Seeking advice, reco. for Orthopedic Doctors, Physical Therapists for my Post-Pregnancy Skeletal Complications (Houston: ob-gyn, home)

[brokenmom]

I am suffering from rare post-pregnancy skeletal complications since a year. I am 31 yrs female, gave birth to a lovely baby last year and ended up becoming disabled and home-bound as a result. My baby is being raised by grandparents. Before pregnancy I was an active, healthy working woman with no history of any major illness.

My 2 post-pregnancy complications are -

Problem 1: Pelvic fracture ( Stress fracture of left superior pubic ramus )
Problem 2: Sacro-Iliac Dysfunction (Severe lower back pain from medical condition called Osteitis Condensans Ilii , it is abnormal bone density i.e sclerosis in both Iliac sides of pelvic girdle)

I have visited 3-4 doctors with mixed results. The physical therapy recommended by one doctor was too advanced and worsened my pain and another doctor advised bedrest. Not many doctors seem to be aware of the right treatment to overcome these 2 disabling conditions in tandem.
My life has turned upside down and I am trying hard to cope with it but the lack of suitable medical resources/help is crippling me further

I am appealing to this forum members/visitors to kindly recommend me -

1) Orthopedic doctors in Austin, TX with expertise in treating the above 2 problems
2) Physical therapist in Austin, TX with expertise in conservative treatment of pelvic fracture and sacro-iliac dysfunction. Home visits welcome.
3) Experience in healing / treatment of pelvic fractures, sacro-iliac dysfunction, will leading a normal life be ever possible again ?

Thanks.

[riaelise]

Originally Posted by brokenmom

I am suffering from rare post-pregnancy skeletal complications since a year. I am 31 yrs female, gave birth to a lovely baby last year and ended up becoming disabled and home-bound as a result. My baby is being raised by grandparents. Before pregnancy I was an active, healthy working woman with no history of any major illness.

My 2 post-pregnancy complications are -

Problem 1: Pelvic fracture ( Stress fracture of left superior pubic ramus )
Problem 2: Sacro-Iliac Dysfunction (Severe lower back pain from medical condition called Osteitis Condensans Ilii , it is abnormal bone density i.e sclerosis in both Iliac sides of pelvic girdle)

I have visited 3-4 doctors with mixed results. The physical therapy recommended by one doctor was too advanced and worsened my pain and another doctor advised bedrest. Not many doctors seem to be aware of the right treatment to overcome these 2 disabling conditions in tandem.
My life has turned upside down and I am trying hard to cope with it but the lack of suitable medical resources/help is crippling me further

I am appealing to this forum members/visitors to kindly recommend me -

1) Orthopedic doctors in Austin, TX with expertise in treating the above 2 problems
2) Physical therapist in Austin, TX with expertise in conservative treatment of pelvic fracture and sacro-iliac dysfunction. Home visits welcome.
3) Experience in healing / treatment of pelvic fractures, sacro-iliac dysfunction, will leading a normal life be ever possible again ?

Thanks.

As a pregnant woman, I really feel for you and wish that I could help. Maybe just pick one from the insurer's list of providers and go from there. If they don't end up being any good, you can drop them and go to someone else. Go to that provider and ask maybe someone in the waiting room how the feel.

Wishing you well.

[brokenmom]

Thanks riaelise. I have been actually trying that option so far.

I would appreciate any more suggestions from Austin people to help with my medical conditions since they are relatively rare. If you know somebody who experienced pelvic fractures or sacro-iliac dysfunction please spread word on this thread so that it can help people like me and many others in coping better with such disability.

God Bless.

[centralaustinite]

I damaged my sacrum and illiac during childbirth. No fractures but displacement and ligament damage. Very painful. Six months of physical therapy with a PT who specialized in pelvic problems made a tremendous difference!

Unfortunately, this was over a decade ago. I can't remember the PT's name and I am sure that she has moved on.

It can be very hard finding people who specialize in pelvic injuries and injuries from childbirth but they are out there. I would start asking every OB you come in contact with if they know of PT's who specialize in pelvic problems. Start with Women Partners in Health, ask to speak to their midwife. Call birthing centers and midwives around town. Ask who they know who has experience with these type of problems. Try contacting the UT school of nursing. I would focus on finding an experienced PT because they work with ortho docs and other docs all the time. If you find a PT who has experience with your issues, they will be able to help you find other medical specialists.

Try looking for a female orthopedic doctor. Another step would be to contact the hospital where you had the baby, and ask to speak to a social worker. A hospital social worker should be able to help you find the resources that you need.

I had a much simpler injury than you (sacral displacement and ligament damage) with no other issues like bone density, so I don't know if my experience is applicable. But six month of regular (3x a week physical therapy -- massage to put everything back in place, then specific exercises to hold it in place) made a huge difference. I went on to have more children and did not experience the issue again.

I hope you can find a solution!

[opalminor]

Hi there, I'm assuming you've already asked your OB-GYN for recommendations...?

[suzy_q2010]

Originally Posted by brokenmom

I am suffering from rare post-pregnancy skeletal complications since a year. I am 31 yrs female, gave birth to a lovely baby last year and ended up becoming disabled and home-bound as a result. My baby is being raised by grandparents. Before pregnancy I was an active, healthy working woman with no history of any major illness.

My 2 post-pregnancy complications are -

Problem 1: Pelvic fracture ( Stress fracture of left superior pubic ramus )
Problem 2: Sacro-Iliac Dysfunction (Severe lower back pain from medical condition called Osteitis Condensans Ilii , it is abnormal bone density i.e sclerosis in both Iliac sides of pelvic girdle)

I have visited 3-4 doctors with mixed results. The physical therapy recommended by one doctor was too advanced and worsened my pain and another doctor advised bedrest. Not many doctors seem to be aware of the right treatment to overcome these 2 disabling conditions in tandem.
My life has turned upside down and I am trying hard to cope with it but the lack of suitable medical resources/help is crippling me further

I am appealing to this forum members/visitors to kindly recommend me -

1) Orthopedic doctors in Austin, TX with expertise in treating the above 2 problems
2) Physical therapist in Austin, TX with expertise in conservative treatment of pelvic fracture and sacro-iliac dysfunction. Home visits welcome.
3) Experience in healing / treatment of pelvic fractures, sacro-iliac dysfunction, will leading a normal life be ever possible again ?

Thanks.

So sorry that this is interfering with your enjoyment of your new baby. I do think you will get better, though.

When were your last xrays and what did they show?

You mentioned that you were physically active before the pregnancy. Are you a runner? If so, did you run during your pregnancy?

What is your weight? Did you gain a lot during the pregnancy? Inactivity promotes weight gain. Have you been unable to lose whatever you gained?

Normal pregnancy causes the ligaments of the pelvis to soften and stretch. That can lead to discomfort as the joints move. Actual fractures of the pubic ramus during pregnancy are so rare that I can find only a couple of references to them. One of those references is 50 years old! That means you are not likely to find anyone who has taken care of someone with your particular situation. The more common fracture associated with childbirth is fracture of the coccyx.

That being said, stress fractures of the pubic ramus are common in runners. The military sees it frequently, and it is more common in females. Stress fractures heal with rest. Any orthopedist who treats sports injuries is likely to be able to help you. My suspicion is that the stress fracture is completely healed at this point. A followup xray and a physical exam should be able to determine that.

The second issue is the osteitis condensans ilii. See here:

http://www.amjorthopedics.com/html/ima/pdf/april01.pdf and here

SpringerLink - Rheumatology International, Volume 30, Number 3

From the first article, you will see that no one knows what causes it, though some speculate that it is pregnancy related.

The second article has a little more info, but not much. The condition does tend to get better, and there is no one ideal treatment for it. Many people with it have no symptoms at all.

My suggestion would be to see a sports medicine oriented orthopedist for a complete reevaluation.

My suspicion is that a good physical therapist will be able to assist you with gait retraining and get you back up to snuff. it will not be easy and may even be painful at first. The orthopedist should be able to help with the pain, but do not be surprised if he suggests you consult a pain specialist while you also do the PT.

It's really the pits to have something with no easy solution, but I really do think you will get better.

I see that you have posted in 4 different forums. You may want to see if one of the moderators can consolidate all of the threads. That will make it easier for us to follow the comments and try to help you.

And, by the way, congrats on the baby!


Edited to add: Another reason for a complete reevaluation is to make sure that the osteitis and the stress fracture are not just red herrings and there is something entirely different causing the pain.

[love roses]

Just a recommendation since I have no experience with this, If the Military sees a lot of this, would a trip to Temple be possible? I know a few people who will travel to Temple or even Houston to see specialists for conditions they can't find someone in Austin to treat. Temple is close to Fort Hood so there may be PT's that are more familiar with the condition. I know there are PT's up there, as my sister is a manager for a PT Group here in Austin, and one of their clinics is in Temple. They also have offices in San Antonio, which is another big Military City.

[faithrube]

I would go to Hands On PT in Round Rock.
They do tons of pelvic floor work and see a lot of SI joint dysfunction.
I sent a friend there who had broken her tailbone and she was on pain pills and getting no relief and she is now 90% improved. i go there for other forms of manual therapy but their specialty is pelvic work.
PM me if you want the name of the therapist I go to who is fabulous.
I live down in Central Austin and hike up there weekly because they are that good.
Good luck, Faith

[brokenmom]

To centralaustinite, suzy_q2010, love roses, faithrube - Thanks a lot for your recommendations and words of encouragement.

suzy_q2010, that is a significant amount of very useful medical information you provided :-)

To opalminor and suzy_q2010, I will post my history shortly.

Update Jan 11, 2011 -

My orthopedic doctor yesterday finally gave up on me and in her own words has said she has never come across a patient with my problems in her entire 30 years of experience. She is a renowned orthopedic surgeon in Austin. She has asked me to search for other avenues as she has no idea what to do with me now.
She mentioned Dr.David Harris who has experience with sacro-iliac dysfunction. Has anyone visited this doctor ? If so please post reviews.

Pelvic fracture as on Jan 10, 2011 - My orthopedician also diagnosed non-union of my pubic stress fracture as per X-rays (no callus evidence) taken on Jan 10, 2011. This is more than a year since fracture ocurred during advanced pregnancy/childbirth. She is unable to understand why has my body stopped responding to bone formation at fracture site.
(But my bone density tests are normal).

Osteitis Condensans Ilii as on Jan 10, 2011 - Abnormal bone mass i.e bone irregularity in iliac side of pelvic girdle persists with possible ongoing increased bone turnover. My orthopedician has no experience with this bone condition.

[brokenmom]

To moderators, I have posted similar threads about this issue on Health and Wellness forum and Pregnancy forum, if possible please delete/consolidate them so that I can receive consolidated responses in this forum only.