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My daughter Olivia swam competitively for years. During her junior year of high school, she experienced intense back pain that worsened when she swam. She also regularly experienced a stabbing pain along the front of her abdomen, and she could trigger that pain by moving her lower ribs back and forth.

Olivia's weekly physical therapy only provided temporary relief for her pain. After her symptoms worsened, leading to her quitting swimming, I turned to the internet for answers. Thankfully, I stumbled across Slipping Rib Syndrome and the Facebook support group. I spent many hours gleaning information and encouragement, and it was immeasurably helpful. Olivia’s story would not be the happy one it is today without this group.

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My internet searches also led me to Dr. Diaz-Muron, a surgeon at Denver Children’s Hospital who is familiar with SRS. In October 2022, he diagnosed Olivia with bilateral SRS through a physical exam. He also ordered a dynamic chest ultrasound to confirm the diagnosis. It was such a gift to have received an answer so quickly!

The techs were puzzled during Olivia's dynamic ultrasound because they had never seen or heard of SRS before. They did their best to decipher what we were all seeing on the screen, and in the end, they diagnosed her with bilateral SRS at ribs 8-9. Later we’d discover that they had counted the ribs wrong, and it was actually Olivia’s 9th and 10th ribs that were slipping. In fact, ribs 9 and 10 on both sides had become completely separated from her costal margin.

In December, Olivia underwent a bilateral intercostal radio frequency nerve ablation (8-10 R and 10-12 L) at Denver Children’s Hospital. While this helped with the pain a bit, it created an additional problem where she temporarily lost muscle strength and tone in her lower abdomen. Thankfully, she has a great manual physical therapist who helped her through that hiccup. Olivia also had an assessment at the Denver Children’s Hospital Genetics Hypermobility Clinic. They diagnosed her with Hypermobility Spectrum Disorder but not hEDS (she got her hypermobility from her mama).

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In January 2023, Olivia had a “normal” CT scan that, when converted into 3-D, revealed her detached ribs. Also in January, she had a consultation with Dr. Pieracci at Denver Health. We both really liked Dr. Pieraacci. He was kind, empathic, and communicated clearly. However, he was performing the Hansen 2.0 surgery, and through the group, I had learned that Dr. Hansen was doing a 3.0 version of the surgery. So, we decided to wait until we saw Dr. Hansen to determine the next steps.

In February, Olivia and I traveled east for consultations with Dr. Shiroff at Penn Medicine and Dr. Hansen at WVU. The consult with Dr. Shiroff went well, and we left with the sense that he is a skilled surgeon who successfully treats many SRS patients. However, he was performing a version of the Hansen 2.0 surgery, and we were eager to learn about Dr. Hansen’s 3.0 version.

Olivia’s consultation with Dr. Hansen was great—he was knowledgeable, professional, kind, and humble. He spent so much time addressing our many questions and concerns. Olivia felt seen, understood, and heard. But I won’t sugarcoat things—the surgery and recovery ahead were daunting for Olivia and left her feeling scared and overwhelmed. And as Olivia’s mom, I was terrified of making a wrong decision that could negatively affect her present and future. (I may or may not have sobbed in the bathtub when we got back to the hotel.)

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It didn’t take long for Olivia, my husband, and I to agree that the 3.0 surgery with Dr. Hansen was Olivia’s best option. However, Dr. Hansen’s first available surgery slot was too close to Olivia’s first day of college. It wouldn’t allow for enough recovery time before she needed to do things like carry a backpack long distance. So, we put her on a wait list and hoped and prayed.

Over the next few months, Olivia’s pain became nearly unbearable. Simple things like sitting in class and driving in a car were extremely painful. The main thing that helped her was lifting weights; her muscle gains and the endorphins she got after each lift helped her to push past the pain, discouragement, and fear. She had been lifting for around a year, and Dr. Hansen told her that the muscle strength she had built would greatly help with her recovery. So, Olivia carefully pressed on in the gym despite her growing pain.

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The day after Olivia graduated from high school, Lisa Hansen reached out with fabulous news. She said that if we could be in West Virginia in exactly one week, there was a surgery spot available for Olivia! The news was both exciting and terrifying. It was difficult for Olivia to wrap her mind around all that was about to change and around the long road to recovery, but she was all in.

Olivia’s May 24th surgery was a tremendous success! Dr. Hansen excised some costal cartilage from her 9th and 10th ribs on both sides, used the excised cartilage to create spacer grafts between ribs 8-10 on each side, sutured ribs 9 and 10 together with the grafts, and bilaterally placed bioabsorbable plates from ribs 7 through 10. The entire surgery took around three hours, and Dr. Hansen was really excited about how well everything went.

After a week at a nearby hotel, Dr. Hansen cleared Olivia to fly home to Colorado. Olivia's recovery was tough, even though she knew what to expect. Ice became her best friend, and she found ways to stay entertained and encouraged while being bed-ridden. Still, those three months were extremely difficult for her.

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About those recovery months Olivia says, “Lifting was my mental and physical solace through my senior year, and to have it taken away was devastating. Those first months felt like purgatory, and recovery was filled with countless tears. SRS patients may feel hopeless during the initial months of healing after surgery, but I encourage them to make a list of all the ways their ribs held them back before the surgery so that they can check them off as they regain strength. Watching my progress kept me sane. I felt devastated right after the surgery, but in time I saw how it brought new abilities and reduced pain that I didn’t think was possible.”

 

As Olivia’s 3-month post-surgery milestone neared, she was feeling quite good. She no longer needed ice, could work as a restaurant hostess, and was back to being the social butterfly that she is. And three months after her surgery, she was back in the gym. Although she had lost most of the muscle she had built, she was determined to regain it carefully.

On August 30, my husband and I moved Olivia into her dorm to begin her freshman year of college in Arizona. To this day, we’re still in awe over the timing of her surgery. She had exactly three months to heal at home under the care of her family and without the demands of school.

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With her four-month surgery anniversary just around the corner, Olivia says, “My body feels drastically better and almost normal, and I’m able to move without popping. Since it’s only been four months, there’s still some healing to be done and there’s still some soreness, but I’m able to do all the things I love. I can do so much more than I could do before my surgery with Dr. Hansen, and I don’t feel held back by my body anymore. Every minute of the recovery pain was worth it now that I get to be under a bar with a lot of weight on it again.”

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Whether to have surgery, what surgery to have, and which surgeon to trust are weighty decisions. We believe that we made the right choice for Olivia and hope that the coming months and years yield even more healing and strength.

If you’ve read this far, I hope Olivia’s story has encouraged you. The road to wellness is hard, and conflicting information and experiences are discouraging. As someone who also lives with chronic pain, I know how difficult it is to keep striving for healing and pain relief. Hang in there. Keep doing the next right thing. Hold on to hope, and remember to look for the beauty around you.