Surgery Updates - 2014

Surgeries are a normal aspect of my life. Surgery will be a maintenance aspect of my life. I had 3 surgeries in 2014. The break from my last surgery in 2013, which happened to be the last day of the year, till I had surgery in 2014 was a long break for me of 8 months between surgeries. For most people that would not seem like enough time at all, but for me it seemed like forever and was a nice break. I was actually able to enjoy my summer a bit.

The first surgery of 2014 was yet another right hip surgery. It made #8. The reason for so many right hip surgeries started because of a botched PAO. I was having groin pain, lateral hip pain and when my hip went into extension, abduction I would experience a very audible "pop" with associated searing pain. But, unlike "snapping hip syndrome" that deals with the hip flexor snapping causing an audible pop, this was occurring in the posterior aspect of my hip. When my local surgeon tested my hip and heard it for himself he was almost certain that it was my hip coming in and out of socket. Dierckman had seen me through 6 surgeries in 2013, but with the complexity of the right hip I needed to see someone who dealt with complex arthroscopic revisions. Doing another traditional open operation on the right was higher risk due to my infection and healing history. I was referred to a colleague of his in Chicago, Dr. Benjamin Domb at Hinsdale Orthopedics. Domb's partner, Dr. Justin LaReau, happened to be a former fellow of Dr. Millis. Millis also recommended Domb for a scope revision. Having both of my docs recommend Domb reassured me, despite mixed opinions I had heard.

I spent almost an hour in the consult with Domb and when he tested my hip and experienced the posterior audible "pop" he replied, "holy shit!" Not quite what I was expecting, but he had never seen anything like it. Being a "unique" patient was nothing new to me. Despite the complexity of my history, he was willing to take on the case and revise the hip. But, he did make it clear that revising this hip would be doing a "Hail Mary" because it would be a fine line between making my hip better or worse. We would do a majority arthroscopic and endoscopic with a small open femoral revision. About 2 weeks before my hip surgery I was diagnosed with stress fractures in my left shin. So, not only would I have a hip brace post-op on my right side, I would also be wearing a walking boot on my left leg for a few weeks.

The surgery was scheduled for 2 days after my birthday on August 8th. The procedures would include: right hip arthroscopy with labral repair, Pincer resection, femoroplasty, capsulorraphy, gluteus medius repair, open femoral trochanteric resection. The surgery took place at Hinsdale Adventist Hospital in Chicago, IL. I stayed in-patient for 2 nights. I spent 3 months in a hip brace and on crutches. Although the restrictions made it tough to get around, the pain was much improved and I could feel a positive difference almost immediately. My incisions healed nicely and I was excited to not have developed any infections.

     

The next surgery of the year was to trial and place a spinal cord neurostimulator. I had been dealing with RSD/CRPS in my right foot and leg for over 5 years. I was on multiple daily nerve medications and the effect was physically draining and I had not seen a lot of improvement, nor did I look forward to the prospect of being on these medications for the rest of my life. My pain specialist, Dr. Wellington, suggested trying a spinal cord stimulator. He was surprised by the fact it had not been suggested prior. He also knew that with my hip surgeries that I needed the ability to have imaging like MRI's. The newer stimulators where MRI-compatible and would allow me the benefit of the technology without hindering the need for future imaging. 

 Neurostimulator Implant Trial

He had several patients in similar situations with great results. I would even be able to trial the implant for 5 days prior to the permanent being placed. A "try before you buy." The goal would be to control and reduce the pain without further medications. A majority of patients where able to greatly reduce the dosages of medications and some where able to eliminate the need for meds altogether. It was something I was definitely willing to try and was hopeful it would work. The trial went amazing and we all concluded that the permanent implant would be perfect for me. I had the spinal cord neurostimulator implanted on October 21st as  an out-patient procedure. 

My last surgery of the year was a right shoulder revision from the previous year. My left shoulder was still holding strong, but my right had already become unstable as well as had a labral re-tear. We would approach this surgery a bit different by tightening more (if that was possible) and would use anchors to repair the labrum and for the capsulorraphy. We also where going to do 6-8 weeks in the immobilizer instead of 4 weeks, as well as little to no activity so that the shoulder would heal as tight as possible. I was fortunate and it was completed arthroscopically and able to be done as an out-patient procedure. We always plan for an overnight stay, but the regional block had worked very well and my pain was minimal, initially anyway. The recovery itself was harder and more painful than I remembered. Also, it being my right shoulder doing anything was very difficult. The surgery itself was successful and my shoulder was much more stable. 

Although the surgery was successful, we know that these procedures will only be a temporary measure because the EDS will cause the tissues to breakdown and instability to re-occur. But, by maintaining physical therapy and staying fit, the hope is to have the muscles help compensate for what my joints can not naturally do. We are hoping to have as much time as possible in between surgeries as possible. The next step surgically would be an open reconstruction which would be much more invasive and a drastically longer recovery. For now, the shoulders are stable and the need for more is not on the horizon.