Thursday, February 9, 2012

And Then, The Orthopedist

Surgeons like to cut.  I know that.  I used it as a mantra when I worked in hospital social work. I should have reminded myself of that before i went to the appointment.

TBG and I decided that he really didn't have to go with me this time.  There were no outstanding issues.  I was healed and making progress in ambulation and RIC pronounced me improving,with a perfectly repaired hip.  Dr. Boaz would x-ray me for a final time and then discharge me until I decided that the pain from the arthritis which was sure to build up made me beg for a hip replacement.

If only that had been the case. Alas.....

The x-rays revealed no more arthritis in the joint than had been there before.  He watched me stand and take a step or two and wondered when my calendar was clear for the 3 months that recovery from the hip replacement would take.  He was ready to schedule it.

WHOA went my brain.  The physiatrist was impressed with his carpentry and saw no need to replace it with ceramic and plastic.  The physical therapist told me that I should continue to improve - and I have the note paper on which she wrote that phrase and underlined it for me.  Was Dr. Boaz seeing the same body that I was?

His assessment was that my right leg is shorter than my left, and he had me lie on the exam table to prove it.  When I asked him to remeasure while I consciously relaxed my tensed muscles he chastised me.  "You are just realigning your hips."  No, I really wasn't moving my hips at all - I had a finger on each pelvic bone to insure their symmetry, just as the PT had suggested.  He wasn't hearing any of it.

To his eye, I have "a remarkable tolerance for pain."  He has repaired most hips with much less arthritis and damage than I display.   The surgery is much less difficult than what I went through last January. I will be walking freely and smoothly 3 months afterwards.

Besides, he went on, he never expected this repair to last more than a year or so,

Really?  Though TBG says he remembers hearing something like that I certainly do not.  I have invested a year of my life in learning to walk with my original parts.  I am not willing to toss that away.

"Why didn't we replace it a year ago, then?"  I wondered?  "Good question," was the response.  It was his call.  I had lost a lot of blood and the hip/pelvic repair was an extensive procedure.  The hip joint replacement would have meant another incision and several more hours on the operating table.  He didn't think I was up to it.  I cannot disagree; the surgery was difficult and the recovery was intense. Somehow I thought I'd get more than a year of therapy without fluidity before I had to start all over again.

He didn't agree that my walking was impeded by tight ligaments and tendons. He didn't think that stretching and building up muscle would make any difference.  He thought I could probably make it past the wedding next September but he kept coming back to my calendar and 3 months I could take off for recovery.

I walked out in a daze.  Stopped at the grocery store and the nail salon and went home to unload on my poor abused husband.  I was steaming by this point - I have two completely contradictory opinions from two completely competent physicians. What am I supposed to do?  Get a third opinion?  From whom?  A surgeon who will want to cut or a physical medicine specialist who will want me to work out?  Why have a spent a year rehabbing a body part that cannot ever work properly....if they guy who fixed it is to be believed?  Am I delusional to think that I can make this happen on my own?  Am I consigning myself to fruitless pain and suffering?  Should I take the easy,surgical route and assume that everything will then be A-OK?

After much back and forth, tears and outrage vying for supremacy, this is what I decided:  I am going with the answer that feels most congruent to me.  The discomfort I'm feeling right now is less than what I experienced 6 months ago.  I find myself moving with more grace and speed than I did 4 months ago.  I like the gym and exercise and feeling that I am in charge of my own health and recovery.  I do not want to be an in-patient again.  Plus, surgeons like to cut.

So, I will go back to the orthopedist in June, as he asked.  I will let him x-ray my joint and assess the arthritic build-up.  I will listen to him tell me that I shouldn't wait too long to schedule the replacement because the bone around the joint may deteriorate even more.  I will smile and nod.

Then, I'll get back in the gym and keep working out.  I am  not giving up on this,  I am going with what feels right.  The surgery can wait.

7 comments:

  1. Complex decisions, contradictory information....geesh, life is never easy, is it? I am glad you listened to and were true to you!

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  2. I agree, in the end, you need to do what's best for YOU. Uggghhh. This isn't easy and I don't want to think of you in pain, but at least if you go the non-surgical route, you are at least giving it a chance and listening to the physiatrist. If it doesn't improve, then you go the more aggressive route. You've already had a year of your life disrupted. If you do what makes you comfortable and comes very easy to you, it will not feel like you are going against the grain. You enjoy exercising. See if that works and go from there.


    Megan xxx

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  3. Go with your gut--there is no hurry to have surgery. xo

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  4. Good for you...I have felt lately that because medical costs are raising significantly and Dr.'s are also feeling the pinch they are requesting so much and ordering this test and that test and just doing outrageous things so we will pay for their jacked up costs...I too go with my gut and if I don't need something, I don't buy into it...

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  5. Well, you're right. Surgeons do like to cut, and it colors their world view. This is a difficult situation for you, there is no clear path ahead with the hip. I wish there was a well defined next step. In the end, I suppose one must go with the gut.

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  6. THANK YOU all... it's very comforting to know that my confusion is shared. For now, at least, I'm putting off the surgery. After all, we can always cut.....
    a/b

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  7. That was ortho, not orthodox! I'm on Kindle Fire.

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So.... what did you think? I'm interested.....

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