Nearly three months have passed since my surgery. I think I made excellent progress over the first month; in fact, I tried throughout that period to be way ahead of the curve in all respects. I met or exceeded just about all my goals in that regard. The one thing I haven't been able to overcome is lingering pain on the outside of my hip area, just an inch or so from the incision. Not only hasn't this pain improved, it's actually gotten worse in the past few weeks. I also think I've unconsciously adjusted my walking motion to accommodate this pain mechanism, leading to some additional discomfort in operative leg and my lower back. I thought some time in the water on our vacation, time away from my computer desk and everything else, would help - but it didn't. In fact, the pain has become even more intense since we got back from vacation. It's been waking me up at night, making even the dog-walks difficult, and limiting my ability to exercise. And, yes, I've been taking pain meds - something I thought would have ended a long time ago.
So I called and made an appointment with my surgeon's Physician's Assistant, T.J. I could have made an appointment with Dr. Mokris, the excellent surgeon who actually did my procedure (with T.J.'s assistance), but I opted not to - and here's why: Sometimes big-picture thinkers really are, well, big-picture thinkers. When I saw Dr. Mokris for my six-week post-op checkup, he looked at my x-ray and said I was doing perfect. I told him I was still hurting - much more than I'd expected to - and he assured me I was fine. And, in the big picture, I was and I am. The new titanium pieces are exactly where they should be, everything's lined up perfectly, the bone is knitting to the metal, and life is good. Big-picture. That's his job, that's what he does, that's where he thinks. Think of someone who is, say, a bridge architect. He designs a bridge, oversees its construction, declares it perfect because the loads are distributed properly, the structure is sound, and you can now get from Point A to Point B without a boat. Perfection. So if there's a pothole in the pavement, this guy is probably not going to get too concerned about it. At least, metaphorically, that's how I've come to look at big-picture thinkers, and this has seemed (to me, at least) especially true in the medical field. The bridge is up - all is well.
I have no doubt Dr. Mokris would have given me his full attention and taken my complaints seriously - I just didn't want to go to the bridge-builder this time around. I wanted to go to the guy who fixes the little things. So T.J. listened carefully last Friday, gave me a thorough exam and found all the movements that caused great pain (he's good at that!), and came up with a reasonable theory: Trochanteric Bursitis. Here's a description from some website:
A bursa is a small sac of fluid, and bursae are present wherever moving parts occur, helping to reduce friction. They are normally found around joints and where tendons, muscles, or ligaments, pass over bony prominences. The trochanteric bursa lies over a part of the femur (thigh bone) called the greater trochanter (a bony lump at the top of the outside of the thigh bone). Its job is to prevent friction between the greater trochanter and tissue called the ilitibial band. The condition known as trochanteric bursitis refers to a situation where the bursa has become irritated and inflamed. This can be caused either by a direct blow to the area or by repetitive friction of the iliotibial band on the bursa, as occurs in long-distance running.
Well, I haven't been doing any long-distance running (darn it!), but there were some mallets and other tools banging around within an inch or so of my left trochanteric bursa - so that all made pretty good sense. (In the edited image, above, the smiley represents ground-zero of the hip replacement operation - pretty close to that bursa. Another note about the image: It depicts a right hip - mine was the left hip).
Anyway, T.J. decided to do a corticosteroid injection directly into the bursa. Did I mention he's very good at doing things that hurt? Yeah, that sucker really did hurt - a whole lot, in fact - but the early indications are he may have made the correct call. It's now about 48 hours after the injection and the pain has eased considerably. It's not totally gone, but it's a lot better. I can walk better now, too - with my operative leg moving straight forward and back, not swinging out to accommodate one kind of pain while creating another type of pain. I like that; it's something I can get my mind around as being a good sign, beyond just some pain relief.
My advice to anyone dealing with any challenging medical issue is pretty much this: Be your own strongest advocate. Keep pushing for answers. Don't stop just because the first doctor, or even the eighth doctor, can't find the problem. If the bridge-builder doesn't do potholes, find a guy who does. Keep pushing. Whether this latest round of treatment will do the trick or not, I feel a lot better today than I did two weeks ago when I was just sitting around waiting for things to get better, feeling grumpy because they hadn't, reading other peoples' reports about being back on the golf course three months post-op. I'm scheduled to see Dr. Mokris for another follow-up in six weeks... and I'm hoping I can cancel that appointment because the pain will be gone. If not, well, I guess it will be time to sit down with the bridge builder.
I'll keep you posted. Meanwhile, I'll keep doing what I can do to get from Point A to Point B.
So I called and made an appointment with my surgeon's Physician's Assistant, T.J. I could have made an appointment with Dr. Mokris, the excellent surgeon who actually did my procedure (with T.J.'s assistance), but I opted not to - and here's why: Sometimes big-picture thinkers really are, well, big-picture thinkers. When I saw Dr. Mokris for my six-week post-op checkup, he looked at my x-ray and said I was doing perfect. I told him I was still hurting - much more than I'd expected to - and he assured me I was fine. And, in the big picture, I was and I am. The new titanium pieces are exactly where they should be, everything's lined up perfectly, the bone is knitting to the metal, and life is good. Big-picture. That's his job, that's what he does, that's where he thinks. Think of someone who is, say, a bridge architect. He designs a bridge, oversees its construction, declares it perfect because the loads are distributed properly, the structure is sound, and you can now get from Point A to Point B without a boat. Perfection. So if there's a pothole in the pavement, this guy is probably not going to get too concerned about it. At least, metaphorically, that's how I've come to look at big-picture thinkers, and this has seemed (to me, at least) especially true in the medical field. The bridge is up - all is well.
I have no doubt Dr. Mokris would have given me his full attention and taken my complaints seriously - I just didn't want to go to the bridge-builder this time around. I wanted to go to the guy who fixes the little things. So T.J. listened carefully last Friday, gave me a thorough exam and found all the movements that caused great pain (he's good at that!), and came up with a reasonable theory: Trochanteric Bursitis. Here's a description from some website:
A bursa is a small sac of fluid, and bursae are present wherever moving parts occur, helping to reduce friction. They are normally found around joints and where tendons, muscles, or ligaments, pass over bony prominences. The trochanteric bursa lies over a part of the femur (thigh bone) called the greater trochanter (a bony lump at the top of the outside of the thigh bone). Its job is to prevent friction between the greater trochanter and tissue called the ilitibial band. The condition known as trochanteric bursitis refers to a situation where the bursa has become irritated and inflamed. This can be caused either by a direct blow to the area or by repetitive friction of the iliotibial band on the bursa, as occurs in long-distance running.Well, I haven't been doing any long-distance running (darn it!), but there were some mallets and other tools banging around within an inch or so of my left trochanteric bursa - so that all made pretty good sense. (In the edited image, above, the smiley represents ground-zero of the hip replacement operation - pretty close to that bursa. Another note about the image: It depicts a right hip - mine was the left hip).
Anyway, T.J. decided to do a corticosteroid injection directly into the bursa. Did I mention he's very good at doing things that hurt? Yeah, that sucker really did hurt - a whole lot, in fact - but the early indications are he may have made the correct call. It's now about 48 hours after the injection and the pain has eased considerably. It's not totally gone, but it's a lot better. I can walk better now, too - with my operative leg moving straight forward and back, not swinging out to accommodate one kind of pain while creating another type of pain. I like that; it's something I can get my mind around as being a good sign, beyond just some pain relief.
My advice to anyone dealing with any challenging medical issue is pretty much this: Be your own strongest advocate. Keep pushing for answers. Don't stop just because the first doctor, or even the eighth doctor, can't find the problem. If the bridge-builder doesn't do potholes, find a guy who does. Keep pushing. Whether this latest round of treatment will do the trick or not, I feel a lot better today than I did two weeks ago when I was just sitting around waiting for things to get better, feeling grumpy because they hadn't, reading other peoples' reports about being back on the golf course three months post-op. I'm scheduled to see Dr. Mokris for another follow-up in six weeks... and I'm hoping I can cancel that appointment because the pain will be gone. If not, well, I guess it will be time to sit down with the bridge builder.
I'll keep you posted. Meanwhile, I'll keep doing what I can do to get from Point A to Point B.
