FAI : The Road To Surgery

I want to share my story with others trying to learn about FAI and arthroscopic surgery.  However, I think there will be some advantage to walking through the steps so that I have the same confidence in my decision that I made in September.  

It started in the chiropractors office.  My chiropractor took x-rays of my lower back and hips.  She decided that she didn’t like something in the x-rays so she sent me over to MK Orthopadics to see the hip specialist. It turns out that whatever she thought she saw in the x-rays was nothing at all. But, I’m glad she sent me because Dr. Komamduri replicated my pain without even thinking hard about it.  He showed me the X-rays and explained what FAI is.  What the X-rays couldn’t show is the state of the labrum. We’d have to do an MRI with contrast dye to find out if the labrum was torn. 

Within a couple of days, Dr. Komanduri’s office had me back for an MRI of my hips.   Each hip was done separately.  So it took about 4 hours total.

 Never having this done before I was naive about the process. The contrast dye is injected into the hip. I don’t know why but I thought that would be done through the fatty part of my hip. Instead, they inject the dye, after a numbing agent, through the groin directly into the hip joint. Duh, I know, but I’ve never thought  much about anatomy.  In the process of getting the dye into the hip, the PA hit a nerve that sent a sharp pain down the front of my thigh. It wasn’t so bad on the right hip but she had trouble finding the mark on the left hip, so,  she went across the nerve several times and caused several tears to fall. She had to pull out the needle and try a second time.  She gave me more numbing agent so the second time I ended up not feeling a thing.  In addition to the dye, they shoot saline into the joint to expand it for better MRI views. 

The injections are done in a sterile room.  After removing the needle, she put a band-aid over it and said, “I just put a hole directly in your joint.  Leave this on for 24 hours.” followed by a direct look that warned me not to screw this up.

Walking over to the MRI with my expanded hip was no problem.  Laying on the MRI table for an hour at a time was a big problem for me. FAI patients commonly have SI joint pain (high buttocks /lower back). I was packed into the MRI machine pretty tightly so there wasn’t anyway to get relief until it was all done. 

When I scheduled the MRI, I asked if I would be able to drive myself home. The boys had a bunch of after school activities, so,  I didn’t have my husband come with me. Yes, technically, I was not drugged. Between the pain of the saline and contrast dye and the stiffness from laying on the table for several hours, I would have preferred to have been able to sit in the car with having to worry about driving. As it was, I stood outside my car for several minutes on the brink of breaking down from the thought of getting into a car. Quite fortunately, my pain receded quickly.  Still in pain, I was able to drive home. Within 2 hours, things felt normal for me again.  

A few days later, Dr. Komanduri reviewed the MRI pictures showing a labrum tear on both sides. We discussed that surgery would be necessary to shave off the extra bone causing the impingement then he would reattach the labrum.  Since I hadn’t attempted any treatment specifically for my groin pain, we decided that I should try physical therapy as conservative treatment to see if it alleviated the pain and for insurance sake.  

I’m a believer and practioner of functional fitness. I have followed programs that incorpate similar activities to physical therapy. At my first appointment, my therapist said I was fairly strong in the hips during my initial evaluation.  I figured that was both good news (the programs that I follow work) and bad news (confirming pain wasn’t caused by poor muscle performance).  We worked for 4 weeks starting at a higher level since I was demonstrating good strength already.  However, the key pain areas never went away. 

I met with Dr. Komanduri again and agreed to the surgery.  I tried to fight it but my husband pointed out that I was unable to drive to visit family just 2.5 hours away without having to stop due to intense pain.  Now, it was just a matter of getting insurance approval. Hip arthroscopy is an out patient surgery. My insurance doesn’t require pre-certification. In these cases, because it is an expensive surgery, the office requires pre-determination from the insurance company. It is essentially the same process as a pre-cert but since it is optional, the insurance company takes 30 days to give an answer.  Just enough time to doubt, double doubt and scare myself senseless about what I was about to do. 

A few days before the surgery, I had my surgical clearance physical then was outfitted for the hardware.  The brace wraps around your waist, hinges at the hip and is set at 70 degrees to protect the hip joint.  The brace is also strapped around my thigh.  They put the brace on you when the surgery is done so that it is under all your clothes. I also purchased an ice machine through the doctor’s office. It is not covered under insurance so it cost me $265.  I easily justified the expense since I have two surgeries to deal with and they promised faster healing.  At this point, I was all about securing the fastest track to normality, whatever that is.  

The hospital called the day before the surgery to confirm a 5:30 arrival time. 

Heavy with doubt and worry, I dressed in my comfy-s and headed to the hospital. 


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