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Wednesday, December 3, 2014

MRI'm a hypochondriac

I'm sure some of you remember when my doctor told me that I was a hypochondriac. About 9 months after that, I was (finally) having surgery for a torn labrum, and I shook my fist in victory and crowed, "I told you so!"
Except he might be a tiny bit right.
I had my MRI this morning, and I was positive it would show a huge tear of the labrum and severe impingement.
But nope, it didn't at all. It showed a mild blunting of the edge of the labrum, more likely irritation than a tear. And it showed mild mixed femoacetabular impingement:

 - Pincher type, where the socket bone is curving too far over the femur, so there's some bone-on-bone contact when you move, and
- Cam type, where the head of the femur is an abnormal shape, so it doesn't fit right in the socket, and rubs and bumps as you move.
Both are just right outside what is considered the normal joint angle. On my left hip, I had cam-type only, but my pain was mostly from the big labral tear. Now, I really don't have a lot going on with the labrum. It's probably being pinched, but it looks like I caught it before it tore.
That's the good news. If I can keep my labrum intact, that's great! (Although it does mean my "high pain tolerance" card has been revoked. I obviously am super sensitive to any kind of hip pain: I was so sure the labrum would be torn on the MRI.)
Bad news is that I still need surgery on my right hip. My doctor reviewed the conservative measures to try first:
1. Discontinue activity causing pain. This means stop running forever. Not interested! Plus, this is not a permanent solution, as any movement (including walking, which hurts right now) will worsen the joint over time.
2. Physical therapy. The idea is to strengthen muscles around the hip to maintain as little contact between bones of the joint as possible. Dr. Van Sice ruled this out since I just got out of three months of vigorous PT and have been continuing 30 - 40 minutes of hip strengthening and stretching every day since then. He doesn't think I can improve on this area.
3. Steroid for pain control: already tried and failed. Not the best solution, since it doesn't help the bone-on-bone, but it can help the irritated labrum. But it didn't help me.

After discussing the situation, we're going through with surgery. I'm in pain when I walk or run, this is the only real option, and I was happy with my first surgery. I am a fan of catching things early, and I don't want to damage my hip cartilage, so I will be having the femoral head reshaped and the socket trimmed. Perhaps the labrum won't need any work at all (it was clear from the MRI that it is completely attached to the acetabulum, so if anything, it will just need to be trimmed to remove shredded, irritated areas). The surgery will be very similar to the one I had for my left hip, and recovery time and prognosis is also very similar.

On a positive note, my left hip is better and better every day, to the point that I don't notice anything wrong with it at all! I'm coming up on the six-month mark, and I really think that's the benchmark - where you are at 6 months tells you a lot about your overall recovery. I feel like my hip is about 95% well: it sometimes clicks and once in a great while I feel a twinge, but generally it feels fantastic. So I am hoping I can say the same thing about my right hip 6 months from now!


  1. Definitely a good news/bad news scenario, but I would absolutely make the same decision as you in this case. Onward and upward!

  2. I guess it's kind of good news. You know exactly what's happening and how to fix it so that's always good.

  3. BOO!!! I'm sorry to hear you have to go under the knife again. I got excited when I started reading this blog post, then I realized that you are in fact still going to need surgery. You are so positive about this. I wish you a speedy recovery.

  4. OK so a little trim here and a reshaped socket there.. doesn't sound that bad. ? Well, it does to me. But after ALL you have been through, I can see how you are excited to do this and get ON with things. It's as if you knew it would probably have to happen and you can get back out there sooner.
    Good golly, I bet you will be so happy when this is all in the past!

  5. Holy MOSES! I don't even know what to say. I'm just wishing you the best, praying things go smoothly and you heal quickly.