And Then A Third Hypothesis

My orthopedist entered my room and announced that he was going to make my day. “Ann, you do not need a hip replacement.” Then he left me still juggling two hypotheses and looking at pictures of 10 new exercises.

He suggested that the problem could be coming from a spinal nerve. This was my first hypothesis. Then he threw out a new one, “or arthritis somewhere else in the pelvis.” He thinks that the exercises are the best way to test the hypotheses.

Of course, next week I will be meeting with my neurologist and the week after that with my neurosurgeon. I am betting that since the hip has been ruled out, they can come up with a way to test the spinal nerve proposition.

I am also willing to bet that the answer is “both/and.” I think that when I first complained about the pain, decades ago and to the same orthopedist, that the primary problem was the compression or entrapment of a spinal nerve. However, constant pain alters gait in ways that promote wear and tear on joints. When this is coupled with misdiagnosis and inappropriate treatment, arthritis somewhere else in the pelvis seems a likely outcome.

The problem under discussion is the one that makes driving difficult and keeps me close to home. However, being able to see my orthopedist at the VCU Neurological, Orthopedic, and Wellness (NOW) Center was worth the discomfort of the drive to Short Pump. The potholes in 288 have been patched and my old car loved the “blowout.”

I love that the suites are named after Richmond landmarks, though I did suggest that the area named after Brown’s Island should include music. I enjoyed the fact that this facility is modeled after those at places like Johns Hopkins and the Mayo Clinic with each patient in a private room and accessible  to a multidisciplinary team instead of stuck in a large waiting room.

My physician’s people skills have been upgraded along with the facilities. Since he was not rude and resisted the tendency to blame and fat shame, I resisted the desire to remind him that this was his third or even fourth opportunity to get this diagnosis right. Is it just me or do other people also feel that the “bedside manner” of their VCU physician improves as the distance from the old campus on the east side of downtown increases?

And not just the physicians. The person staffing the registration desk at Short Pump was a far cry from the one at one of the downtown clinics who told me that I was mispronouncing my own last name. It could be a change with the passage of time and not simply location. I am always willing to consider alternative hypotheses.


But now it’s time for my afternoon exercises. I am determined to do my part. I am still in physical therapy and I have come a long way since the right leg started to collapse. We will see how far I can go with a team of medical experts and a little grit.


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