505 Live

It’s a long story, but for the benifits of the internets I should probably summarize from the begining.

Vanessa and I started training for triathlons ~ May 2004, both having been quite active prior to that. I was cycling and Vanessa was primarily running. I was never good at running, tried a few times but stuff always came up, shin splints, knee aches, etc. Triathlon training started reasonably well, even the running was going pretty good. The intensity of the workouts ramped up fairly quickly, and progress was being made with the running and it was feeling pretty good. By December I had my first sprint distance AG win (5th overall?), with ~ 25min 5K I think.

Around February 2005 after a particularly intense swim workout (lots of hard pushes of the wall) I woke up w/ an extremely stiff right knee. Basically worked through it for quite a while, after warming up a bit it was ok. I went to my PCP who prescribed PT. Started the PT and did another sprint tri (my last), (AG win, 4th overall, ~19min 5k). I’d pulled back the running intensity a ton, and at the suggestion of my PT I tried running faster to try to make it less jaring on the knee. At this point the diagnosis was a persistant patellar tendonitis. Well, I tried that once I think, and wound up w/ a bad groin strain. The kind where you can’t put all your weight on that leg, or even walk normally. I stopped running entirely, focusing on traing for my first Leadville 100 mtn bike race which I completed.

I tried running a little after ompleting Leadville, figuring I’d given the knee/groin plenty of time. The groing was immediately a problem, subsequently I was referred to an orthopaedic at Lovelace. X-ray, MRI of the knee showed no issues and the groin was still considered a soft tissue injury. Had a couple 30 day courses of prescription anti-inflamatories, had a pelvic x-ray to rule out a possible stress fracture. Unfortunately, I think this ortho was primarily used to dealing w/ older patients in need of knee replacements. With the idea that things would get better I signed up for Ironman CDA, and all the diagnosis said nothing was wrong.

I recovered strength in the groin, and the knee was feeling ok. However, groin issues continued throughout IM run training. I did minimal running, with lots of discomfort. Certain stretching types of movements would result in a click/pop from the right hip. I had 2-3 Prolotherapy treatments for both the knee and groin w/ my PCP. I limped through IM (5hr marathon) and stopped running entirely and spun up for my second Leadville 100 mtn bike. In September Vanessa and I both signed up for Ironman Wisonsin (figuring I just needed to take a few months off running) I didn’t run (at all) starting in July, until around November when I started a very slow, deliberate build to running again. Things felt ok for a while, but by December while on vacation it was apparent that the hip/groin/knee was just as bad as ever. It was obvious to me that this probably wasn’t a muscle strain issue, and strength didn’t seem to be a problem. I basically made my PCP prescribe a knee and pelvis MRI, and give me a referral to the best knee doctor in town (still fixating on the knee, since that was where everything started), Dr Wascher.

I had the MRI, they did the knee w/o issues, and were doing the pelvis. They stopped the scan and informed me that they’d “forgot” that they needed an intravenous contrast dye and to sign here. They hooked up an IV and loaded me up w/ a gadollinium dye. I thought this was odd, and figured they’d hadn’t “forgot” but maybe found something interesting. I got the report for the MRI from my PCP’s aid on a voicemail type system, extremely lame and without detail, but the words “bone lesion” were involved and that I needed to make an appointment. From that it is recommended I get a radiograph (x-ray) of the lesion. I get the x-ray done and picked up, and have all my films/reports when I go see Dr Wascher. The report on the x-ray says that the bone lesion looks benign and isn’t uncommon and generally goes undetected unless you’re looking for something else in the area. But, the report points out that of interest is a bony portrusion on the right femoral diaphysis that could be causing femoral acetabular impingement. Dr looked at all my films, reports, checked over my knee and we agreed the most interesting thing was the hip issue. He referred me to Dr Franco at NM Orthopaedics for the hip and Dr Wilson at UNM Cancer Center for the lesion.

I went to see Dr Franco, I think in April, for the first time. He looked at the x-ray and MRI and felt the impingement was significant, and had both hips x-rayed in a different position which really showed the bump on both femurs. “X-rays could be in a textbook” I think he said. I investigated having surgery done in Vail w/ Dr Philippon, sent my films there for consultation and their diagnosis was the same as Dr Franco, no surprise. Dr Franco’s recommendation was to have arthroscopic surgery to correct the impingement, and look for any tearing of the labrum. I ultimately decided to have surgery with Dr Franco, partially b/c a week long trip to Vail for surgery and PT would be very costly, but largelly b/c Dr Franco was extremely personable and responsive, I had another couple appointments over a few months with him where I was able to ask lots of questions. I originally scheduled surgery for September 21, but also said if there was a cancellation in July I would be interested. (The idea being that I should be mobile to help Vanessa who is still training for IM WI)

The opportunity came together in less than a week to have surgery last Wednesday (7.25), and with some things going on at work it was a good time to get off the books for a while (know anybody needs an engineer?).

Surgery was 7.25 (day 0), arrived at 06:30 and paid my facility co-pay ($1600, gasp) (all this is “out of network” with my crappy insurance). After that was the standard pre-op dog/pony. I woke up in recovery around noon I think, in a bit of pain and more than a little nauseous. Nurses there are great, btw. Hooked up w/ some more IV drugs, which have the effect of knocking you out for another 45min.. After that I started to come around fairly quickly, and we were out of there by around 2pm I think. Felt good enough tanked up drugs for the rest of the day, americano and a Golden Pride #2 b-fast burrito hit the spot after not eating in previous 17hrs or so. Presciptions were 2 weeks of Relafin anti-inflammatory, and asperin for DVT. Percoset as needed. Anti-nausea meds as needed (which are great for nausea, but also make you go to sleep for about an hr). Crutches and 20-40lbs of weight bearing on the affected leg.

Day 1 (Thursday) was ok, stayed on the percoset and laid around. Noah came and hung out for the afternoon, and also picked up my DVT machine and plugged me into it. Pain wasn’t bad, moving around was a challange. Watched Greg the Bunny DVDs. =) Up and down to the bathroom, things are tender and stiff, can’t move the right foot forward of the left foot.

Day 2 (Friday) sucked, not so much the pain but the gastro-intestinal implications associated with the general anesthetic and percoset were pretty severe. Milk of Magnesium resolved one issue in favor of another, and I tried to quit the percoset. Removed the surgical dressing that morning (very disgusting) and showered. Three small incisions each w/ one stitch. Getting the dressing off and showering was quite a bit rougher than I’d anticipated. Vanessa helped out tremendously. Ultimately went back to the percoset mid-day, but was generally off my feed. Noah hung out again that afternoon, watched some motorcycle DVDs and an 80s classic “Dragon Slayer”. Good stuff.

Day 3 (Saturday), much improvement. I took my last percoset at ~ 7am, and switched to tylenol. Still nauseous and not enjoying food, digestive system having not yet reached equilibrium. Still taking my asperin and NSAIDs as directed. Lots of TV. Lots of getting up to the bathroom (pretty much starting day 0 I was up to pee about every 2 hrs, trying to stay hydrated w/ all the drugs).

Day 4 (Sunday), improvement continues. Didn’t even require tylenol, since then I’ve just taken some tylenol PM in the evening to help me sleep. Stomach is pretty much settled, and I got out a crutched my way up and down the street for about 20min. Layed on the floor and did some crunches and stuff, did a few lifts of the leg. Range of motion is much improved, not nearly as stiff and can move my right foot well forward of my left. Went to Matthew and Elisa’s for dinner and to watch Nacho Libre in hi-def, and the premier of Shark Week.

Day 5 (Monday), improvement platues. Pretty much what I expected, things feel ok. No pain of note, things are getting stiff from lack of activity. Doing much more for myself, doing some small things around the house. More core, more crutching up/down the street.

Day 6 (Tuesday), today. Pretty much same as yesterday so far…. One week follow-up is Thursday morning.
Incisions as of today, the bruising is coming in nicely. =)

Vanessa has been extremely helpful and sweet, and lots of people have been kind with the well-wishes. Noah has been very helpful, and having somebody to hang out w/ has been great.

Oh yeah, as far as the bone lesion I saw Dr Wilson and he didn’t think it was of concern, and we would follow it for a while. I’m scheduled for another x-ray in November to see what it is doing, if anythng.

The Hipscope website is a good resource.