It's a mad hip world

This is a hard post for me to write because I'm putting down in words what I'm not sure I'm ready for quite yet. My appt was on Thursday with Z and started out well enough. He reviewed the xrays and asked how both hips were feeling. I joked around, telling him that I felt like the left hip didn't even have surgery and then explained that the right hip was still so bothersome. He asked about symptoms and I explained the aching and popping, and just this weird feeling like I'm walking on a giant bruise. I also noticed that my tolerance for walking is only about 10 minutes before the right hip is done. He nodded and had me walk down the hall and back toward him. I know I still have a slight limp but from which side now, I'm not sure. He asked if I felt unstable on the right hip. I told him not so much unstable but definately felt popping a lot and that was not normal. I explained that the hip hurt more now than it did pre op to the SDD.

Then he had me lie down on the exam table and checked the ROM on the left hip, which he was satisfied with. He then palpated the pubic bone and scar and that was very tender. He noted the top area to be the screws and the bottom to be the ischial/pubic cut he made during surgery. He pointed out on the xray that the cut is still not totally fused together but overall the hip is healing great and looks great. Then I had to lie back down and he checked the ROM on the right hip. It was uncomfortable. He had me sit back up and he told me that the right hip was definately going to need the PAO. I expected that, so I wasn't too surprised or upset. But this is where it gets a little fuzzy for me because I got so overwhelmed. He asked me how uncomfortable I was and would I be ready to go back to work yet? I told him that honestly I wasn't physically ready but mentally I was geared up to go back. My mother in law was with me and she mentioned that she didn't think I was comfortable at all and just watching me walk in the mall yesterday she could tell things were getting worse. I think I remember Z explaining that since the pubic cut wasn't totally healed he'd keep me off work just a little longer but because I was so uncomfortable still with the right hip, it wasn't unreasonable to write  me off work  indefinately and suggested that the RPAO could be done within 4-6 months of the LPAO, which would put me somewhere in the month of April, May or June. I asked if it was his opinion that it would be better to do it sooner vs later and it seemed we were in agreement that it would be to help the pain. Basically he said that there was nothing else that was going to make me feel better at this point. I asked about the steroid injection and if he remembered that I requested one. He said he did and he would do it right then if I'd like but he didn't really think it would give me much relief since it's the dysplasia itself that is causing the problem but there is possibly a labral tear and if so the injection would help that. I'm not a fan of injections so I refused then. He suggested getting the cortisone injected during my MRI-arthrogram that he wants me to have prior to surgery. At least I'm a pro at these now!

He did explain that when a pelvis is dysplastic and one side is "high grade" and the other side is "mid/low grade", once the high grade side is fixed and that pain is gone, generally the "mid/low grade" side begins to feel much worse. Not always and he wasn't sure if mine would feel that way since he had done the SDD, but he did say he was afraid that was going to happen. That explains the bruised feeling when walking that I complained of.

So that was the basis of the appointment. He told me to keep strengthening and to schedule with Jennifer, his surgical coordinator, today for surgery. I asked when I should do it and he felt May would be best to give my left leg a chance to heal a bit more and to get the right side stronger. Speaking with Jennifer is always a treat. She is so caring and genuinely interested in you the person, just like Z, and I love dealing with her. She sat down with me and began looking at options for dates. Now, keep in mind that Z is booked at least 5 months out and here we are in March. Do the math. She was looking awfully intent at the computer and I started to think that she wasn't going to be able to make it happen but she was able to get me into a slot on May 31st with the option of being on the "call" schedule in April for two Saturdays that Z takes call and has OR time. She did not have the April call schedule yet and said she'd let me know which Saturdays were available as soon as she received the schedule. My mother in law says she has the time off during May 31st to be at the hospital with me. I am relieved for that, but wishing that I could have my husband with me too so he could be informed of needing more time off. It's hard to make a big decision like that without your partner and I started to feel a bit sad, overwhelmed and scared because not only was I making a decision that was going to affect his work, I realized that I was also going to be giving up my position in the OR. Was I ready to do that?  Jennifer noticed I was tearing up and she got me some tissue and chocolates and began telling me that it would all be okay. Then she proceeded into telling me a funny story that had me laughing out loud. She also helped me schedule my MRI-arthrogram/cortisone injection. So she is truly a wonderful person to deal with.

I wore my "screw it" shirt again and not only did Z notice it and comment again how much he loves that shirt, but Jennifer saw it and she loves it too. She calls us girls the "hippies" (she is very fond of my friend, Niece, as well) and thinks we should make t-shirts for Z (in hot pink no less!!) that says "team captain" and she wants one that says "cheerleader".  It's great to have this team be so supportive!

On the way home everything started to hit me though and I began to panic and feel sad. I didn't know if this was going to work! I would be forfeiting my position in the OR, I would lose my insurance and have to pay for cobra instead which is so expensive, I felt like I would be screwing my co-workers over, and I knew that I would disappoint my husband due to having to change a lot of plans we'd made over the next few months. Financially I wasn't sure if it was going to be feasible because I wasn't sure of how disability was going to pay me. I called my human resources benefits specialist to go over some of my concerns and she answered a lot of my questions. When I got home, my husband was told of the appointment and he was shocked and didn't want to talk about it just yet. It was a lot to deal with. The next day we both felt a little better and were able to discuss the options. Bottom line, he is supporting me and wants me to feel better. We will be okay financially, although a bit tight at times, according to his calculations. My mother in law has offered to loan us money should we need it. What a blessing! As long as I am not denied long term disabililty, which I will find out in the next two weeks, I will be able to go ahead with the PAO. We are 95% decided this is the route to take. I will have to drop my husband from my insurance and he will have to pick up his own from his work so it won't be so expensive. Cobra makes you pay 102% of the cost of the insurance and I will only receive 60% of my wages if long term picks up my case. And the way I figure it, long term pays out more than short term and the difference is the cost of cobra so we will be making about the same income as we have the last 3 months. One thing about cobra is that they have to give you the exact same coverage you had before, so my deductible is met and all bills will be covered 100%. One other plus we have found about doing the PAO sooner is that everything will be fixed and out of the way much sooner and we can get on with life and start our family that much sooner.

I have let my managers know what could possibly happen and they support my decision either way. They feel that my health is much more important than me trying to come back and be miserable. My manager also pointed out that I am to the point where I would have to be cleared by the occupational med doctor to come back to work, since my FMLA is exhausted and I'm using personal leave to extend my recovery. He felt that the occ med doctor would make it very difficult for me to pass his exam and stress me to the point of not hurting me but at least proving that I wouldn't be able to function without getting an injury. His focus is financial, and if I look like an injury waiting to happen, he won't clear me to work at 100%, but only light duty. RN's are not allowed to be light duty where I work, therefore I would then be layed off or terminated. So at this point, it really only makes sense to go ahead with the RPAO. I am saddened but also feel like a load has been lifted off my shoulders after talking to the managers. They have let me know that I am their best nurse and it kills them to say go and take care of myself, but that it would be wrong of them to encourage me to come back to work and risk me hurting myself. They do have to post my position though, if I give my notice of staying off work beyond March 23rd, when personal leave would end.

I'm still trying to wrap my head around everything but it's starting to feel more real and possible. I don't think I have cried as much as I have Thursday night in a long time. I'm so relieved to think I could just get this done and over with so soon, and I'm so thankful that Dr. Z is in my corner willing to help me do whatever needs to be done, but it's also going to bring about huge changes. My job, finances, worrying about my coworkers, worrying about my husband working so much and taking care of me again. Once I am release to work again, which would be in September some time, I have to wait for an opening to come available at work and most likely it will be a night shift, and could be part time. That worries me too. I can't afford part time and I have worked my way up from night shift to the perfect 7 am to 3 pm schedule M-F that I will lose. It's a lot of change, but at the same time I do embrace it because I was seriously looking into changing jobs and furthering my education, so maybe this is the answer or a step in that direction. I have to look upon this positively or it will crush me. I am excited to be able to get the right hip as pain free as the left hip! And the surgery and immediate recovery does not scare me this time. I don't look forward to the affects of anesthesia though.

One huge plus to all this is that two of my friends that I've met through Z will be there during my hospital stay. Chel's daughter is having her LPAO the same day as I am and Niece will be having her scope later that week and needs to stay overnight. So I will see both my friends while in the hospital! I am not sure what to do with myself for the next 12 weeks though before the surgery. I am determined I will learn to become a great cook and maybe I can help with the getting the vegetable garden going this spring.

To cap off this entry, I either return to work the week of March 21st or stay off work indefinately and have the RPAO May 31st and tentatively return to work in September.

It's a mad hip world.