Still Sittin' On The Fence

Hi again. Well, the trip to Portland went smoothly. The flight was good, on-time, and the rental car was fine. Heck, there wasn't even much traffic on the way to the doctor (it's about 30 miles away).

When I got to the doctor's office I was about 30 minutes early but they took me right back anyway, stating that the doctor said he was was back from lunch and ready to roll if I got there early because he wanted all the time possible with me.

My first impression was a good one. I'd never met this surgeon (Dr. V) before, I'd only been to Dr. S, my surgeon from 5 yrs. ago and his associate who referred me. Dr. V is a pretty cautious man, I can tell, and I liked him a great deal. He did a thorough exam and we talked for a long time. I'm very blessed because Dr. S arranged his schedule so that he could come in the exam room as well. That gave me comfort. It's not many doctors who stay on the case after they bring in another specialist. I'm so used to being passed off like a defective football, it was a rather pleasant surprise!

Here's the situation with my hip-- at first glance on the x-rays it looks relatively normal. The joint spacing isn't bad-- a bit tighter on the left (the bad hip) but all in all, not bad. Certainly not a radiographic hip that would make you think that I'm in terrible pain at all. However, when you look a little closer it makes you go "hmmmm" and scratch your head because it does look a little odd. That's where the MRI and arthrogram come in. I do have another labral tear that's likely caused from the delaminated cartilage on the head of the femur rubbing against it in a very irritating way. Translation?

The head of the femur is rough (from Lyme arthritis which acts like osteoarthritis attacking the joint) and that's catching on the soft cartilage of the acetabular labrum (this is the cartilage that "holds" the head of the femur in place).

I also am "blessed" with severe inflammation-- which is like Rheumatoid Arthritis-- in the joint capsule itself (also from the Lyme). The synovium is really riled up.

So, put the arthritis, inflammation, labral tear, and cartilage delamination all together and what do you have? Yep, a mess.

So, the docs tell me that they like to have the probability of a 90/10 success before they sign off on a THR (Total Hip Replacement). I don't have that, however, they feel that I do have a better than 50/50 chance of getting better. Because Lyme arthritis and THR is an area they've never ventured, they can't promise any better than that. But, Dr. V is a very, very cautious man and the odds are probably much better than 50/50, but because he's cautious he doesn't want to make any false promises.

We don't know how the Lyme will affect healing, the acceptance of the prostheses (because Lyme is an auto-immune problem), or whether it will take away any pain other than what is directly in the joint or not.

So, I'm sitting on the fence, feeling like it's *probably* going to work, but I'm scared it won't. Everyone keeps telling me that with the MIS (minimally invasive surgery) I'll heal quickly and there will be no problems. But, of course, this comes from people who #1 don't have Lyme, and #2 haven't necessarily had a THR.

I'm going to pick the rheumatologist's brain tomorrow. :)

For now, the surgery is scheduled for 9/11/08, but I'm still sittin' on the fence. I have time to continue my research and chicken out if I want to.