Here is my latest update:
I started back in PT a couple of months ago now, and that seemed to be going well. It's been a lot of work, but I do think it has helped. It was PT who mentioned an LLD of ½ inch. I started out with a ¼ inch heel insert in my shoe, which really did seem to help with the lurch. I figured I would wait for any extra lifts until after I had seen my surgeon again.
I had my follow up appointment with him last Wednesday. My concerns were that I still have swelling in my op leg, my gait, and of course the LLD. He took x-rays and made his usual comment about how everything is still where he left it. Which of course I asked where did he expect it to be? That's when he showed me my x-rays and pointed out that my THR is angled slightly different than my natural hip on the other side. He said that because of my previous injuries there wasn't sufficient bone to have them angled the same, hence the offset, and the worry that things could possibly shift during the healing process. He advised against using the lift, saying that it could aggravate more things than it helped.
He used computer software with the x-rays and says that I have a .5cm LLD, which should not even be noticeable, and that he really hates when PT acts like they know what they are talking about on those types of things.
The swelling he explained as that after 3 surgeries there could be some scarring to vessels that will take a while to heal, and that he would not be concerned about it at this point.
He says my gait issue is Trendelenburg gait, and the only fix for that is more PT to build the muscles that I lost during my months of non-weight bearing.
I did request copies of my x-rays that day and am still waiting for them to come in the mail. I did get my hospital x-rays of everything from the day of the accident until the THR. So I have my complete timeline from original break until THR. Would love to post some, but for some reason, the file is not a format that I can upload here?
I was pretty satisfied with my visit, and with my progress to that point. I'm not anywhere near where I was before the accident, but feel that I have come a long way from where I was before the THR.
When I returned to PT on Monday of this week I was wearing sandals. And one of the women was asking where on earth did I get a lift that wouldn't show with sandals. I told her that my surgeon said that I did not have a noticeable LLD and shouldn't be using a lift. Went ahead with PT as usual. My usual routine there is 15 minutes on the nu-step, some exercises at the parallel bars, and some more exercises on the mat.
It was during the mat session that one of the other PTs came through and said that I should get my surgeon to check my LLD. Which of course led into the discussion again about how he said that I did not have one etc. So I had 3 PT people standing around me, having me adjust the way I was laying and saying that one of my legs were definitely longer than the other. During this time one of the Drs for the clinic came through also. And they were telling him they thought I had a LLD but my surgeon disagreed. So he asked did I mind standing and walking for him. Of course I didn't mind. So he watched me walk and said the same thing as my surgeon did about the Trendelenburg gait. He watched me both with the crutch and without, and with shoes and without. He had me stand with my hands on my hips, feet shoulder width apart. He said he thinks there is more of a degree of LLD than my surgeon is telling me. And that I need to go back and question that.
He asked me to lay back on the mat again so he could check a few things since he was there. He was asking me about pain, and I told him that I was a little sore after PT, but that ice and Tylenol helped with that. He started pressing down around my hips, around the joints as well as the bony area at the front of my pelvis and asked did any of that hurt. And the bony area at the front did hurt when he pressed down. PT stepped in and did this thing where I laid flat on my back and they bent my leg at the hip to a 90 degree angle and held it for 90 seconds, they did this to both legs, and when they were done the point that was so tender wasn't tender any more. It was like an 'aha' moment. So then they had me lay on my stomach and the Dr went back to pressing down on different areas and said for me to tell him if anything hurt. Nothing hurt, but it wasn't really comfortable either. He ends up by saying that he thinks that my pelvis isn't aligned correctly. He said that my left side seems to be higher than the right, and that my sacrum sticks out more on one side than the other. As in on one side it's level with the surrounding bones, but that on the other side there is a noticeable difference. He ended by saying that I should probably have some x-rays done that focus on the entire pelvis and not just the new hardware.
That same day, directly after the PT session, I had my first visit with my new PCP. I mentioned to him what the other Dr had said during my PT session about needing x-rays. He basically said that with my accident and THR status that anything dealing with my pelvis was out of his range of expertise, and suggested I call my surgeon and discuss this with him. He checked my vitamin D levels and sent me on my way said to return in a year.
After the appointments I went home. In public I still walk with one crutch everywhere. It controls the lurch and helps out with unlevel surfaces. At home I sometimes go without it for short distances. As in if I need something from 3 feet away I am going to get it without the crutch, it's just quicker that way. Well I noticed that when I walked without the crutch after the PT session that I had less of a lurch than I had been having. So I thought, great, I am making progress. Fast forward to the next morning. I could barely get out of bed, my lower back hurt so bad. When I did make it out of bed it seemed I felt something shift and I was back to my usual lurch only worse. So it basically seems that whatever adjustments they made unadjusted themselves and left me with pain.
I called my surgeons office and left a message with his nurse. She called back and I told her what PT and the other Dr had told me, she said she would speak with the surgeon and see if he wanted to see me again and maybe do some more xrays. She called back later and said that he said I should quit worrying over every little thing PT told me and that he would see me in 3 months.
So now I am sitting here like now what? If something is out of alignment that needs to be aligned, by all means lets get to it. On the other hand, I cannot allow PT to do any more of this alignment because it hurts to bad the following day. Is that normal? Where do I even start to get answers to what is going on now? Hoping maybe
@Josephine will chime in here.