Wednesday, May 19, 2010

Yet another medical opinion

The first doctor I saw about my knee pain made the diagnosis that it was ITBS. He prescribed to stop running (my long run was up to a half marathon distance at this point) and to do physical therapy to cure the ITB issue. That didn't work since the PT did nothing except make my hip hurt. A. Lot.

The second doctor I saw said the knee pain was not as serious as the hip pain (he was really a hip guy). Lots of test later my hip pain was under control due to a steroid type injection done while getting setup for am MRI of my hip. The MRI showed that I had FAI, and torn labrum, and degenerative disk disease in my back. The doctor said that I also had a lot of arthritis and a hip replacement was sometime in future. Running would be the worst thing for me.

But there were still many questions. I most likely have had these "issues" for some time but what made it start hurting now? Is there a scenario where I could run again (note I was never a strong runner post high school)? Is surgery the only option - note the surgery would put me on the bench at least a year? Is my athletic career, as loosely defined as possible, entering it's twilight?

So, I found "the" expert with my hip injury and tried to see him at the Hospital for Special Surgry. He pawned me off on a physiatrist to rule out a muscular cause or a lower back (see previously mentioned disk disease). I saw the physiatrist at the Hospital for Special Surgery today.

After having his assistant check me out, the real doctor came in. They bent me like Gumby in a variety of poses to find out what hurt and where. His diagnosis: I do not have ITB. All of my knee pain is from my back. I do have a hip issue but it really doesn't look that bad at this time. I should still see the hip guy about that though since he also said that there is a hip replacement in my future (he estimates 5-10 years). He recommended that the hip discussion should be about how to push the hip replacement off as long as possible to allow technology to advance. He believes that targeted PT on my back will make my knee better. If not, some other sort of shot/MRI would be next up. I can cycle and swim as much as I'd like and whatever intensity I'd like as long as I use common sense. Yoga won't help (won't hurt either). ART won't help (won't hurt either). While running won't hurt my back per se, every bit I run probably makes the hip replacement necessary earlier.

Overall I thought this was the best news I could expect but the main question going through my mind is "Is he right?" The other doctors thought they were right too but then again, I'm not getting better. If I do the back PT and it doesn't work, I'll be in the same condition I am now. If it works, there is the miracle cure I've been looking for.

I'm going to make the appointment with the PT as quickly as possible and the follow up with the hip guru doctor too. Yet another chapter on the road to recovery is starting.


Ewa said...

Talk about frustration. This is the problem I have with doctors. I just don't trust the diagnosis because when I go to another doc, the verdict is always different.
As far as running hurting your hips, I wonder if there is any good research to substantiate that. They used to claim that running causes arthritis in the knees. Recent studies say something to the contrary.
Gosh, I hope you will get your answers.

Glaven Q. Heisenberg said...

Even the best doctor on earth - i.e., Dr. Gregory House, MD - makes THREE wrong diagnoses before getting it right. EVERY time.

Seriously, we sometimes forget that doctors are just people and whereas, to you, your back or hip or knee issue is THE MOST IMPORTANT THING, to them it's just the fifth such issue they've seen today before lunch. Or I should say, to some of them.

That being the case, it's surprising they ever get it right, since they'll tend to diagnose the most common cause because in 90% of the cases they see, the most common cause is correct.

But what if you're one of the special 10%?

See if the PT works. That's the only way to know with something approaching certainty that they got it right this time.

Good luck, brother!

Big Clyde said...

Yeah, this is frustrating. Good for you to keep looking and asking questions.

Unknown said...

Three experts,three opinions. It just goes to show how much medicine is 'educated guesses'

And yes, it is extremely frustrating. Who is right? I hope the last guy is correct because that is the best news. And it does make a lot of sense...

Tri Mommy said...

I think you should believe the last guy. And if worse comes to worse and he was wrong, you gave it a shot. And a shot at the comeback is sometimes all you need!

Caratunk Girl said...

UGH! So frustrating. BUT I will say I tend to go with Dr's who don't want to do surgery and believe it can be fixed through PT and massage therapy. SO, I personally would listen to the last guy. If he isn't right, then you can try one of the other options.

I also think that Dr's all have their own philosophies - Some think surgery is the answer, some think stopping all movement is the answer (and are strangely anti-PT), and some think things can be worked out by moving (PT), but without surgery...So if you went to 3 guys who were "surgery" minded, I bet you would have gotten 3 similar opinions...Best of luck, it is frustrating!

Al's CL Reviews said...

I'd go with the last guy, because it seems to be the least intense (no surgery yet).

And if it doesn't work, you rule it out.

Patrick Mahoney said...

Last guy. He's taking more of a holistic approach. Why is Western medicine so keen to get you on a drug or cut you open? Have you read Chi Running?

joyRuN said...

Damn quacks. All of them!

Whenever I get differing opinions like that, I go with the one that I like (wrong or right).

Good luck :)

Aka Alice said...

Ditto on the frustration...

I went to a sports rehab place for PT when I had PF last year. Their whole spin on things was to strengthen my glutes, hip muscles, hamstrings to take the pressure of of bones and other soft tissue (like ligaments). Worked wonders for me. I don't know if that would help with the back-pain issues, but it makes sense.

On the other hand, what do I know?

Are any of the docs you've seen into sports rehab?

PS G. is definitely NOT a ghost writer for my blog :-).