My Introspection

As I mentioned yesterday, I've been feeling extremely introspective lately (are there actually degrees of introspection?).

Now I am, by nature, an introvert.  And I do spend a lot of time "living in my head," as John calls the syndrome (I'm sure you know lots of people who do that).

But since I launched this blog (two years ago on April 12th, actually), I've gained a certain degree of comfort from voicing my thoughts here.  It seems that once I've put my thoughts to paper I feel relieved of the pressure that those thoughts had been bringing to bear on me.  Then all of a sudden, two years into it, I fall back into my old way of keeping my thoughts to myself.

Why, I must ask myself, am I doing this?

The only answer I can come up with is because I am conflicted about a situation that is critical to my well-being.

The Lord said, "know thyself."  And I know myself very well indeed.  When I struggle with a difficult problem, I turn inward until I've resolved the issue.  It's always been that way for me.

Now, what plunged me into this introspective state?  My visit with the orthopaedic surgeon -- on April 12th, the two-year anniversary of my having launched this blog -- to discuss the prospect of my undergoing hip replacement surgery.

That visit was not at all what I had expected.

First, the surgeon was predominantly concerned with the x-rays and the fact that mine showed "only mild" osteoarthritis and therefore did not meet the criteria for replacement.  (He did grant that my history, his examination of me and the fact that the cortisone injection had given me such profound relief all indicated that replacement of the hip would bring me relief.)

Yet, the material that I had been sent home with from the Assessment Clinic played down the importance of x-rays and stressed instead the three criteria that more closely identified the need for surgery: (1) interference with sleep; (2) prevention from doing activities that one would otherwise enjoy; and (3) effect on personal relationships.

The surgeon didn't even touch on those points.

Which leads me to wonder why I was given that material.  The Nurse Practitioner had made such a point of impressing upon me the importance of my watching the video and reading the material -- it would all help me in making my decision.

Apparently, she didn't share that view with the surgeon.

That visit left me wondering if I really need hip replacement.

What if it won't prove beneficial and in the end, I'd have undergone the procedure, suffered through the rehab, and come out the other end none the better?  What then?

My physiotherapist had settled me down somewhat, reminding me that examination clearly indicates the need for surgery (Lord knows we've tried everything else).

Then my massage therapist visited me and contributed her sage opinion.  She used to teach anatomy so she is well versed in how each part of the body is intrinsic to the other.

As she put it to me, what the doctors aren't understanding is that while I might be a person with only mild osteoarthritis of the hips, I am not just a person with bad hips.  I am a person with bad hips who also has other issues (fibro and bursitis) and those issues are worsened by the aggravation of the bad hips.  So the hips have to be corrected in order to control the pain of the other issues.

She made it all sound so simple.  But she brought clarity to the matter for me because she is absolutely right.  She also agreed that I was wise to ask for the anterior approach, given the problems I have with inflammation along the IT band, which is precisely where the lateral approach would cut.

And then when I saw my physiotherapist yesterday and we discussed how my pain level has been very good lately, she reminded me that the reason for that is my lack of activity:  I'm controlling the pain by doing nothing.  And in the past, as soon as I start doing stuff (ie "having a life"), I get myself into a crisis.  She too is absolutely right.

Bottom line is, if I want to "have a life," I need to have my hip replaced.  The left one for sure.  My jury is still out with respect to my right hip; perhaps that's not nearly so urgent.  That's an assessment that can be revisited once the left hip has been replaced and I'm sufficiently recovered from the experience.

My physiotherapist is confident that the decision to request that second opinion from a surgeon who uses the anterior approach was a wise one.  It will give us another perspective and perhaps a whole new thrust from which to look at this.  And maybe, just maybe, this other surgeon will have some input with respect to hip replacement and fibromyalgia. 

Since we know that surgery of any kind will incite a fibro flare-up, it's in the best interest of the patient to minimize that impact. Surely I'm not the first person to raise concern about the lateral or posterior approach surgery and its effect on fibro trigger points (although the surgeon I saw earlier this month said that it has never come up in their meetings).

Who knows, perhaps I've started a dialogue among Ottawa surgeons that will benefit the fibromyalgic community.