There are some events in life that change you. No matter how you may pick up the pieces, you will never be who you once were. Your outlook on life permanently changes. Looking back, what I thought were some of the hardest moments in my life, I now realize were a mere blip on the “toughen up radar.” I hope to look back one day on my “overcoming dysplasia” journey and also view this as a tiny blip.
Prior to April 2012, I did not have any symptoms of hip dysplasia, other than my ability to make a popping sound near my groin as you would cracking your back or neck. I didn’t suffer from lower back, gluteus, leg, or knee pain. I have always led an active lifestyle; former rock climber, diver, runner, weight lifter, swimmer, and crossfitter. I thought I would be one of the few that would grow into old age without a hitch. Actually, I was pretty confident of it. Looking back, I think we all think we are invincible.
When the symptoms started, they hit fast, and I quickly went downhill. There was no gradual decline; it was an avalanche. The take-down started April 2012 when I was 35. During workouts, I noticed knee pain. For a few months, I thought nothing of it and ensured to closely watch my form. Since the pain persisted, I requested that my Primary Care Manger (PCM) put in a physical therapy consult for me. The Physical Therapist diagnosed me with a tight IT band. Over the course of six months, my treatment consisted of dry needle therapy and corresponding workouts to strengthen the weak areas of my leg. The PT noted mild disuse atrophy of the left leg, but assured me that once the tightness/trigger points were resolved, my muscle strength would come back. Sadly, it did not.
The atrophy worsened, leading to a left hip labreal tear. Unfortunately, the doctors misdiagnosed the tear as a groin strain, and for the next nine months, I filtered through four different specialists while continuing with PT as the atrophy increased. The first hip orthopedic missed the dysplasia on my x-rays. Instead, he ruled that my hip structure looked solid and was not the cause of my pain. I was then sent to a Rheumatologist and Neurologist to rule out a potential diagnosis of myositis, which is a muscle disease. Both the Rheumatologist and Neurologist cleared me through advanced blood work and a muscle biopsy.
Meanwhile, as each specialist dismissed me, I still had pain, weakness, atrophy and instability. Random movements would flare up the pain even further in my inner groin area and hip flexor area. The symptoms improved on some days, but most days were painful. As I progressed down the chain of specialist, different drugs were prescribed to help manage the pain. Dry needle was, and still is, my form of pain management. I did not want to be on narcotics with small children and a full-time job. I needed mental acuity to get through the day. Finally, I settled on a stronger version of Motrin called Lodine and Tramadol paired with additional supplements suggested by a naturopath to help reduce inflammation. I also relied on massage, chiropractic care and acupuncture to help manage the pain,
The roller coaster of emotions that accompanied me through this part of my journey was a struggle. Working full time, mid-career, trying to make up hours before and after work while managing pain, all while trying to be a mom and wife, exhausted me. Just getting through the workday was a chore for me. Most days I was in tears by the time I got home, feeling frustrated with no answers, in pain, and trying to keep my life moving along. I wasn’t the mom or wife I wanted to be. I missed so many sporting events with my kids, due to appointments and physical therapy or just the inability to go. The gravity of my situation really weighed heavily on my heart. How can a person in near-excellent health go from being on the go and active one day to suddenly in chronic pain and with limited movement and atrophy? It just didn’t make sense…. I wasn’t satisfied with any of the answers the previous doctors provided, but understood that they were best trying to diagnose me within their area. I wanted a doctor that would assess the whole situation, not just auto-immune, nerve or bone. I may not have a degree in the medical field, but my background in IT kept me moving. I knew that there had to be a cause, and I wasn’t giving up. I would not let this situation hinder my life. It might set me back on many levels, but I would keep digging.
That next step was to see a physiatrist who was finally able to diagnose me with hip labral tear. From there, things moved along quickly. In addition to the labral tear, the second hip orthopedic I saw also diagnosed me with bilateral hip dysplasia. The doctor was honest when listing my options, informing me that if I chose the PAO route, I would need to seek a doctor who specializes in that procedure. After my initial consult with one of the top hip preservation specialists in August 2014, I had my LPAO on November 5, 2014, at Duke Regional. Eight months later, on July 22, 2015, I was once again being rolled into the OR for my RPAO.
From the time my symptoms started in 2012 to the moment that I met with the doctor that would ultimately perform my surgery, 28 months of my life had gone by living in chronic pain. Chronic pain at any age makes you feel cheated, but especially in midlife. By the age of 30, the majority of Americans are typically married, possibly with young children, while trying to climb the ladder in their professional career. We rely on our health in order to achieve all that needs to be done. The care-free life of the 20’s is now gone, and in your 40’s life becomes more secure. You don’t think in your 30’s, “What if my health…?” That thought just doesn’t enter your mind. That happens to older people… like 60ish on… but not in your 30s.
When trying to explain this surgery to others, the biggest question people asked me was “Why subject yourself to such a surgery?” The answer is really simple. Having dysplastic hips is similar to driving your car across a poorly designed bridge. One day that bridge is just going to give out from the poor design and wear and tear. Dysplastic hips are essentially the same concept. One day, they are going to give out from repeated stress. One can try and train the muscles to force fire, but at some point, the joint itself is going to wear down, and osteoarthritis will set in. Likewise, tired muscles become angry and create trigger points. These trigger points can cause a slew of problems: pain, atrophy, additional weakness, and so forth. This is why the PAO surgery is recommended for people that have hip dysplasia. It structurally sets the hip in the right position preventing any further damage to the joint and structurally aligning our body thus relieving overworked muscles. Once the bone grafts back together, pain subsides by correct alignment and muscle firing.
Recovering from a PAO is a delicate situation because of all the ups and downs. However, dealing with a bilateral situation takes perseverance and acceptance, but most of all it takes patience and willpower. As I write this 3.5 three-and-a-half weeks post-RPAO, I can say with confidence that early diagnosis prior to the onset of symptoms is imperative. It doesn’t take a medical journal article to articulate that early detection and subsequent surgery prior to the onset of muscle atrophy positively impacts post-op rehabilitation and reduced the chances of living in chronic pain. Although I am only a few weeks into my rehab, I can already see a different in my muscle control. I will continue to blog my journey as I progress through rehabilitation, hoping to live a pain-free life.
I am a wife, mother and career woman. I am also fighting to overcome hip dysplasia and the subsequent pain that accompanies it. I am fighting to get my mobility back.