MaryAnn Turco

I would not be where I am today without my wonderful team of doctors at HSS who helped get me back in the game. My journey to HSS was a long and painful one. My story begins with a fall out of my car onto the ice on Dec 28, 2010. I was told at my local ER that I had a fractured coccyx based on a physical exam. I was given pain meds and told that it would take 6 weeks for the fracture to heal. After a couple of weeks I knew that something more serious was going on. I was in constant pain, it hurt to sit, walk and lay down so I went for a 2nd opinion. That doctor told me he doubted that I fractured my coccyx and took an X-ray and told me that it wasn't fractured and that it was just bruised. I asked about an MRI,but he said he didn't want to put me through that. He gave me more pain meds and sent me home and said I didn't need to follow up. Not happy with that doctor, I went to see a 3rd orthopedic, he finally sent me for an MRI of my lumbar spine and pelvis, 6 weeks after my fall. He told me the MRI showed a sacral fracture in an area he'd never seen before and that it would take a few more weeks to heal. As weeks passed and I was still struggling with pain he sent me for a cat scan which showed the fracture was not fully healed. He then referred me to a local spine surgeon. When I called to make appointment I was asked if I was braced after fall, with that I knew something was overlooked along the way. I saw the spine surgeon who told me no surgery was needed and started me in physical therapy. Ironically, my mom was having her hip replaced at HSS in June 2011, as she was in recovery she told the nurse about my fall and my struggles. The nurse came back and handed me a post-it with Dr. David Helfet's name and number, little did I know that my journey would lead me to him the following year. As I spent the summer caring for my mom, I was still struggling daily with walking, sitting and in constant pain. Finally that September at a follow up with the spine surgeon, he sent me for an MRI of my left hip, which revealed that I had a fully detached labral tear, as well as a tear in my gluteus minimus. It was then that I knew I needed to find a doctor out of HSS to repair it. I was referred to Dr. Struan Coleman by my physical therapist and met with him in January of 2012. Dr. Coleman sent me for a series of injections into my left hip to see if they brought relief, which they did for a couple of months. It was after the 3rd injection we discussed surgery to repair, and that May, Dr. Coleman surgically repaired my labral tear and hip impingement. As I rehabbed from first surgery, I started experiencing debilitating pain by my original fracture site. I also noticed that when I squatted down to take care of my dog I couldn't get up, I literally got stuck. My kids would go behind me and lift me up. I was also struggling getting up from a chair, I would have to put my 2 hands behind me and push myself up. My PT suspected that something was going on with my sacroiliac joints. So at my 4 months post-op with Dr. Coleman, I explained what was going on and he sent me for an MRI of my pelvis and lumbar spine as well as an injection into my left SI Joint to see if I would get pain relief. He called me a few days later and told me that the MRI revealed severe arthritis in both my sacroiliac joints, and he referred me to trauma surgeon Dr. David Helfet. After I hung up from him I cried out of relief just knowing that I could be fixed.

At my first visit with Dr. Helfet I explained my fall and my journey and he asked to see all my MRI films to date. when he came back from examining them,he explained to me that when I fell I had indeed fractured my coccyx, where the coccyx and the sacrum meet, and the whole area buckled, which explained bump in my lower spine. He told me that the area that buckled is the mecca of where all the nerves come together and that it would be catastrophic to try and repair, so he sent me for another injection. As I had some pain relief from the first SI joint injection, he sent me for a second injection after the first one wore off. A couple of months later I was back down at HSS for my 3rd injection. Unfortunately as I was being prepped for injection and the area was being x-rayed the radiologist and anesthesiologist came to me and said there was so much arthritis in both joints that I mostly likely needed surgical repair. That was in Feb of 2012, that 3rd injection brought me no relief at all. We went ahead with a family vacation that we had planned to California that month even though I was struggling and in so much pain. Sitting through the flight was brutal as well as trying to walk through Disneyland with my family. I was literally walking at a snails pace. When we returned from vacation I had a follow up with Dr. Helfet that following week. At that visit he explained how I was completely bone on bone in both the joints, and that was why every step I took I felt pain and why I had such difficulty walking, sitting and getting up from a chair. He told me that I would not benefit from anymore injections. He explained how if it was my hip or my knee it could be replaced but since it was my SI joints they cannot be replaced. He explained how some doctors might fuse them together but he wouldn't do that because it would be very painful and an extremely long recovery. He explained how instead he would repair the joints by locking my joints together with 2 screws on each side. As he could see how I was suffering he asked me when I would like to have surgery. I told him my son was getting married in 7 months and I wanted to be able to dance with him at his wedding. So my husband said to him "How about today doc?" so Dr. Helfet turned to me and said "I can't do it today but I will do it tomorrow." He proceeded to clear his schedule and his wonderful staff went out of their way to schedule all my pretesting and physical that same day and I was back the next morning for surgery. I woke up from surgery with that horrific pain gone. I joked to everyone that I was all screwed up but in a good way! My recovery included 8 weeks on crutches doing a 4 point gait followed by 4 months of physical therapy. At my 2 month post-op Dr. Helfet asked me to walk across the room, and when I turned around he had such a smile on his face and he said to me "2 months ago you could barely pull yourself off the chair and look at you now, you just got up from the chair and walked across the room." I was on my way to getting Back in the Game and just thrilled to be able to dance with my son at his wedding!!

I want to extend a very special thank you to Dr. David Helfet and Dr. Struan Coleman who gave me my life and my mobility back. Dr. Coleman, thank you for listening to me and guiding me along the way to both Dr. David Helfet and to Dr. Peter Moley. I would also like to thank Dr. Peter Moley my newest doctor at HSS for helping to keep me Back in the Game.

7.26.17

As my Back in the Game story continues at HSS I wanted to acknowledge and thank the wonderful Dr Peter Moley. He has been treating me the past 2 years for 2 residual issues that I have been dealing with since my fateful fall. He has been my biggest cheerleader and with every visit he reminds me how far I've come since my 2 surgeries at HSS. My hip surgeon, Dr. Struan Coleman, referred me to him after I came back from a vacation in Italy in Sept. 2014 with recurring pain in my surgical hip as well as tingling down my left leg. Since I traveled in from New Jersey he called his colleague Dr. Moley and got me in to see him that same day. He said Dr. Moley is the best of best at finding the source of pain in these complicated cases. From the moment I met him I knew I was in good hands. I explained my fateful fall and my 2 surgeries and he poured over my MRI's and discovered my 2 residual issues. The first being a slightly herniated disc between my 2 Sacroiliac screws at the S1 which was causing my tingling and pain down my left leg. The second issue was a defect in my left hip capsule. So Dr. Moley scheduled me for an injection into my S1, in the OR he had images of my SI screws and also took x-rays and very carefully went around the screws and injected the area. He called me a few days later to see how I was feeling, we discussed doing a repeat injection 2 months since I was still symptomatic. After the 2nd injection I got the much needed relief I needed to resume physical therapy. In Feb. 2016 we were traveling to Ireland to visit my daughter who was studying abroad, so I went in for a 3rd injection 2 weeks before our trip. Upon my return at my follow up with Dr. Moley I mentioned to him that while in Ireland I had a hard time walking, at times limping and keeping up with my family. So he had me walk down the hall and he noticed that my gait was off and that my hip was unstable. I had another MRI of left hip which showed the defect in my hip capsule had gotten larger and that my gluteus medius and minimus had shut down. He said my other muscles were over compensating for these muscles that weren't working and that's why I was limping and had this hip instability. He had me try a course of physical therapy to see if we could get them to "fire up" but with the defect in the hip capsule I had no positive results. Dr. Moley suggested we try a PRP (Platelet Rich Plasma) Injection, he explained the pros and cons of the injection and that it was experimental. I told him I wanted to give it a try. On April 4 I went to his office with my crutches in tow ready for this next challenge. His nurse took a large vial of my blood and then put it through this machine for about 20 minutes as it separated my platelets and plasma from the white blood cells. Dr. Moley came in and via ultrasound he injected my hip capsule with my own PRP. I left on crutches and was told to stay 2 weeks on crutches and to just rest. He warned me that the pain would intensify because the PRP actually causes the area to re-injure for the first 3-4 weeks before the healing process begins. I kept a daily log of the pain and truth be told it was quite painful and at times I questioned if this was the right thing to do. I started very gentle physical therapy at the 4 week mark, my physical therapist gave me some very gentle small muscle activation exercises. It was very difficult at first, my first few sessions lasted only 20 mins, trying to engage my abdominal muscles and my gluteus muscles with the right breathing techniques was exhausting. I had a wonderful physical therapist who was so patient with me and guided me slowly through each exercise. It's been quite challenging but slowly over 12 weeks and 13 PT sessions as well as at home exercise not only have my gluteus medius and minimus muscles fired back up my abdominal muscles have also fired back up. I went to a wedding last month and was able to dance and stand most of the night. I am no longer limping. Words cannot express how happy I am, yesterday was my 4 month follow up with Dr. Moley where we took this picture, he is quite pleased with my results. I am off to Italy in Sept with my husband for an 18 day vacation, I am scheduled for another injection into my S1 2 weeks before I leave and with my hip instability gone, I know I will have a pain free vacation. Thank you Dr. Moley and HSS for keeping me back in the game.