# Twenty-Three Means Another Surgery For Me...

The last few weeks have been quite difficult for me. I am just over 8 weeks post-op from left shoulder surgery and about 10 days away from probably the biggest surgery I have had to date.

The left hip issues have been worked on for the last couple years, but with returning symptoms and little relief the decision for a surgery to fix the underlying problems once and for all was made this past month. My left hip has had 2 prior scopes, 1 traditional scope, 1 scope with open capsular plication and work on my IT band, etc. I also had an additional surgery on my left hip for a superficial wound infection. The last time my left hip was worked on was over 2 years ago and although at the time we knew it may only be temporary it was worth not enduring major surgery if it was successful. I did gain some relief for awhile, but eventually the pain and problems returned. The LPAO or FO have been discussed the last 2 years with multiple visits to Boston with Dr. Millis, my local surgeon, etc. Many additional x-rays, MRI's, CT's, injections, endless PT have all been performed. Until recently, everyone was hesitant with my history of complications and infections to proceed with such a massive surgery, but at this point we are left with no other options and all I want is a sense of normalcy back in my life. 

Until recently, I thought for certain my surgery would be in Boston with Dr. Millis. My local ortho, Dr. Dierckman, had left for LA to pursue another fellowship in Hip Preservation. Although I am excited for him to be pursuing a passion and have another great hip doc join the ranks I also lost my local ortho who gave me incredible care. Not too long after Dierckman left, Indy got a very well trained hip preservation specialist, trained in both open hip surgery and arthroscopy. His name is Dr. Presley Swann and he trained under Dr. Chris Peters out of Utah. His residency was at Mayo and one of his classmates happened to be the fellow who assisted Millis on my FO! I was very weary of a new doc, but who could blame me! Dierckman actually urged me to make an appointment with him and had spoken with Swann prior to leaving. He had nothing but amazing things to say about him. I greatly trust and respect Dierckman, so took his advice and went to see what Swann had to say about my hip. At this point, Millis still was leaning towards a femoral rotational osteotomy, but really wanted to wait and push for more PT because of my complex history. Dierckman did not agree that an FO was the right option for me with a femoral version of 14 degrees being normal and that a PAO was more suitable. Swann would be the opinion with fresh eyes on my complex case. 

When I first met Swann I could see why Dierckman had so many great things to say about him. He was very personable, super intelligent, compassionate and not only cared about my hip, but about me overall. His personality and approach was very similar to Dierckman and we hit it off right away! Swann agreed that my hip and case was very complex, but was willing to take me on as a patient and believed that he could help me. We both know that my hip will not be perfect, but he believes that he can give me significant improvement. My first appointment with Swann was long and we ended up talking for over an hour. We even got off-track and discussed hip research, post-op protocols, etc. He told me that I was quite educated on hip issues, even more than most docs. My bio research background helps! 

Swann's initial impression was that a PAO would be a better option than an FO. Swann wanted more information before deciding on a more definitive plan, so I had a 3d CT scan to help give us a better overall picture. When I returned for my second consult he wanted to discuss and make the decisions together since I was so educated on the topic. He ultimately recommended an open surgical dislocation first to address some of the boney anomalies of the socket, femur, and if the joint was in a good condition it would help prep the hip for a better PAO. Depending on the status of the joint he would reconstruct the labrum with an allograft from a donor tendon. Typically, an autograft or "self donor" is used with part of the patient's own hamstring, but with my EDS and high complication rate, the allograft was the better option for me. After doing the first phase of cleaning up the hip, refining areas from prior surgeries and reconstructing my labrum he would then perform the PAO. Typically, the SDO (open surgical dislocation) is done from a lateral incision, but again with my history he made the decision to perform everything through the anterior PAO incision to help minimize my infection and healing risks. The anterior approach is rarely used, but decided in my case the better option. This will be the largest and most invasive surgery to date. 

As much as I love and respect Millis I ultimately decided to go with Swann's plan. Numerous docs discussed the case at a conference with him and agreed on the surgical plan based on my history. After starting this hip journey 6.5 years ago I am at my limits and do not want to continue with protocols that are only giving temporary relief. I want to regain more function and less pain and ultimately put hip surgeries behind me for quite some time. I do not fault him for his hesitancy because my case is complex and comes with a huge risk, but it has been long enough and I would like to close this chapter of my hip journey. 

This surgery will take place in Indianapolis at Community North Hospital on Dec. 8th. It is scheduled to take over 6 hours, in-patient for 4-6 days and months of recovery. I had to have a consult with the Medical Director of Anesthesiology because of my history and having a spinal neurostimulator in place. Swann wanted to use a spinal, but we had to do a bit more planning to make it safer for me. My pain doc has been consulted with numerous times for pain protocols. In addition to the spinal, I will have a regional block and general anesthesia. Specialty surgical and recovery equipment has been ordered. I will be using a bone-growth stimulator post-op, cpm, and Game Ready ice/compression system during my recovery. At this point a lot of the prep work and my to-do lists
are complete, but I am beyond anxious and scared for this surgery!!!