Patient Stories

Tyler

It was a dismal Saturday afternoon on October 23, 2013, and I was falling down the stairs. All I could feel was the ripping apart of my right femur and pelvic bone; it felt like I was involved in a dismemberment. I frantically fell down the stairs in what seemed like slow motion, while my family members stood there and witnessed my downfall. As soon as I landed, my mother ran over to see if I was alright, but from the petrified look on my face; she knew I wasn’t. Even with my mother seeing my facial expression, her only expectant response was, “Go put some ice on it — and take an Ibuprofen.” That was always my mother’s “go-to” when someone was ill or injured. I think she got that mindset from her dad, my papa, who whenever he cut himself, would just put a paper towel on it, and duct-tape it. I am the opposite. I am the type who thinks he is going to die even if it’s just a hangnail. Unfortunately, this injury was far from a hangnail.

I had been showing signs of my progressing hip dysplasia prognosis’. My right hip was deteriorating faster than a new 2014 Ford F150 driving off the dealership lot. We knew it was time for me to have the inevitable operation, a Pariacetabular Osteotomy(PAO). A Pariacetabular Osteotomy is a surgery that is to try and preserve the hip and delay a total hip replacement. Only one surgeon in the entire state of Michigan would do the surgery. The surgery involved strategically cutting my pelvic bone in four places and rotating it to cover my femoral head.

My hip dysplasia was an undiscovered issue that wasn’t diagnosed until I was an adolescent at the age of sixteen. After falling down the stairs I complained, moaned, and groaned the next few days to my parents about the stabbing pain in my hip region. This provoked them to schedule an appointment with my physician. So, it came time for me to go see my doctor. As a typical kid in school, I saw it just as an opportunity to miss school and not as anything serious. But as soon as I was examined by my doctor, he knew something was seriously wrong and he sent me to a radiology place to have my hips and pelvic region x-rayed. Getting my x-rays done was excruciating, the technician insisted on turning my hips and legs in the most unpleasant and painful positions possible. By the time I left there, I was in more pain than a human trying to urinate a marble. We had a call at home in less than thirty minutes after the x-rays from my doctor with the diagnosis of hip dysplasia and a referral to a hip orthopedic specialist. This was when my mom realized that no ibuprofen or ice was going to fix my hip. I was going to need medical treatment.

It was January 8, 2014, before I was able to be seen by the hip specialist, and I was getting worse. He ordered an MRI arthrogram when he examined me. That is a procedure where they stick a needle into your hip joint and inject dye into it to have a contrast for the MRI. This was not just any needle though, this needle was like the Rambo of needles. The needle looked like it was on more steroids than Lance Armstrong. It was one of those situations where you just naturally want to run away as far as possible. Unfortunately, when your hip is in stabbing pain and has deteriorating arthritis, your options are pretty limited. The doctor who was injecting the dye into me told me to lay down on the table and that it would only feel like a pinch. Well, a pinch is also what he would describe a car getting crushed by a compactor I imagined. When I was actually injected with the dye, it did not hurt very much, but only felt like a sting ray tail entering into my hip joint. After that I was taken to the MRI where I was forced to lay in a machine that was more obnoxious than a child’s tantrum and louder than a fighter jet. Fortunately, my hearing was shot in the first few minutes and I was able to drown out the sound of the MRI.

When taken out of the MRI, I was presented with the problem of not being able to walk due to the fluid in my hip joint. This was definitely a problem. I could hardly walk before and now I was being faced with not walking at all, temporarily. They brought me a wheelchair that looked like it was built to carry a sumo wrestler and was as wide as a couch. (I am oblivious to why they have a wheelchair of that description in a children’s hospital.) After eating a sufficient amount of popsicles to numb my brain, I was ready to leave. They wheeled me out in the wheelchair which had to be operated by a team of two people, I might add. I soon realized that I had to transfer myself from the wheelchair to the car, and noticed that without legs this was going to be an astronomical problem. Luckily, I was the king of hopscotch back in second grade, so I knew I could do this. I mentally psyched myself up for this the whole wheelchair ride to the car and then I proceeded to get into my car without a flaw.
We drove in a typical “Michigan blizzard” home, my mom gripping the steering wheel so tightly that her knuckles were as white as the snow. I was as apprehensive and tense as any typical back seat driver who felt completely vulnerable. To add to my apprehension, we received a phone call from my father who was at home, saying that the hospital had just called and that we needed to turn around and come straight back. Now, you can’t just state something like that and leave it that vague, but they did. So, now we are having to make a “U-turn” to go back, which was not very hard, though, on an ice covered road. Of course, a typical person’s mind will assume the worst possible case scenario, which is exactly what my mom does. I just assumed if they found something and they want us to come back; it must mean they can fix it.

We arrived back at the hospital with the greeting of a problem, no wheelchair, and I still can’t walk. My mom said we did not have time to go get one and come back, so with her supporting me, we ventured into the hospital with the expectation of bad news. We took the longest route possible to our destination it seemed. The MRI technician met us and informed us that they did not have the MRI imaging the doctor wanted and before the dye was out of my hip joint, he wanted to do another MRI. This led to me being put back into the cockpit of the pretend fighter jet and again losing my hearing which I had just regained. Of course, as soon as it was over, I indulged into numbing my brain with popsicles once more.

Fast forwarding about a week, we drove back to discuss the results of my MRI. This is when I was informed that the cartilage in my hip joint, the labrum, was obliterated and that my femur and pelvic bone were rubbing against each other causing very bad degenerative arthritis. The hip specialist said he wouldn’t touch it and was going to refer me to another hip specialist in another city. He told me that this doctor is the best in the state and only takes the “worst cases” — how reassuring.

February 10, 2014, was the earliest I could be seen by my new hip specialist. His office was located at the Children’s Hospital. The hospital was very dilapidated and gave me the assurance of a hospital in a third world country. When I arrived at the hospital we went to the orthopedic doctors’ office where they proceeded to check me in on a computer that ran using Windows 95. Then we were ushered into a crowded waiting room, where we waited almost forty five minutes past my scheduled appointment time. The doctor had requested x rays by an x ray technician who was rougher than sand paper. She, without saying a word, approached me and pulled back my sweatpants to check if I had any metal on the elastic band before my x ray. I was taken aback by the fact she just did that without saying anything and told her that she could have at least bought me a drink first.

After the encounter with the friendly, perverted “X-rated” technician, I was sent to an examination room to meet with the hip specialist. When the doctor entered the room he expressed a manner that exuded confidence and made me feel reassured, which was greatly appreciated after the underwhelming confidence given by the hospital, itself. He looked at my X-rays and told me that my options as a seventeen year old kid were between a PAO or a total hip replacement. Wow, I thought, they’re just all such good options; it’s basically choosing the lesser evil of the two. He told us the pros and cons for each operation and said that the PAO would only preserve the hip to the point of delaying a total hip replacement. So, we chose the route of a PAO.

The doctor told us for the PAO surgery he would need to do some testing, an arthrogram to be more specific. Great, just what I wanted to do, another Rambo needle in my hip joint. This was even more of an ordeal because I was at a children’s hospital where their policy was that they put you under general anesthesia for the arthrogram. I was not a big supporter of that and after ruthless fighting and bickering, we arranged for it[arthrogram] to be done without the general anesthesia. This was the worst idea of my life. I was taken back, completely conscious, to an operating room. If you have never walked into an operating room completely conscious and had to get up on the table, you are lucky. It is a very traumatizing experience that you do not forget. The room was very cold and gave a sense of hostility. I described to the anesthesiologist my interpretation of the operating table: it is like a warm toilet seat, it seems nice until you really think about it. The operating room nurses gave me a warm blanket to put on to reduce the hypothermia shock that I was already experiencing from the subarctic temperatures. The hip specialist came into the room and flipped up my blanket leaving me completely exposed to everyone in the room (very awkward) while he injected my hip with the same sting ray tail that I had already experienced a month earlier.

The ball was rolling and my PAO surgery was set for April 28, 2014, and I was very excited to have the day come where hopefully my pain would be alleviated. I had to be at the hospital at 5:30 in the morning on the day of my surgery, and if you know anything about teenagers, 5:30 in the morning is not part of their biological clock. But luckily, I was so scared the night before I didn’t sleep so I didn’t have to worry about getting up, since I was already up. Prepping for the surgery was pretty simple except for other than the lysol bath I had to endure. I wiped myself down with six lysol wipes that made me feel as sterile as the operating room. Before I went back to the operating room, I hugged all of my family members like I was going off to war, unsure if I would ever return. Of course I had the pleasure of walking into the operating room once again completely conscious and being told to lay on the operating table. This time there were so many more instruments and tools in the room and, being a curious kid, I wanted to see all of them. That was also a huge mistake, it was similar to a death row inmate wanting to watch the guy in line before him get executed. Next thing I knew, I was on the operating table having my last functioning day of my right hip.

I woke up after surgery to find myself extremely lethargic and exhausted which I was informed is normal after a major operation. I was in the recovery area and was not allowed to see any of my family members so I laid there and panicked like an eaglet wanting his mother who was off fetching food. I was told it was going to be a while before they could get me situated into a room because space was limited. I was thrilled and ecstatic to be spending a few days in such a comfortable and delightful environment. I assigned a room in the burn unit, and I could not have asked for a better place, unless I actually wanted to be able to sleep, that is.

My hospital stay was in a room that I had to share with a small child who was covered in burns. He was brought to the room around three in the morning. He was screaming and crying, which is definitely not a conducive environment for someone who is trying to sleep. Thankfully, I just had to push my morphine drip one time and I was out and on my way to drowning out the small child. My hospital stay wasn’t just difficult and uncomfortable because of this roommate, but also because of my first experience with a straight catheter.

A straight catheter is only admitted into the bladder long enough to drain it and then it is promptly removed. Sound simple? Well there is nothing simple about it. When it was decided I needed a straight catheter to empty my bladder, an ultrasound of my bladder was the first fun step of the process. When I was getting ready for the catheter, my heart rate became extremely arrhythmic and sent me into borderline ventricular fibrillation. The catheter was inserted into me, and I experienced a new type of pain that even morphine couldn’t help. This was the only time I had been in so much pain, I could not cry. The nurses had it almost all the way up there but could not pass it into the bladder due to what they called “special anatomy”. The nurses informed me that I would need a special pointed tip catheter to be catheterized. Now being a male, when they informed me that I was going to need something inserted into me with a pointed tip, I rationally decided I would rather die. Needless to say, my first catheter experience was one that I will never forget.

Now with my discharge from the hospital I was at home living on our ground floor with six weeks of trying to coordinate crutches. I was gifted with the ability to be naturally clumsy, so I feared the crutches would be interesting, but fortunately I did not have any issues with them. I had to be off my hip completely for six weeks while my pelvic bone healed and then I was to commence physical therapy for the summer. Physical therapy was a constant struggle of trying to become stronger while facing pain that hadn’t been alleviated by the surgery. Due to the tear in my labrum, I was not allowed to do any type of stretching exercises, this resulted in the intense tightening of my right leg.

I went to the doctor at the end of the summer with the same pain I had before surgery, and there the surgeon deduced the PAO surgery was not a success and that I was going to need to try a total hip replacement to completely alleviate my pain. Post surgery x-rays showed my labrum being more damaged than pre surgery x-rays. The hip specialist said he would not do the total hip replacement on me, because, in his exact words, “it is too easy of a surgery for me”. He referred me to a hip replacement doctor in yet another city who had served a residency with him.
Fast forward a few days after that appointment and the Orthopedic Center  called us to schedule a consult for my hip. They scheduled the consult to be in February of 2015, but using the pity story of “I want to walk at graduation,” I was given an appointment at the beginning of January. I went to the Orthopedic Center to meet the next doctor in my prolonged hip journey. He was a man of about forty and was very relaxed in his manner, but was still confident. This was also my first doctors experience after becoming eighteen, which resulted in more signatures than J.K. Rowling would sign at a Harry Potter book release. I went into an examination room where I was asked to change into shorts they gave me, at least twelve sizes too big. They x-rayed my hip in very painful orientations once again. The doctor came into the room and told me that the x-rays were bad and that he would recommend a total hip replacement — well duh, kind of why I am here. He asked me, coming from the small town of I lived in how I found him as a surgeon. I told him that the hip specialist had recommended him, and this apparently boosted his ego into a new aura. The doctor scheduled my total hip replacement to be January 28, 2015.

Knowing that my pain was finally going be alleviated after over a year of suffering was quite the relief. I was ready for the pain to be gone and to put this ordeal behind me. Before this surgery I was given this fancy soap, mouthwash, and nasal ointment that I was supposed to use for four days before surgery. I attempted one day before surgery to finally just try and use the soap but it made me gag and my eyes water, so I decided that I was going to take sepsis before I was going to use any of those fancy disinfectants that I was given.

It was surgery day and I had to be to the hospital at 5:30 in the morning to be prepped for my surgery. The prepping began with me signing so many papers that my hand was cramping. I was taken back and changed into a gown and was given more pills to take than they have at a Pfizer factory. The nurse that was inserting my IV was an apparent amateur and ended up giving me a very nice bruise on my arm. I met with the anesthesiologist before surgery and he told me I would be under general anesthesia for the surgery, but he said if the medicine didn’t work that he could use a hammer to make sure I was out. That was not reassuring. They wheeled me back to surgery and I was transferred to the sterile operating table and was out before I could count back from twenty six.

I awoke in a recovery room where I felt very conscious and alert. I sat up and was prompted to order lunch if I was up to it, and boy was I hungry. I ordered like I was at Old Country Buffet and only ended up eating two bites as I fell asleep just after I ordered. When my food arrived I jumped up and took two bites, but I guess the thought of food made me too excited, because I became tachycardias and promptly passed out after the two bites.
I am on my resilient recovery now and am two weeks post-op. I have begun physical therapy and can feel myself getting stronger. My pain has been completely alleviated and I feel like an entirely different person. I hope to be ready to start training for a professional speed walking competition this summer.