I’ve been banned from the barn?!

What happens when you ban a professional equestrian from the barn? Madness, chaos, and a whole lot of frustrating boredom ensue… Not only have I been ‘banned’ from the barn by my doctor, I have been relegated to the couch. In fact, I have been assigned the most miserable torture device of all medical profession: the crutches. In protest of my inability to function, I am mentally shedding my frustration in a series of blogs that I should have started last week. However, I used up several days completing tasks that have sat long forgotten during my busy days. Today, I am motivated to write, and I have a couple of hours before the pool opens.
By now, you might be wondering just what I did to myself this time. I’m very familiar with crutches; I’ve had a long-standing tradition of knee, ankle, and hip injuries over the years–nearly all of them non-horse related. This all started about a month or so ago. I cannot remember a time when I did not have some sort of back pain. I’ve never had anything definitively diagnosed other than a bit of mild scoliosis, some bursitis in my right hip, and various comments about ligaments being too tight and muscles too weak. Over the years I’ve strengthened my core, quads, and glutes and stretched my appendages as much as possible. I spent nearly a year in solid weight-training after a physical therapist told me I had weak quads and glutes that attributed to my runner’s knee. I became a machine–developed a reputation for out-lifting the boys in the weight room (relatively speaking, of course), out-performing them in the gym, and pushing myself beyond reasonable limits. I had one of the best PT tests of my life post-partum. I became an elite athlete. I ignored pain and pushed past it. Then, I moved back to Kentucky and started working at the barn every day. I didn’t have time to lift weights or hit the gym, but it didn’t matter because I was lifting full water buckets, mucking out stalls, hefting 50 pound feed sacks, and engaging my core in the saddle. I have actually lost weight over the past few months as I literally worked my butt off–and loved every second of it. But, the back pain, my old familiar friend, began to get worse. And two weeks ago, it reached a point that scared me: I actually voluntarily gave up riding. My right leg was weaker, and I knew I couldn’t effectively ride our green horses that needed equilateral support. It was time to visit the doctor. After a physical exam revealed slight weakness in my right leg but no other findings, the doctor ordered radiographs and blood tests. Neither of us expected any conclusive findings, but they would offer baseline exams for my regular physician. I was sent to the pharmacy to pick up a low dose steroid pack pending further examination by my primary care physician. As I left the pharmacy, headed home, as soon as I reached cellular service again, missed phone calls started popping up. Before I could listen to the voicemails, a new call came in. I answered, and the doctor who had just sent me away told me to return immediately to the clinic. I figured they needed a new blood sample; it had taken three people to draw two tubes of blood. Instead, before she even came in, I was being fitted for crutches. I was a bit bewildered. When she sat down, she spoke quickly and cryptically about increased opacity of my right femoral head and compromised vascular supply. I tried to take it all in–I’m very well-versed in medical terminology and understand most doctor-speak as a result of my background. Then she gave me the worse news: you are to stay away from the barn–absolutely no barn chores and no riding whatsoever. I was allowed to walk, but only with assistance from the crutches. And, I was to make the first available appointment with the orthopedic surgeon, by-passing my primary care physician. Furthermore, I sensed the relief in her voice that she was able to pass me off to the surgeon. There was a grimness about her that worried me, but I was more concerned at that point about having to spend another hour plus downstairs in the dungeon at the pharmacy.
After nearly two hours in the pharmacy, I came home and began researching conditions that cause increased opacity in bones on radiographs and effects of compromised vascularization. I came up with only one condition that fit: avascular necrosis or osteonecrosis. To spare you from googling these–it essentially means the femoral head (the part of the hip that joins the socket) has suffered from a limited blood supply and the bone cells begin to die. In later stages, the new bone that grows as a result absorbs the dead bone and glows brighter on x-ray–much like a healed fracture. It’s often found in the elderly. I am thirty-one years old–far from elderly. I called my mom, a nurse who works with elderly folk. I called Ryan’s cousin, a radiology technician. I scoured my A&P text. I did further research. I am now an expert in the anatomy and physiology of the hip joint. And, I still find it difficult to believe there is a possibility I could be diagnosed with avascular necrosis. I suppose I’ll find out soon enough. I meet with the orthopedic surgeon tomorrow at 0800.
I’m not a hypochondriac, and my research isn’t because I’m self-diagnosing–I’ll wait and see what the doc says. That being said, I’ll appreciate any thoughts and prayers that come my way. I’d like to get out to see my horse soon.
Incidentally, I have noticed after nearly a week of non-weight bearing that the pain is actually radiating from my right hip. My guess is that I was compensating and my back was taking the pressure. More to follow…

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2 comments

  1. osteonecrosis77 · August 1, 2012

    Hello, I have osteonecrosis in my distal femurs. I write a blog about avascular necrosis/ osteonecrosis. If you are interested in reading research you can check it out at: http://www.osteonecrosis.me

    AVN in it’s early stages is only detectable on an MRI, that would be the next diagnostic step for you. MANY orthopedic specialists don’t know enough about AVN. It’s a rare condition. You have to educate yourself and be your own advocate. Good luck!

    Cassandra

    • justjump3day · August 1, 2012

      Thanks so much for your comment; the doctor did mention that they would most likely order an MRI. She told me “I am not diagnosing you; the ortho will have to make the diagnosis,” but she seemed fairly concerned about the possibility. I didn’t see the radiographs, so I don’t know how much they revealed. I will definitely check out your blog, and I will be keeping in touch if this turns out to be osteonecrosis for sure. Thanks again!

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