Confusion leading to clarity. That's why writing helps.

Remember back in April when I re-opened this blog because of pain? It had been around for over a half year at that point. It's now almost a year since the pain started. We are making some progress as to the nature of the pain and what can be done about it.

First the news on the progress of getting an MRI for my NY doctor. I went to the plastic surgeon here in Soroka last week, and I had to really be my own lawyer. He wasn't convinced that I needed an MRI and at first didn't want to recommend one. He wanted me to go to the pain clinic for pain control. I ***hate*** that answer. I am no longer a candidate for pain pills or narcotic patches or any pills or elixirs. I told him that. I told him of my long-standing experience with pain medication, and that in the end of it all I get rebound headaches for months from them. Even over-the-counter ones. The last time I was on strong pain medications (my right hip replacement surgery 2 years ago) it took weeks of weaning to get off them, with debilitating headaches every day. I told him that I am not a candidate for the pain clinic. I even got sensitive to Cannabis, which everyone says is totally natural and nobody reacts to it. So I was successful in shutting that idea down, thank Gd. 

I had to explain to him why my NY doctor wants an MRI now, to evaluate this pain (looking for possible nerve entrapment amongst other things). I really had to advocate for myself, this doctor wasn't really with me at first. But after a while, he said yes, he actually does see reason to do an MRI now. So in the end, he did write a referral for me to have the MRI's.

Then I had to submit that recommendation to my HMO, and I am now awaiting the answer from them. Their job is just to give me the payment form necessary to do these MRI's. The HMO ("Clalit" in Hebrew) told me weeks ago (months ago?) that I needed a referral from an Israeli plastic surgeon in order to get their payment form for the MRI's. Now I have that, and am awaiting the confirmation and payment form. So much red tape. The first MRI is scheduled for August 8th.

MEANWHILE....

Today I was at the orthopedic oncologist at Ichilov hospital, where I have been a patient since my left hip had the PVNS (in 2008, a year after NF). It's funny to have two different doctors for two different hips.

I showed them the CT that I had done at the beginning of July. They think all my pain, after explaining where the pain is, is from the fact that my hip is in an advanced state of osteo arthritis. They showed me where I am walking bone-on-bone in my joint. They think that all my pain with walking is due to that. Even when I explained that the pain is over my hip joint as well, near the scarred areas from NF, they said that that is a classic spot to have pain in a hip that is beyond it's time. I also have bursitis, by the way, but that alone isn't a reason to do a hip replacement. My orthopedic oncologist brought into my exam room two other doctors- one who is the head of their joint replacement department, and another guy who is his fellow. "Brilliant doctors" he said to me. OK, so they examined my hip as well, and the CT films, and came to the conclusion that I need a left hip replacement. That all my pain is from the hip. They went on to tell me that because of the surgeries and extensive scarring around the front of my hip, they would do an anterior approach to the hip replacement surgery. This is less ideal than what I had for my right hip replacement, which was a lateral (side) approach. With the anterior approach the recovery time is longer and harder. The doctor who replaced my right hip only does it with the lateral approach, so he wouldn't be able to do the anterior approach for the left one. The doctors who I saw today do both approaches, and are the ones who recommended it.

Now I'm in a quandary. Do the MRI's (assuming the HMO will cover them...), send them to my NY doctor and wait to see how that turns out, maybe fly to NY to get a plastic surgery there to possibly help the possible nerve entrapment syndrome, or skip the MRI's altogether and go for the hip replacement, where it'll take up to six months before I'll really know if the pain I've been having with walking for the past almost year is really gone? Or, do the MRI's, send it to my NY doctor, and see what he says and weigh my options.... I think that last one is the answer. This is all very confusing, but I think I've worked out what to do. Assuming that the HMO will now pay for the MRI's, I'll do them, and see what comes of that. If my NY doctor doesn't find a problem, then I'll do the hip replacement.

Either way it looks like I'm headed to a surgery. I knew it that when this pain started, I knew in the back of my head that it might lead to another surgery. It's my track record. I hoped that the physical therapy that I have been diligently doing (as recommended by today's doctor, 4 months ago) would solve the problem. Now, in physical therapy, we are working on my years-old knee problem, stemming from the same problem from the NF.

What would my life have been like if I never had NF? I just try not to "go there". No point. 

I know that there is a lot of good that has happened since that horrific disease in 2007, and I prefer to focus on that. I am much more than merely my body.