CT image and toe one week out

Early morning CT imaging for the hip, much quieter and faster than an MRI. They said they do 3D reconstructions, now that's a CD I want for my imaging collection!

My toe doesn't seem any better. So at what point do I worry about it? Torqued it last Weds, then on Thursday I really hurt it (just sitting at the table) and I'm wondering if I popped it back or broke it more or...? After that it started to purple, but never black or grotesque. Oh and swelling, across the top of my foot and into the 4th toe. Then I think Saturday I was walking the dog and torqued it again after tripping over a small tree branch in BP. I was wearing stupid flip-flops as they hurt the least. Up to that point I was able to wear my new Jambu sandals with the better support. But since then no shoes -- flip-flops or my other sandals. Still really swollen, bruising is mild, and I have a burning stinging type of pain. 

Of course, I'm not resting it much. Taking elevators and not stairs, but still biking and walking around. Hard to hit step goals these days. 

And of course, this limping is aggravating my left hip, as the weight is shifting to that side. Ugh. 

So at what point should I get this looked at or get worried? Dear Gawd, last thing I want is more medical shit and even worse some boot to wear!!

A +100 mile week on the bike!

After wrapping up last week's training log I noted that I was around 95 miles --- soooooo close to 100. Noted the same this week, and went out Sunday for a 7-8 miler around Lafayette that would give me that magical number.

Between the 29 miles I get on Mondays, the 9-10 I get every other day, and the frequent extra 5-miler TGP loops I do the miles are adding up.

Remember the days when 100 in one day was do-able!?

Dr L visit

I limped into the office in what probably looked as terrible of a walk as it felt. The receptionist asked, I briefly explained, she sympathized. Or empathized, I get those mixed up. After talking to her, I felt even more sorry for myself.

Many updates for Dr L, about meeting surgeons and how I'm feeling. He looked over the rehab and post-op protocols for Dr P-G that I brought -- he seemed to like and approve so that help my confidence with selecting a surgeon. As for my back, he said it's doing OK. As for my toe, didn't mention it. Not why I'm there. After talking to him, I felt better again.

Dr L thought Dr C wasn't as interested in my surgery because my x-rays showed normal hip bones with no dysplasia, and that is his specialty. So maybe.

Stupid pinkie toe

BIKE COMMUTE: 10+9.2

Well don't blame the toe, blame me.

I rode early into work to catch a time point and get some extra miles in. I've been logging extra miles on many days this past week -- catching when I can the extra 5 miles in TGP in my loopty-loop. Last week I was only a few miles short of 100 for riding!

Purposefully picked a different route to ride the first to-work-and-back (rode my old Compton-house route), got home, and in my now-usual brain fog and fatigue clumsiness caught the 5th toe of my right foot on the shower edge while stepping in. It wasn't a blinding broken pain, but DAMN it definitely hurt. And immediately looked out of place. Calmed myself down, finished the shower, tried to ignore it until afterwards. No need to further injury myself trying to look at in on a wet shower floor in the dark with water running in my face.

Inspection shows it's now aligned differently that the left, the toenail facing upward instead of outward, it looks like it's sticking out to the right too much. But it moves, bends, and doesn't have a focal spot of pain. I can walk on it, not very willingly but it will flex and bear weight.

So maybe not broken, maybe sprained or dislocated? Ugh. My first thoughts were about how I might have to drive to work, I might have to see yet another doctor, that I'll be limping more now.

Some quick googling said there's nothing a doctor would do, I could buddy tape it to the 4th toe, and it would just take some time if really broken.

Hours later I'm icing and elevated, I can wear my wide toe shoes and bike shoes with minimal discomfort, and I'm not limping all that much. Whew.

But here I am with my stupid toe, and my mind keeps berating me for being so shallow while AmberR is dealing with Ben's death, how horrible that must be, and how heartbroken the family is. While I'm worried about a stupid toe.

Ben

Got the sad email this morning.

This surgeon I like MUCH better

Met with the second surgeon this morning, the one I originally had an appt with before I met with Dr C. I'll call by her nickname Dr CC. Just to be funny I guess.

She's also a runner and I had high hopes that this would translate into a better "click" of connection. It did! She was still surgeon-ishly blunt and straightforward, but too all the time to explain, examine, ask, although I didn't get all the way through my October 2016 stories. She could pinpoint motions that caused pain and explain why they hurt, she pointed to a potential tear and fluid accumulation in the MRI, and theorized that the fall last May in Greensfelder was what caused the damage.

Good news in that I don't have inherent hip deformities, bone problems, bad angles, etc. Also that I'm active and otherwise healthy, it will help with healing. She can see what looks like the tear, it will be tacked down to the bone with sutures and she made it sound straightforward to do.

On Monday I happened to meet LC walking between buildings -- she said that for her knee surgery she needed to know what the surgeon would tell her sister or a friend in terms of whether or not the surgery is a good idea. Dr C didn't do that at all for me, but Dr CC did! Without me asking, I nearly laughed out loud when she said that as a fellow runner she understands the concerns about surgery but also the desire to get back to normal life. She said that I've done what I can with PT and recovery, and need to do something different.

She reviewed briefly how the surgical cuts would be, what the post-op and recovery would be like. Since I'm older it will take longer to heal. About 2 weeks non weight bearing then a taper back into walking. Upright no-resistance stationary bike same day or day after surgery. About 15 days then pool work. Didn't specifically mention PT but I'm sure it's in the plan. As for running, younger patients tend to get back at 3 months, but maybe longer for me. Hiking and elliptical on the agenda too, as possibilities for exercise.

As with Dr C, she said I can take time to think about it. I've already thought about it. I wonder if this is a pre-planned thing like a waiting period to consider this option?

Where am I right now? Waiting for a CT to get scheduled. I don't need to see her again, just get the CT then call her coordinator to schedule surgery. No mention in this visit about how far out scheduling is.

Funny thing she said at the end, that she doesn't "need to do this surgery on me", that's she's "busy enough already". Ha!

"The" Hip Surgeon of STL

My appt with Dr P-G was schedule for next Tuesday the 18th. Last week I called Dr H's office to see about getting an appt with Dr Clohisy, who Dr L calls "the" hip guru. After no follow-up from Dr H's I called again, and to my utter surprise got an appt for this morning with Dr C! I expected a long wait just to see him. Thank you to whoever canceled (I'm assuming that's how this happened).

940 appt, then around 1030 the send me for xrays. In the meantime I filled out the Tablet Questionnaire of Black Cloud Thinking (for the 3rd time in a month) and a 13-page research questionnaire that went waaaay to long in to details. X-rays, back to waiting, standing (because sitting hurts) with my MRI CD copies and lots of swirling thoughts.

Called back, waiting, but enjoying the quiet because I slept awful last night. A team of 3 comes in and asks the expected questions. Some of them are funny. Seriously, how can you expect someone like me to answer questions about "can you walk, climb stairs"  and pain levels? Of course I can walk, hell I can run 100 miles on a fibula with a hair-line fracture and I can run on broken ribs. Of course I limp and I hurt, but you won't see it for my pride. I felt kinda silly.

They hung my x-rays and did an exam for impingement and range of motion. Then they left, with one of the team saying his bro-in-law was getting ready to try again at the Leadville 100 trail run. Good for him, I'm jealous! Kinda. This shit still hurts.

I wait again, staring at my x-rays, what do I see if anything? The bones look webby, but I think that's normal. The femoral head looked smooth, but what is that white spot? My gut is full of something, guessing gas bubbles? (Gut unhappy with low sleep). My IUD looks crooked, should that be fixed? Waiting.

Dr C comes in, this time with 6 others in a team, crowded into the room and not speaking. He is to the point, direct, clear, detailed. The questions are pointed and fast. No chitty-chat. I get the ROM exam, he notes numbers that don't seem too different between right and left. He looks at the MRI but doesn't see a tear.

Doesn't see a tear?! He explains that he doesn't like coronal views, which I think the tear was visualized in by others. He explains that he doesn't see a detachment or anything specific. Huh?! He explains that just because he can't see it doesn't mean it's not there. Something is wrong, he just can't see what from the MR image.

Then the surprise. He says, well what do you want to do? I want to do what's best to make progress. He says my options are more PT, build strength, and get as best as possible. Second option is surgery. I ask if a surgery would reveal what can't be seen by imaging, yes. I ask about returning to running and normal, he explains the odds are 50/50 and that impact sports are harder to get back to. I think on this. I say that 50% is more than I have right now. He says I'll never have a "normal" hip again, good point and poor wording on my part as I guess I meant a New Normal.

He waits. I say I'm interested in the surgery, what I'm doing now isn't working. More surprise. He lists the potential risks of surgery, infection, blood clots, nerve and/or muscle damage. But then -- he's scheduling 6 months out, so what do I want to do? Again the ball in my court, with 6-7 people waiting. I mentioned in a self-thinking sort of way that he came highly recommended and is worth waiting for. He says he's happy to help me, wants to do what he can, but understands that this timeframe might not work for me. He offers me the opportunity to speak to his associates, and mentions my originally-scheduled surgeon Dr P-G. I think. He asks me to think about it, I say I have, and agree to speak to his scheduler.

The team leaves the room, a researcher with the 13-page report and more research questions comes in. Then back to the waiting room, then to another room with Dr C's scheduler. Yup, January.
OK, I mention the opportunity to see Dr P-G. She agrees, says the same as Dr C (we want to help...). I ask if she's new to WashU or new to hip surgery, she's just new to WashU. In the end I get back a similar appointment as my original on the 18th at 9:45am. Full circle in the end, with a whirl of questions in the meantime.

Being asked all these questions about daily function, pain, ability got me thinking. Here's the answer. It hurts to sit here and type. I just went for a 'smoke break' walk and that hurt. Took the stairs, uncomfortable. Sleeping last night was terrible.  I feel fragile, limited, distracted. This thinking caused some anxiety, I typed it out to TH in an email to vent it.

In retrospect I came into this appt hoping to get Then Answer from The Man, and instead left without it. Yes I can have surgery if I want it, not what I expected. But I do appreciate the honestly and lack of "oh yes of course I can fix you and of course I'll do the surgery". In the end, I really do appreciate it. I just don't feel like I got an answer.

ETA I typically don't edit posts, but I don't want two posts of this day. So here's additions.

Looking back I wonder if I was honest enough with them about how poor my day to day can be. It isn't always a painful problem, but nights like the previous in which sleep is really disrupted, days when I don't feel like walking the dog, and stuff I don't do because it might hurt.

When I was leaving the scheduling office, she saw my tattoo of the M-dot and commented that I'm an 'Ironperson'. I replied that I used to be, before all this.

And when I got home I realized why the appt seemed so disappointing. Everyone else I'm working with is taking a supportive approach. Yes, I might not run like before, but it's always supportive just the same. This guy just stuck to a 50-50 answer. Even a 55-45 answer, even a "hope for >50" answer would have made a big difference. Just the drop of extra hope and encouragement. Again, I appreciate his honesty, he didn't puff it up or mislead. But it just didn't leave a good vibe afterwards.

Banking the subject until next Tuesday when I meet the other surgeron.