Meeting Dr. Millis

Today my mother and I drove up to Boston to meet Dr. Millis and discuss my potential surgery. I say "potential" because it still was not guaranteed that I was an appropriate candidate for the PAO surgery, much less that I would have the renowned Dr. Millis as my surgeon. If Dr. Millis felt I was not a good candidate for a PAO, or if he opted not to take me as a patient, I would have been frustratingly back at square one. So my biggest concern heading into this appointment was getting everything nailed down, and most importantly, getting a surgery date inked into the calendar.

Prior to meeting Dr. Millis, I had to get additional X-ray and MRI imaging at the Children's Hospital's Waltham facility. I must admit that getting procedures done at a children's hospital is really kind of wonderful. For example, there is fun, whimsical decor in the waiting room, including fish tanks! I remember fish tanks in my pediatrician's waiting room when I was six years old. Nothing bad can happen to you in a place with fish tanks, right?

Additionally, the staff at children's hospitals are cheerful, patient and comforting. My X-ray tech was joking around, making sure I was comfortable and breathing, etc. I'm not particularly scared of X-rays but there is something to be said for treating sick and hurting adults like they are frightened children. Maybe all our hospitals should be like children's hospitals.

At the very least hospitals should always have a fun dragonfly mobile above the table when they try to inject contrast medium into you for your MRI. It was at least somewhat soothing to glare at the swaying, cartoonish insects, clenching my teeth as two nurses tried their hands at finding and piercing a vein in my superhero body. Apparently I have such good elasticity in my veins that they flatten out or roll away at the sight of a needle. Elastigirl indeed. Finally after five excruciating tries they got the contrast medium injected and so into the clanging doughnut I went.

After my Innerspace photo shoot at Waltham, we headed over to Boston to meet Dr. Millis at the Children's Hospital's main campus in Boston. While waiting for the doctor, I filled out a couple of questionnaires about my hip pain. It was a bit tough to know how to answer the questions since I wasn't in a lot of pain today. I am not usually in a lot of pain, but mostly that is because I limit my activities so much and stay off my feet if I begin to have any pain. This has especially been the case in the last six months or so, when my pain threshold has dropped such that I have had to carefully mete out my hip usage to keep myself pain-free most of the time.

My mother was concerned I was downplaying my pain but I really was not. I know the threat of severe pain is always there but I try to keep myself out of pain by preventing it rather than treating it once it has started. So for me the real pain is in how limited my physical activity has become in my efforts to avoid aggravating my hips.

That is not to say I have not had severe hip pain in the last couple of months: there are several times I remember being almost unable to walk and gasping in pain when I'd "overdone it". I put that term in quotes because overdoing it in my current state is doing activities that normally would be completely manageable for someone without my hip condition. Things like a tennis match or a long walk of a few miles. A healthy 29-year-old should not be felled by an afternoon at the museum.

I was still filling out the questionnaires when the doctor came in with his associate Dr. Brighton. Dr. Millis is an affable man with an enthusiastic air. He took a conservative approach, initially saying "if we decide this surgery is right for you" and similar flirty statements. Needless to say, this was annoying. I wanted him to say "OK, you need this surgery, and I'm doing it for you. Now let's talk logistics." But I guess he wanted to ease into it. Or maybe most new potential patients are not as decided, determined and dispassionate as I am about this whole thing. I've accepted the diagnosis and the need for the surgeries. Now I just want to get them over with. Right, recover; left, recover; done.

I truly think Dr. Millis had decided I was a good PAO candidate and that he was going to take me as a patient before he entered the room today, maybe even before I got to Boston and had the second set of images taken. I don't think he would have even had me come up to Boston if he hadn't, and I seriously doubt he would have spent so much time with me during the appointment if he was unsure.

The doctor watched me walk in various ways: normal, on tip toe, on my heels. He did some range of motion tests on both hips. I have no gait problems and have very good range of motion in both hips. We looked at the images from Waltham and the images I'd taken in October at HSS. The doctor drew the various angles on the X-rays to show where my socket edge was and where a normal socket edge should be. In the false profile view, it was even clearer that my sockets were far too shallow on both hips.

In the images, there doesn't seem to be that big a difference between my left and right hips, so it is a bit odd that the right usually hurts so much more. When I was off my right leg last summer, on crutches for a right knee injury, my left leg took all the weight and hurt more than it ever had before. So it is clear that my left leg has the same capacity for pain as the right. I guess the right is just quicker to pain because of the chronic labral tear and so I end up getting off my feet before the left hip even starts to hurt.

Dr. Millis confirmed that I am going to have to have the left hip done pretty soon after the right PAO. It will depend on the healing rate for the right hip, but it could be as soon as three months after the first surgery. That is faster than I expected, but honestly, the more I can compress this disability and recovery period, the better it is.

"Can we talk dates?" I asked, finally. Dr. Millis got his scheduling coordinator on the phone and offered me February 9. One month away! That was a bit too soon, even for me; I need to coordinate with work and other commitments. I took the next available slot, which was March 16. So there it is. Right hip PAO in two months. Giddy up!

Consult Scheduled

Sharelle Davis from Dr. Millis' office called me on Thursday morning to let me know that Dr. Millis had reviewed my file, and to schedule my first consultation appointment with the doctor.

When I had first begun talking to Sharelle last week, collecting my records and films for Dr. Millis' review, the doctor still had consultation appointments open in December; by now his first available appointment was in January. Dr. Millis sees new patients on Thursdays only, and with Thanksgiving, Christmas and New Year's Day all falling on Thursdays, the holiday season is not a scheduling cornucopia.

As an alternative, Sharelle offered to put me on Dr. Young-Jo Kim's track. Dr. Kim is on Dr. Millis' team and has worked with Dr. Millis for quite some time. The advantage is that Dr. Kim's schedule is lighter -- I'd be able to get a consult with him in early December. But if I chose Dr. Kim for the early consult, I was also choosing him as my surgeon -- one can't switch between the two.

It seems from his bio, resume and publications that Dr. Kim is younger and less-reknowned but by no means incompetently skilled at PAO surgery. That said, this was a choice I didn't really know how to make. How to choose between the doctor referred to you specifically by name as the "best" or his similarly qualified, yet unrecommended, understudy?

I called Dr. Su's office to ask for help with the decision. What had Dr. Su heard about Dr. Kim? Would he recommend him as an alternative to Dr. Millis? Dr. Su never got back to me with any answers, which I found disappointing. He might get back to me next week, I suppose, but I did not want to stall on the scheduling. I wanted to secure an appointment and have something concrete in the calendar right away.

I surveyed the message board about Dr. Kim and found no negative comments and one first-hand comment: a woman who has a surgery scheduled with him in the spring and who found him to be knowledgeable with a good bedside manner. In the absence of an answer and affirmative recommendation from Dr. Su, however, it seemed prudent to go with the doctor he had initially recommended by name. After all, Dr. Su hadn't recommended Dr. Millis' "team" or "program," he'd recommended Dr. Millis himself.

I took Dr. Millis' earliest available consult appointment, January 8, 2009. The appointment consists of an MRI at the hospital's Waltham facility in the morning, followed by a 12:30 appointment with the doctor at his Boston office. Sharelle could not estimate my surgery date based on the consult; she said it was something the doctor would discuss with me at the consult.

While I am glad to have an appointment in the books, the sluggishness of this process is very frustrating. Ideally I would have been having the actual surgery in early January. But I suppose I have unrealistic expectations for a busy, reknowned doctor and a major surgery. And I could always have gone with Dr. Kim if it was so important to me to race through this.

To her credit, Sharelle has been very kind, patient and responsive with me despite my many questions and phone calls. I have tried not to be an annoying patient (as I have had enough annoying clients myself to know how it is on Sharelle's end of the phone) but my impatience is difficult to suppress.

A woman on the message board told me that Dr. Millis' surgery lead time is typically three to five months from the consult. Since I am under 35 years old, I can have my surgery at Children's Hospital where the doctor has more operating room time available, so that should help. Even if we assume best-case scenario, I won't have anything earlier than a March surgery date for the right hip.

I suppose all this speculation is silly, though. There's nothing I can do now except carry on until January, doing what I can when the pain is minimal, taking it easy when the pain is worse, and enjoying the holidays until the dawn of 2009, the Year of the Hips.