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Surgery or not
OptionResults
Yes have surgery19 Votes - [45.24%]
No don't have surgery3 Votes - [7.14%]
Use crutches for another month and see what happens16 Votes - [38.1%]
Give up triathlons entirely0 Votes - [0%]
You are crazy for taking advice from people you barely know1 Votes - [2.38%]
Get a 2nd, 3rd and 4th (professional) opinion first1 Votes - [2.38%]
Rest until it is properly healed1 Votes - [2.38%]
Do whatever other excersizes\workouts you can until the injured area heals1 Votes - [2.38%]
This is a multiple choice poll.

2005-06-24 5:10 PM

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Champion
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Williamston, Michigan
Subject: Surgery or not

Ok...Question of the day...

I have a stress fracture in my hip.  I have had pain with nearly every step for 3 months now.  Its not worse but only mildly improved.  I could have surgery (Have the fracture pinned)  which may make my pain better and MAY get me better slightly faster.  the surgery would only take about 10-15 minutes to do, btu then I would have hardware in my hip and I am not crazy about that idea, or the idea of having more surgery

IF it were your hip would you:



2005-06-24 5:23 PM
in reply to: #183259

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Extreme Veteran
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Lafayette, CO
Subject: RE: Surgery or not
Hm. I am rather conservative, but not completely. I'd say give it one more month of complete rest. (Maybe no swimming, too...couldn't the kicking be aggravating it?) It would be a tough month, but if there's any possible way to avoid surgery, I say do it. Then again, if NOTHING helps, including rest, PT, or whatever, then I say have it pinned.
2005-06-24 5:33 PM
in reply to: #183259

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Master
1551
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Virginia Beach, VA
Subject: RE: Surgery or not
Any idea why it's healing so slowly? If it were me I would be hesitant to put hardware in my body, but you've been battling this for a while now. I might give it a little more time, but that's easy to say because it's not my hip. Good luck!
2005-06-24 5:57 PM
in reply to: #183259

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Champion
7704
50002000500100100
Williamston, Michigan
Subject: RE: Surgery or not
The other thing is I am going to the olympic training center as a doc for 2 weeks beginning at the end of July and I really don't want to be limping around.  Actually most of the time I can suck it up pretty well and not limp but I'm having a bad week for some reason...Ithink our crappy summer weather has somethin gto do with it....It si REALLY hard to be single and be on crutches too
2005-06-24 6:16 PM
in reply to: #183259

Elite Veteran
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Subject: RE: Surgery or not
I don't think we have enough information. Do you know what caused your stress fracture? What are the recovery times either way? What are the complications?

I wouldn't be concerned with having hardware in your body (my daughter just had orthognathic surgery and has permanent screws in her jaws), so will surgery help you heal a lot faster? Forget training, you need to think about healing.

Please let us know how it goes and what you decide.
2005-06-24 6:29 PM
in reply to: #183259

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Expert
893
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Livermore, Ca
Subject: RE: Surgery or not
I would follow the Dr opinion.


2005-06-24 6:30 PM
in reply to: #183259

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Champion
7704
50002000500100100
Williamston, Michigan
Subject: RE: Surgery or not
What caused it...probably crappy biomechanics from having had 3 surgeries on each knee and 5 on my left ankle then Left hip flexor strain (the side of injury) and running...I was not over training the run...check out my logs if you don't believe.  It should be getting better after 3 months.  I'm not the most patient person in the world and after 3 months of pain I've had about enough.
2005-06-24 6:32 PM
in reply to: #183259

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Champion
7704
50002000500100100
Williamston, Michigan
Subject: RE: Surgery or not
Oh yeah I am the dr....physican heal they self blah blah blah...........Its a lot easier to tell someone to use crutches than to do it yourself. Have a vitrtual Drs ( and friends)  in KY, TN and IL...decision is split three ways
2005-06-24 6:44 PM
in reply to: #183259

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Pro
4612
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MA
Subject: RE: Surgery or not
I'd say wait for another month.  Then go for the surgery if it's not getting better.  The hip is a nasty area, involved in most movement.  Unless you don't move, it's going to heal slowly by itself. Whatever your decision is, good luck.   
2005-06-24 6:46 PM
in reply to: #183259

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Pro
4578
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Vancouver, BC
Subject: RE: Surgery or not
Definitely don't give up triathlons entirely. I agree with Line. But having hardware in is not necessarily a bad thing.

Jen
2005-06-24 7:01 PM
in reply to: #183259

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Resident Matriarch
N 43° 32.927 W 071° 24.431
Subject: RE: Surgery or not
if it were me, I'd have it pinned, but you knew I'd say that.  I think you're doing too much as it is and not giving it enough of a chance to heal.  Having it pinned will plant you on your ass, hopefully long enough for it to heal.

I would not have a problem with my orthopedic surgeon being on crutches, especially when it is an active person trying to recover from an injury.  Forget what people think and do what you need to do.

I'm stepping off my soapbox now....


2005-06-24 7:21 PM
in reply to: #183259

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Extreme Veteran
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Peoria, Arizona
Subject: RE: Surgery or not

If it were me I would take into account all of the following:

1. Healing time for both options;
2. What is the possibility of the hip getting worse with and without the surgery; and
3. What % of 100% can you expect to achieve with and without surgery.

But, never ever consider giving up on triathlon.  Remember, triathlon is a way of life not just a sport we all love to compete in.

By way of example: Here is how I approached just such a decision during college.

     I suffered a separated shoulder (the right side) while playing basketball (severe strain/partial tear of the tendon that holds the collar bone down into the shoulder).  I could have surgery that could get me back to 90% of pre-injury (keep in mind this was 15 years ago) and would have a 4-6 week immobilization of the shoulder followed by 3-6 months of rehab (more towards the low end).  The problem with the surgery was it was only effective 50% of the time, and the results could be less than the 90%, but could also be slightly better - odds on that were 50/50.  Here is were the decision got tough: of the 50% that were uneffective half the time the results were no better than just immobilizing the shoulder for 8-12 weeks followed by 3-6 months of rehab, and the other half of the time the surgery was a failure and the shoulder would actually end up worse than just immobilizing it and doing rehab.  Just the 8-12 weeks of immobilization and rehab was always effective but could only usually achieve results of getting the shoulder to about 80-85% of pre-injury.

     The way I looked at was - if I had the surgery, I had a chance of getting back to nearly 100%, but had an even bigger chance of ending up worse off.  I don't know if all the figures I gave above are completely accurate, but I just remember that when I broke it all down the best odds of getting my shoulder the healthiest were to just go through 8-12 weeks of immobilization (something according to the doctors a lot of people could not, or would not do - so a lot of people took the crap shoot on the surgery) and 3-6 months (more towards the higher end) of rehab.  I was patient (I normally am not either, but when it came down to maybe having diminished use of my shoulder I found the patience), listened to my doctor and PT til the final appointments, and by the time I was released my shoulder was believed to be at about 95%.

     Today, the shoulder is no different than the left shoulder (I am left handed); and as a matter of fact any time I have a problem with swimmer's shoulder it is on the left not the "weakened" right side.  I also have a small problem with aches and stiffness from some scar tissue, but nothing that isn't taken care of by a good massage.

Moral of the story for me: sometimes we just have to let this amazing biomechanical thing we call a body do its job and heal itself - it is the best at knowing what it needs - we just have to be patient and let it do its job.

Just MHO - give it another month, and as long as the healing process is progressing I'd let your body heal itself.

2005-06-24 7:30 PM
in reply to: #183259

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Champion
7704
50002000500100100
Williamston, Michigan
Subject: RE: Surgery or not
The surgery if all goes well will probably do no harm and may help me get better faster.  Sorry to burst your bubble Ellen but one of the reasons I'm considering it is that I can probably be more active more quickly..so its not going to slow me down ...it will probably keep me out of the pool 10 days.....although I have pretty much written off the season.  Potential surgical complications...infection..unlikely but out there, damage to head of femur...but my partner is a good surgeon and I trust him.  I'm just sick of hurting and proabably everyone is sick of me whining too
2005-06-24 7:55 PM
in reply to: #183310

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Extreme Veteran
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Peoria, Arizona
Subject: RE: Surgery or not

If there is no downside (i.e. surgery could make it worse) and if the hip will heal to a set % of pre-injury that is the same with or without the surgery and the only difference is the surgery will most likely speed up healing time - I would say have the surgery.

The other possible complications have to be weighed against the difference in healing time and only you can make that determination.

2005-06-24 10:55 PM
in reply to: #183259


32
25
Subject: RE: Surgery or not
Sue,
I'm with the total rest for a month. I tend to think that the last invasive the cure, the better off I'll be in the long run. I'm no orthopedic surgeon, but if I were in your shoes the bad consequences of having this get worst would have had me on total rest of the hip from the get go.

I also think that being on crutches should not negatively impact how you are viewed professionally, but reinforce the importance of resting when your body needs it. (Plus you could come up with a really good story about why you are using crutches...this could be fun)

This is probably a stupid question, but did you have PT after the other surgeries? I learned a lot from my physical therapist, especially about when to push through and when to ease back. Has a PT evaluated you body mechanics? Once you get this hip healed the obvious thing to do would be to figure out how to avoid injury again. I would recommend starting back slowly after healing, and with the help of a PT. If you were in CA I would highly recommend mine, but I'm sure you know some!!

I know that injuries, daily pain, and changing your activities are frustrating...

Michelle
2005-06-24 11:23 PM
in reply to: #183259

Extreme Veteran
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Honolulu, HI
Subject: RE: Surgery or not
pin the fucker.




2005-06-25 5:58 AM
in reply to: #183259

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Champion
7704
50002000500100100
Williamston, Michigan
Subject: RE: Surgery or not
Yeah I have been down that PT road.  Right now PT isn't going to help get this better.  My orthotics that I have been running (Pre-injury everyone don't get mad at me) in were made by one of the top biomechnists (she is a PT/PhD) in the country whos' specialty is running biomechanics.  When I'm better I'm going to go up to her lab and she is going to help me get things straightened out and make me new orthotics if I need them etc.I have this part covered I just need to get better.
2005-06-25 7:23 AM
in reply to: #183259

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Master
1831
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Keller Tx
Subject: RE: Surgery or not

Sue,

I guess that I would have to take the side of giving a month of **NOTHING** to stress the hip before taking the additional chance of surgery.  If there is any chance at all that by biking and swimming you could be limiting or delaying the healing you've got to stop and give it a chance.

That probably goes for your Golf as well.  No more competitive golf dates in the near future!

I'd hate to see you get surgery if there is a chance that your hip has not had any real time to heal on its own.

Don't worry....we'll all still be here when you are healed.  Besides you like this sport too much to lose sight of what you can and want to accomplish in it in the future. 



Edited by Doughboy 2005-06-25 7:24 AM
2005-06-25 7:27 AM
in reply to: #183294

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Extreme Veteran
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Horse Country
Subject: RE: Surgery or not
With all due respect...

If you'll allow me the freedom, I'm going to speak as though you are my sister, so please take this "frank talk" as from one who cares - because even though I don't really know you, I do.

You're kidding, right? You're not ACTUALLY trying to diagnose and treat YOURSELF, are you? I mean, I know you're a surgeon (right?) and even the right kind of surgeon (right?), and you say here you're conferring wih other doctors on it, but if I were in your shoes, I don't think I could even begin to have the objectivity required to treat myself...

I only know what's been posted on this thread about your injury, and I'm not a medical person other than folks in my immediate family being "chronic patients" (wife is a former collegiate cheerleader), but it sounds like the "rest another month" is really only an option if you will ACTUALLY REST another month. Come to think of it, so is the surgery.

I KNOW how frustrating it is to be unable to do any working out (well, scale of weeks, not months). If it weren't for the swim challenge my avatar would be an xray of my broken 5th metatarsal.

But you should know better than just about anybody the darn thing isn't really going to heal until you get off it as best you can and give the bone a chance to knit. I agree with whatever other poster that you probably even want to get out of the pool. You sound like you're so frustrated with not being able to work out that you might be "pushing things" a bit and not letting it heal.

At this point, I'd challenge myself to stress it as little as possible for the next four weeks (make it a game!). I think I'd do this whether you pin it or not. Then, I'd decide on the pinning based on any possible gain over just sitting still for the month. But I'd bet that if you don't back off some more on the activity, neither option will work very well.

Oh, and quitting triathlon is NOT AN OPTION. YOU WILL BE ASSIMILATED!!!





I will be praying for you. I hope it goes well. And I hope my "frankness" doesn't tick you off. I swear it isn't intended to.

2005-06-25 9:03 AM
in reply to: #183259

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molto veloce mama
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Subject: RE: Surgery or not
go for the surgery...especially if it will be a short and safe procedure. i have a bolt in my elbow from a bike accident in 98 and i forget its there. the scar bothers me more than the idea of metal in my body...but not having full use of my arm would bother me even more. there will be more tris next year. if you do get hardware, make sure you get copies of the xrays so that you can show off
2005-06-25 9:21 AM
in reply to: #183259

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Champion
7704
50002000500100100
Williamston, Michigan
Subject: RE: Surgery or not
Surgery is gaining on it.......Please keep in mind that it has been 3 MONTHS already..also I have a nice window next week with a 3 day weekend and wouldn't have to miss any work.  I won't have this time block again until the holidays. 


2005-06-25 9:26 AM
in reply to: #183259

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Extreme Veteran
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Peachtree City, GA
Subject: RE: Surgery or not
I had a broken scaphoid (wrist) for the better part of a year. It felt like a sprained wrist, and it was very frustrating. My point being, I would get the surgery because if you wait like me you may not be able to heal otherwise. Sitting on the sideline for a year drove me nuts. Good luck.
2005-06-25 2:04 PM
in reply to: #183259


32
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Subject: RE: Surgery or not
Now, I realize that this is a little beside the point, but if you get a pin you will end up having to be wanded and have the entire hip area patted down every time you fly. I know this because I briefly worked in airport secruity while the local economy was in the toilet. Many passengers even said, 'but my doctor told me this card would be proof so that I wouldn't have to go through this,' but, unfortunately, that is not the way airport security works.

Also, I am in full agreement with the with the 'Frank Talk' guy. I would have said the same myself if I had thought I could do it without being obnoxious. Yet, this is the first time an orthopedic surgeon has ever asked for my health advice (for her own hip, no less), and I am finding it amusing...

Michelle
2005-06-25 2:42 PM
in reply to: #183259

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Champion
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Ottawa, Ontario
Subject: RE: Surgery or not
You should seriously consider getting the pins put in.  I do not feel that surgery is not required in many cases, but in yours it seems warranted.  You have been having so much trouble with this fracture and because you are so active physically, it will never heal properly. 
2005-06-25 2:49 PM
in reply to: #183494

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Expert
916
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San mateo California
Subject: RE: Surgery or not
1st tri - 2005-06-25 1:04 PMNow, I realize that this is a little beside the point, but ifyou get a pin you will end up having to be wanded and have the entire hip area patted down every time you fly. I know this because I briefly worked in airport secruity while the local economy was in the toilet. Many passengers even said, 'but my doctor told me this card would be proof so that I wouldn't have to go through this,' but, unfortunately, that is not the way airport security works. Also, I am in full agreement with the with the 'Frank Talk' guy. I would have said the same myself if I had thought I could do it without being obnoxious. Yet, this is the first time an orthopedic surgeon has ever asked for my health advice (for her own hip, no less), and I am finding it amusing...Michelle


Ha ha... I know the feeling. I have a craneal shunt implant thus I refuse to go through any sort of metal detector or anything that might have  a magnet (it screws the setting), so everytime I fly I know I have to take my time in the security line cuz they will not know what I am talking about and what does that little card means... If surgery will save time and get you on your feet fast... go for it...


Edited by velasqu7 2005-06-25 2:50 PM
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