#coredecompression

AVN HIPS- Minimally Invasive Surgery

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It’s currently 8:25 AM and I’m laying in my old bed at my parents house on Jan 27, 2017. Today at 12:15 I am scheduled for a Core Decompression, but before I go into all that I’ll give a little backstory on myself.

My name is Josh and I am a professional ballet dancer in Atlanta, GA. I'm 5'5 on a good day and 134lbs with an athletic build. Not buff but lean muscle that's toned. Between teaching every night and dancing for a company during the day a few times a week I'm constantly on the go. Prior to being diagnosed with Avascular Necrosis I thought I had hip flexor strain (which is common in dancers) which is what prompted my doctors visit to Resurgens Orthopedics. We both agreed that it was my hip flexor that was giving me issues so I did a couple sessions of physical therapy but wasn’t happy with the results. As a dancer we have a different way of working our bodies than an average person. My primary issue being working from a parallel position versus a turned out position. About 95% of ballet requires the dancer to turn out so without it there not much you are able to achieve. After two different sessions of PT followed up with an X-Ray and MRI I was diagnosed with having Avascular Necrosis across 100% of my femoral head. In lay man’s term this means that there is almost no blood flow getting to the head of my femur.

I was referred to another doctor who works in sports med as the original doctor I was seeing was a hip replacement surgeon and I didn't need a hip replacement. So I went to Northside Hospital to see what my options were in terms of fixing this issue. This is when CD was introduced. Basically this doctor was VERY adamant that I stop everything immediately and having surgery ASAP which…if you know me I can’t just put my life on hold. I’m far too busy with far too many commitments to ever do such a thing. Needless to say I took the crutches he gave me used them for a couple days and then threw them in the back of my car as they were literally slowing me down and I don't have time to waste in my day hobbling to and fro. As I researched the CD surgery myself I initially thought there was no way in hell I was going to have this done. Essentially for a CD they DRILL into the head of your femur and take out all the dead bone and using bone marrow inject bone marrow in the hole and cover it with a bone graft. First all it sounds like it hurts like a son of a $!&?# and second the recovery for that is longer that I ever need to be off my feet for. So I got a second opinion, as you should to surgery to see if there were any less invasive options. Sadly for me…not so much BUT my second opinion doctor a Resurgens Ortho Doctor (who happens to work with my sister in law HEY WANDA 👋🏽) basically said it’s up to me. I wanted to wait until May when my dance season is over and my obligations are far less. And I could have, which was taking a risk, but if I felt like the risk was worth it he'd be more than willing to set up an appointment in April for an MRI and see if anything had changed and set up for surgery in late May. The only IF and it was a big IF was that if in fact my AVN got worse during those 5 months I could be putting my career in jeopardy as the head of my femur would be crumbling away.

After about a million questions and awkward shuffling and a gentle push from my sister in law who went with me, I decided to have the surgery. I wasn’t thrilled in the least but at the end of the day I’d like to keep dancing for as long as possible. That was about three weeks ago and I’m still a stressed and nervous wreck. Having to tell your employers and people who you work so closely with was the hardest and most heart wrenching thing I've done in quite some time. There were many commutes home spent in tears. There are so many opportunities that I'm missing out on but unfortunately my career at stake. I've spend night after sleepless night googling "Core Decompression Recovery" "Core Decompression Blog" but there are virtually no recovery blogs about this procedure which is what prompts me to make this. Plus it gives me something to do while I’m laying in bed going stark crazy.

These next three months are going to be a true test for me. Aside from a bad sprain that put me in a boot for almost 8 weeks this is the most time I've spent sidelined from my career AND the most invasive and intense surgery I’ve had. It’s my goal to be as candid and honest as possible with you all about this journey which for those of you who know me know that’s not me at all. I’m rather tight lipped about everything but hopefully by writing it’ll be somewhat therapeutic.

The hospital preadmission screening session had me seriously reconsidering doing the surgery. I felt completely lost amid a situation in which nobody could relate. How many near-30 year olds have you met who need to decide the right time for a fucking hip replacement?

Some of my friends had suggested getting a second opinion, but it wasn’t until this point that I actually carried out the idea. I visited another orthopedist in the area who, in short, told me that having a bilateral total hip replacement was too aggressive a treatment for someone like me just yet. This is mostly from the facts that my hips haven’t shown full signs of collapse yet and my pain level is only mild to moderate. The fact that I can continue to work an 8 to 8.5 hour day of physical labor without returning home in excruciating agony is a plus, I guess.

This orthopedist suggested that I have a core decompression of the hip done instead. In this procedure, a wire is inserted into my hips and a series of holes are drilled into my hip down to my femur. It’s believed that increased pressure may contribute to the pain (hence the reference to the term decompression), but it also serves as a channel for additional blood flow to where the diseased bone exists on the top of my femur (from the whole avascular necrosis thing).

In general, I liked this orthopedist a hell of a lot more than the first one. I don’t blame the first orthopedist for not suggesting the decompression first; it was likely his medical opinion that the state of my AVN wouldn’t have benefited from such a surgery. But the second one suggested that there was a 50% chance of extending the life of my hip long enough to where I’d get a hip replacement at a more reasonable age (say, 40 or 45, instead of 29).

I think I jumped the gun a little too quickly on getting the full hip replacement. I didn’t have much of a guideline to go by, given the already rare state of events. The first orthopedist more or less said “When you feel like you’ve reached a point where you can’t continue on with how your hips are doing, give me a call, and we’ll do the surgery”. I don’t think I really gauged the overall level of my pain until the day of the preadmission testing, where one of the nurses asked me to rate my pain on a series of scales. When I said it was an overall 3 or 4, she sort of looked at me in shock, and said to me that I’d likely be in a lot worse pain right after the surgery just because of the nature of it. Way to keep me secure in my decision.