Monday, March 14, 2016

Bring on the Easter Bunny

 Gosh. I purposefully reduced the time spent on Reasonably Well over the past few months, but I didn't realize that "reduced time" had morphed into something bordering neglect. Here's a few reasons why:

1.) Mom, now at nearly two months post-stroke, has stalled in her physical rehab which means that it appears that she will need care that is different than the intense day-long therapy focused unit provides. So we need to move her into more of a nursing home type facility. She has memory and cognition issues which actually seem to be worsening. My sibs and I are continuing to work through the complicated process of establishing guardianship and following through with Dad's wishes for the use of he and Mom's properties after his death; which involves preparing to sell one of their three farms. And amidst the legal and financial issues is this enormous need for us to support each other as we grieve for essentially the loss of both parents within a month's time.

2.) Of course I had to add yet another medical issue of my own to this mix; gaaaahhhh. I've been dealing with trochanteric bursitis for years now, but after my total knee replacement I noticed that as my knee pain subsided I experienced a new twist to the bursitis in that I developed an odd but significant pain in my lower back that extended to my buttock. In between trips to Wisconsin, I visited my physiatrist who looked at my MRI results and told me that in addition to a very cranky bursitis I had acquired several partial thickness gluteus medius tears. Egads. Treatment will consist of rest and ice and NSAIDS, gentle exercise, and follow up physical therapy. We may throw a few steroid injections in there to temporarily settle things down.

So what is a partial thickness gluteus medius tear? (Ouch.)

A gluteus medius tear is a severe strain of one of the major hip stabilizer muscles. The gluteus medius muscle is located at the outer part (lateral region) of the hip, and functions as a hip abductor and internal rotator of the thigh while keeping the pelvis level during ambulation. A tear in the gluteus medius muscle often occurs at its tendinous insertion onto the greater trochanter of the femur bone and can be a major cause of lateral hip pain. 
Muscle strains are graded according to severity: Grade 1 strains are mild and are associated with pain but no loss in range of motion or strength. Grade 2 strains are partial tears in which there is incomplete loss of flexibility and strength. Grade 3 strains are complete tears (full-thickness tear, or rupture) in which the musculotendinous unit has been severed; individuals with grade 3 strains will have complete loss of strength and difficulty in actively moving the affected limb (Armfield). 
Gluteus medius tears may be traumatic (acute) or degenerative. With an acute trauma, a partial- or full-thickness tear may occur in the gluteus medius muscle or tendon that causes localized bleeding (hemorrhage) and subsequent scar tissue formation, tendon calcification, and weakness. However, the majority of gluteus medius tears are degenerative, caused by chronic inflammation of the gluteus medius tendon (tendinopathy) that results from many small tears over time from overuse, repetitive movements, or friction from a tight iliotibial band. In many cases, degeneration of the gluteus medius tendon is associated with greater trochanteric bursitis; the combined injury is called greater trochanteric pain syndrome. When chronic gluteus medius tendinitis occurs, the gluteus medius tendon is vulnerable to subsequent injury and degeneration that may result in a tear (Miller).
Enough about my gluteus muscles.

3.) On a much more positive note, I'm in the thick of Easter preparations. It appears that we will once again fill the house to the rafters, which as y'all know, is my absolute favorite way to spend a holiday. I have twelve Easter baskets to fill this year! How awesome is that?

This year's find? GLOWSTICK SWORDS. Oh, man. It doesn't get any better than that. 

I leave tomorrow for Wisconsin, Mom, and my brother and sisters, so I think it's time for me to electronically check in for my flight and begin packing.

So. Anyone else experience this unique pain in the butt?? Share your gluteus medius tear stories, please. And as always, thanks for being there for me. I appreciate y'all more than you can know.


Kate Stout said...

Your plate is cup is over flowing, your calendar is full, and you need to pick and choose what to do. We'll be here when you come back.

In the meanwhile, here's hoping everything is going as well as can be expected under the circumstances.

Anonymous said...

Hi Julia,
Recently, my best friend who also happens to be a nurse experienced a gluteus medius tear. She did try to deal with the issue with the typical methods of rest, meds, ice, PT but was still having problems. Surgeon left the decision to fix the tear up to her. He explained that sometimes these tears can heal on their own. She went forward with the repair and is doing really well. Was about a 6-8week recovery coinciding with PT. She is all healed now and feeling great.
Hopefully your tear can heal with the least invasive approach but wanted you to hear story with an excellent outcome. You have enough on your plate, so sending prayers and good wishes to you and your family.