Paradigm Shift

Last night I experienced somewhat of a paradigm shift in how I've been looking at my hip issue.

Until now, I've been trying to exhaust my options of things I can do on my own to heal my hips (or at least the parts that I can heal, such as the muscle tightness and the strength imbalances) so that if and when I need to undergo surgery, I'll be in a good place mentally and physically. I know that, if I undergo surgery, I'll have a long recovery process, but I anticipate that (unless something goes wrong) I'll eventually be "healed." This way of thinking has been frustrating me because I am feeling increasingly frustrated with the pain and waiting around for it to go away. After all, I've been doing so much!

So a wise person asked me, what if there is no "end" to the hip pain? What if I think about "managing" the pain rather than erasing it?

My first reaction was to reject this idea completely. Of course. Why else would I even think about surgery unless I believed that I wouldn't be forever doomed to have hip pain.

But, I thought it through a bit more. From what I've read, it seems like even in "successful" surgeries, there can be some residual weakness and pain that will require physical therapy, stretching, or some other way to keep strong and limber. And not all surgical patients end up pain-free. It's my understanding that doctors consider the surgery a success if the pain goes from a 10 to a 3. So if I were that patient, I'd still be in the position of having to manage the pain long-term.

A life filled with yoga, gyrotonic, swimming, biking, stretching...all to stay strong, increase joint mobility and reduce pain. Is that really so bad? Would I really even want to give that all up if I woke up and found myself "fixed"?  (Granted, I'd really love to add the running to that list, and I'm hoping I'll be able to add that back into my routine at some point.)

The best part about thinking about pain management instead of pain elimination is that I instantly stopped waiting for the day when I'm healed, but rather, gained a measure of peace in knowing that I'm making a difference on a daily basis.

I'm definitely not ready to throw in the towel on the possibility that the surgical route could correct the underlying issue that is causing my muscles to be all out of whack. But I'm also not ready to throw in the towel and say I've done everything I can do to manage the pain and I'm ready for someone else to fix me. I am going to focus on whatever pain management I can do now, and cross the surgery bridge if and when I get there. I've realized that the activities I'm doing so that I can manage my existing pain are also going to help me prevent pain from developing in other areas of my body.

Tempting Fate?

I have been very concerned with jinxing my progress by explaining how much better I'm doing, but I've decided to tempt fate and share it. 98% of my day I have no hip pain. That is HUGE!!!!! The other 2% of the time is when I stand up from a sitting position. And it doesn't happen all of the time. I'm still trying to figure out how to avoid the pain when I stand, because I assume it has something to do with the angle of my leg, hip, etc. But I feel like a completely different person than I felt when I started keeping this blog a couple of months ago.

Physical therapy is a gift from God. It has to be. I've been able to exercise pain-free, and I'm able to see just how strong I'm becoming. I have been increasing the intensity of the exercises (larger fins for resistance, increased number of squats, faster walking/running). And the water exercises have the added benefit of working my abs and arms also. That sense of accomplishment I got from running -- the pushing beyond my own mental and physical limits -- I'm getting that again, but in the water. And I'm even starting to enjoy the water. It's been hot here -- over 100 degrees each day this week. The water is a wonderful way to workout.

I'm still following Noell's 6-week eating plan (http://pickorstab.blogspot.com/) and I'm not really sure how many inches I've lost or how many pounds, but my clothes are getting very loose. I'm wearing a shirt today that I haven't worn in years (literally). Same with my pants. I even bought a new pencil skirt 3 weeks ago that was quite form-fitting, and I wore it yesterday and it was baggy in places. So, I assume that the reduced weight is helping relieve the pressure I'm putting on my hips also. 

I still haven't really resumed much activity beyond the pool-based, so that's my next challenge. Can I maintain this level of comfort and reincorporate some of the other activities I so dearly want to do -- bike, pilates, walk, yoga? I won't tempt the fates with running. I'm sad about that. There's a Keith Urban song, Till Summer Comes Around, and he's basically frozen in this place where he had a perfect summer love and hopes she'll return each year...she doesn't. He can't leave. I kind of feel like that's me and running. I fell in love, head-over-heals, and (due to my hip), running has said goodbye. I'm still wishing for it turn return to me, to give me the clarity of mind, the release of my over-busy head, the sense of accomplishment, etc. But I think I need to come to terms with the lost love and learn to love again. I'm seeing some shimmer of hope for a long-term relationship with the water.

I still don't know whether or not I'm going to end up requiring surgery. I know that the exercises I'm doing are not actually fixing my labral tear or FAI. They are just allowing me to function with minimal pain. I have a real concern that by not fixing the real underlying cause, I'm just postponing the inevitable, and when I do ultimately get the surgery, I'll have frayed more of my labrum, and caused much more damage to the joint. That is what is driving me to still meet with Dr. P and hopefully gain some more perspective. But at a minimum, I know that losing weight and strengthening my body is the best thing I can do pre-op anyway.

The rest is out of my hands. There isn't anything that this world can throw at me that I can't find a way to endure and of all of the possible things, this truly isn't that bad. Am I tempting fate? Maybe.

Not the end of the world

I won't lie...the blinding pain I had last night scared me and sent me through the whole spiralling thought-process about the futility of PT and the ultimate result of surgery, and concern that I haven't heard back from Vail, etc. etc. So I was really scared to wake up this morning and see what sort of pain awaited me. I felt a little twinge when I rolled over in bed, which I promptly ignored and snoozed through. But eventually I couldn't put it off any longer and I scooted myself to the edge of the bed and stood up. A quick systems check, and voila, no hip pain. (A little muscle tightness though, and I think my IT band is still pulling on my right knee). But I took a large sigh of relief, and went through my morning routine. Fingers crossed that I get through the entire day pain-free!

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.