Wednesday, January 14, 2015

Some Hip News

Yesterday I drove down to NC to see a orthopedic specialist about my healed hip fracture.  It has now been 9 months since my original injury in the bike wreck (and 4 months since my last elbow surgery).  We had an informative discussion about my concerns and specific issues.  Dr. Stubbs at Wake Forest Medical is a nice man.  I now know much more than I did previously about my hip (a valgus impacted fracture of the neck of femur, surgically repaired with two titanium screws).  

Cutting to the chase Dr. Stubbs told me that I could continue to run, ride and swim as I've been doing over the past several months.  He suggested conservative progression and that I pay close attention to how my hip feels (and moves), but he does not want me to stop pursing my passion for exercise.  This is, of course, music to my tiny little ears!  As did my local orthopedist, he stated that I would probably end up with a full hip replacement at some point in my life, but "probably not in the next 5 years…but further down the road".  

On the more positive side he thought that my potential for avascular neucrosis (AVN) was less than I'd previously thought (due to how I've progressed to this point and the fact that the fracture was more a compression and less of a sheering force, possibly leaving slack in the vessels of my bone, not stretched/broken vessels).  At this point he suggested that I was more at risk of long term arthritis due to change in angle at the hip articulation.  It will take another two years, or so, to know if he is correct about the blood vessels, but at that time I could be considered clear from neucrosis potential.  Dr. Stubbs said that around 60% with this type of fracture has issues with avascular neucrosis, but most often these fractures occur in folks older than my relative youthJ.  

Anyway, I also learned that I should NOT be pushing hard on regaining full flexion at the hip since I have a spur of ossification (they took new x-rays) that would potentially cause more arthritis potential if I push into it.  Here's a few shots of my hip flexion to show my ability and my limitations with motion.  No, it is not the old "normal"...but it is not too bad considering the potential.  

He also suggested that I NOT become a gym rat doing things like lunges and squats.  He actually recommended not being in aero position too much of my riding (bummer, but livable) but suggesting that I spend most of my ride time sitting up on a road bike.  Again, he expressed the need for me to pay attention to how it feels/moves and go conservatively forward.  Several times he told me that I "should do what I love doing" and that sounds good to me.  Anyway, I certainly can not complain and I feel much better knowing what I know now.  

Below are some updated photos to show you how well my elbow is doing these days (please proceed cautiously at risk of your eye sight with the bottom picture as I show my updated "He-Man" look).  As you can see I continue to need to rebuild strength in the shoulder, chest, upper back and arm...but am progressing there.  I've been limiting my swimming a bit since I do continue to have some mild restrictions in my shoulder movement.  As seems to be the new norm, I continue to have some general stiffness in the elbow at the extremes of motion, but I am moving and swimming, so no complaints really!  

Thanks again for your expressions of love, concern and support over the past 9 months!  My family is doing extremely well and I am excited about continuing to move forward and challenging myself.  As I have told many of you, 2015 will not define me as an athlete! I will take the year as my body allows and as I feel confident.  I will feel or respond to no pressure from the outside.  My strongest desire is to be moving consistently and happily over the many years to come, involved in triathlon, running and endurance sport as I have been over the previous nearly 30+ years.  Here's to an active and healthy 2015 for both you and I!

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