A couple more diagnosis for my complex hip problem

I have femoral retroversion.  This is when the femur is turned the wrong way.  Only about 1/5000 babies are born with femoral retroversion.  I think I should buy a lotto ticket this week.  Femoral retroversion causes my foot to turn out.  I also have a huge range of motion when my hip is turned out, for example sitting cross-legged is easy-peasy for me.  In the case of my hip turning in I have very little range of motion. For example, I cannot sit in a W formation.

Someone with femoral retroversion could not sit like this.

The surgery to correct this involves an  open surgery where a huge, giant, long incision is made  down the top of the thigh.  The femur is broken and then pinned back together.  The surgery sounds scary and nasty.  I am going to talk to a surgeon about whether he thinks I will need a surgery to correct my retroversion.   I would rather just do one aggressive surgery to correct everything at once.  That includes the retroversion, impingement. blister and labral tears.  There is a possibility that if I just I have the impingement surgery, although I will still have femoral retroversion, I will no longer be in severe pain.  Another possibility is that the surgeon could over-correct the retroversion, just leaving me with the opposite problem.

A second diagnosis I talked about previously is the blister in my labrum.  The labrum has come detached in the middle of my acetabulum, like a blister.

The red circle would be the blister

Some surgeons treat this blister with a procedure called microfracturing.  With this procedure your body can grow new cartilage.  Some surgeons shave down the blister, however this damages cartilage cells.  Other surgeons make a glue out of your own blood then glue the blister back down.  It is unknown how long the glue lasts.  The other option is to ignore the blister.  Frankly, I don't like this option.  I want to nip all my pain sources in the butt at once.  I am so sick and tired of being in constant, debilitating pain.

Okay, just wanted to keep you up to date on the growing complexity of my hip problem.

Will you still be my friend?

I wish I could go for a walk with you, go to a concert, on vacation, and be your gym buddy, but I can't. I hope you can understand and you will still be my friend. I can show you how I did my latest painting if you want to paint with me, we can knit together, and play video games and I have a million movies I would love you to share with you. We can go get something to eat. Everyone has to eat.




Even though I don't look like I am in pain, and I don't say I am in pain it doesn't mean I am not in pain. I just don't want to complain. I know I look healthy, but just walking across the room feels like a marathon and going anywhere outside of my house feels like climbing a mountain.




I get tired more easily than most people. Just because I don't look tired and I don't tell you I am tired I actually am. I am just having so much fun hanging out with you I don't want to spoil the fun for either of us.




I have good days and bad days. I don't know how I will feel day to day. Just because I could go to the mall with you yesterday, doesn't mean I can go today. I hope you understand if I need to cancel plans and I hope you will still ask me to go do things.




I don't want you to think that I am lazy when you come over to my house and it is messy, or when I am at your house and I can't help you move a box.  If I do too much then I will be in too much pain to sleep and then I will be too tired to do anything the following day.



I feel really embarrassed that I have to use a cane or crutches to walk. I feel really embarrassed when strangers stop me to ask what is wrong with me. I didn't ask for this and I just want to be a normal 26 year-old like you. I hope you're not embarrassed to be my friend.




I don't want to talk about my condition when I am with you. I spend all day talking about it with my doctors and my husband and thinking about it when I am by myself. I just want to hang out with you and talk about all the great things in your life.



I am worried you wont want to be my friend anymore because I am not much fun to hang out with. Even though I try to make my life as normal as possible, I know this is not how a normal 26 year-old lives. I am a 26 year-old stuck in an 80 year-old's body.  On the inside I am still the same person. Will you still be my friend even though I am not the same on the outside?

How I lost weight and kept it off Part 2 of 2

Keeping it off is a Piece of Cake!



Keeping off the weight is easy.  I rarely think about calories.  I have a routine of healthy eating and that is just what I am use to now.  Having a healthy diet is like putting your contacts in every morning.  You do it every day, you're conscious of what you're doing, but you don't really give it much of a second thought.  It is just what you are accustomed to.


Now I will share with you my routine of healthy living.  Right now my mother-in-law is staying with us and cooking delicious and healthy food.  Lucky me!  But I will share with you what my routine is like when I don't have a gourmet cook living with me.

When I wake up in the morning my first thought is COFFEE. 


Coffee is my favorite, and my most important, meal of the day.  Then I think about my husband.  He needs to eat.  After my coffee is made, and I have had my first sip, I can function like a human being to make a fresh fruit smoothie.  Smoothies are so easy and you can make a wide variety of flavors.  My favorite is usually an apple, banana, strawberry smoothie.  Gavin likes and apple, banana, blueberry smoothie.  Everyday is a new flavor and the possibilities are endless.  Then I might either warm up a breakfast croissant for Gavin, or I might make some eggs and turkey bacon.



When I am on my own for lunch I love to have either a bagel and cream cheese or a sandwich loaded with veggies.  Sometimes I will treat myself to a $5 veggie sandwich at Subway or on a rare occasion I will take myself out to sushi for lunch.




For a snack I love cheese alone or with apples.  I will also grab a yogurt, or cottage cheese for a snack.  I know some people can't eat dairy but I can tolerate diary and I love it.   It has a lot of protein and nutrients.   If your body doesn't tolerate dairy, don't eat it.  Listen to your body. Also, at our house, we go through a lot of orange juice  and lemonade.  I love these two juices but I have acid reflux so I cant drink a lot of these kinds of juices.




For dinner, if we stay in, I make something easy.  I can't stand up for long so it is hard for me to spend a long time cooking.  I do have a kitchen stool I sit on when I am cooking and cleaning the kitchen.  My specialty is salmon with lemon dripped on top.  It is so easy to just bake in the oven.  Then I make some rice and steamed vegetables as a side.  This is my favorite meal because it is yummy and it practically cooks itself.  In the fall I love to make corn and yams.  Corn takes 1 minute to boil or you can throw it in the microwave for 3 minutes with the husk on.  This is how my grandma does it and it is my favorite.  Yams, you can wrap in tin foil and bake in the oven for an hour.  Just don't forget that they are in there.  I forget about those poor yams all the time.

I am a dessert gal.  I eat dessert almost every night.   I am addicted to chocolate.  My cupboards are always stocked with some sort of sweet snack for me to enjoy after dinner.   You can always find, cookies, candy, and ice cream at my house.  I would go crazy without these goodies. You have to have some fun in your life too.



Eating out is a huge challenge when it comes to eating healthy.  Gavin and I eat out a few times a week so it is important to make smart choices when you go to a restaurant.  It is hard to gauge how many calories are in a restaurant dish, or how much butter the restaurant used to cook something.  I order dishes that come with lots of vegetables and stay away from fried food and creamy foods like The Olive Garden.   I only eat half my meal and always take home leftovers for lunch or a snack the next day.

Stay busy.  Right now, I don't have a job, but that doesn't mean I am not a busy gal.  Everyday is packed full of activities, errands, and responsibilities so boredom never sets in.  Some people eat when they are bored, just don't let yourself get bored.

Listening to your body is important.  If you are hungry it is important to eat.  If you are craving a steak really bad, your body probably needs a steak.  Sometimes I get a craving for a milkshake and a burger.  After a week of craving a burger I go straight to a burger joint because my body is telling me it needs that.  However, if you are eating a burger everyday, that is probably too much. 

The Japanese have a saying that translate to "eat until you are 80% full".  This is a great tip.   Eating until you are 80% full means that you are eating enough so that your body has energy but you are not consuming too many calories and gaining weight.

My final weight loss secret is that I don't eat pork.   I am sure that you can still maintain a healthy weight if you do eat pork, but I am sharing with you my own personal diet.

How I lost weight and kept it off. Part 1 of 2

Shedding the pounds

As some of you know I lost 50 lbs, or 32% of my body weight.  Losing weight was not easy but keeping it off is a piece of cake!  My highest weight was 155 lbs.  I dont even think I have any pictures from this time in my life.  I got down to 104 lbs at my lowest weight, but I weigh a steady 108lbs , in the morning, after going to the bathroom, of course.  Losing weight is different for everyone and I dont think there is one program or routine that can work for every person.  However, I can share what worked for me in the past and what works for me now.

But first, what does losing weight have to do with my hip?  Imagine carrying around a backpack with 50 lbs of weight in it all the time.  Your body would not like that and you would probably be in a lot of pain and very tired.  My hip cannot support an extra 10 lbs of weight.  It can not even support me now as it is.

I struggled with my weight for a long time.  I am going to be honest, I didnt always use the most healthy means to lose weight. (Clears throat, 2 caffeine loaded lo-carb monsters per day). Now I know how important it is to treat your body like it is a temple.  It is the only one you got.  Let's get started;  I am ready to share my weight loss secrets with the world.

Step 1 Whole Foods
Cut out all foods that contain either high fructose corn syrup or partially hydrogenated oils.  These are highly processed ingredients. I wont get into the science of it, but it is interesting if you want to look that up yourself.  If you don't purchase foods with these ingredients you are eliminating a lot of processed foods from your diet and incorporating more whole foods into your diet.  You dont even have to change what you are eating.  For example Breyers makes an all natural ice cream so you should opt for Breyers over Dreyers ice cream.  Don't confuse the two.  Yoplait yogurt adds high fructose corn syrup to their product, while other brands, like brown cow, are made from whole ingredients.  Just read the ingredients.  It is pretty easy and you can still eat whatever you want.

One of my favorite yogurts

My favorite ice cream

Step 2 Portion Control
After a month of eating unprocessed foods now we are going to address portion size.  To this day I still eat out of small bowls and off of small plates.  This is so that you are actually eating a portion size.  Studies show that eating from smaller plates and bowls will reduce the amount of calories you consume.  So for now on, eat from small, child size bowls and small plates.  If you want seconds that is okay, you can always get another bowl.  You can get another eight bowls if you want.  A diet is not about deprivation.  It is a healthy way of living that you will need to maintain for the rest of your life.  This is just to make you aware of what a portion size is and how much you are eating.

about a serving size of soup

Step 3 Exercise
When people think of exercise, they think of going to the gym and running on the treadmill.  Exercise does not have to be that way, unless you enjoy that.  Exercise is just moving your body.  It could be cleaning your house, gardening, volunteering at your local food bank, playing a game of ping pong, going for a walk on the beach, chasing a 3 year old around, playing with your dog, going shopping.  The possibilities are endless.  Just move.  Personally, I am very limited with what kind of activity I can do.  Therefore, I go swimming and do low impact exercises on the floor in front of the television.  I can exercise all day if you put a tv in front of me.  Also, it is important to add resistance to your routine to help build and maintain strong bones.  The bottom line is exercise should be something you enjoy doing. 

Step 4 Incorporating fruits and veggies

You can never have enough fruits and vegetables.  Well, you can, but it is hard to overdose on broccoli.  Whatever your lifestyle is like, you must incorporate more fruits and vegetables into your diet.  This can be a difficult step because you really have to change your lifestyle to accommodate fruits and vegetables, but still, so far, we are not depriving ourselves of anything.  Gavin and I like to make fruit smoothies in the morning.  For dinner, I steam frozen vegtables that I buy in bulk from Costco.  It takes only a few minutes to steam vegetables and it makes a delicious addition to our main course.  Maybe your lifestyle calls for a fresh strawberry daiquiri every morning, and a fresh tomato cesar in the evening. 

Step 5  Getting rid of the junk

This is for sure the most difficult step for people and that is why we saved it for last.  Now we have to get rid of all the junk we are eating.  You do need to cut calories to lose weight.  But don't worry it is only temporary.  We can incorporate the junk back in after we have lost the weight and have a healthier attitude and lifestyle all around.  By now we are not eating all that much junk because remember in step one, we are only eating whole foods now.  But I know, even soda comes in all natural varieties.  So now lets get rid of the chips, the cookies, cheeseburgers, french fries and candy bars.  This is not about deprivation; don't worry you wont go hungry.  This junk food is going to be replaced with healthier options.  Instead of a cookie when you are craving a sweet carb, you can eat a piece of toast with Nutella on it.  Instead of a McDonalds cheeseburger, you can make your own cheeseburger at home, with a whole wheat bun, and lean ground turkey.  Instead of deep fried french fries, have a baked potato.  Replace junky snacks, like chips, with a healthy snack, like yogurt, or a cup of blueberries.  Make it a snack you like though, don't eat anything you dont enjoy eating, just because it is suppose to be healthy. There are so many healthy food options out there, there is something for everyone.  Every type of lifestyle can maintain a healthy diet.

Oh, I forgot to mention.  Replace ALL fruit juices with water.  Water is your best friend now.  Fruit juices are usually loaded with sugar and lacking a lot of nutrients that a whole fruit has.  The only exception to this is if you are making your own juice from scratch.  If you are willing to go through all that work for a glass of homemade fruit juice, you deserve it. 

Now say you are super hungry and the last and only food item on the planet is a piece of pizza.  You know you are suppose to eliminate the junk but remember that it is better to feed and nourish your body than to starve it.  If pizza is really the last thing on earth, then eat the pizza.   Losing weight is a slow process, and changing your old habits can be difficult. That is why it is important to take it slow and relax.  Have fun with your lifestyle change and enjoy it.  You are doing something great for your body. 

And I will share some before and after pics.  These are not my highest weight.

before

before

after

And I know the only way to get you to read my blog is to have a cute cat picture. 

I Dr. Sampson: 5th opinion

Dr. Sampson is such a kind and caring guy.  I am so happy that I met with him today.  Dr. Sampson is an excellent arthoscopic surgeon.  He is one of the top surgeons with raving reviews.  I would 100% get a scope done with Dr. Sampson if Gavin and I can afford it.  The thing is, Dr. Sampson is out of network, and I dont know how much my insurance will cover.  When I tried to call my insurance company today so I could crunch the numbers, their systems was down.

I also got an additional diagnosis.  I have what Dr. Sampson described as a blister (I forget the actual term, but blister is a good explanation) in my hip socket along my labrum.  This is the source of a lot of my pain.  However, Dr. Sampson is the only OS that treats these blisters during surgery.  If I have the surgery with anyone else I will just have to hope that it goes  away on its own and risk having a revision surgery  in the future, which will be done by Dr. Sampson of course.  Dr. Sampson has done many revision surgeries after another surgeon (including the ones I am considering), did not address the blister, or took out too much cartilage.  In whole, Dr. Sampson's technique for the procedure is just more elegant.  He specializes in these scopes, whereas the other surgeons I am considering specialize in PAO surgery, or trauma to the pelvis.  Not to mention an open procedure means 3 days in the hospital and a huge scar.

I really hope that I can afford to have the scope done with Dr. Sampson.  If not then I will have a difficult decision to make.




Here is a link to one of Dr. Sampson's videos
http://www.hiparthroscopy.net/hip_arthroscopy_in_depth.php

What opinion are we on now? 4th Opinion from Dr. Mast: now we are getting somewhere. open surgery for sure

Short version:
I decided to have an open surgery and not a scope.  I am not having the PAO surgery.  I just have to pick my surgeon and make sure I don't have any autoimmune disorders.




Long version:
I met with Dr. Mast today in San Fransisco.  He is the younger Mast, there is also his father Dr. Mast who is the same type of orthopedic surgeon.    The first thing Dr. Mast wants to do is to test me for autoimmune disorders that could be causing the pain and inflammation such as Lupus and Rheumatoid arthritis.  I really, really hope I don't have an autoimmune disorder but if I do we will cross that bridge when we come to it.   After an autoimmune disorder is ruled out we can talk about surgery. 

Dr. Mast suggested an open surgery to remove my impingement.  He would remove part of the acetabulum and part of the femur.  Removing part of the acetabulum is really hard to do with an arthoscopic procedure.  He does not think I need a PAO surgery because I will have enough acetabulum left after the impingement is removed to cover the ball of my femur.   It is like a woman wearing a hat, the hat has to be on top of the head.

dysplastic hip needs PAO surgery

non-dysplastic, good coverage

So as long as I don't have an autoimmune disorder I now have no question in my mind that I will have an open surgery as opposed to an arthoscopic surgery.   I will not be having a PAO surgery.   I just have to decide which surgeon is going to do my surgery.  Dr. Mast is out of network for my insurance and it would be a financial strain to have a surgery that is out of network.  

I need to come up with some fast money to have this surgery or pick a surgeon that is in network.

I am going in tomorrow for my lab tests and I will keep you all updated on the outcome.

acetabulum is circled in yellow

Angie's Tip of the Day

I know soda is not that good for you but I love Cherry Coke.  I don't drink it often, usually on a special occasion, like a particularly hot summer day, my birthday, or at a party.  But, sometimes I cannot finish the whole can.  Either I forget about it or it gets warm and warm Coke is not delicious to drink.  Then I am left with a 1/3 full can of Coke.   Instead of dumping all that Coke down the drain you can dump it in your toilet to clean your toilet bowl, no scrubbing required.

And it is super funny if someone goes to use your toilet and sees the Coke in there.  Coke looks disgusting when it is sitting in a toilet bowl for some reason.

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Recap on my Conditions

I know my condition is difficult to understand and probably most of you have never heard of it before.  I will give a brief recap on my condition for those of you who have not been following my blog from the beginning.  Shame on you.  You should all be on the edge of your seat waiting for me to publish my next post about what I bought at Target this week.  Hehe, just kidding.  My blog is just to keep my friends and family updated on my hip and on my life since I am so far away from all of you.  So here it goes, my conditions.

 FAI
First is my Femoral Acetabular Impingement also known as FAI.  The head of my femor is grinding against the rim of my acetabular, or pelvis, and in the process grinding away at the tissue in between and causing painful inflammation of the joint.

I have a mixed impingement

SURGERY REQUIRED FOR FAI
My FAI must be addressed with surgery, there are no ifs, ands, or buts about it.  The surgery that treats FAI is a surgical dislocation and debridement.  This can be done either arthoscopically, or with an open surgery.  I am trying to decide whether to have an arthoscopic surgery or an open surgery to treat my FAI.  With an arthoscopic surgery, two or three small incisions are made, the size of a dime.  With an open surgery, one long incision is made across the top of the thigh. I will use Megan Fox to demonstrate where the incisions will be.  Her right thigh is an arthoscopic surgery and her left would be an open surgery.

HIP DYSPLASIA and SUBLUXATION
My next condition of my hip is hip dysplasia.  This is when the hip socket is shaped too shallow to support the femur.  A subluxation is when the femur comes part way out of the hip socket, so that it does not fit tightly.  My hips feel loosy goosy.

Dysplastic hip.  Not mine.

SURGERY REQUIRED FOR HIP DYSPLASIA AND SUBLUXATION
The surgery required for hip dysplasia is called a periacetabular osteotomy also known as a PAO surgery.  With this surgery, a very long incision is made along the underwear line, or at the top of the thigh. Again Megan Fox will model the location of the scar. The pelvis is then broken and moved to a better location.  Then pins are inserted into the pelvis to hold it back together.  I heard one person describe it as putting the hat back on top of the head.  Many months or years later the pins are removed with another surgery.  I am trying to decide whether or not I need this dramatic surgery.

Before and after PAO surgery

OSTEOARTHRITIS
The third condition I have is arthritis of the hip.  This is a deterioration of the cartilage from years of having my bones pinching on the cartilage and from years of inflammation of the joint.  Because of my arthritis my chances at having a successful Impingement or PAO surgery decline dramaticly.  However, if I can have even a 30 % reduction in pain and delay a hip replacement, I would consider that a success.  Right now I rarely leave my house because of how much pain I am in.

arthritis of hip

SURGERY REQUIRED FOR ARTHRITIS
I think most of you know what surgery is required for arthritis.  A total hip replacement (THR).  With a total hip replacement the diseased joint is removed and an artificial joint is put in its place.  The problem with a THR at my age is that there needs to be a revision every 10 to 20 years.  With each revision surgery more bone is removed and each surgery becomes more difficult and more likely to have complications.  Every surgeon I have talked to has been very adamant about me not having a hip replacement in the next 15-25 years.  It would be much better for me to be managing my pain for the next 20 years with strong medication than to be in a wheel chair when I am 55.

Total hip replacement

I know I have a long road ahead of me and I am very lucky to have the support of my friends and family.  The decision as to what surgery I proceed with is ultimately my decision alone.  I tell the surgeon what I want to do, not the other way around.  You know what they say, when life gives you lemons, you make lemonade.  And in my case, I think I will add a shot of Tequila to my lemonade.

Angie's Tip of the Day

What do you do with all of your adorbs winter sweaters during the Summer months?  Those gorgeous sweaters better not be hanging in your closet.  Knits should never be hung up because they lose their shape that way.  The knit will stretch out into a weird shape and leave hanger dents.  Instead you should neatly fold your sweaters and place them in your dresser, storage box, or vacuum pack.

Have you ever taken out your sweater on the first cold day of fall only to have it smell not so fresh?  To keep your sweaters smelling fresh after all those months of storage place a few bars of soap amongst your sweaters.  No need to even take the soap out of the package.

Your sweater will smell clean and fresh like you just washed it and not like it has been sitting in a dresser drawer for 6 months.

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