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?

Temporarily disabled? Me?

I realized over the weekend that things were getting bad when my husband (Noah) and I went to dinner and couldn't find parking that was close to the restaurant. When I got out of the car and put the weight on my legs, the assault of sharp dagger-like pulses resulted in somewhat of an involuntary but (I thought) quiet string of curses. Noah, who informed me that I wasn't nearly as subtle as I thought, asked me if I wanted him to just drive me to the door and then he'd re-park. Wow, unable to walk through a parking lot?  No, of course not.  I walked it (hobbled, more like) and reached the door, pain aching in my hips and knees. Brilliant. We spotted an empty handicap spot steps from the door, and I realized that post-surgery, I'm going to need to get a handicap placard while I'm injured.  I mentioned this to Noah, who asked the obvious: I'm clearly having trouble walking...why not apply for one in the meantime, especially since I don't know how long I'll be hobbling around before I can even schedule the surgery?

Did it really get that bad? Am I temporarily disabled? It's so strange for me to wrap my head around. I had no idea what California's requirements are for getting a temporary placard. So of course, I googled "how to get a handicap plate" and found a really helpful website:
http://arthritis.about.com/od/driving/a/handicapparking.htm

It provides some general information and then has a state-by-state breakdown of the requirements, forms, etc.  I didn't realize that I truly fall into the category of people eligible for temporary placards in California. I'm not sure what I thought (if I even had considered it at all) the requirements would be. But I thought at least a cast, walker or cane would be necessary to qualify a person as handicap. In the future, I'll definitely think twice before ever again judging anyone in a handicap spot who isn't "obviously" handicap. I'm still amazed at how strong pain can be from such a seemingly-minor injury. Which of course, begs the question, am I just a wuss? Do most "normal" people just suck it up and hurt while they walk through large parking lots with their hip injuries? Is my hip injury worse than I've been assuming?

So, I decided it makes sense to have the placard in case I need it, but of course, I can use it as a backup if I can't otherwise find parking that's close enough. Clearly there are people with greater needs than I have at the moment. So I figure that for the most part, I'll just park in the regular parking. But on a particularly gruesome day or where there's no parking to be found anywhere near my destination, it'll be helpful to have the placard.

But of course, I'm finding that obtaining one is not a simple process -- for me, that is.  The orthopedist who referred me to the surgeon won't sign off on it because he's no longer my "treating" physician.  And of course, the surgeon can't sign off on it until he actually sees me.  I've been calling every day asking whether anyone has cancelled and whether there are any earlier appointments available than my appointment two weeks from now, and so far no luck. So this morning, I swallowed my dignity and begged to at least see the physician's assistant so I don't have to wait two weeks to apply for this placard. They told me they'd see what they could do and would call me back. So far, no call, but I suppose I'll give them at least 24 hours.

My other option is to ask my regular internist to sign off on the paperwork. But I'm sure he won't do that without examining my hip. Afterall, I've been seeing orthopedists and I don't think he's even aware that I have any problem with my hip.

So I'm in a state of limbo. In the meantime, I suppose I don't need to go anywhere with a huge parking lot.

I read that water is supposed to help people with screwed up joints, so I worked out in the pool today, swimming laps, and doing some aqua jogging and walking.  The walking is HARD. Much harder than the jogging, because there's so much more resistance from the legs and arms. The jogging was no impact because I did it in the deep end. Nevertheless, I think I overdid it because although it all felt wonderful in the water, once I got out, it all came crushing down on me again.

And that's something else that I've gotten absolutely no consistent answer on -- how do I stay strong and fit while not messing up my hip with a labral tear? The stationary bike hurt like hell this weekend. So that's out. Yoga and pilates made logical sense but ended up hurting. Swimming may turn out okay, but the way I did it today certainly didn't work. Walking hurts. Heck, sitting hurts. I don't know what to do and it's driving me nuts. I called the surgeon's office and spoke with some assistant who told me to "just do what feels good. If it hurts, stop." Well, that makes sense, but I don't usually know how it really feels until after-the-fact.

How many doctors is too many?

So I looked at my schedule and realized that I had appointments with three local surgeons and one out-of-state surgeon.  That felt a little much, given that the originally recommended surgeon will likely be excellent, and my backup out-of-state surgeon is probably easily sufficient for a second opinion. Do I need a third? Or a fourth?

Ultimately, I may. But given that I haven't even gotten a single opinion yet, I decided that I should cancel the first appointment. Nothing against Dr. Snibbe. His credentials looked amazing, and he appears to have performed this surgery ample times. He appears to be board-certified, which sounds impressive, though I'm not actually certain what that title specifically entails. But given the great things I've heard about Dr. Guanche, the surgeon to whom I was specifically referred, I decided that I'd wait until I see him before going for a second opinion.

So I'm currently scheduled to see Dr. Guanche in the middle of July. I keep calling the office to see if they've had any cancellations, but the best I've been able to do is to move my appointment ahead by one day.

In the meantime, my pain has gotten worse and I'm miserable. I seriously am running out of patience and I just want to get my full range of motion back.  Dr. Klapper, another surgeon with whom I've scheduled an appointment (at the end of July) co-wrote an excellent book I've been reading on hip care (called Heal Your Hips). In it, he and Linda Huey provide a set of exercises to perform in water as well as on land. I'm looking forward to trying them out (though I need to copy and laminate the page or I'll ruin the book at the pool).

But I am concerned that maybe I should have kept my appointment with Dr. Snibbe. Seriously, how does a person choose a surgeon? Is it overkill to seek a second opinion? a third? a fourth? It seems indulgent to do so, but on the other hand, it's my hip. And I'm young. I want to maximize my chances of having the best possible outcome.

It's pretty scary.

Hassles of Gathering Medical Records

I'm currently in the process of obtaining copies of all of my medical records from the various doctors and physical therapist I've seen about my hip. So far, I've got most of the documents and all of my images (conveniently on disk).  But I wish I had simply asked for copies each time I visited each doctor. Then I wouldn't be running around the city, picking up documents, and returning for the ones they inadvertently forgot to include. One of the reasons I'm attempting to collect these materials is because I need to copy them and send them to Dr. Philippon in CO, but the main reason I figured I should have copies is that this is my hip. Years from now, who knows what further issues I'll have in either hip. But I can count on myself to keep all of my documentation for comparison purposes and general history.  I don't know how easy these materials will be to get 10, 15 years down the road.

Yesterday was brutal. The pain was so severe I could barely concentrate on anything else. Today, thankfully, it seems much more manageable. Each time I stand, it hurts, and I've noticed I'm limping slightly. I spoke with my mother-in-law, who recommended that I don't put off treatment because even though I might not realize it, I'm probably making adjustments in response to the hip.  Those adjustments might wear away or result in injuries to other body parts, such as my knees. That's a scary thought. But it makes a whole lot of sense.

I'm picking up a book at the library today on water therapy and pool exercises that should be hip friendly. I'm not a huge fan of swimming (I find it somewhat boring), but given the importance of staying strong and healthy, I'm willing to give it a shot. Particularly if it can help this awful pain dissipate.

I don't know how people live with chronic pain. And so many people do. How do they function? How can they put up with it? I don't know if I'm especially wussy, or if other people are exceptionally strong. I must have broken down into tears three separate times yesterday. And I truly believe my tear is a minor one. I don't know how I'm going to deal with this pain for the immediate future, much less however long it takes me to get the surgery and recover. But I suppose I can only take one day at a time.