Surgery vs. Waiting (with the possibility of surgery)

I learned another important lesson yesterday at the doctor's: I can't read x-rays despite all my research online. I saw a sneak peak of my x-ray, and saw this glowing white line, which I thought was the stress fracture, but there are still NO signs of healing.

So here are the options:

1. Surgery- one to two half inch slits to insert the screws into my femur. It would be done at the outpatient center, with a suggested overnight stay, though I might be able to go home that night. The chance of infection or nerve damage is low. (If the slow healing process is the result of something internally wrong that could lead to the surgery not healing and possibly other issues. Blood work here I come.)

2. Wait Another 4.5 Weeks- this might give my hip the time it needs to heal (femoral neck fractures take 6-12 weeks to show signs of healing), but if it isn't healed by then I will need surgery. If I fall, this would most likely cause a full break and put me at risk for AVN, thus total hip replacement. We're looking into a drug that is used for bone growth to see if there are any studies that show it's ability to help with fractures.

I'm supposed to make a decision by Monday, but I think I'm going to need more time. I've been talking to a lot of people, and have lots of question to ask the doctor:
· If I have surgery, how likely is it that I will need other surgeries on the hip in the future? (i.e. hip replacement)
· Do the pins stay in? Or will I have them removed?
· If we wait, and it doesn't heal will this mean a slower recovery after surgery?What is my rehab surgery vs waiting?

I'm trying to make the best decision for my body with the most information possible. I'm ok either way, just have a lot more that I know I need to ask the doctor.

Comments, or additional questions welcome.

Thursday, July 20, 2006

Happy Jen Had a Party...I'm Really Not as Upset as my Last Blog

Ok, so I thought I'd set something straight. I had a party on Saturday with lots of friends and family to celebrate my MBA graduation, it rocked. I'm not upset about the possibility of surgery anymore, I just want to feel better and walk around 100% of the time and not have pain in my leg. I'd almost welcome surgery at this point, to which Lisa keeps reminding me that surgery should only be a last resort and she reminds me again that surgery equals more pain (no thank you!). I agree, I've just lost a lot of my patience as it seems I'm watching summer fly by and having to cancel plans hasn't been much fun. But oh well, Lisa and I are going to be two naughty girls in... oh I can't say yet, it would ruin the surprise.

It has been fun, my girls are making sure I get out. Oh yeah, and my excuse that I'm going swimming or biking has so far been a lie, I've been a lazy girl. I need a schedule.

Well, I'm going to the doctors tomorrow, a week and a half early, because I had pressure in my hip and pain in my leg for two days. So I should have something to say tomorrow....I'm hoping for the "you're experiencing psychosomatic problems from paranoia" or him telling me to suck it up.

Wednesday, July 05, 2006

Beginning to Walk & The Not So Good News
Deflated, that's a better description of how I'm feeling. The day started off optimistic, I was ready to start my walking program today, and even more ready to go out with a couple girlfriends after work (I'd get to drive- the first time in 7 weeks). All I needed was the doctor's ok to walk and drive, and find out what my recovery was to entail. Start with the typical x-rays then wait for the doctor, but it wasn't the happy smile, it was the we have some issues look. The first thing he asks is if I've been putting any weight on my right leg, maybe a couple times it's touched the ground a little bit of weight but no walking.

The rest of the talk goes something like this: "I was looking at your x-rays and called my partner in, we stared at it for 10 minutes and couldn't find any indication of the fracture healing on the x-rays. I want you to start slowing putting more weight on your leg and see how it feels, if you have any and I mean ANY pain you are to call me at once. If this happens you'll have to have surgery and we'll put pins in to secure your hip. We're also going to check the recovery in another four weeks, if this doesn't show it healing then again you'll need surgery."

So after a couple cries, yes I admit it, I cried a handful of tears here and there, I'm finally numb after being frustrated and scared. Surgery wouldn't be too bad (if it was 7 weeks ago, and there wasnt another recovery period), but I've killed my social life in so many ways, I love summer/working out/being active, so this has been torturous. I want to start running, but will settle for biking and swimming, which I can do as long as it doesn't hurt (baby steps, one thing at a time).

MRI Number 2 - Last Leg Standing?

So for the last week my left hip had been hurting, to the point that the only reason I was taking pain medication was because it was hurting so badly even on days I was sitting down all day. Now come on, my good leg only hurts every now and then. Last Thursday I talked with my doctor and after having x-rays taken on my left and right sides, we schedule another MRI to see if it's just inflammation or have I done the unthinkable, another stress fracture. That would be awesome, from crutches to wheelchair, I've sufficiently managed to kill my social life, let's make sure we ruin the rest of my summer too.

There's one thing you can count on when the doctor comes into the room, the look on their face, I remember the look the doctor gave me when he told me I fractured the right leg. When he came in the room today, he had a big smile, what a relief, it's just overuse, no stress anything. It's a good day. Three more weeks then I can kiss my crutches good bye and start rebuilding the muscle in my leg.

X-Rays 1 & 2 - Plus the Countdown to Driving & Walking

The x-rays from week 1 and 2 both looked good. The bone is still in alignment and I'm guessing that maybe, just maybe the healing process can be seen... Overall, my right side has been feeling better, last week that was entirely due to the pain medication, but Thursday through Saturday my left side hurt so badly that I had to use my pain medication to make it through those days. I guess you could say I overdid it Thursday night, when I went to track practice with Don and was on my left leg for 2 hours watching everyone run then went to dinner for another 2 hours--that's the longest I've been out at one time. Maybe it was the euphoria in seeing everyone and wishing them good luck that it didn't hurt, but I felt it that night, the next day and the day after. It seems to be fine so far today, which is great because I really don't care to take pain medication. Don't get me wrong, feeling great is awesome it's just feeling loopy and needing a nap (basically passing out) that I don't care for.

On the good news front, I might be able to drive in 2, yes 2 weeks. Friends and family have been great at getting me out, gold stars go to my mom, brother, dad and Lisa, who without I would have gone crazy. From taking me to appointments to taking me out, they have kept me sane these last three weeks.

Four more weeks and counting to possibly walking...

Bone Density Results - Normal

Had my first bit of good news today, my bone density tests came back normal. That's a relief, my parents would have been shocked, we drank milk all the time as kids. My mom actually had to put a limit on how much we drank because my brother and I went through it so quickly. I've been staying at my parents and every chance it's been would you like some OJ there's extra calcium in it, or what about some milk, chocolate milk? My vitamins have calcium in them and I have calcium supplements too. Not stopping the supplements, no way, anything that might help me heal faster is still in the mix.

My first x-ray is tomorrow, crossing my fingers that it is setting properly. I've been a little concerned because I almost fell at my 5-year college reunion, and hope I didn't hurt it.

Femoral Neck Fracture

Friday was loads of fun, add a little false hope and you have yet another adventure that I think I'd rather avoid... I went to the orthopedic surgeon's and he took a look at the x-rays, there was not any indication of a fracture (my pelvis isn't perfect - part of the bone didn't grow completely so there's a little space) and after some movement test, he said I might be lucky and have a hip flexor stain after all. I went in immediately for a MRI so we could have a definitive answer. That was an experience, I understand why some people have issues with small spaces, the air feels different and if I lifted my head I could have hit in on the dome. They said the tests would be done at 2:30, I wasn't that worried I wasn't going to see the doctor until Monday after I had my bone density testing done.

I went to lunch with my mom and had just bit into my sandwich when my phone rang, it was the OS calling to tell me to come right in. Umm, that can't be good. So in I go, and I'm not lucky, actually it's worse than he thought, it isn't my pelvis but my femoral neck that's fractured. He starts to tell me that I have to stay completely off of my right leg and the complications that can arise should I decide to put pressure on it. The stress fracture can displace, with that the head loses blood flow and can die resulting in required surgery and permanent arthritis with a potential for more issues- do I ever want to walk again? He had to have said no weight bearing and crutches and made sure to point this out, and that this news generally tends to lose something over the phone.

Once a week for the next 3 weeks I will have x-rays taken to make sure I'm healing and the head hasn't displaced or lost blood flow. Then, in 6 weeks, hopefully the x-ray will show enough healing that we can start working on walking. No marathon, and we're not even going to talk about it. I keep hoping it's the you have to walk before you run... (It's ironic I hated running for 15 years, and made myself run for a great cause, now I love it and can't do it.) Actually, the way it sounds, I might not ever be able to run a marathon (possibly not run again) and I was so close to it, but if there's a chance even if it takes years, I will do it - with the blessing of the OS. If not, there's always another endurance sport to try.

So now, I get to sit or lay down as much as possible or crutch around. Upper body work is the only working out I'm allowed to attempt. How many days can you lift weights?

I do have a disabled placard, but it's not as cool when you actually need it.

Still waiting on this morning's bone density testing and hoping that it comes back with positive marks.

Hip Strain... Or so I thought on the 20-Mile Run
(don't stop reading until you get to the end)

Three and a half weeks of training, two weeks of an impeccable diet, and one last long run before the marathon, add in the attitude I had that day and it should have rivaled the 16-mile run for being the best run of the season. Like the 18-mile run, I started cramping early around mile 11, hamstrings and quads, but between 11 and 14 (water stop) it felt like my hip flexor was cramping. When we arrived at the water stop I was almost in tears, somewhere between pain and disappointment in knowing I might not complete the 20 mile run, and not knowing whether to continue or throw in the towel. After talking with a coach, run captain, and mentor, I decided to keep going, knowing that if it became worse that a car would come get me.

Emily kept me going, with encouragements for another couple miles when Erin joined us. She said it looked like I had marathon runner's shuffle, which is from cramping of the hip flexor muscle. I couldn't raise my leg over obstacles, and it spasmed pretty bad a couple of times. I ended up walking to 18-miles and grabbed a ride to the start, at 18 I really felt I could walk, but not run the last 2 miles. It took about 30 minutes to get back to the start, and when I tried to get out of the car my right leg gave, it felt as if all the power had gone out of my leg and hurt worse than I imagined it would.

So I got home and barely able to put any weight on my leg, hopped and limped around using a cane until Monday morning when my friend Kris brought over a pair of crutches. I love my friends, those crutches made my life so much easier. I figured that with the hip strain I might still make the marathon... I called Coach John and at this point I could put about 50-70% pressure on this leg and he informed me that not being able to bear weight on a limp generally meant fracture and that I might have a stress fracture.

Yeah right, I'm sure, me a facture are you kidding? The podiatrist just told me a couple weeks ago that I look like I have good bone density. So I go into work today and chat with my friend Lisa, who has had 4 kness surgeries, broken bones, and fractures, because I have never experienced any of these things and she convinces me to go to Urgent Care. Come on, I can put 80-90% of my weight on it today, I barely need the crutches, but I'll go. I need the ok to run the marathon; it's two and a half weeks away.

Well, after explaining the situation to the doctor and 3 x-rays later... no sugar coating, it's straight to the "I have bad news, you've fractured your pelvis, right there. Stay completely off your right leg. And see the other side, it looks like you've fractured that one several years ago and it healed fine, are you sure you didn't hurt it before? No work or activity for 3 days, and you can't go back to work until you get the orthopedic surgeon's ok. "

I actually had to have the nurse re-explain the part above to me, I heard fracture and managed to hear, but not process the rest. I knew it was a possibility, and it made sense, but I kept hoping above all else that it wasn't so. I was ok, until I hit the parking lot and started laughing and crying together. It just seemed to go so well together, to get so close and then blow it. Then came the calling the fewest and most important people that needed to know - Lisa, parents, work, my doctor, and my coach. The OS my doctor recommends, is booked solid and we have to see when he can fit me in...

I will know more once I see the doctor, but according to the coach 8-12 weeks until I can start training again and, even then, I will have to take it a little slower. Supplements, yes lots. Sitting on my rear, was hoping that was almost over as I had booked a full weekend- Friday -social event, Saturday 5-year college reunion, and Luau party, Sunday-Bay to Breakers (hmmm, not this year). We'll see. I want off the crutches as I swear I'm hurting the left side - let's see that would be the almost falling, tripping over my feet/crutches, and landing too hard on my left side because crutches are a lot more difficult than they look.

I will continue to keep the blog up, as it just seems to be one adventure after another. I have more doctors appointments and this could get interesting - I've already learned a lot about running.

Mental vs. Physical Limitations at the 18-Mile Run

They say it's mind over matter, that the only limits to our distance running are our mental limitations. I disagree, I was ready for 18 and was looking forward to another great run like the 16-mile, but muscle cramps and hurting knees made this run almost as uncomfortable as Santa Cruz. Around 10-miles my hamstrings and quads started cramping, the fun thing about running is once it starts it does not go away, it stays with you and walking only makes it worse. So Emily and I ran the last 5-6 miles, with 10-20 second walks here and there (water stops basically).

Oh well, the dip in the ocean and the fabulous breakfast in downtown Monterey made it worth it.