Last Tuesday I drove to Tacoma for my 6-month check up with Dr. Mayo. The appointment was very similar to previous ones. I arrived about 15 minutes early and had 3 x-rays taken, one lying on the table shooting anterior (front) to posterior (back), one standing anterior to posterior, and one standing of a false profile (shooting through the right hip to the left hip).
After x-rays I waited for a few pages of my book and was then taken back by a nurse. She took vitals and asked some basic questions, then I waited for a few more pages of my book. Normally Kenda would come in first, so I was surprised when the next face I saw was Dr. Mayo. He slammed the x-rays into the light box and asked how I was doing. I told him the left was still gaining back strength but doing well. I mentioned the continuing tightness on the right and said my PT had a theory about the cause. When I told him Dan thought the tightness was because of scar tissue, he seemed to think that was very possible. He explained that there’s not a good diagnostic measure to see scar tissue, so it’s a guess that it’s there, but it’s a good guess.
He also it could be tendonitis. I asked about trying massage therapy and he was agreeable to that. I also asked about Iontophoresis, or Electromotive Drug Administration (EMDA), which is a technique using a small electric charge to deliver a medicine through the skin. This can be done by a PT with ultrasound. Dr. Mayo was agreeable to that too and gave me a prescription for an NSAID gel called Voltaren.
He mentioned a few other possible treatments also. One is an injection of a steriod into the area. I might consider that if massage and ultrasound don’t work. Another option is a psoas tendon release. That is a surgery to cut a tendon. I’m not sure I’d want another surgery. He also didn’t seem too positive about that either. I don’t think the success rate is great. I think I’d rather live with it how it is than go through another surgery that might not help.
After discussing that, Dr. Mayo watched me walk and didn’t see any problems. I hopped up on the exam table and he did a quick physical exam to check my range of motion. One thing he and Kenda always do during exams is roll my leg side to side to see how far the hip socket rotates. You can sometimes diagnose a labral tear by doing this. He mentioned something about me having loose joints. It was the first time anyone had mentioned that to me. Being too loose-jointed can be a bad thing, but in my case it just means I have a high but acceptable amount of rotation in my hips. He thought it was a good thing.
Overall, the appointment went well. I expected to get a good report on my left and I was happy to leave with the massage and ultrasound referrals and the prescription for iontophoresis. After Dr. Mayo was finished with me, I went out to the nurse’s station to say hi to Stevi and Kenda since I hadn’t seen them as a part of my exam. At the previous appointment, Kenda had shown me and Steve a video taken during the first surgery. I had come armed with a thumb drive this time, so she copied videos and x-rays during both surgeries for me.
Later that day I called Dan to update him about my appointment and the referrals. I had talked to him before about massage. His office doesn’t offer massage but he recommended a woman at his previous employer, Peak Sports and Spine, which is a lot closer. I figured since I’d be going back to Peak for massage, I’d go there for the ultrasound too. Dan initially said he would recommend his boss, who is a woman, for the ultrasound. He understood if I didn’t want him rubbing a device around in my groin, but if I was okay with him doing it, I should just make sure I’m wearing my nicest underwear and he’d cover me up with towels as much as possible. That made me chuckle. I would have felt a bit uncomfortable with that. I told him I was thinking about going to Peak and he immediately rattled off a few names of women therapists there.
I called Peak to make an appointment for a massage and was able to get in a couple days later. I talked to the receptionist about the ultrasound referral too but decided to do the massage first and then make an appointment for ultrasound when I was there in the office. I wanted to see how the massage went before planning anything else.
The massage was Thursday. I had only had one massage before, so I wasn’t exactly sure what to expect. I was hopeful that someone working at a PT office as apposed to a salon would be highly skilled. I was immediately impressed with Robbin. She started with a quick assessment and noted some tightness in the soft tissue in both hips, more in the newest surgery side, which makes sense. She also said she was impressed that I didn’t end up with internal rotation of my legs after the surgery. She said my surgeon must be really good. I couldn’t agree more. Later she commented about how good my scars looked. I changed into shorts and she got to work.
The massage lasted about 45 minutes. She worked on my feet, calves, and thighs a little to start but spent most of the time on the area of my scars and into my groin a little. She showed me a technique for loosening up the tissue around my scars. She also suggested I start stretching my hamstrings because she felt they were a little tight. Overall, I liked her and felt she was very skilled and knowledgeable. I’ll continue to see her weekly for a while. Thanksgiving week, next week, is out for me because we leave for a trip to Bend, Oregon, on Wednesday and Monday and Tuesday will be filled with work and preparing for the trip. I have another massage scheduled the week after. I also scheduled with one of the women PTs for ultrasound earlier the same week. I have the Voltaren gel and have been using it for a couple days. It smells like a mix between arthritis cream and bug spray, but the smell goes away after a little while. I’ll bring that with me to the ultrasound appointment.
Overall, I’m hopeful and encouraged. I haven’t been able to say that for a while. Aside from the multiple appointments, the one other change is I’ve started to ride hills on my bike. I’ve had a few dry days to test out the climbing legs the last 2 weeks. I’m starting slow, riding on gently rolling roads instead of always having to be on the bike trail. The one challenge in my rides is I’m now riding the hills to my house instead of changing into flip-flops and walking up the hills. The first time, I was quite sore after, but I’ve done it 2 more times and it gets a little better each time. I think riding hills will help rebuild my weak iliopsoas muscle on my left side.