Chapter 1-The Back Story

So here is the story.

About a year and a half ago, around April 2006, I started feeling some aches in my left hip. I was pretty healthy and was relatively active; I'd take the stairs instead of the elevator and walk rather than drive, if it wasn't too far or too hot. I thought the hip pain was probably related to some minor back problems, and that things were just out of balance. When the aches continued, I went to see my chiropractor who took x-rays and thought I had bursitis.

I finished my thesis in August and started an exciting new fellowship at CDC in September. I had wanted to work at CDC for a while, and these days the best way to get in is through a fellowship. For these reasons I decided to take the job, even though it meant a pay cut from my previous career as a flight attendant and purchasing individual health insurance. Fellows working at CDC, the nation's public health agency, have to purchase their own health insurance, and they don't have access to the federal plans.

Back in September when I started working, my hip felt okay. My friend Oscar (not his real name) at work says he noticed I had an "antalgic gait", but other people just asked why I was limping.

My hip pain seemed to be getting worse. I was tired of people asking about my limp, and a new chiropractor and acupuncture weren't helping. Finally I went to see an orthopedist who took an x-ray. He took one look at it and said "You have avascular necrosis" (also called osteonecrosis). He explained that the blood flow to the top of the femur bone (the femoral head) had been compromised, and that the part of the bone inside the hip was dying, and that there was no cure for this condition except a total hip replacement. He also told me about two other surgeries, a core decompression and a bone graft. Core decompression consists of drilling holes into the joint, increasing the blood flow. Bone grafts involve taking a piece of vascularized bone from the lower leg and inserting it into the hip joint. The doctor recommended I get a second opinion.

At this point I was totally opposed to the idea of surgery, because a bit of pain and a limp just didn't seem like enough to replace the whole entire hip. I started asking around for referrals and several people recommended the same person, Dr. Roberson. Dr. Roberson told me about hip replacements, and told me there wasn't much else that could be done for the left hip. He told me, as the first doctor had, that he thought I probably had avascular necrosis in the right hip too, but that it just wasn't showing up yet on the x-ray. My right hip had started hurting, but I was hoping it was due to favoring it while trying to stay off of the left one. Dr. Roberson did say there was a technique that could potentially save the right hip, but that if it was already hurting it was probably too late. He also recommended not doing anything for the left hip until it got so bad that I wasn't able to sleep, although he said he'd replace it now because my quality of life was already suffering.

I got an MRI and sent my x-rays and the MRI DVD to Dr. Mont, in Baltimore, who is an expert in osteonecrosis (hereforth referred to as ON). Dr. Mont will provide phone consultations to ON patients, since many physicians don't have a lot of experience with this disease. He called last Sunday--from home--and told me that the left hip would have to be replaced, but that the right hip could potentially be saved with a core decompression (CD). However, there is already a fair amount of damage and he felt that this surgery should be performed as soon as possible--as in, within a week! I had already scheduled an appointment with another surgeon to discuss the right hip but I couldn't even see him until mid-September, so I was sort of panicky about how to get this done quickly. I told this to Dr. Mont and he said "well, I'll do it", but that just seemed overwhelming--how to get the insurance approvals, how to get to Baltimore, does he really have room in his schedule, etc...

First thing Monday morning, as soon as I got to work, my phone rang. It was Dr. Mont's secretary telling me that I had an appointment for a CD on August 13, in one week! So I'm busy getting ready, trying to think of things that need to be done. Mom and Dad and I are driving up Sunday as soon as I wake up, and starting to head back Tuesday assuming I feel well enough. Wish me luck!