Dulcimer Diva
graduate
2.5 years post-RTKR and 1.5 yrs post-LTKR, I was doing great (with a slight setback from a torn L upper gastroc after overdoing hiking in the Rockies), right up past New Year’s Day 2015. Late in the first week of Jan. we had our first accumulating snow of the year, so I decided to be conscientious and shovel as best I could. (Unshoveled sidewalks had always been a bone of contention for me whenever I was temporarily disabled after orthopedic surgery, and I didn’t want to be “that” heartless negligent homeowner). All seemed well until a day or so after a particularly strenuous shoveling and ice-chopping session, when I began getting pain in the general area of my R hip upon getting up from first a recliner, then any chair or toilet. The pain didn’t occur when sitting, standing, or lying on my back or other hip--just on walking, especially ascending (but not descending) stairs--just the opposite of when I had arthritic knees.
At first, I figured it was just a strain. I kept up my maintenance doses of acetaminophen (2 x 500 at bedtime, 2 x 650 “arthritis formula”) and 200 mg. celecoxib on arising, prescribed for the gastroc tear (and successful in healing it). Tried icing and heat to no avail. By the end of the month it had worsened to the point where it would hurt getting out of bed and even sometimes when lying on that side. Went to my FP, who manipulated my leg, poked, prodded, and had me step up with my R leg. He said it’s not arthritis but rather trochanteric bursitis. He said to continue the same pain meds (would have preferred I take naproxen but acknowledges it aggravated my GERD and even caused a small gastric bleed last year). He also prescribed Lidoderm and Flector patches with Voltaren and arnica gels and menthol rollers if they give relief. He also said that since it’s not arthritis there’s no need to expose myself to the radiation from an X-ray, nor the expense of an MRI (tricky with all the hardware in my legs).
Well, it’s been getting worse. The pain on weightbearing motion is so diffuse (radiating to groin and down my thigh, sometimes even to and below the knee) it’s difficult to pinpoint whether it’s coming from my trochanteric bursa or from the joint itself. A little background--back in ’96 I was hit by a car, which shattered my R tibial plateau. Ancillary to the open reduction-internal fixation surgery, my then-OS harvested bone from my R iliac wing to mix with epoxy to form a stable matrix in which to implant hardware in my tibia (which remains to this day, minus the top 2 screws and rod portion that had to be removed for the TKR). In 2004 after a rapid but intentional weight loss, I experienced painful snapping and catching in my R hip, relieved only by swinging my leg (and temporarily at that). My successor OS (who’d been the tibia-surgeon’s partner at a different office before it split into two groups) discovered on X-ray that the top horn of my iliac crest had actually snapped off and was floating free--causing a tendon or ligament to catch on it. After putting me through a nuclear scan to rule out osteosarcoma (I was too young then for osteoporosis to have been a cause), which turned out to be negative for anything but inflammation, he opined that his ex-partner may have harvested an excessive amount of bone for the ’96 graft, which ultimately weakened the iliac wing causing the fracture--and until the weight loss, my fat was holding the broken-off piece in place. He advised watching and waiting to see if the piece would resorb, and it apparently did.
So I’m wondering if what I’m suffering, if not bursitis, is either referred pain from arthritis, further degeneration of the iliac wing, or--more ominously--either necrosis or heaven forbid, a tumor. Should I demand an X-ray and/or MRI? I’m using a cane now, which helps only partially. (After being on my feet for a little while, the pain isn’t so bad, but it does re-intensify after half an hour or so, such as when shopping). Complicating matters is that I have a weeklong trip to Las Vegas coming up this Thurs. We got a good deal on first class airfare and thus don’t need exit row seats, so I can use a wheelchair in the airport and openly carry my cane. But walking distances in Vegas are huge--my husband says he’s willing to push me in a wheelchair the whole time (I joked that I should rent a scooter, in order to blend in with all the other sixtysomething Midwestern female tourists--but then I’d need a fanny pack, ugly T-shirt, shorts, baseball cap and giant plastic cup full of quarters to complete the ensemble). And I have a continuing legal ed trip to Spain (Madrid, Barcelona, Seville) coming up in early April--traveling alone to boot. (Husband let me spring for business class air, though between cities in Spain there’s just coach or rail).
What would you do? Further complicating matters is that my wonderful OS Dr. Wixson has retired. I can get into the walk-in clinic at North Shore Ortho in Skokie tomorrow.
At first, I figured it was just a strain. I kept up my maintenance doses of acetaminophen (2 x 500 at bedtime, 2 x 650 “arthritis formula”) and 200 mg. celecoxib on arising, prescribed for the gastroc tear (and successful in healing it). Tried icing and heat to no avail. By the end of the month it had worsened to the point where it would hurt getting out of bed and even sometimes when lying on that side. Went to my FP, who manipulated my leg, poked, prodded, and had me step up with my R leg. He said it’s not arthritis but rather trochanteric bursitis. He said to continue the same pain meds (would have preferred I take naproxen but acknowledges it aggravated my GERD and even caused a small gastric bleed last year). He also prescribed Lidoderm and Flector patches with Voltaren and arnica gels and menthol rollers if they give relief. He also said that since it’s not arthritis there’s no need to expose myself to the radiation from an X-ray, nor the expense of an MRI (tricky with all the hardware in my legs).
Well, it’s been getting worse. The pain on weightbearing motion is so diffuse (radiating to groin and down my thigh, sometimes even to and below the knee) it’s difficult to pinpoint whether it’s coming from my trochanteric bursa or from the joint itself. A little background--back in ’96 I was hit by a car, which shattered my R tibial plateau. Ancillary to the open reduction-internal fixation surgery, my then-OS harvested bone from my R iliac wing to mix with epoxy to form a stable matrix in which to implant hardware in my tibia (which remains to this day, minus the top 2 screws and rod portion that had to be removed for the TKR). In 2004 after a rapid but intentional weight loss, I experienced painful snapping and catching in my R hip, relieved only by swinging my leg (and temporarily at that). My successor OS (who’d been the tibia-surgeon’s partner at a different office before it split into two groups) discovered on X-ray that the top horn of my iliac crest had actually snapped off and was floating free--causing a tendon or ligament to catch on it. After putting me through a nuclear scan to rule out osteosarcoma (I was too young then for osteoporosis to have been a cause), which turned out to be negative for anything but inflammation, he opined that his ex-partner may have harvested an excessive amount of bone for the ’96 graft, which ultimately weakened the iliac wing causing the fracture--and until the weight loss, my fat was holding the broken-off piece in place. He advised watching and waiting to see if the piece would resorb, and it apparently did.
So I’m wondering if what I’m suffering, if not bursitis, is either referred pain from arthritis, further degeneration of the iliac wing, or--more ominously--either necrosis or heaven forbid, a tumor. Should I demand an X-ray and/or MRI? I’m using a cane now, which helps only partially. (After being on my feet for a little while, the pain isn’t so bad, but it does re-intensify after half an hour or so, such as when shopping). Complicating matters is that I have a weeklong trip to Las Vegas coming up this Thurs. We got a good deal on first class airfare and thus don’t need exit row seats, so I can use a wheelchair in the airport and openly carry my cane. But walking distances in Vegas are huge--my husband says he’s willing to push me in a wheelchair the whole time (I joked that I should rent a scooter, in order to blend in with all the other sixtysomething Midwestern female tourists--but then I’d need a fanny pack, ugly T-shirt, shorts, baseball cap and giant plastic cup full of quarters to complete the ensemble). And I have a continuing legal ed trip to Spain (Madrid, Barcelona, Seville) coming up in early April--traveling alone to boot. (Husband let me spring for business class air, though between cities in Spain there’s just coach or rail).
What would you do? Further complicating matters is that my wonderful OS Dr. Wixson has retired. I can get into the walk-in clinic at North Shore Ortho in Skokie tomorrow.