Second guessing

Is it second guessing, or is it sober second thought?

My head has been reeling for the past couple of days with "should I?" or "shouldn't I?" thoughts.

The nurse practitioner at the Assessment Clinic sent me home on Monday with a booklet to read and a DVD to watch to help me make my decision.

So I asked her right out, "But if I understand you correctly, your recommendation is that I have both hips replaced?"

"Well," she replied, "you've tried everything else that I could recommend.  You're already going to physiotherapy; you're using acupuncture and massage therapy; you're using a cane and walking poles; you have a stair lift in your home; you've tried drugs and can't use them for various reasons.  There's really no other option left.  And you can't really tell me which hip is worse so not only am I referring you for surgery, I'm not indicating that one hip should be done before the other, that will be your choice."

I have since read the book and watched the DVD.

And I have again reviewed my x-rays (you had to know I burned a copy for myself!).

Clearly, there is a patch of bone-on-bone on each hip joint.

And clearly I meet all the criteria discussed in the book and in the video as to how to know when to have surgery.

"Some doctors suggest that it's time to consider surgery if hip arthritis pain:

• Keeps you awake at night.
• Makes you give up normal activities that you enjoy doing or need to do.
• Affects you emotionally and puts stress on your relationships."

I read that and I wonder, what took my doctor so long to refer me?

I mean really, I don't know how long ago it was that I complained to him about waking every two hours or so because I could not sleep on either side so he jokingly suggested that I'd have to learn to levitate.

And it was many years ago now that I sat in his office, in tears, telling him that I simply wanted to have a life again.  Was that too much to ask?

Now in his defence, he was basing his diagnosis (bursitis) on the many x-ray reports, and the two MRI reports that stated "mild degeneration," which on the surface would not suggest a reason for the degree of pain or the diminishing range of motion I was exhibiting.

Therein lies the problem.

A radiologist was reading the x-rays and MRIs, without knowledge of the history.  My doctor knew the history, without benefit of actually seeing the X-rays and/or MRIs.

Now the doctor on the video actually discusses the matter of some patients presenting with serious pain and diminished range of motion, with very little evidence being seen on x-ray; while other patients present with practically no pain and full range of motion, but significant evidence of degeneration is found on x-ray.

The diagnosis must be made based on the history and the impact the symptoms are having on the patient's life.

Everything is subjective and my x-rays don't look like anything "debilitating," so the radiologist reported what was seen.  My doctor acted accordingly.

Obviously, the action he took in December (referring me in spite of the x-ray report) is what should have been done six years ago.  Had the ball been started then, we could have avoided the past six years of misery because presumably, based on the three criteria mentioned above, my hips would have been replaced then.

• My sleep has been seriously disturbed by this nemesis for well over six years now.
• I have had to curtail many normal activities for almost ten years -- so many years that I don't know if I remember what is "normal" for me any more.
• The emotional toll has been tremendous and I can never get those years back.

Having said that, there is no point lamenting what can't be changed.

We can only go forward and move on from here.

But it makes me very angry.

Because I have endured this pain, and the interruption to my life, needlessly.

All because the left hand doesn't talk to the right hand.

From this day forward, whenever I am sent for x-rays, I will be asking for a CD of the images.  They are, after all, mine.  And I will take that CD to my next doctor's visit and let him review the x-rays himself so that he gets the "whole picture," and not just a radiologist's impression of the situation.