I figured I might as well take a little time to go more in depth as to how and why I decided to go forward with this surgery. As I surf the web and read about others' experiences with this surgery or hear about people grappling with the decision to go forth with it themselves, I figured I could shed some light on how I made my decision and my reasoning behind it.
After being told that I had FAI, I proceeded to do a TON of research. I read medical studies and reports, I read blogs...anything that I could do to gain more information to assist with forming my decision. The one recurring theme among all of it was that this is a structural condition...the bones, in my case my femur, had either been born with excess bone mass (genetic), or it was developed as I grew (acquired). This is the basis for FAI, the symptoms or pain or damage is then unique to each individual diagnosed based on many factors such as age, prior activity level, etc. I used this info, in addition to other factors, to make the decision to go forward with surgery. I believe there are four main factors that weighed on my decision, and could be used by others to help in deciding which path to pursue: age, current health, future goals and psychological/mental strength or "desire".
Age
Age is a pretty straight-forward and easy one, in my opinion. I was 34 when diagnosed. In my mind, I had plenty of "active" years ahead of me. I also have two young and very active kids, active in the same endeavors as I am. I wanted to be a part of this, as well as other activities that I personally wanted to partake in still. Enough said.
Current health
I was in the middle of training for the Rock N Roll marathon in San Diego, with my eyes on a Boston Qualifying time when diagnosed. Training had been going extremely well and I had incorporated some amazing cross training into my routine in the form of CrossFit. That being the case, I was in just about top notch shape. I was at a very healthy weight and I was strong, both important factors going into any surgery. If I waited to have surgery I could risk losing some of those health benefits. I would not be able to continue running and performing other activities with the current pain I was in, therefore possibly going into surgery at less than optimal health. Also, and I feel this is a huge point, if I waited, there is a risk at doing MORE damage than already existed. The fact that there was already pain means that there is already damage. Doing further damage while waiting it out could have resulted in consequences such as more invasive and extensive surgery or repair, which could then prolong rehab and recovery. The fact that I was in such good health meant that the surgery would hopefully go smoother, and I would be better able to hit rehab with full strength.
Future Goals
This factor is kind of tied into age. I have a lot of "young" years left in me and had some pretty lofty goals I still wanted to attain: qualify for Boston, run a sub 3:00 marathon, complete a Full Ironman, run the Ragnar Relay, and complete Tough Mudder, among other things. I just couldn't see myself hanging it all up, at my age, and "giving up". I had to give myself the best chance possible to achieve these goals. But more than anything, I think, was that I wanted to be active for my kids. My kids LOVE doing triathlons and running. They have the most pure passion for these sports, and I wanted to be a part of it. I know they looked up to me for what I was accomplishing prior to the diagnosis, and I wanted to continue to show them what they could do. I wanted to be a part of it with them, to run with them, to do triathlons with them. My son constantly asked me when I thought he would beat me in a 5K, or when he could run his first 10K...I want to give him the chance to beat me head-to-head, and I want to run that first 10K with him, and his first half-marathon, and hopefully his first full-marathon. As an Amish Proverb states: "What children don't learn by hearing, they learn by seeing." The best way I can help my kids reach their goals and to guide them is to be actively doing it with them. Plus, some of my most memorable moments growing up were spent going to races with my father, or running the last few miles of his training runs with him. As I have now experienced those same moments with my kids, there is no way I was ready to give that up.
Desire
Surgery is not easy. Recovery is not easy. Recovery for FAI surgery is long and slow, depending on what all is done in the process. Combine this with my prior activity level and it seems even longer. It is a huge mental hurdle to get over and accept. I feel I have been given a gift to see the positive in tough situations, and to somehow stay motivated. In fact, I think I get even stronger when confronting difficult obstacles in my way. This, I feel, was my greatest asset and the reason I felt so comfortable taking this on. To me, it was just another challenge, another bump in the road called life. I immediately looked at it as an opportunity to actually come out the other side stronger and faster. Imagine it, I will have an anatomically "perfect" hip! Perhaps the FAI was holding me back previously, even before the pain started? Think of all the things I will be able to accomplish when not hindered with this anymore! Those are the thoughts that entered my mind, and that I continue to keep at the forefront to keep me motivated. I will be able to build strength in other areas of my body as part of my rehab, my swimming and cycling will get stronger. I will be able to start running again, but from square one...able to work on my mechanics and have proper form. Combine that with the corrected anatomical issue, and just think of all the heights I can reach! It is this type of desire and determination that makes the process easier to handle. These thoughts and feelings were there from the beginning, almost as if I had accepted it and that this was the only path for me.
Ultimately, these four factors are all intertwined and related to each other. It almost seemed like perfect timing in so many ways. Had this happened a few years earlier or later, I can't say whether my decision would be the same...but the way I saw it, there was no other choice, based on what I have shared above. Not to over-simplify this extremely important decision, but in summary, I knew that doing nothing would result in pain and no activity or a cycle of visits to pain doctors and PTs, while moving forward with surgery would at least give me a chance at accomplishing the goals I noted above. I just hope that sharing this will help, inspire or reassure others that are going through the same process.
'Are you going to be a wimp, or are you going to be strong today?'" --Peter Maher
Sidenote: Check out the link below for a perspective from an OS that now performs this procedure as well as having gone through it himself...another great perspective. And also, an article with great info from Dr. Philippon, which basically outlines what occurred with me and validated my decision.
http://www.aaos.org/news/aaosnow/jun08/clinical2.asp
http://www.aaos.org/news/aaosnow/apr12/clinical16.asp
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