Too Good To Be True?

Ok, this is going to be a long post. This morning I met with another local orthopedic surgeon, Dr. Klapper, who is the Director of the Joint Replacement Division at Cedars-Sinai here in Los Angeles. I had an idea of what to expect from him because I read the book that he wrote entitled Heal Your Hips, in which he advocates non-surgical approaches to hip recovery and hip well-being. He only advocates surgery when the conservative approach fails. But what I like is that his conservative approach seems to be a joint pool and land therapy program. In his book, he discusses the downward cycle of hip pain, how it causes people to move less, and that lack of using the hip joint (and replacing the fluids in the hip) actually causes the hip to stiffen and results in more pain, when thus, makes you even less active, etc.

He looked at my films and the MRI and arthrogram reports, performed a physical examination of both of my hips to see at what point in the range of motion I have pain, and then he showed me on my x-ray where the extra bone portion is located and explained to me how that is bumping into the labrum. He said that it is FAI. BUT, unlike the other surgeons who have looked at my films, Dr. Klapper did not believe that I have mixed-FAI. He saw the evidence of it only on the ball, not the socket. If he's correct, and the portion of the socket were shaved down, there's no question it would make my hip unstable. So who is correct? YIKES! And ultimately, I'm not sure anyone can be 100% sure what's going on simply by looking at these films. I assume once I'm cut open, it's a whole other world and they'll actually see what is what.

But Dr. Klapper said words that I didn't dare to hope to hear:  "I don't advocate surgery for you, and definitely not yet."  Given the fact that this past week I've been nearly pain free and given that I have almost full range of motion, he suggested that I learn the pool therapy exercises and see if we can keep the pain from returning while slowly reintegrating activity into my life. He said that my labral tear was small and that although some surgeons will scare the crap out of me, tell me they need to cut sooner than later or I'll end up with early on-set of arthritis, they simply don't have the conclusive studies on that. Will I get arthritis? Maybe. But can I make some modifications to my lifestyle now to postpone it for many years? Possibly.

But Dr. Klapper said the words I dreaded -- that running is the best activity for mood, stress regulation and weight loss, etc., but the absolutely worst activity for your joints. He wants me to give it up completely. No running ever, unless I'm being chased.

At first, I immediately rejected that suggestion. And then I really thought about it. I'm not a professional athlete. Until last year, I wouldn't have even called myself an amateur athlete. A little over a year ago, I'd have never even considered running to be enjoyable. Now I adore it. Maybe I could feel that way about a different sport that is less taxing on my joints. I love to exercise outside. Okay. But I can swim, walk, and bike outside.  (Once I'm feeling better). I absolutely LOVE pilates. The mat work, at least, is not high impact. (Actually, I don't think it's impact at all, it's just the bending motion that was irritating my hip). If I want to do marathons or half-marathons, many of them allow you to walk. And I know first-hand, walking 26.2 miles or 13.1 miles is no easy task. What is it that I want long term? To be a fast runner? To complete Boston? Or to have a lifetime of mobility, activity and good health?

I keep hearing horror stories of complications from surgery. If you dislocate a joint, it's my understanding that that joint will always be a little less stable than it was before the dislocation. But that's what they'd do (to some extent) to get into the labrum to repair it. There are simply no guarantees with surgery, no matter who is doing the cutting.

Is it realistic for me truly to live a life with FAI and a small labral tear with minimal pain and moderate activity? Who knows. It certainly seems like I've got nothing to lose by trying. The pool therapy sounds like a really good idea to try because it's non-impact and I'll have someone trained to explain the exercises and watch me to make sure I've got the right form.

He wants to see if I've got any improvement in the next 6 weeks. Either way, I wasn't planning on having surgery then, so I don't see why I shouldn't give it a try. And if I ultimately need surgery, I'm still waiting around for a call from Vail to set a surgery date. And if I don't end up needing it, I don't end up needing it. Still, I don't want to get my hopes up. But if I could have a week like this week every week for the rest of my life (and I mean that level of comfort while doing activity, not while sitting around), I would definitely forego surgery.

But two conflicting ideas are swimming through my head, both trying to answer the question of why was this week so much better than the last bunch? 1) I did very little activity of any sort this week. That makes me concerned that once I kick up the activity level, I'll go right back to the pain. 2) I ate better this week than I have in months. No added sugar, no alcohol, no processed foods, regular healthy snacks and small healthy meals. Lots of water. I'm sure I've lost a few pounds. Maybe my excess weight is really a huge factor that the surgeons are awkward about calling my attention to. I know that FAI and the labral tear won't go away. BUT, maybe without the extra body weight, the pain would go away. There's only one way to know for sure, and it's about time I shed this fat!

My First Hip Surgery-Related Nightmare

I tend to have nightmares when I get stressed about things. So I'm not at all surprised that I had a nightmare about hip surgery last night. But upon a bit of reflection this morning, I found it sort of funny.

Basically, I went to the hospital to have the surgery, having never met the surgeon. They prepped me and suddenly I panicked. I wasn't sure, if I didn't speak with the surgeon, if he'd know which hip he was supposed to operate on. I was told not to worry about it...to just draw a smily face on my right hip, and they'd know what to do. So I responded, "but shouldn't I at least meet the surgeon before you guys put me under?" I was told that this was purely routine and if there were a problem, I'd be introduced. But then I had to wait, wearing a thin blue surgical gown that did not keep me warm at all, and they told me that the surgeon was running behind schedule, and that I should just spend the night at the hospital, and they'll get around to performing the surgery at some point during the night or early morning. So, I held my husband's hand and I fell asleep.

And then I woke in a cold sweat, freaking out and wondering why I would let my dream-self progress so far into the surgical process without having met the surgeon.

Some News!

Ever have a problem that you can't wrap your head around, and that no matter how hard you think about it, you can't make any progress? You know that irony when you finally stop thinking about it, and suddenly the answer comes to you? That's pretty much how things seem to be working for me on this hip thing.  I finally accepted that I can't do anything to rush the process and I will just make the best of the time I've got during this waiting process, and I got a call from Dr. Philippon's office yesterday!

I can't remember the name of the guy I spoke to, mainly because I was so excited to hear from them at all that I don't think my brain was working at it's normal capacity. But he was nice, patient and explained a lot. He confirmed that my MRIs showed both a labral tear and mixed-FAI. 

But best of all, he asked me all sorts of really good questions that showed that he (or someone there) had read my incredibly long narrative of all of the information I thought that they should know about my medical health in general and the discovery and development of the hip pain. They asked me questions that showed that they were not just looking to jump in and fix the hip, but wanted to ensure that nothing else could be causing the pain, or that my other medications and/or complications from PCOS could be contributing factors. It showed me that they're looking at the body more as a system, than as a butcher might. It gave me some confidence.  It also gave me a little more confidence in my local surgeon's diagnosis.

 As I expected, however, it looks like the process is a slow one. And there are still no guarantees they'll ultimately operate on me. They asked me if I had gotten any injections (to isolate whether the pain is actually in the hip or if it's pain in the lower back that I feel in the butt, etc.). I haven't. I don't know if they'll want me to do that. They also indicated that, since they're backed up scheduling wise and are already into 2011, I'll need to have another MRI closer to the date of the appointment (whenever that'll be). That actually makes me feel better -- I don't want them to be surprised if they cut me open. 

But 2011 -- that's not particularly quick. And I won't even speak with the scheduling person to book a surgery date until approx 2 weeks from now (which I am just going to assume will be closer to a month). So I am guessing that realistically, they wouldn't be able to do the surgery before Feb/March next year.  The guy I spoke with explained that they're very busy -- they get 150 requests per month from people like me, asking for a review of films, etc., and Dr. Philippon does approx 40 of these surgeries per month. Seriously, I don't know how those numbers add up. Does the man sleep? Are there enough hours in a day? And I thought I had a busy schedule!

They're going to look into whether there's any local surgeons that they feel comfortable recommending to me in case things get worse quickly and I don't want to wait. And I still have an appointment with another local surgeon I found on my own. 

But in the meantime, I feel pretty good. Not much has changed between Monday and today, and, in some ways, my life has gained a new level of uncertainty. But I feel good. I don't know why. Peaceful. Like I've gained some acceptance finally. I trust that I'll take the time I need to take to make the right decision for me. And the result is beyond my control and even beyond the complete control of a surgeon. But if I give myself a half a year before surgery, I have the gift of time, which may ultimately be a blessing in disguise.

I'll have time to really research everything and be as knowledgeable as I can. That should help me go into surgery with confidence, which necessarily will help me recover. I'll have 6 months to lose weight. For sure that will help me recover faster. Think of all of that extra weight that I won't have to feel pounding down on my hip joint. I'll have 6 months to save money -- which it seems I'll need a lot of if insurance becomes problematic. I'll get to plan ahead work-wise, and not spring a long recovery on my bosses. And I get to be as mobile and healthy as I can be. 

Yes, I'm still in pain. A lot of it.  But I'm finding ways to live with the pain. No -- I really don't want to live like this permanently. I really want the surgery. But I think I can manage for 6 or so months. I went swimming today during lunch. It was only 20 minutes and I used a pull buoy so I didn't kick with my legs. But I really felt great and it's the first real cardio I've done in a while that I haven't finished in more pain than I started with.  Though my arms may be yelling at me tomorrow! I had purchased a waterproof ipod shuffle case/headphones from H2O Audio, and it worked like a charm. That made swimming laps a lot more fun for me. (I don't know why, but I just don't find swimming particularly fun). But it's exercise, and I'll take it! 

And who knows -- after swimming for 6 months, and biking during recovery and ultimately running again, maybe in a few years I'll end up doing something I thought I'd never be able to do -- a triathlon!

 I believe that we humans are given such amazing gifts, including the ability to choose how we perceive the world around us. We can choose to view a challenge as a roadblock or an opportunity. We have each other for compassion and support. We can focus on what we wish were different, or make the most of what we've got. 

So maybe the only real thing that changed in the past 72 hours is the way I've begun to view the situation. I truly don't have any more answers. But I have a measure of peace. 

Outside My Window

My office is located right next to a park and the view from my window includes a grassy area where people take their dogs, two little league baseball diamonds, and a portion of a dirt track that circles the park. I've got two trees that hummingbirds enjoy visiting, and a small window sill where small finches come to leave dropping and peck my window. And in moments like this one -- where I turn my head and see a Yellow Jacket trying to come through -- I'm actually relieved that the window does not open.

The window (and its associated view) is what I love most about my office, and also, what frustrates me about it.  I love seeing so many active people on the track. In the morning, I see small groups of people performing "boot camp" workouts. As a dog person, I enjoy seeing the variety of excited furry four-legged visitors. My view of the baseball diamonds isn't good enough for me to truly enjoy watching any games, but I feel like there's a world of constant motion outside of my window, and that always makes me smile. I love the colors (primarily browns and greens), but I also love the way the sun's angle subtly changes those colors. And I love watching people run -- noticing the variants in form, expression, speed, companionship, etc.

But it's also easy for me to now see the track as a reminder of what I'm no longer able to do...and of what I wish I had done more...did I hurt my hip because I ran on asphalt and concrete most of the time? If only I had trained here on this softer ground, would I still be running this evening? It's so easy to second guess and let myself feel sorry for myself. But it's sort of silly and self-centered of me. I'm so blessed. Today, I saw two hummingbirds hovering only a few feet away from me. I'm looking at a beautiful blue sky and branches blowing softly in the wind. I live an easy drive from some of the most beautiful places I've ever seen. And I WILL get back out there and enjoy it all. If I can't run, I'll walk. If I can't walk, I'll learn to ride.

And I'll use that track as my symbol of where I've been and of what I aspire to do.

A view through my window

Uncertainty...almost as bad as the pain

The worst part about waiting to hear from other doctors so far is that I feel like my hip is getting worse each week.  It's no longer even just my right hip. My left hip has been popping, and hurts sometimes when I stand up. I wonder if I should start the ball rolling on that hip also, since, I assume, it's probably the same thing as what's wrong with the right hip. My unscientific theory for linking the two hips is that the pain in the left started at the same time as my right hip pain (though much easier to ignore because the pain wasn't as severe) and because it's also getting worse in the same way and the pain moves around in the same way. Or I can try to fix the right hip, and possibly live with the issues in my left. It really doesn't bother me nearly as much as the right. On the other hand, if it's a labral tear, I'm sure it will start bothering me more once I regain my activity. So maybe it's not worth waiting. Who knows. I suppose I should ask the surgeons about it.

But almost as bad as the increasing physical pain is the complete and utter lack of certainty about who, what, where, when and why.  Who will be doing the surgery? What surgery (FAI, labral repair, labral debridement)? Where (in-state, out-of-state), When (next month, the fall, the winter, 2011)? Why? Well, I know why I need surgery, but I link the "why" question with the "what" question. The answer to "what" or "which" surgery I need will necessarily depend upon "why" I need any particular procedure.

I called Vail for an update on Wednesday and spoke with Madeline, who as usual was incredibly kind, but let me know that I probably wouldn't hear anything until next week.  So naturally I'm bummed.  At this point, I'd just like to know if I'm looking at a 2011 surgery or something within the next month or so. I am going to have to take off of work for the surgery and some of the rehab period, and I'm sure I'll need to adjust my schedule somewhat as I return to work (with various PT appointments, follow-up visits, etc). How am I to plan around two completely distinct possible scenarios? And more than actual preparation, I simply have this nonstop nagging in my head about the five W's. It's like a broken record that I can't stop from repeating constantly.  And completely aside from the numerous questions about the surgery, I have as many about post-surgery. Mainly, how will my body heal?

I know I love to be in control and this feels a bit like a sick joke that the universe is playing on me.  But truly, how else can a person learn to surrender control and certainty than to be in a situation where she has neither?

Traveling Tales -- Swallowing My Pride

This weekend, I flew across the country.  I knew I had a layover at the Charlotte airport, which, most inconveniently, seems to spread its concourses as far apart as it possible.  Having literally run through the airport in previous trips (nevertheless missing a flight), I knew the airport would present extra difficulties for me these days, now that walking hurts.  Upon the excellent advice of my father-in-law, I spoke to the gate attendant at my gate in LAX, and let them know that I will need assistance at my connecting airport, and asked them to call ahead to have an electric cart waiting.  They gave me a form to fill out (with three carbon copies), and told me to give the top copy to a flight attendant when I board the plane.  I did.  However, the flight attendant, using somewhat of a rude voice, asked me, "What am I supposed to do with THIS?" Lovely.

So I didn't have high hopes when I deplaned in Charlotte, but to my surprise, the flight attendant had passed on the paperwork to a gate attendant, who had called for an electric cart.  I shared the cart with a guy who wore a huge leg cast and was walking with crutches.  I felt so self conscious, as if everyone who saw me on the cart was wondering why this lazy young lady was taking advantage of the electric cart system.  I had to go from the very end of terminal C to the very end of terminal E.  My embarrassment ended abruptly during the ride when I recalled exactly how large each concourse was. WOW.  I'd have been yelping in pain for the entire trip if I hadn't swallowed my pride and asked for assistance.  

The drivers of the carts (that's intentionally plural -- I needed two different carts because terminal E requires an elevator/stairs/escalator trip) couldn't have been nicer. I was expecting them to take one look at me, give me an angry look and demand to know my justification for the cart.  They're probably not allowed to do that.  But still, it was nice to get the help I needed without any big production.  I was in a bit of pain for sitting on the airplane for a while, but I was able to do enough walking (between my gate and the bathroom) to loosen up, but not so much that I overdid it. 

For future travel, I don't think it's necessary to arrange for transport up front, but it sure was helpful and did save me a lot of time and aggravation. I'm sure that each airport has its own way of doing things, but I feel a little less intimidated by the process. And as with the handicap parking spaces, it's good to remember that people need assistance for all kinds of reasons, and pain is definitely not always visible to others. 

Deciphering x-ray images

Picture time! Here are my x-ray images from the end of last year (from which I've cropped out the text). I think I understand a little better what might be the extra bony part on the CAM and Pincer, though I'm still far from sure. I've been trying to compare my pics with others online and I suppose that given my complete lack of medical training, I may simply be wasting my time. But I think it helps me to wrap my head around my hip issues when I can visualize the problem. This one is me with my right leg in a bent position:

And below is my right hip in a neutral position:

I'm not sure what to make out of any of this. I think I looked pretty much the same in the subsequent x-rays that were taken more recently. Here's the one with my right leg bent:

And here's one of my right hip in a neutral position:

So I'm not sure what to make of any of this. I looked at the x-ray of both hips, and decided that, in my lay opinion, the left hip looks as bad as the right one. That is, if I'm looking at the correct portion of the hip socket -- which I very well may not be. This is the left hip in a neutral position:

So, other than the fact that now my blog has pictures, I don't know what value any of this really adds. I'm not comfortable posting my MRI pics because I REALLY don't understand what I'm looking at, and for some reason, it seems a little too personal to share on the Internet. (But it's truly amazing and somewhat mindblowing just how much of our insides can be revealed through an MRI). 

Anyway, enjoy the pretty pics!

I met with the surgeon...and my head is spinning.

I don't know why I was so nervous to meet with Dr. Guanche this morning, but I was uncharacteristically anxious. I arrived 10 minutes before my scheduled check-in time, and about a half hour later, I was given the necessary paperwork to fill out. Needless to say, the office was incredibly busy this morning. I was finally called back to meet with the doc, and offered whatever combination of MRIs/X-Rays/medical records they wanted. (I've got both the films and the electronic images). The assistant made copies of the reports of the MRI and Arthrogram, and uploaded the images from the discs. Meanwhile, I was given some disposable shorts to change into, and I had a very short wait. I realized that even though I had printed out a long list of questions to ask, I had inadvertently left that at home, so I quickly tried to reconstruct that list. Then doc came in and introduced himself.

To his credit, he asked me to explain the onset of the injury and where the pain is. (Always an annoying question to me, since I feel like an idiot when I say, "I really can't pinpoint the pain. It seems to move around, sometimes in the groin, sometimes in the front, sometimes in my butt, sometimes on the side...I just don't know.") He asked me about popping/clicking, and I said I didn't know if the sensation I experienced counted (I get what feels like when you crack your knuckles, but in my hip -- no associated pain with that though). He seemed to think my description was useful. I tried to recreate it, but of course, that was the one time my hip didn't crack.

I really appreciated that he performed his own full physical evaluation of my hip pain (i.e., range of motion test, etc.) instead of reviewing and relying on the notes from my referring orthopedists. That gave me some confidence. And apparently I'm pretty consistent -- the same positions caused that searing pain with prior exams were the ones that made me cringe this morning.

He showed me some images from my x-rays and MRIs (not sure if it was the regular MRI or the arthrogram), and explained that, not only do I have a labral tear, I also have a combined CAM and Pincer FAI.This was what I feared. It suddenly feels like a much more serious surgery -- removing a bit of my bone!!! I'm not sure why that scares me more than removing some of the cartilage, but it does. It feels so much more structural. And I'm a little concerned that this is the first I've heard of that. Neither my MRI nor Arthrogram Reports indicated the presence of FAI. To the contrary -- my lay man's reading of the reports made me think that there was no indication. (The arthrogram noted "There are no morphologic changes of the acetabulum or proximal femur to suggest primary CAM or pincertype femoroacetabular impingement.") So, I'm scared, I'm confused and I'm concerned. Why the discrepancy? Of course, I didn't remember what was in the report while I was meeting with Dr. Guanche, so I didn't ask him about it. He did show me on the images where he thought the FAI was.  But when I looked online at x-rays of normal hips compared to mine, I just don't know if I see it.

I did my usual skimming of google and came by a website with a roundtable discussion amongst orthopods about FAI and how they're being diagnosed more often, and how 86% of labral tears are associated with combined CAM and Pincer FAI. http://www.orthosupersite.com/view.aspx?rid=40509   That made me feel a little better, that this isn't coming from left field. And that my combination is not particularly rare.

Dr. Guanche took time to answer all of my questions, and I asked him everything I could remember to ask. I did remember to ask him about his feelings about the Game Ready ice machine and CPM machine that I've heard so much about. He said that over the past few months, he's been recommending devices like the Game Ready machine, but that he still has concerns with recommending the CPM machine, because it requires you use if for 8 hours (and most of his patients don't have that ability to do so given the need to return to work, etc.) and that he's concerned that if you slightly adjust your hips, it can actually rotate the hip slightly (and I suppose do more harm than help). The rest of what he told me sounded like what I expected. He told me that he performs approx 250 of these surgeries per year. (I forget when he started, 15 or 17 years ago?) He said that of those 250, annually, there are generally approx 2-3 that need revisions due to complications (scar tissue, etc) and unfortunately there's no way to know whether you're going to be one of the few upfront. I asked a lot about the physical therapy protocol, and I liked the fact that some of my PT would be in the pool. He said within 6 months, I should be able to resume my training, and when I mentioned my love of pilates, was very enthusiastic about my doing it pre-surgery and then (when ready) post-op. He said there were a few positions that would cause me discomfort for now, but most of it should be doable.

He was definitely not Mr. Gloom and Doom with the risks and side effects of surgery. I assume all of that is detailed in the reading materials he gave me, and probably in the pre-op appointment when I'm sure I will have to sign away my life in various legal documents. But truly, I expected a little more of the this-is-a-risky-procedure kind of speech.

After meeting with the doc, I met with the person who schedules surgeries and deals with insurance companies. She told me that most often, insurance companies deny this surgery because they consider it "experimental" or "investigative." They seek pre-authorization, and if it doesn't go through, you can of course appeal it, they will write a letter, but most often, it seems, patients pay out of pocket, and then after the surgery, mail to the insurance company the records from the procedure (showing it was not unnecessary) and sometimes the insurance company will then cover the procedure. But it's not cheap. I got a quote for the facility and doctor, but not the anesthesiologist or any of the physical therapy (which would be 3x/week for 12 weeks, and which I'm certain is not covered substantially by my plan), and I already had sticker shock. It certainly gives me pause. If and when I decide to do the surgery, they would start the process with my insurance company. But I didn't set a date because I am still waiting to get a second (and third) opinion.

I realistically can't do nothing. I'm in way too much discomfort for that. And I'm prevented from doing so much. And for the things that I can do, the pain still gets in the way. It's a constant. But I'm particularly concerned about what happens if this is in fact, CAM and Pincer FAI with the labral tear. I highly suspect I already have a small tear in my other hip, and if it's a bone structure thing -- that makes me think I'll probably end up down this road again at some point trying to fix that hip too.

So, the best I can do is to continue to get more information, continue to try to be healthy and to take each day at a time. I look forward to finding out if the other specialists also think I have FAI.

A lot to consider

I'm feeling so anxious.  I guess I'm somewhat of a literal person, so when I was initially told that it would take a week for Dr. Philippon to review my records and get back to me, I pretty much looked at the calendar and expected to hear back within 7 days. Two follow-up calls later, I've finally realized that I just need to wait. This isn't going to be a quick process.

In the meantime, I'm trying to get more information and I've been lucky enough to get to talk to some very very helpful people who have gone through similar experiences. Of course, not all of the information I've gotten is pleasant. It seems like there are a lot of potential complications from the surgery, including the very real possibility that what starts as a seemingly easy surgery may turn into something a lot more complicated once the surgeon takes a look. And there are the even more disturbing stories about how the surgeons treat patients who have such complications. Physical therapy approaches also seem to differ depending on the surgeon and it seems as though PT is one of the most important aspects of the healing process. So not only do I need to find a surgeon who is well-qualified, takes the time to explain the procedure and answer all of my questions, etc., I also have to find one whose philosophy on PT matches my ultimate goals. As one very helpful person pointed out to me today, if one surgeon's idea of a "success" is enabling a patient to tie her shoelaces, and another's idea of "success" involves running marathons, it's important to figure out whether your surgeon's idea is consonant with your own ideas.

I'm thoroughly freaking out.  The fact that the pain is currently the worst it's been in weeks is not helping anything. And I'm wondering if my labral tear is just a labral tear, or whether there's some underlying issue that hasn't yet been diagnosed, but which is contributing to the tear and which will also need to be addressed.  That's a scary prospect.

And I'm scared that Dr. Philippon won't accept me as a patient. I like what I've heard of his rehab protocol quite a bit. It seems very proactive and intended to return patients to extremely active lives. That's what I want. But I wonder if the fact that I'm an overweight and extremely amateur athlete might affect his view of how seriously I would take the post-op care. And maybe that will affect whether or not he wants to take on my case.

And this train of thought is where I simply stopped running through the possibilities in my head. One thing I'm sure of for now -- I am not getting this surgery anytime within the next month. And, there's a possibility that I won't get this surgery for half a year. What can I do now to help optimize my chances for a smooth recovery no matter who is ultimately going to perform the surgery?

I can definitely lose weight and get as strong as I can in the meantime. Although I'm limited in what activities I can perform currently, I still have complete control over my food intake. I can still work my upper body without any limitation. And once my current flareup subsides, maybe I'll be able to swim.

So instead of letting this waiting period add to my stress, encourage inactivity and increase my weight, I get to use this precious time to nourish and detox my body and prep for what will hopefully become an easier recovery period.  Maybe the fact that this is a slow process with so many factors outside of my control is actually a blessing in disguise, forcing me to truly think through all of the aspects of this injury and treatment, and of my body in general.

I'll try to focus on what I can control and what I can do right now, rather than how sorry I feel for myself. Seriously, reading about other people's experiences and speaking with others shows me that I've really got it good compared to some others. I'm still quite blessed.

I can:

• work
• walk (short distances)
• drive
• swim (somewhat)
• travel
• read
• play trumpet and piano
• hang out with friends and family
• throw balls for my dogs to chase
• organize and clean my house (bit by bit)
• go to movies, theaters, concerts, etc.
• go out to eat
• shower
• change my shoes and socks, and tie my laces
• scrapbook

All of these things that I take for granted are things that my hips don't prevent me from enjoying.  And that was just a quick list off of the top of my head.  While I'm waiting around for something to happen on my hip front, I can enjoy the fact that I'll be:

• traveling across the country to visit with my family at a beach
• working on fascinating cases involving basic rights of employees
• performing at Disney Hall with the Los Angeles Lawyers Philharmonic
• planning improvements to my backyard
• reading interesting books
• spending quality time with my husband, my two dogs and my parrot
• spending quality time with my friends

 And of course, I can work to make each day the most positive one yet, mentally and physically.

And I'll at least get to meet Dr. Guanche next Monday and discuss with him what he sees, and whether he believes I have any other underlying conditions that might have caused the labral tear, or whether it is simply from my overtraining with extra poundage.

Here's to the power of positive thinking!