Joe A Shaw PA-C - 6/2/2009

Question
Hello, on March 24, 2009 I was in labor and having my daughter 6 weeks
early, I had an epidural since 5 pm the evening before ( 3-23-09) due to my
right kidney hydronephrosis, I had 7 nephrostomy tube since december 7th
08, they all kept clogging with calcium stones, well the 7th one was clogged
and they could not remove the tube, I was in so much pain so they gave me
an Epidural Pump and a Fentanyl pain pump, needledd to say I was pretty
outta it, the next morning they decided to indure me, they were rollingme
from side to side sitting me up and they laid me back down and went to roll
me onto my left side, now I was very close to he left side of the bed( w no rail
up) the nurse went to roll me over and my left leg (dead weight, i had no
control over it, not to mention I gained a lot of weight being on bedrest and
water weight), well my left leg fell off of the bed pulling my leg down very
hard, well she put it back up on the bed... A little while later she had to roll
me over again, she cld another nurse to come help, she asked the other nurse
to watch my left leg since I had no control over it, well she didnt pay attention
and this time it dropped even harder, y ankle hit the ground hard and my hip
bent out ver hard, I felt this hard yanking sensation thru my whole body, no
pain due to the epidural , well anyways, I had the baby not to long after. They
turned off the epidural and I slowly started to feel some pressure in my low
back(which neither have ever hurt before at all) and a strong burning
sensation in my left leg which kept intensifying... It hurt worse than my Neph
tube in my kidney and my delivery pain So they kept me on my pain pump... I
told my Dr he ordered a lt Hip xray and a venous doppler the next day. They
were normal, he said that my hip could have possibly dislocated but was put
back in place when my legs were put into the sturrups to deliver, not sure
though.. I couldnt walt on it, it would pop out of place if I put any pressure on
it and the pain was tremndous in my leg and low back... I was in the hospital
for a week until I could walk and I got my tube out.. 7 weeks later (now) I am
still having a hard time walking and especially getting up and down, my hip
even gives out and I will fall.. I saw my Ob dr for my Post appt and he made
me go see my Primary Dr right away, my PCP then ordered an MRI I just got it
done yesterday and the results say...
Left hip- High T2 signal is present within the posterior aspect of the vastus
lateralis muscle where it abuts the inferior margin of the greater trochanteric
of the left hip indicating the presence of interstitial edema or hemorrage
likely realted to a muscle tear. Impression says Left Vastus Lateralis Muscle
tear.

MRI Lumbar spine-L3-4, L4-5, L5-S1 all say Small Broad based posterior
annular disc bulge, Bilaterl posterior facet joint arthrosis, no foraminal or
central canal stenosis.
Immpression-1. Mild mulitfactorial degenerative disc and joint disease at L3-
4,L4-5,L5-S1 without evidence of canal or forminal stenosis
2. Mild degenerative disc disease at remaining lumbar disc levels...
Im so sorry for the book..  My PCP want sme to go to Physical Therapy which I
have been before nad know it is only a temporay fix..:-(
I am still in a tremendous amount of pain, only 27 w 3 children and am
desperate to get better, My leg keeps giving out, it hurts so bad to get up and
sit down in a seated position, if I lay down my back feels like its going to
explode, my left hip feels like it is on fire and in knots ans the both spasm
like crazy... Can you help me understand what all of this means for my future
and how can I get all better so I can play with my kids and clean the house
without hurting, I feel like an 80 year old woman.....  Again sorry for the Book,
Im just desperate for some help... I am still on Percocet 10/325 which helps
but not completely, pretty sad huh and I hate taking it so I go without it most
days and take Ib Profen which doesnt touch it...Ahhhh

I hope to hear from you soon, PLease help

Thank you so much,
Melissa Martin  

Answer
Melissa,
It's not really my speciality and I was going to send question back but I really feel for you so I will tell you what I know.
Vastus Lateralis Muscle tears can take months and months to get better. It can keep football players out all season and that is w extensive rehab etc... You do need to get w a PT and hopefully w time it will heal. You do need to make sure that you don't have AVN (avascular necrosis of the hip) this is where the hip bone (ball and socket) get pulled apart and it pulls the blood supply apart causing the bone in that area to die..which eventually requires a hip replacement. The football player Bo Jackson got this after a tackle yrs ago and it obviously ended his career.
Sounds like your doctors are doing all that can be done as you got a hip MRI, but just make sure they keep an eye on it.