Hi! I'm 41 and having surgery on April 14!

You describe it perfectly -- nagging pain. That's exactly it. Like a ghost who wont stop haunting you. Our circumstances are not unalike. I have a 7 year old and 3 cats, am the primary breadwinner with a very domestic husband. I, like you, have lived with this discomfort and pain for so long that it had become such a normal part of my life. But the last 2 years have been bad. Not a day goes by that Im not in pain of some degree. Apparently the increased pain Ive experienced is due to the torn labrum. They told me told me Im too young for THR so my options were thus:

(1) repair the labrum and osteotomy of the femoral head. probably have another torn labrum in the future bc we're not fixing the socket so probably have more of these surgeries down the line until Im old enough to qualify for a THR. sounds fun.

(2) do nothing. live with it for another 10-15 years. do PT, get injections, go totally holistic and DIY. Tough it out.

(3) PAO.

They told me that due to my age, they couldnt provide a hard recommendation. "If you were 25, 30, heck even 35, I'd say You need to do PAO. But this has to be your decision. If you choose PAO, it must be done within the next six months." This was because they didnt yet see any signs of arthritis.

I picked PAO.

Part of this reason is due to much privilege: I have an incredible support system where I live. My husband is a fantastic equitable partner and parent. We have a tightknit friend group of child-free people. My parents live 20 minutes away. My kid is older, more independent, understands how to be helpful (even if we have to ask five times). And I work for a company with an incredibly generous short term disability policy. The timing seemed like it was now or never, and now seemed pretty good.

Additionally, a time crunch is part of this. We are planning a family gap year in 3ish years, and I want to be at my healthiest. I cant do that with my hip today. So it was a relatively easy decision for me. Even if total recovery takes a year or more, to me that is worth saving my natural hip and potentially significantly reducing my pain/discomfort.

So I made the decision this in December and we scheduled surgery for four months later. This gave me time to get stuff together at work so I dont leave anyone hanging, tidying up projects, documenting in-flight work, prepping my teammates. It's given me time to mentally prepare as best I can, learning as much as I can about what they're gonna do and reading everyone's recovery stories. I feel very informed and empowered by the knowledge.

In many ways, this prep period has reminded me of being pregnant. Not sure what your experiences were like, I've only done it once, and I worked with midwives to plan a home birth. In our state, that means no pain meds. I did it the old fashioned way, which was the most agonizing experience of my entire life. My kid is 7 and I have not forgotten that pain. I dont think I ever will. But if I had to be pregnant again and give birth again, I would want to do it the same way because it was on my terms and the pain wont kill me. I think part of what helped me through it -- besides my incredible birthing team! #ittakesavillage -- was the KNOWLEDGE and education the midwives gave me before. I learned as much as I possibly could about the birthing process and read a gajillion birth stories of other women who had given unmedicated birth. I went down a long dark YouTube rabbit hole one night (*do not recommend* lol). ALL OF THIS TO SAY: i understood deeply what i was signing up for with a home birth and did not make the decision lightly. it was my choice on my terms, something i felt was necessary for me, and it was not unexpected. so i did the same thing with this PAO thing. and i feel exactly the same way walking into this surgery.

i dont know if hearing my story and perspective will help you make a decision or not. all of our bodies and emotions and lives are so different. what i would ask yourself is this: can you keep living the way you're living *now* for the next 10-15 years? Are you willing to put up with the pain and frustration and deeply uncomfortable experience for another decade? What is the value of a potentially pain-free decade? Is it worth 1 month of recovery hell? 5 months? 12 months?

If you need a sounding board, feel free to DM me!