Nuerostimulator Pocket Revision
The original surgery and healing went very well except for the need to later revise the pocket, there where no complications or issues. Unfortunately, this time around was not that simple. Within 18 hours the incision was showing signs of infection. It had become red, hot and more painful very quickly. When originally talking to the nurse, she said that it couldn't be an infection because it typically takes a couple days for an infection to set in. Regardless, he doctor wanted to see pictures right away. I sent him pictures around 1pm and within 15 minutes he was on the phone with me. He asked how soon I could be downtown because I needed surgery right away to have the implant and leads removed and cleaned out. It looked like an infection had already set in and was rapidly spreading. 
My doctor wanted me downtown at the hospital immediately because he had an OR waiting for a 3pm surgery. He informed me that I would also need to quickly pack a bag because I would need to stay overnight at least 2 nights while cultures and tests ran as well as receiving IV antibiotics. I was terrified because of the severe infection I had summer of '13 and the amount of time I spent in the hospital and on medications, not to mention that this left a route open directly to my spinal cord susceptible to infection. My bag was still packed from the previous day as a precaution so we left immediately. I have never been rushed through pre-op so quickly. I had also hardly eaten all day so getting an IV was difficult. They put the line in while in the OR and I was already terrified and in tears. It took 2 docs and an ultrasound to finally get a line started and medications going. My doctor held my hand the entire time while they prepped because I was scared beyond belief. I also couldn't believe this was happening. I was afraid I was going to forever lose the relief I received from my stimulator and that medications would be my only option going forward. I was reassured that I would be able to get another implant once in the infection had cleared. There was still hope despite being absolutely terrified. 
I stayed in-patient for 2 nights on IV antibiotics. I was sent home with oral antibiotics for another couple weeks. They where glad that they where able to catch it so quickly, but it brought up another issue of possibly being immune deficient because of the rapid onset. That is still being investigated. With the stimulator out, my nerve medications had to be increased temporarily. Nerve medications take time to re-adjust to and do not have fun side effects. My RSD/CRPS also flared because of having the stimulator removed, the infection and then back on higher medication doses. It was a miserable couple months with all the changes. I was excited to have my stimulator back in and with insurance approval we where finally able to re-implant the neurostimulator on March 4th. We took extra precautions with prophylactic antibiotics, incision closures, etc., to reduce the risk of another infection. We also decided to move the pocket from the former right side to my left side to avoid the prior infected area altogether. Fortunately, this time around was successful on all counts. I healed well and the unit was charging easily and providing great relief! It was worth it all to have it back and working amazingly!!!
The next surgery is currently being planned. It would be for my left hip and femur. I have borderline dysplasia combined with a retroverted femur, excessively externally rotated. I also have another labral tear, hip flexor tendinosis and bursitis. The last surgery was only meant to be temporary and while it proved relief for about 18 months it is now time to fix the underlying issues. My joint space itself still looks good with minimal arthritis so it is better to fix the issues before the joint is deteriorated to the point of only having a THR as an option. I went out to see Dr. Millis at Boston Children's Hospital for a consult. He also had me see his colleague Dr. d'Hemecourt who is a sports physiatrist for a dynamic ultrasound and injections. We did determine that there was a lot of soft tissue inflammation and overcompensation, but that there where structural issues at play. Prior attempts of less invasive options had failed so we where looking at other approaches. Millis wanted to allow the injections time to work as well as continue PT. If we decide to proceed that a femoral varus rotational osteotomy would be the preferred option over a PAO, since he believes that the retroversion with my tissue laxity are the sources of pain than the borderline dysplasia.My local hip/shoulder surgeon, Dr. Dierckman, decided to further specialize as a hip preservation specialist and has left for another fellowship. It is bittersweet because I am very happy that another talented surgeon will be doing hip preservation, but I would be losing my local surgeon who has been so amazing in taking me on as a patient. He has been training with Dr. John Clohisy in St. Louis and has presented my case to him. He wants me to see Clohisy and to get his opinion on the case as well because he believes that I could benefit from a PAO instead. He would like to also see it fixed before more damage is present. I am hoping to hear back from him soon so I will be to find out what Clohisy's opinion on the case. Fingers crossed to know more soon!
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