Ultrasound

I had my ultrasound done today on my gallbladder. The tech that did the procedure told me that she did not see any gallstones in there and my gallbladder looked clean. So my stomach problems are still a mystery. I was hoping it was just gallstones so that I could know the problem and fix it quickly. After my ultrasound, I went to the lab and had my blood drawn for the doctor. I was trying to be brave and went to the little room by myself. The lab tech tapped around on my arms looking for a good vein for a few minutes and that started me getting nervous. I didn't look when she stuck me or took the blood. But then by the time she finished I felt sick and broke out in a sweat. I almost passed out, but after a few minutes of resting I was able to get up and leave. I hope they find something in my blood just so that wasn't all for nothing. Now I just wait for my MRI results and my appointment with the gastroenterologist on January 21st.

Merry Christmas to me!

I went to the gastroenterologist today to find out if I have gall stones or not. He ordered blood work, scheduled an ultrasound, and gave me some powdery stuff to drink each day. He wants to check everything out. He told me to stay away from fatty foods and try not to take anything with aspirin in it (which is all my pills for knee pain). He said if my ultrasound does show gall stones, then he'll schedule me for a surgical consult right away. Otherwise I go back to see him on January 21st.

Also, I spent all day yesterday cleaning my house top to bottom. Something a healthy 26 year old woman should be able to do. By the time I was done cleaning, both knees were throbbing and my hips were very tired. No more full house cleaning days for awhile.

Still awaiting the MRI results. I think the holiday messed things up for me. Hopefully I will hear something Monday after my ultrasound and blood work.

I survived!

So I survived the MRI. I was a little worried because Jeff couldn't come back with me, but the staff at CDI was very friendly and helped me calm down. I was squeezing the tech's hand while the doctor inserted the needles. I did not look at the needles at all but I did feel some pinching and a little bit of shooting pain when they were doing it. They injected some cortisone right after the dye using the same needle so I would not have to go back and get more needles after the MRI. I got to keep all of my clothes on except my bra (since it had metal in it), so that was nice. I almost fell asleep while I was in the machine. I had headphones on listening to X103 and then the dull roar of the machine in the background. All in all it wasn't that bad. I walked around the mall for a little while afterward and my hip was stiff, but not painful. I can't wait to get the results to find out how my cartilage looks.

Also, I talked to Dr. Scheid's office today and scheduled my surgery on my knee. I'm having it done on March 22nd. My check in time is 6am and the surgery will be at 8am. I'm having the Elmslie Trillat done, so I will be taking two weeks off of work. One of the weeks is Spring Break so I don't have to take all of those days. I will be on crutches for awhile, but I should be pretty much back to normal by Key West in June.

Today's the day!

I'm going in for my MRI this morning. Check-in time is 10:00am at CDI in Fishers. I'm ready to get it over with. I took two Hydrocodone this morning left over from a car accident I was in, and so now I'm feeling pretty happy. I will update later today to let everyone know how the procedure went.

Wrong knee!

I went to my husband's holiday party last night hoping to have a great time. I wore some cute high heeled boots like most of the girls at the party, and was only on my feet about 3 hours. By the time we were walking to an after party, I could not walk. We decided to drive to a friends house and when we got there I discovered I could not squat or put any weight on my right knee without pain. I laid around there for awhile and then slept it off. When I got up this morning and had to clean up something on the kitchen floor, there was the knee pain again. I'm worried because this is the knee I normally do not have problems with. I think I'm definitely going to call the doctor on Monday to schedule my TTT on the left knee for Spring Break and tell them about my right knee pain. I don't want to be hurting this summer when we go to Key West.

Getting closer...

I'm getting closer to my MRI and school is doing a good job of keeping my mind off of it. I'm having a hard time getting a hold of the imaging place that is doing the MRI. They called me to prep me, but I keep getting voicemail when I try to call them back. They are only open 8-4 M-F, which are my teaching hours. So that is really frustrating. Also, my knee pain has increased a lot since I stopped physical therapy. My legs, knees, hips have hurt every night this week, and I've been wearing tennis shoes each day. I guess I just can't win. Right now I am hoping to have my knee surgery done over spring break and then take an additional week off for recovery.

Doctor visit #3

I went back to see Dr. Scheid today to check up on my knee pain. I told him that I haven't had much change. He looked over my report card from physical therapy, and wants me to continue my at-home exercises. I asked about miserable malalignment and my rotation issues. He said that I do have miserable malalignment, but my tibias are the main location for the deformation. He said I could have my tibias reset straight, but it's not necessary to take care of the knee pain. Instead he still suggests the elmslie trillat procedure on my left knee. He doesn't want to schedule it quite yet though. Instead he is having me get an MRI done and an injection of an anti-inflammatory with my left hip. He wants to check for any torn cartilage since I am having a lot of clicking and popping in my hip. He also wants to see if the injection helps at all with my knee pain. So I go for my MRI on December 22nd, and I am not looking forward to the biggest needle in the world.

I had more medical issues last weekend also. Sunday night I woke up with a severe gallbladder attack. The pain was so intense I could not get up of the floor. I missed a day of work from it trying to recover. So I go to the gastroenterologist on December 24th (in the morning) to check for gallstones.

So my body is starting to turn into a theme park for medical issues...

So much to think about...

I have one more day of physical therapy left and then it's back to the doctor for me. I have been reading up a lot about my possible problems and coming up with a lot of questions for the doctor. I want to make sure that this knee surgery is going to be the best option for me in the long run. I don't want to have this done and then find out that derotational osteotomies would have been the best fix for my problem. My PT did notice some different things going on with me at my last visit. My left hip (the problem hip) was actually sitting up about an inch higher than my right one when I laid down. After going through my exercises though, they settled fairly even. He gave me some new exercises to help focus on the hip muscles because he said the rotation is definitely one of my major problems. He also told me to stop sitting indian style or any variation because it only makes the situation worse. So I keep having to readjust my normal sitting ways. Very annoying for me, but it is supposed to help.

I also had to downgrade in cars today. I normally drive a 2005 Mitsubishi Evolution that is a 5-speed manual. It can really irritate my left knee and hip to work the clutch, so we got a car for me that is automatic. It's a mid-90's Civic with some body damage and a flat black hood. Not very styling. But when it comes time for surgeries, I'll be able to get back to driving a lot faster in this car.

Turkey Break

Turkey Break was a great break for my hips and knees. I got to wear boots to my family gatherings, and did not have any pain! It was good to get full nights of sleep and not be standing and walking all day. Even today was pretty good on the pain scale for my knees at least. I did a lot of walking, not much standing still, so my hips were a little sore. I had physical therapy after school and that started to wear me down. My right knee hurt on the ride home and then once I got out of the car my left knee started to throb. It's just starting to be random pain that makes no sense. I found some interesting information last week after therapy about something called miserable malalignment syndrome. Here's a snippet about it:

"The symptoms of MMS (caused by femoral internal rotation, external tibial rotation and forefoot pronation, and may involve an increased "Q" angle of >20 degrees, genu valgum, patella alta, and generalized ligamentous hyperlaxity) include compensatory internal rotation of the femur to maintain coverage of the femoral head with the hip acetabulum. It can also include a discrepancy between the axis of the extensor mechanism of the knee and that of the femur, resulting in a lateral displacement of the patella with increased quadriceps angle ("Q" angle). Patellofemoral Pain Syndrome from the patella mistracking with internal tibial rotation may result in proximal or distal iliotibial band syndrome, patellar subluxation or dislocation. The internal tibial rotation is a compensation for foot pronation. Achilles tendonitis, plantar fasciitis, posterior tibialis tendon strain and dysfunction and strain of the medial ankle and foot can follow. "
-http://www.curemms.com/syndromes/index.html

The physical therapist said that this syndrome makes sense for what is going on with my legs. Hopefully I can talk to my doctor and find a non-surgical solution for this pain. However, I know there is no getting around the PAO for my hips. I even had some pain in my right hip today (the good one). I was sitting on the couch inputting data into the computer. When I leaned to the left to look at some papers I got a sharp pain in my right hip like it was being pulled out of socket. NOT FUN!

We'll keep trying...

I had physical therapy again this afternoon and we started by going over my symptoms and if they were improving. So far there has been no improvement. Which I guess should be expected since my pain is a result of a deformity and not an injury. I did all my exercises with more reps, and when I left she said "We'll keep trying."

When I got home I called Dr. Scheid's office to find out the name of the surgery and hopefully the costs so that we could start preparing. I did get the name, but they said that they would not know the costs until the doctor ordered the surgery. I also searched my insurance agency's site and found nothing about the surgery. The name is the Elmslie Trillat procedure, and it sounds scary. It involves cutting bone, moving tendons, and inserting screws (sounds like a PAO!) The recovering is easier than a PAO, but still not fun. So I have three more PT appointments and then back to see Dr. Scheid on December 9th to sort everything out.

Zero Change

I have been continuing with my physical therapy and so far there is zero change in the amount of pain in my knee. Friday I worked a full day and by the end of the day I was limping and keeping weight off of my left knee. I had to return to school for a benefit concert and spent most of the night sitting in pain. I cleaned our house for 3 hours straight yesterday and again I had pain all night. I just had a full body massage and could definitely could feel tenderness on my left side. My outside leg muscles were tender and around my hip. I guess my next step is going to be calling the doctor to find out the name of the knee procedure and the cost.

Been reading...

I have spent most of the afternoon reading other blogs and information about my hips and knees. My husband thinks I need to be looking into my knee more since it is probably the procedure I will have done first. But the hip is more scary to me, and so I keep reading about that. However, I did find more technical terms about what is going on with my knee. My deformities have caused me to have Patellofemoral Pain Syndrome. Since it has caused me pain for over 5 years, I will most likely have a procedure done called a Patellar tendon relocation. There is not a lot of info about this procedure online, so I am going to keep digging and hopefully have details to share soon.

Started PT

So I started physical therapy last Thursday, and I go back two days this week. My therapist was perplexed by my situation. She spent a lot of time looking over my legs. She even said that she wished she had a student with her because I would be such an interesting case to study. She taught me 5 home exercises to use to build up my inner thigh muscle that controls my knee cap. I have been doing those exercises daily, and so far I haven't noticed much of a change. My muscles are just a little more sore than normal. I go back tomorrow and will probably do some exercises there and also learn more home exercises.

As for my hip, it seems to be mad that I am spending time on my knees right now. One of my knee exercises irritates it a lot. Also, I attended training yesterday on non-violent crisis intervention strategies. It involved getting up and trying these strategies on the other adults that were there. I could definitely feel the stress on my hip. I'm worried about waiting another year and a half to have my hip fixed with all the pain I am having right now.

I'll update some more after more physical therapy. I'm trying to think of how I can walk around at school less too. One of my more needy students is suspended the first three days of the school week, so hopefully that will give me a little rest.

The Start of a Journey

After reading several other blogs from women who have experienced what I am about to experience, I've decided to start a blog to share my journey for those who need to feel camaraderie. I am 25 years old, will be 26 in less than a month, and I teach special education. I began working when I was 13 and have been on my feet constantly since I was 16. I danced in show choir in high school and became much less active in college. February of 2004 is the first time I remember feeling throbbing pain in my knees. I had worked my first 8 hour shift in a hospital basement serving food and also danced in a sorority competition that night. Since then, I have experienced the pain more often and more intensely. I always thought the knee pain stemmed from my hips. I also noticed my hips clicking, clunking, and popping in college, and they've started aching recently. At the beginning of October I decided that enough was enough and I scheduled an appointment with an orthopedic surgeon to diagnose what was wrong and find out options. They took X-rays and quickly diagnosed me with hip dysplasia. However, the doctor I saw did not normally work with young adults with hip problems. He knew there were more options for me than just a hip replacement, so he offered to find another doctor for me to see. I asked him about my knee pain, and he stated that fixing my hip would straighten out my knee and stop the pain.
A week and a half later, I went to see Dr. Kevin Scheid with OrthoIndy. He confirmed my hip dysplasia and told me about a procedure called a periacetabular osteotomy. Hip dysplasia is when the hips do not form correctly and it creates a shallow socket for the femoral head (top of the femur). PAO (periacetabular osteotomy) surgery corrects the shallow socket by cutting the pelvis and realigning it using screws. The hip bones then heal and more of a surface is provided for the femoral head. This has to be done before arthritis forms in order to be successful and could give me much more time with my original hip(s) and I may never need a hip replacement. I had already read about this surgery online, but it was good to hear from the doctor that the procedure was an option for me. Then I asked about my knee pain, if the hip surgery would help it stop. Dr. Scheid started looking more in depth at my legs, having me walk up and down the hall, and I laid on the exam table while he moved my legs. He told me that when my legs formed, my femur twisted in and my tibia twisted out, causing my knees to be a hot mess (not a technical term). My tendon in my knee is not in the right location, and is causing abnormal rubbing and A LOT of pain. He told me there was an outpatient procedure that could be done with a short recovery to relocate my tendon. He didn't want to rush into the surgery yet. He prescribed me physical therapy 2-3 times per week for four weeks to see if building my thigh muscles takes away some of the knee pain and then I go back to see Dr. Scheid on December 9th (5 days after my 26th Bday).
I start physical therapy for my knee tomorrow evening at Advanced Physical Therapy. I'll post on how that goes and how my pain progresses. I know this post was long, but a lot has happened so far. I'm frustrated by the situation I am in, and I don't even know if it was avoidable. I just hope that Dr. Scheid and my physical therapists will be able to work some miracles and give me a better quality of life.

Here are my knees, bent with feet straight.
Here are my hips: