THR Psoasis Relief

[Jws.]

@Hip4life @SaraK
(don't know if josephine is using this name)....well June 3rd is my surgery date...I just flew in here from los angeles and will meet with the doc tomorrow at 1:20pm. I can't tell you the range of emotions but the one that keeps me going is the thought that no matter the fears, anxiety or "what ifs" , I have to push forward and get this over with in my life. I couldn't have gotten to this point without pat giving me the referral to the OS who when I talked to was exactly on the same page as I was, and knew what I wanted and didn't want. He was informed , empathetic and a "nice guy". (unlike the LA and NY docs I've talked to ) ...It's time for me to try some legitimate hometown doc to get this right and not be pressured by the 6 other surgeries he has that day.
He is going to totally release the tendon at the lesser trochanter, look that it retracts 2-3 cm so he knows their are no spurs, or adhesions it's hung up on and if it doesn't release back 2-3 cm he will follow it up looking for where it is still caught and release whatever it's snagged on. His governing theory is that if you get relief from the cortisone shot in the psoas then the psoas is definitely significantly involved in your pain plain and simple.
I don't know why (nerves, etc.) but I am plagued with "mouth sores" (not herpes) , the white little blisters that you get in your mouth .. (I had them just before the last psoas release) ...anybody have a remedy (home or medicinal to get rid of these as their really not helping things) ...I also am having headaches. Lastly, Nebraska has decided that May 25th today, the state shall be totally mask free. Coming from LA it's pretty difficult to see everyone unmasked ,just another stepping stone to deal with on the way back to "normal"....will post again after I see the doc...fingers crossed he's the same as he was virtually if not better..I would love this to not have any last minute hitches...thank you all..jws

 

[Layla]

I don't know why (nerves, etc.) but I am plagued with "mouth sores" (not herpes) , the white little blisters that you get in your mouth .

Try gargling with warm salt water, or baking soda and water and see if that helps. Eat yogurt. Get on a good pro-biotic if you’re not already on one. If you’re vaccinated try not to worry about the unmasked. They maintain we’ve reached herd immunity with half of the country receiving at least one injection and that’s not taking into account those that have already contracted the virus, either with symptoms, or asymptomatically.

Good luck with your appointment. Hopefully this is the ticket and brings you long awaited relief.

Just an FYI - Josephine retired and is no longer on the forum. So we’ll remove Jo Wo from those you’ve tagged.

 

[Hip4life]

Hi, Jeffrey. Welcome to Nebraska! Just checking in to see how things went with your appointment. BTW: like anywhere, feel free to wear that mask wherever you want. I still do most places and most medical facilities still are requiring them. Let me know if I can help with anything.

 

[Jws.]

Hi Pat,
Have met with Dr. Burt...was easy, informative ...really nice guy...surgery like we both know 45 minutes beginning to end...he set me up same day to meet w anesthesiologist -had long talk..(everything casual -love it)...he really says the cortisone shot relieving the pain in the groin trumps everything (overhang in cup, caught on bonespur, etc.) He says if he doesn't immediately see it release at least 2 mm = he says he will go up and find where it is caught and free it up..
Yes ..everyone without masks is a bit disconcerting so we try and avoid going out too much until after the surgery next week -don't want to mess this up..lot of work and planning went into getting here..(as you well know..not just covid, strepp. or ???)..if i'm going to get sick has to be after next week..
Thanks again for all the info and especially the referral ..will call you before the surgery...fingers still crossed...

 

[Jws.]

Ok Hip4life, SaraK, Layla, Meldoy......thursday is my surgery at 11am . HOPEFULLY, IT WILL BE MY LAST! Full Psoas release from the Lesser Trocanter. I can't thank those people enough on BS who have helped me on my way and have given me invaluable recommendations, support, and sage advice.
Pat, Sara, Melanie , Layla, Josephine, etc. A better group of wise, understanding and empathetic women is not to be found .
Their messages of hope and aid at each of my "ups" and "downs" has been terrific.
This journey has been for me a complete nightmare. ( At some point I will detail it all out-but for now thursday is hopefully the end of my chronic groin pain.)
All is done..met with anesthesiologist, Doc, PA, ....warm ,nice , knowledgeable professionals.
Obviously, given my past there is doubts, what if's and anxiety. As Sinatra says " get up, dust yourself off, and get back in the race' or something akin to that..
Will see you all on the other side ...could use all your good wishes...fingers crossed...best JWS

 

[Pumpkin]

Good Wishes and for your surgery on Thursday!

 

[Jamie]

@Jws. I'll be thinking of you on surgery day and hope this is what finally gets the job done for you. I'm so glad that our BoneSmarties have helped you get to this point where you may finally have some relief from your pain.

 

[Sashimu]

Hi, @Jws. I've been having psoas trouble as well since my THR March 4. I hope that this procedure gives you the relief that you're looking for. Best wishes for Thursday.

 

[Layla]

Hey @Jws.
Best wishes and fingers crossed for a successful surgery on Thursday. Sending up a prayer for your peace of mind, an uneventful surgery and recovery with perfect healing.
You’ll be in our thoughts so give us a thumbs up once you feel like updating.

 

[Wyn wombat]

Hello @jws, fingers crossed and will be thinking of you Thursday. You can do it.

 

[SaraK]

Keeping my fingers crossed that this one does the trick!

 

[Hip4life]

You’ve got a great, skilled, and compassionate team. Try and lean into that and let them take good care of you. We’ll see you on the healing side, where hope and a return to wholeness awaits. Pat

 

[Jws.]

Ok ..finally ..the day is here...its 5am ..my surgery is at 11 am..having my "black ' COFFEE" -NEW GUIDELINES 5 HOURS BEFORE BLACK COFFEE OR GATORADE.. will report after...best Jws

 

[Mojo333]

All the best.. @Jws.

 

[SaraK]

At least you can wake up before they have you sleep! We'll be waiting to hear from you!

 

[Layla]

Big day today....brighter days coming your way!

 

[Jws.]

@Hip4life @SaraK @Layla So I am on second day post surgery. So here is the update. The surgery was about 45 minutes long. Not eventful.. clean hospital..professional and nice people.

Positive

1. Before surgery was unable to get up from seated position due to groin pain in right crease of groin.
After: gone
2. Before surgery (full psoas tendon release at lesser trocanter (no lengthening)..was having hypotensive symptoms due to vasovagal reaction to pain in groin( low blood pressure, sweating profusely every morning for about 18 months, migraine headaches with auras, heart palpitations, etc.)
After :gone ( this could also be due to the cortisone shot OS gave me during surgery into the greater troch and piriformis, -notwithstanding all hypotensive symptoms gone, and pain in trocanteric bursa and piriformis gone.
Before Surgery groin pain when walking.
After: Gone


Negative
Before Surgery was able to lift my right operative leg up to left knee and cross over. In addition able to lift my right leg into bed, in addition able to lift my right leg in car.
After: Gone
so here is the difference from the psoas lengthening at HSS a year ago and the TOTAL PSOAS RELEASE yesterday. THERE IS NO MORE PSOAS TENDON AT ALL. you are immediately aware that it is missing and there is nothing that is going to lift that operative leg anywhere unlike the lengthening where by the second day you can lift the operative leg almost like normal, (at least by the third day.)

Here , this is absolutely more than I bargained for as it feels like "dead space" no tendon , no lifting from the tendon...not weakness as they describe but on this second day NOTHING , leg has to be lifted up..
I am assuming that the other hip flexors will kick in after awhile and I will be able to lift the leg close to normal but as of now there is a definitely profound difference between "lengthening and full release" and those having this surgery should know that immediately after this surgery you will not have "weakness" you will have nothing to lift the leg with so do not be shocked...
I have talked to MANY Os's before this surgery and they all agree that you will end up with weakness ONLY and all were adamant that you will get the power back in the operative leg through the help of the other hip flexors. I can't imagine any surgeon doing this surgery and their patients end up like this as the "end game"...so I am just laying out the facts as they are for me.. and I now understand that the total release of the psoas tendon is A TOTAL RELEASE OF A PSOAS TENDON and the attached powers of lifting that came with that psoas tendon are gone.
Now will the other hip flexors (adductors, abductors, etc) pick up the slack...I am sure that will happen and am not that concerned yet. I can tell you it is quite a difference from the "lengthening" I had at HSS where by the second day everything was fine EXCEPT I HAD HORRIBLE GROIN PAIN which developed into the above complication symptoms above.

ALL OF THAT IS GONE! so we will see , if I get my lifting of my leg back ...and rid of the groin pain (which I have already) I will be back to almost normal and thrilled..but it feels like this is going to take some work to get those other hip flexors fired up... I wasn't as lucky as @saraK to get relief from just a lengthening at the central compartment (that would have been ideal -as you still have your psoas tendon attached (a little longer but nonetheless attached and working).
In addition , I hope to get the same relief @HIPFORLIFE got from her total release and many others got from their total release given some time (THIS IS ONLY MY SECOND DAY) when the other hip flexors kick in.
Don't get me wrong I am thrilled to get rid of that damn groin pain and the debilitating complications that started to "eat at my body" (slouching, hypotensive reactions, sweating, low bp, vasovagl, pain in testicle from psoas pulling, worse walking with limp, etc...and everyday more .)

I am not being a doom and gloom guy here...I truly expect this tobe the last and best surgery I have had with this hip and expect that I will be done given some time. any questions are welcome and so are your kind wishes for recovery...will update as I heal..best JWS

 

[SaraK]

Keep in mind that this is the second day. I still had a lot off stiffness and difficulty lifting my leg at that point because of all of the fluid they inject during an arthroscopic procedure. It was a few days before I could move it sufficiently to drive (was right leg).

In addition, whether you do a lengthening or a total release, you do need to retrain the brain and the muscles. My doctor said PT was optional but I did it because I had a great PT. We worked with me to get all of the muscles firing and learning how to move with their new configuration. Give everything a little chance to heal first and then take things slowly. Find a PT or someone else to monitor and make sure you don't do too much too soon. My PT always said his main roles were to give me the roadmap and then keep his foot firmly on the brake (he figured that out after I went dancing the 6th and 7th day after the second THR).

I'm glad you're already seeing the benefit. Just don't expect the pot of gold to be right around the corner.

 

[Layla]

Oh my goodness this is all so encouraging already! I’m really happy for you.
The positives are outweighing the negative and Sara’s words are such an encouragement.
It’s wonderful to read that some of the nuisance and I’m sure frightening symptoms you were suffering pre-op have abated. Through your words I’m feeling totally confident about a full recovery and bright future. Praise the day your hip finally becomes an afterthought. I believe it’s coming!
Wishing you comfort as you heal. Thanks for the update, please keep us posted.
@Jws.

 

[Jws.]

Ok day three and I am definitely getting nervous that this hip flexor "weakness" is here to stay and i wont be able to get in bed , or car without lifting my leg or when I sit down . It is impossible to lift my leg and knee up at all with the operative leg when sitting.

My understanding is that I no longer have a psoas tendon as it was fully released at the lesser trocanter. Therefore , that tendon is obviously not going to lift my leg. I am then left with the abductors ,adductors ,piriformis and iliacus, (and I am just naming muscles I would think are hip flexors) to take up the job of lifting my leg when seated. @SaraK I understand that Sara and I after my previous "lengthening " of the psoas tendon at the central compartment at HSS were easily able to lift the leg AS WE STILL HAD A PSOAS TENDON (albeit lengthened but nonetheless it was there and I was able to lift my leg after the second day - NO PROBLEM. Here, it feels like I am in a vacuum with my operative leg and with really nothing to lift the leg at the moment. @Hip4life and @Meldoy they seem to be able to lift their legs from a seated position and I would love to know the timing on that.(BTW , I am thrilled that they have gotten that result) but I am not clear on how mechanically the weakness in the hip flexor in the seated position is culminated...is that a 2 week healing period, 3 months or 8 months...
@Hip4life @Meldoy Please if you would tell me how long approximately did it take you to be able to lift your operative leg from the seated position post op as well as straight leg lifts, as well as getting in the car or bed with no problem and tying shoes and putting on socks with no problem ...2 weeks, a month..it would reduce my anxiety greatly. Thanks guys for always being there...JWS...(I do know I am early in the healing process -3 days- but exactly what is healing (other than the surgical wounds) that would allow me some hip flexor power to lift leg.