26 August 2009

MRI Arthrogram – my experience

I was quite nervous on the day or the appointment (two days ago) as I’d read a lot about MRI arthrograms on the internet. Not thrilled at the prospect of having dye injected into my hip joint, I tried to forget the things I read and focus on the positive, which is getting a diagnosis.

The radiologist talked me through the procedure and asked whether or not I wanted to have local anaesthetic (What?! I thought it was always done with anaesthetic!). He said that local anaesthetic requires a series of injections, each getting deeper, whereas without there would be one injection straight to the joint and it would be over more quickly. He said most people find this tolerable but it’s my choice whether to have it or not.

I’m not usually too bothered about needles, but my stomach churned at the prospect of having one in my hip joint without anaesthetic. However, I trusted the radiologist and decided to go for the quick anaesthetic-free option.

I lay on the bed as the injection fluid was prepared at a table beside me. My heart was thumping. After a few minutes, I was cleaned and then told I would feel a scratch. The needle was pushed in quickly and fully, which made me shout out... more through
surprise than pain. It certainly was painful and very uncomfortable, but not excruciating like some people would have you believe. The needle stayed in for a while and was aligned using x-ray. The contrast fluid was injected and the needle removed (I didn’t enjoy the removal much either).

The needle is injected in the front near the groin area, not the side. Here’s a picture of me showing where the injection took place (I’ve covered my man parts so as not to scare readers).

After the injection I was put in a wheelchair and wheeled through the hospital for the MRI scan. As I had the scan (which is completely painless) my hip was good. It felt a little strange and numb but nothing notable. After 30 or so minutes of banging and clunking, the scan was complete and I was allowed to go home.


After the appointment

I walked along the car park and all seemed well, until one movement made my hip hurt a lot, but it was a new sensation and not like the usual catching pain. In the car on the way home I was fine for 95% of time, but would occasionally get bursts of pain and discomfort (I'm glad I didn't drive). By the time we reached our destination about 90 minutes later, movement was pretty uncomfortable and it hurt to walk. Things were fine as long as I didn’t move, so I sat in a chair until some painkillers kicked in.

I wasn’t able to walk normally up stairs that night. I had to use my left (good) leg to lead up each step and a walking stick for balance. I didn’t have any pain during the night and I woke feeling good and agile. It still felt a little strange that day but I could walk around just fine. Today, 2 days on, it’s as though I never had it. All I have to show for it is a tiny red dot.

My experience of the MRI Arthrogram is that it’s nothing to fear. Yes, it hurts and makes you feel uncomfortable, but is it as bad as some people make out? No, not for me anyway. If you’ve had one of these yourself, please post a comment to let others know about your experience.

19 August 2009

MRI Arthrogram - booked

Only four working days after my appointment at the Duchy, I received a call to be booked in for the MRI arthrogram, which is scheduled for this coming Monday.

I’m impressed at how quickly they turned this around. The regular MRI that I had at the NHS hospital in Exeter took about 4-5 weeks from referral to scan, so this was incredibly quick!

I browsed the web for information on MRI-A’s and there are some mixed stories out there. For some it’s all pain and doom while others say it’s not too bad. However you look at it, it doesn’t sound like the most enjoyable of things but it’s something that has to be done.

I’ve been told I shouldn’t drive afterwards. That makes things slightly awkward as the hospital is 90 miles away, so someone has to spare an afternoon to come with me and drive me home. One of my brothers has kindly offered his chauffeur services for the day, which is also good as we get to spend some time together.

I’ll post my own account of the MRI arthrogram next week!

13 August 2009

Hip impingement diagnosis (maybe)

Yesterday I had my appointment with the consultant at the Duchy Hospital in Truro. It was a 90-mile drive from my office in Exeter and I was eager to see if my hip problem would be diagnosed. It was ‘orthopaedic day’ at the hospital and the outpatients’ area was bustling with people (mostly hobbling). After a short anticipative wait, I was called into the consulting room.

Following a chat about my problem and how it came to be, a walk around the room and some prodding, pulling and twisting, my consultant seemed confident that the cause of pain was a torn labrum developed as a result of a hip impingement, as suspected by the hip surgeon I’d previous communicated with. It can’t be confirmed for sure until I’ve had an MRI arthrogram, but this is the preliminary diagnosis.

I was also sent to x-ray as a matter of practice and the results were normal, which was expected. So next step is the MRI arthrogram, which I hope won’t be far too far away.

Remedy

Having read quite a lot about FAI and the two main types of surgery (open and arthroscopic), I already had a pretty good idea of the steps needed to fix the problem. However, I had convinced myself that, given the relative minority of my pain and problems, arthroscopic surgery would be the chosen path.

My consultant said that open surgery would be the preferred option as it’s more likely to have a positive outcome in the long term. I was informed that arthroscopic surgery has its limitations and is therefore preferred in older patients where the likelihood of other problems is lower than with open surgery. However, as a young man in good health without any other hip problems, I would expect to recover well from open surgery.

I was informed that a complete recovery takes about 12 months and that the operation has a 90% success rate.

Is this right for me?

I really didn’t expect that open surgery would be for me. My pain, although bad at times, is sporadic and I’m generally able to walk well. I’m unable to do most activities and sports so my life is certainly restricted, but not to the extent where I’m constantly in pain or unable to lead a fairly normal life. Since the appointment yesterday I keep asking myself, ‘do I really need major surgery and 12 months of recovery?’

The more I read about the procedure, like the trochanteric osteotomy, hip dislocation and osteoplasty, the more I’m beginning to worry. We don’t yet know for sure that this is the problem, so I should probably stop thinking about it so much until I have the MRI arthrogram.

4 August 2009

A pain in the butt

My hip has been pretty good over the last few days. I managed to walk from my house into town (about half a mile) and back twice in that time, without any notable pain, catching or twinging.

It’s quite a contrast from last week. At the weekend I went to see a friend compete in an endurance mountain bike race near Plymouth (once which I’ve competed in previously but now can’t). A slight turn or movement irritated my hip and it caused it to flare up for a few days. This is nothing new but it brought on something else…

More troubling was the pain in my right buttock and thigh. Parts of my right buttock were very tender and sore to the touch deep in the muscle, and my right leg was both numb and painful near my groin for about 6-10 inches down my leg. My whole leg felt like a lump of wood and moving it was unnatural and clunky.

I read on some other blogs that people with hip problems (FAI etc) can get sciatic nerve problems too. Looking at the route the nerve takes, it certainly seems possible that this is what was causing the problem in my glute and thigh.

I’m glad it only lasted for about 4 or 5 days. Here’s hoping it doesn’t become a regular symptom.