THR 1 year post-op, Still in pain. Still on cane. So confused!

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Hi @Marge75 so sorry you are in so much pain....I hope it gets sorted really soon and you get some relief. Xxx

Hi @wgmj still early days...take it from me...everyone's recovery is different and you can't compare yours to others.

We are here to guide you through yours.

I hope you have started a thread for a bit of support

Good luck
 
Hello again!

Today is my first day of a much needed summer vacation after what's been an intense and trying year.

(Oddly my "thread tools" link has disappeared. I had it the whole year, but it just vanished, so I can't update the thread title to reflect the time frame. I'm posting the link to the thread here for reference:
https://bonesmart.org/forum/threads/9-months-post-op-still-in-pain-still-on-cane-so-confused.21072/

Although I know @Josephine (most likely rightly) believes at this point that my pain and limp are not necessarily caused by my THR, I figured I would still post an update, since my pain has gotten increasingly worse over the last couple of months and I'm hoping for any related insight.

My surgery was just over a year ago and I'm still in terrible pain on my right (operated) hip, I have a severe limp, and my left hip (which I was scheduled to have replaced last week but obviously canceled) is not long for this world.

The thinking for the last couple of months has been tendinopathy in my hip flexor. I also have terrible pain in what I call my "back pocket"--so chronic inflammation of the piriformis.

A quick recap of my treatment over the last couple of months: I got a psoas sheath injection from a radiologist early May. The numbing agent made me feel better for a bit, but there was no lasting relief. The nurse told me that most people get these injections in a series of 3. I have a prescription for another one, but my surgeon is wary of me having so many injections in the last few months, so he has told me to try to wait a bit.

The pain manager I've been seeing has tried nerve blocks and cortisone injections. No lasting relief.

My surgeon gave me two shots into the hip--one left, one right--two weeks ago. No lasting relief.

I saw my surgeon yesterday and asked him about exploratory surgery or even revision surgery. He said those are not options and that he is sorry the surgery didn't fix my pain, but there is nothing more he can do. This is not a complaint about my surgeon; while I'm beside myself with confusion and sadness, I know he would do more if he felt he could. So that was very hard to hear.

Then I saw my pain manager who says at this point he is also out of options. He wants me to consider implanting a spinal cord stimulator--which, he says is a permanent device that works like a pace maker. I am terrified by this option and am wondering if anyone has needed to go this route?

I'm 39 and healthy aside from my hips. I got THR to improve my quality of life. The last year has been the worst of my life. I was in pain before my THR, but at least I could walk. Now I cannot walk without a cane, and on days when my left hip is acting up I need my walker. I don't think getting the left hip replaced any time soon is an option, which makes both the near and distant future seem even scarier. I have not exercised in a year, so that compounds my depression (further exacerbated by a 12 pound weight gain).

I didn't mean for this post to turn into a rant or downer. But I'm pretty much desperate to be out of pain and to walk again.

Any advice or insight would be very appreciated.

I'm particularly interested to hear how @Andy1976 is doing? Also thank you to @tollertwins for the advice about ART. I have been seeing a new and wonderful PT based on the info you shared.

Good thoughts to all.
Meg
 
@Marge75 I moved your new post back to your old thread and retitled it for you. If you want another title please just ask.

So sorry you are still having all this pain. As a person that has chronic back issues, I would suggest you find a spinal expert and see if these issues are more spinal related. I am not a medical expert but my back kicked up big time after my THR. I am now waiting for a second THR and my back is playing up again. Have you seen anyone just for your back?
 
Thanks @Jaycey--for updating the thread and the insight.

I'm actually not having any back problems. I had an MRI of my back last year, and it was normal.

The pain is exclusively in my hip--in the front hip flexor and the back pocket. The pain manager wants me to try a spinal cord implant to see if it can "distract" me from feeling the pain. While I'm absolutely desperate for any relief, such a procedure seems extreme and scary.
 
If it were me I would get a second opinion on that hip - from someone totally disconnected from your surgeon. If your back MRI was clear, I would focus on the hip. And frankly, I can't see the sense in the spinal stim. You don't want distraction - you want relief!
 
Oddly my "thread tools" link has disappeared. I had it the whole year, but it just vanished
We had an upgrade of the forum last weekend so it probably got sidetracked.
I'm actually not having any back problems. I had an MRI of my back last year, and it was normal.
contrary to popular opinion, an MRI does not show everything. And around 90% of back pain is caused by muscle spasm which does not show up on such a scan anyway.
The pain manager wants me to try a spinal cord implant to see if it can "distract" me from feeling the pain. While I'm absolutely desperate for any relief, such a procedure seems extreme and scary.
It's really not scary at all, actually. Just a small electrode placed in the tissues adjacent to the spine and nerve roots, roughly between it and the site of the pain. It's a bit like an internal TENS machine TENS machines for pain management.
 
@Marge75 I had a really angry piriformis muscle, too. The pain went on for a couple of months, and was awful. I went to an acupuncturist and after two sessions she released it. The second time she did it, I felt a twanging in the muscle deep inside, and the pain just stopped. Didn't do anything for the arthritic hip (this was pre-surgery) but it sure helped with the piriformis pain.
 
Hi-

I've been away for the month of July and haven't logged in a few weeks. I didn't get email notifications about the last couple of posts to this thread! Thank you @Josephine, @LeeApril26, and @Jaycey for your feedback.

I actually did get a 3rd opinion from an ortho surgeon at Columbia Pres in NYC last Wednesday. I had x-rays done that day, and he said he sees a little "windshield wiper" effect around the screw which could be causing loosening of the cup. He says that while it's clear I have inflammation and that acupuncture has given me a little relief, he thinks there is an underlying cause we have not figured out yet--in other words, he doesn't think it's simply tendinopathy. He also said if tight adductors were my biggest problem, I wouldn't be in his office.

He then went on vacation before calling me back to talk about what he saw on my most recent MRI (9/13, I showed him the disc), but his PA called me today to say that they can't rule of loosening of the cup based on the MRI. She said that if there is loosening, I'll need revision surgery--which is of course very upsetting to hear. I'm seeing the doc again next Wednesday to discuss this. But my own surgeon who ordered the MRI (in September!) said it looked great and that the report was boilerplate. So I'm eager to hear what this new surgeon has to say...

Also, next Thursday, I'm seeing a PT who specializes in pelvic floor dysfunction. My regular PT thinks maybe there are trigger release points that they can't get to externally.

But 14 months after THR, the pain is worse, still totally reliant on the cane, spending what's amounting to thousands of $s on PT and specialists and acupuncture (I've gone 6 times in the past month, the needles she puts in my inner thigh and hip flexor go crazy!)...so I'm having a hard time these days...

Ok, that's all for now. I'm going to look at threads here about cases of revision surgery to try to gain some insight...

Thanks!
meg
 
Hi @Josephine--

I actually don't have access to my most recent x-rays (from last week). I can ask for a copy when I'm there next Wednesday though. I have a pic of the ones I had done in July (a month after my surgery), but that's not the one they commented on.

I'll be sure to post when I have access.

Thanks so much.
meg
 
@Marge75

Hi Meg,

@lee0605 here. It looks like @Josephine has given you some great direction and has many years of orthopaedic experience. I'm sorry you have had such a terrible experience. I have placed you on my follow list if just for some emotional support. I can say for sure that searching for an organized OS who can bring all your records and files together to make sense of things seems to be the most reasonable option you have here. I know this can be difficult. As a nurse myself I tend to be very proactive, ask lots of questions and have an expectation that I am the customer somewhat "purchasing" a service. It looks like we have had the same surgery and implant and Meg has given you great direction in terms of doing TO MUCH, which seems to be exactly my problem as well. I have also suffered some rather severe financial setback with my knee/knee/hip/future hip and know how much tension this can cause. And the tension itself can really set you back. For instance when I finally found this blog I felt so much support and relief my pain (and expectations) decreased and I did feel the lowering of tension brought the tension in my whole body down. I imagine this doesn't help you any. Would it at all possible perhaps for you to apply for Social Security Disability on a short term basis, which they can often do? Or would this be a nightmare in the state you work in? Does your union cover anything like this (are you familiar with your contract?). I do know that when I listen to folks like Josephine I can see I am somewhat where I should be but I feel very bad for you. Your tension and frustration is so obvious. So I really just wanted to reach out to you and tell you I am here, on your thread, thinking of you and hoping all this comes together for you.
 
@Marge75, I've read through your thread, and I'm SO SORRY you have had so much pain and suffering, particularly since you got a surgery that you would have hoped would have gotten you out of the rabbit hole instead of so deep in. I also have/had two dysplastic hips and lived with increasing pain since the early 1990s and in acute/severe pain since 2008. I was trying to make it to 50, but I finally had one hip replaced in 2013 at age 47 and recently the second hip on July just a week shy of my 49th birthday.

My parents are both medical doctors, as are many of my aunts and uncles. When I was in severe pain in 2008, which started with a fall down the stairs and cascaded into crippling/mysterious pain, I was bounced back and forth from different medical doctors with different specialties. I also tried physical therapy, which was ineffective and in fact exacerbating my pain. Desperate, I finally turned to alternative forms of medicine, which turned out to be incredibly helpful to my health and well-being. Through this process, I realized that allopathic doctors (including my parents) do not have all the answers, and in some ways, the Western medicine framework is too narrow and even damaging in some cases. They default to surgery and to meds.

What was incredibly help -- lifesaving in fact -- was a trip to a kinesiologist. I had no idea what he did, but he reduced my pain by 75% in the first visit. I can't really explain kinesiology, but it deals with soft tissue dysfunction. In my case, even though I had arthritic and dysplastic hips, the main source of my pain came from my glute and hip flexor muscles not functioning properly, which put stress on all the surrounding secondary muscles. Once he "tested" my muscles and got them to function properly, it changed my life. Since you're in NYC, I feel you will have access to chiropractors who specialize in this. If you don't, you can come up to Darien, CT, and I will pick you up from the train station and take you to this guy. He is amazing and also is trained in other modalities (energy healing, sacro-cranial, Graston technique, etc.).

I also did acupuncture, but it wasn't effective for me. I suspect I just wasn't going to the right person. There is an amazing acupuncturist in Flushing that my friend goes to -- I can find out his name if you want. Of course, there are many in Chinatown, and I can ask my brother if you want some references. He lives in NYC too.

The other thing I did was get tested for food intolerances, went on an elimination diet and removed all foods that were causing inflammation in my body. It's amazing what food can do to increase or alleviate pain. My pain levels are much lower when I'm eating what I'm supposed to.

An experienced masseuse can make a HUGE difference. My brother goes to someone in Chinatown whom he can't live without. I can pass on the reference if you would like it. I go to someone in CT regularly who stretches out all those tight muscles.

I also get energy healing done -- also a lifesaver -- and meditate regularly. Stress and worry cause the body to contract, and since I'm an A type personality, I'm wound up pretty tight. Meditation helps me let go and maintain some mental and emotional balance. As a result, there are physical improvements.

I have also done myofascial release and Graston technique, which was helpful, but not as helpful as kinesiology and energy healing. In your case, the Graston technique may be something to consider as it's very good at breaking down scar tissue. You may have a lot of that.

Now that I've had hip replacement no. 2, you can bet that I will see the kinesiologist/energy healer and the masseuse in a few weeks to make sure my muscles are working properly and that I'm ready to go with more agressive rehab once I'm six weeks out. They will continue to be part of my health and wellness regime, even though I'm supposedly "fixed" at this point.

Like you, I have spent $$$ pursuing my health. At first, I thought I couldn't afford it, but since general health and wellbeing affects everything, I figured I didn't have a choice. In addition to the medical docs, trying out these alternative medicines have reduced my pain substantially. You of course should keep trying to get a way forward from the Western medicine people, but I hope that some of the alternative options I mentioned may provide new paths of healing for you. They also may be new tools in your toolbox and bringers of hope. I'm happy to talk to you on the phone too or via email.

You are in my prayers.
 
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Thanks so much for sharing your own story with me @cthipster. I really appreciate the support. And thank you @lee0605 for your concern and support as well.

I had an MRI of both hips yesterday, followed by an appointment with the newest OS . He says he can see no loosening of the cup on the MRI. He is sending me to get a bone scan on Tuesday to rule out the possibility of scar tissue growing into the cup. He also told me to stop spending time and money on PT. After this, he says, he stumped.

At this point, I have to admit I'm almost hoping the bone scan reveals a problem so I can get a revision or at the very least have some answers. The OS says that if he were 39 and limping around in pain on a cane after a THR, he would be just as upset and angry as I am and would leave no stone unturned to solve the problem. After 14 months of dealing with this failed recovery (and after years of being in pain), I'm drained of money and time and am scared and depressed. I am obviously still committed to figuring out what's wrong, but when 3 surgeons, 3 neurologists, a physiatrist, a pain management doc, and countless PTs have no idea what's going on (not to mention dozens of pills, shots, x-rays and MRIs) it's hard not to lose hope about ever being able to walk without a cane and terrible pain again.

I'm on my way now to the pelvic floor PT session, though the OS recommended that I not waste my time. At the very least, the evaluation will be educational, so I'm going anyway.

@Josephine, I can't seem to access the images off of the disc I picked up yesterdayt. I think perhaps it doesn't work with my mac/apple. I'm going to have access to a PC later in the day, so I hope to be able to figure it out.

My best to all.
meg
 
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@Marge75, I hope you get the answers you are seeking. Sounds like you have gone through all the allopathic doctors and one alternative modality. A kinesiologist may be really able to help you.
 
Marge, I just reviewed your entire thread and am so sorry for all you have been through. I know you are absolutely exhausted with all of this. The last thing you probably want to hear is a suggestion to visit yet another surgeon! But, if your latest doctor cannot find anything wrong, that is actually what I'm going to recommend.

Sometimes these things are so subtle that it just takes the right set of eyes to determine the problem and get it fixed. Never, ever give up!!! Below are some revision specialists in the New York City area that were personally recommended to me by an excellent primary hip surgeon on the east coast. In fact, the third doctor has done a revision on one of our BoneSmarties and it was completely successful. When you are up to it and you are sure at least part of the expenses will be covered by your insurance, I suggest you chat with one or all three of these very capable doctors. I'll repeat the most important part of my message to you....never, ever give up!!! We are all here to support you when you find yourself weary trying to get to the bottom of your problem. (((HUGS))))

Dr. James Nicholson
14 Tech Drive, #11
East Setauket, NY 11733
(Suffolk County)
(631) 444-4233

Dr. Bradley Gerber
36 Lincoln Avenue
Rockville Center, New York 11570
(516) 536-2800

Dr. Scott Marwin
761 Merrick Avenue
Westbury, New York 11590
(516) 357-8777

New York City Office
333 E. 38th Street
New York, New York
(646) 501-7300
 
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