAVE TO do it alone, i'll use my helpers!)
4. Choosing a Surgeon
I saw 3 different orthopedic surgeons. The first was Joseph Schwabb in
Milwaukee, referred by my doctor. My first impression was he was a real
nice guy, and didn't seem like he was in a hurry. He said he did the
"mini-open" version of the FAI surgery, but not full arthroscopic.
With the way science has progressed, I wanted to have it done
arthroscopically. And this would help keep the scars to a minimum and would be less invasive. So this doctor wasn't really an option for my needs.
Doing some research online and reading
other blogs, my next stop was Dr. Charles Bush-Joseph in Chicago, a partner of Dr. Shane Nho. He was
listed as one of the Chicago Bulls' doctors, and had a very extensive history.
My first impression was that he was too busy to meet with his patients.
He had 4 or 5 other people with him (his assistant, an intern, a high
school kid and a college kid which they were doing for experience or school
credits or whatever) which was fine I guess. I just felt rushed.
All my questions were answered with quick answers and i felt that he was
getting frustrated with every new question I had. I'm a thinker, so I have
lots of questions. After I left, I had some more questions so I emailed
his assistant, which he answered, but finished it up with "if you have
more questions, please schedule an appointment." This didn't sit
well with me.... on to the next. (I'm in no way saying he is not a good or great surgeon, I just didn't have the best experience)
My third doctor was Dr. Patrick
Birmingham, also out of Chicago. He was listed as one of the Chicago
Bears' doctors and also appeared to have extensive experience. My first
impression.... awesome guy! I had to have asked at least 30 questions,
and NOT ONCE did I feel like I was ruining his day. All his answers were
thorough and he was just a great all around guy. Not sure if he was the only one that noticed it, but he was the only one that mentioned I had pincer impingement as well (on the pelvis), the others just mentioned the CAM impingement. And, he was the only one that mentioned he would be popping my leg out of the hip in order to get anything on the inside. Admittedly, this scared the hell out of me; I mean, I can hang upside down by my feet, so thinking about the pressure it takes to pull it out of the socket worried me a little... Not sure if the others were going to do the things they didn't mention, but this is why it helps to shop around, they may not even have noticed.
After I left, as one would expect, I had even more questions. I emailed the assistant, over and over and over, and I always got an immediate response usually within the day. Based on my overall experience, it was time to schedule my surgery.
Dr. Patrick Birmingham
After I left, as one would expect, I had even more questions. I emailed the assistant, over and over and over, and I always got an immediate response usually within the day. Based on my overall experience, it was time to schedule my surgery.
Dr. Patrick Birmingham
NOTE: From the research I've done online, it is always recommended that you ask your doctor how many FAI surgeries they do each year. I didn't ask the first two, but Dr. Birmingham said he did about 3 to 5 week (if i remember correctly) so that comes out to hundreds a year. He said this is the most common surgery he does.
3. Diagnosis
I finally decided to go see a doctor. I skipped my hometown
doctor and went straight to a Sports Medicine doctor at one of Wisconsin's
Medical College's. She tried some hip movements and eventually decided to
start me on therapy to see if that would help. I did 4 or 6 weeks of
therapy (1x week at facility, along with home exercises) and it didn't help.
Some of the stretches felt good, but didn't help the overall problem.
She asked if I could sit cross legged (Indian style) and I told her that
I haven't been able to do that my whole life, and here I thought I was just not flexible.
The doc then gave me a temporary numbing
injection into the labrum after checking with an ultrasound. It helped.
The next step was an MRI. The MRI showed CAM and PINCER impingement and labrel tearing. So there it was, I had FAI. My next step was finding a surgeon.
Sorry for being so brief, I'm not great with technical terms, but I'm sure most people aren't, so maybe this blog will be a breath of fresh air!
The next step was an MRI. The MRI showed CAM and PINCER impingement and labrel tearing. So there it was, I had FAI. My next step was finding a surgeon.
Sorry for being so brief, I'm not great with technical terms, but I'm sure most people aren't, so maybe this blog will be a breath of fresh air!
2. The Injury
I started to put on some pounds and was up to about 220.
I've lost weight before, then I gain it, then lose it, then gain it.
Its hard on my body I'm sure, but I love food!! So back in November
2012 I bought a spin bike (indoor bike) and along with 45 minute youtube video
workouts, I hit it hard. I lost about 20 pounds in 2 months and IT WAS
FUN!! Finally, and exercise routine that I actually enjoyed.
By the
way, I hate the gym. About 3 months into it I started to feel sore in my
right groin after a workout. I took a day or two off, then tried it
again. During the workout it was fine, but afterwards it was sore.
I did this off an on for a week or two, then I took a month off and tried
it again. Same result.
I had a constant pain but it wasn't terrible, but enough to the point that it was very annoying. It almost felt as if I took 2 fingers and pushed them into my groin and held them there. I could do normal activities generally fine, but long periods of sitting or standing would aggravate it. Sitting in a car or on an office chair was probably giving me the most discomfort. I never did get a cortisone shot just because I didn't want to.
I had a constant pain but it wasn't terrible, but enough to the point that it was very annoying. It almost felt as if I took 2 fingers and pushed them into my groin and held them there. I could do normal activities generally fine, but long periods of sitting or standing would aggravate it. Sitting in a car or on an office chair was probably giving me the most discomfort. I never did get a cortisone shot just because I didn't want to.
Sypmtom I've had my whole life, but thought it was me just not being flexible: If i sat on a chair with my legs out in
front of me, and I would bend forward, I could only go about half way until
feeling a "block" if you will, and a pinching pain. If i swung
my right leg out to the side but left my left leg in front, I could go all the way forward.
The internet is a beast when learning about surgery and people's experiences. My injury, i feel, was quite simple. I caught it right away and stopped doing what caused it. Most people online have different injuries to different extents. My FAI is not the same as your FAI, so always keep that in mind. Also, everyone doesn't follow rehab properly or take the necessary steps, but they will never tell you that in their blog. I agree some people may just have a bad surgery or bad luck, but again, trying to decipher which it was is impossible for someone reading a post online to do.
1. About Me and my blog - Please read first!!!!
This is my first blog ever, so please bear with me!! While doing research about FAI I saw a lot of posts about how terrible the surgery experience was and how terrible things were altogether. I also realize that most people don't post online unless they're complaining. I thought I'd start this from day 1 of surgery, so it would be unbiased. I'll try and keep it updated, but forgive me if I lag behind. The main purpose for this blog is to help others so that they can know more of what to expect during and after the surgery and to keep the anxious feelings to a minimum. I know it's easy to have a nervous breakdown, especially for things as serious as surgery, so I hope that I can help put your mind at ease (depending on how everything goes).
If this blog helps you in any way, please leave a comment as I'd love to hear about it and I'd love to know if this blog helps even one person or their mind at ease.
Now to get to know me. I'm a 28 year old guy, and I love being outside. I enjoy my job, and the people I work with. Because of my job I'm not sure yet how long I will be off. I have a toddler at home so being able to spend time with her once i'm walking about will be a good change of pace, but I know eventually I will be itching to get back to work.
My biggest fear was that this surgery would leave me worse off then I was with the original injury and not be able to return to my job. I watched a video on youtube of the actual surgery, and realized that was a bad idea... whatever you do (if you are squeamish or not) do not watch it... You really don't want to see what they do, it appears that there is no finesse at all.
If this blog helps you in any way, please leave a comment as I'd love to hear about it and I'd love to know if this blog helps even one person or their mind at ease.
Now to get to know me. I'm a 28 year old guy, and I love being outside. I enjoy my job, and the people I work with. Because of my job I'm not sure yet how long I will be off. I have a toddler at home so being able to spend time with her once i'm walking about will be a good change of pace, but I know eventually I will be itching to get back to work.
My biggest fear was that this surgery would leave me worse off then I was with the original injury and not be able to return to my job. I watched a video on youtube of the actual surgery, and realized that was a bad idea... whatever you do (if you are squeamish or not) do not watch it... You really don't want to see what they do, it appears that there is no finesse at all.
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