Revision THR 8wks post op - more pain than before<<

[AMR1879]

Nonsense! a) there is always fluid in the joint, even in an artificial joint! It can't be avoided. b) that fluid always looks blood tinged because that is the normal colour of tissue fluid. Even saliva has a faintly yellowy-pink tinge. Perfectly normal.

I am very curious to see what, if anything the fluid shows. I hope you're right @Josephine and it is normal fluid! Then again, if there is a sign of an early infection, that may be the answer!

I can promise you that all surgeons have a fairly rich vocabulary of "medieval epithets" which they use freely in the operating theatre! I went in an innocent and naive young girl and pretty soon learned a LOT of words I'd never heard of before!

Haha! They totally didn't care, the Dr joked and said I can curse if it was okay if he did too! I said, as long as he curses for a good discovery, not b/c of something bad! And to my surprise, as I'm cursing away at the pain, he blurted out a surprised reaction with a curse included too....he was genuinely surprised at what he got out of the second aspiration deep between the ball and socket (the time it hurt the most).

I still feel it is a loose stem (or a stem that never even got anchored)--but I am not the Dr, I am just the one living with the pain! The more I read about people's symptoms they experienced before their Dr's concurred w/a loose stem, the more I feel I fit the bill--but many situations are years after the THR.

There was an older post on another forum that I was reading, it was so similar to my situation, I actually had to check to see if it was written by me at another time, lol, it sounded almost exactly like what I am going through. The person, unfortunately, did not follow up so I don't know how they made out.

I can't seem to find many people who have experienced the same type of situation as me (being within a year of the THR), which is hard, because I want to feel like I am not crazy and that I am not being over dramatic or expecting too much at 4+ months out.

I revisit my previous posts in this thread when you (Josephine) said,

This is very characteristic of a loose stem. No doubt about it. It certainly IS the reason you are having increased pain! That's a definite no-brainer! Got nothing to do with haematoma or doing to much. You have a loose stem. It needs to be dealt with.

You have been the only one to talk definitively and confidently, not brushing me off or thinking I am being over dramatic....and it is appreciated. Thank you for taking the time to help everyone who finds this site looking for guidance or just empathy for their situation!

My pain has been worse since the aspiration on Friday. I am feeling more pain when I rest in both my hip and lower back/high butt area. I even tried icing last night because it was so irritating. I still have the lumpy side of my scar (it was referred to as a hematoma post-op) but it is still there and is has never been and still is not discolored, just ugly, and I tried massaging it yesterday with my massage tool, but it was actually painful, so I stopped. I didn't feel like adding to my pain!

@Josephine is there any chance the lumpy side of my scar, and my hip pain could be related?? Maybe I am just grasping for straws. The lumpy scar has kind of gotten pushed to the side (no pun intended!) and forgotten by my Drs, while dealing with my hip joint pain--I even forget to mention it. But I see it every day when I look in the mirror, dressed or undressed -- right side of hip goes straight down (pretty much) and the left side has a bulge/small saddle bag look.

I am so eager to go see the new OS tomorrow and hopefully figure out something! I hate to get my hopes up for some answers, because I have been disappointed many times. I honestly feel like I will have left hip pain for the rest of my life. For heavens sake, at the in-practice 2nd opinion, the OS was CERTAIN my hip was not the problem at all and wanted to do nerve blocks as a "way to diagnose" where the pain is coming from. That was devastating to me, not only did I not get any answers, but I was told by a hip replacement specialist that it wasn't my hip!

So I took the next step down the nerve block path and made an appointment with the pain management Dr within the same practice last week, I have met with him before for x-ray guided cortisone injections and I felt he was a knowledgeable Dr who would take the time to explain things to me. He very strongly recommended to hold off on nerve blocking, he feels (and I agree) I am too young to start messing with nerves and going down that road. He suggested I wait to do anything until I hit the 6-month mark, unless they find there is an infection, of course.

Anyhow, this has become more of a rant than an update, reply or even question! I'm sorry, sometimes just venting helps, especially if it is to an audience that has been through something similar.

Just sending you supportive hugs I have no wisdom being new to this myself but my heart goes out to you

Thank you @MyAussieGirl for the support! It is much appreciated!! And thank you @Josephine for your in-put, I can only imagine how full your inbox must be!

 

[Jaycey]

That procedure can't have been fun! Well done on your persistence. I hope you get the results soon and can then move forward to get this fixed! Please keep us updated.

 

[Krista]

Feel free to keep on venting, @AMR1879. Living in pain/disability limbo, knowing something is very wrong, having a pretty good idea of what is wrong, and the doctors you have seen not figuring it out to your satisfaction...is all very upsetting. I lived through it myself, although my situation wasn't as bad as yours, with the very distinct possibility of a loose stem and revision. Even with my limited knowledge, I agree with you and Josephine, that it looks very much like a loose stem. I have read posts/stories of people who have had them within the first year. It's not un-heard of, for sure. Can't wait to hear what the new OS says tomorrow! Wishing you all the best.

 

[Horseshoe]

You're making progress! Funny about the dr's spicy vocabulary and fully understandable too

Perhaps your scar troubles are related to your hip pain, never hurts to mention it.

During my research phase lol, I typed in "loose stem" and "revisions" in the search bar and found many loose stem stories. Some occurred mere mos after thr, others a year or more, it was informative. It's my understanding that bone growth around the implant occurs during the first weeks after thr.

Good luck tomorrow

 

[Josephine]

but many situations are years after the THR

Actually not. Loosening can occur at any time.

My pain has been worse since the aspiration on Friday.

That would be perfectly understandable.

I still have the lumpy side of my scar (it was referred to as a hematoma post-op) but it is still there and is has never been and still is not discolored, just ugly, and I tried massaging it yesterday with my massage tool, but it was actually painful, so I stopped.

Sounds like it really was a haematoma but those things can last a while. The blood in them gets organised and hard and ultimately becomes fibrous tissue which is a normal sequence of events. So do stop trying to massage it away because you can't. It might stay there some months or even years.

Josephine, is there any chance the lumpy side of my scar, and my hip pain could be related??

Assuming it really was a haematoma, no chance.

And thank you Josephine, for your in-put, I can only imagine how full your inbox must be!

That's very kind of you but these don't go into my Inbox! But may I please ask you not to keep on making my name into a tag. Those do go into my log of alerts and it gets annoying when I visit one only to find my name has just been made into a tag as a matter of course. :smile2:

 

[AMR1879]

Had my second opinion from a Dr at a different practice. Doesn't look like there is an infection, which I didn't think there was, X-rays look okay, but b/c bone scan and blood work pointed to inflammation, The Dr recommended waiting another month and redoing both the bone scan and bloodwork. He said if the issue is in fact the bone has not grown around the stem, the window of opportunity for the bone to grow has passed and it will not grow around the stem. So there is no point to try taking fosamax or anything thing like that b/c it won't make a difference. So I go to see my original Ortho Surgeon tomorrow and see what he thinks. This dr is friends with my Ortho Surgeon (which may not be such a great thing since I was hoping for an unbiased 2nd opinion) and will be calling him this evening to talk about my case.

I feel so strongly it is the implant, I have had this pain since PT right after surgery. If it goes away, it will be a miracle. But I'm afraid it isn't and then I'm going to need surgery to fix it smack in the middle of summer which will ruin the whole summer for my children including a vacation in August that we have had planned for months already. If that is the case, I would keep living with the pain until after the vacation and have the surgery in Sept.... If they would just do something about it now or even next month, I would be healed enough to enjoy at least the second half of summer and the vacation we have planned b/c it is at the end of Aug.


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[Delphi]

@AMR1879, I have nothing constructive to say about your situation, other than I am sending you hugs and support. At your age and with your family commitments, I wish you were able to focus on things other than your health. You have gone through so much.
Hope things work out well for you,
Diane x

 

[Horseshoe]

Totally get your frustration. As a loose stem doesn't get better and can cause inflammation then why make you wait? In my non medical opinion it would be best to revise it sooner rather than later so you can be mobile enough to enjoy your summer. Hope you like my priorities :smile2:

Too bad the new OS knows the first one but very glad to hear you don't have an infection. You know your body best and think you're right.

Good luck tomorrow and it will also be interesting to hear what Josephine has to say.

 

[Krista]

So the new-opinion doc is going to call up your original surgeon and talk about it with him! Not ideal, IMHO. I wonder what they will come up with. I believe you still have another opinion appointment? Maybe this time from someone completely unassociated with your OS?

I do hope that if they decide to do a revision that it can be done quickly. That wasn't my experience at all. It took forever to have the second surgery, but part of that was because I had two surgeons working on me, and it was hard to get them both on the same day in the same place. Good revision surgeons are usually in demand, and it takes awhile to get surgery scheduled. I wouldn't have a revision with the original surgeon. I haven't been on a vacation in almost three years. Last year, during the vacation time we had scheduled, I had to deal with my fractured vertebra, and my husband spent it taking care of me. That postponed my second hip surgery yet again. So much can happen to interfere with our plans...I truly hope you get to recovery and health as soon as possible, and get to go on that trip with your family!

 

[Jamie]

AMR.....I know it's disappointing to have something like this happen. But you really need to put your health and this hip as your number one priority. Vacations come and go, but this hip will be part of your life for decades to come. You want it right. You need a good revision surgeon....not the doctor who put this hip in. If you want help finding someone, tag me and give me your zip code. I'll take a look around and see what revision surgeons might be within driving distance. This is critically important for the rest of your life!

I read back through your thread and feel even more strongly that you need to see completely different surgeons than the ones you've been going to. They are not doing you any favors with all the "trying" they are doing to make the problem be something else than a loose stem.

You mentioned the possibility of seeing someone at HHS. Please do this as soon as possible. This is where you need to be.....with revision surgeons who can really take care of this for you.

 

[AMR1879]

AMR.....I know it's disappointing to have something like this happen. But you really need to put your health and this hip as your number one priority.

@Jamie you are totally right, I need to put my health first. But, it is hard to see how this is affecting my young kids. I hate that they are or may miss out on things that kids their age shouldn't miss out on b/c I am laid up. They have a young mother, not a 70-year-old mother. It seems unfair they have to be waiting around while I deal with this, I also need to consider them. With that said, you bring up a good point, and it makes me even more motivated to find someone capable of fixing me ASAP. I will I will message you with my location if that is okay--thank you for the offer!

I believe you still have another opinion appointment? Maybe this time from someone completely unassociated with your OS?

@Krista yes I do have another appointment, but with another type of Dr. who is totally unassociated with my Dr. He looks at the body as a whole (yes he is an MD) and tries to fix issues without surgery. Unfortunately, I don't think I am fixable without surgery, but I am willing to see if it is possible! That appointment isn't for another 2 weeks or so.


Thank you @Horseshoe and @Delphi and everyone who has been commenting and keeping up, I will keep updating as I go!

 

[Irish Joe]

I'm going to jump in here.
I think back to when my wife was your age our children were 12, 10, 8 and 5. They were the Centre of her world as yours are to you. But likewise they would want her to be better if something was wrong.
Please get another totally separate opinion (not from a phone buddy) because I feel you need a revision and in my limited opinion I think the sooner the better.
If you get this sorted as a priority now you will be giving your family the best chance to enjoy there loving mother. Deep down though it may look sometimes like they are Pee'd off a bit they want you better.
Your the priority now (a thing women find harder to do that men I think).
Joe........

 

[Krista]

@AMR1879, yes, it is hard on children when their mom is ill or temporarily debilitated. If they are missing out on things, then perhaps you could figure out ways to help with that. Maybe their friends' parents could take them out to activities while you are laid up. Perhaps relatives or other friends could do more to help keep them involved. This is crisis time for you, and life does not just go on as usual for anyone in the immediate family. Perhaps you could pay someone to help out during this very difficult time. Bottom line, though, is that your treatment/recovery should not be jeopardized in any way, no matter what, or else you may prolong the suffering or even never get better.

I really like Jamie's advice above about getting an opinion from a good revision surgeon who is completely unassociated with the original surgeon. That is what would give me peace of mind - what DID give me that peace of mind AND body.

 

[Josephine]

the window of opportunity for the bone to grow has passed and it will not grow around the stem. So there is no point to try taking fosamax or anything thing like that b/c it won't make a difference. I feel so strongly it is the implant

Have I not been saying that since day one?

I have had this pain since PT right after surgery. If it goes away, it will be a miracle. But I'm afraid it isn't and then I'm going to need surgery to fix it smack in the middle of summer which will ruin the whole summer for my children including a vacation in August that we have had planned for months already. If that is the case, I would keep living with the pain until after the vacation and have the surgery in Sept. It seems unfair they have to be waiting around while I deal with this

I agree with the others on this. I'm sure if you asked them, your children would be more than happy to see you getting your hip fixed even if it did mean them missing out on some things. After all, it's just one summer but I can promise you that if you do try to live with it, you risk some seriously damaging things:
1. the implant will just get more and more loose
2. the implant moving around inside the femoral shaft can cause damage which can include

a) remodelling inside the bone

b) breaking though the bone

c) causing serious bone failure

​

So I would urgently advise you to treat this as a priority and get it done before anything like this happens.

 

[Nivea]

I agree with the others. It is just one summer that may be inconvenienced. I know my son would want me to have felt better as soon as I could. Being in pain and cranky is certainly not a good combination. Your pain may worsen, in the end suffering more and not being able to do things anyway.

 

[KarriB]

Children are resilient. This summer will be a blimp in their lifetime, but they'll remember that you did everything you could to get better. If you are able to have the surgery soon you may still be ok for August, as long as you aren't climbing mountains, skiing etc.

 

[AMR1879]

Had a long appointment w/my Ortho Surgeon. Bottom line: He doesn't know what to fix....the X-rays of the hip replacement is "text book" perfect, zero signs of loosening. So far, no infection has come up from the hip aspiration. He wants to wait four weeks, then redo the bone scan, blood work and possibly the aspiration.
So that is what I'm going to do. There isn't any other revision surgeon that will touch me until at least a year post op. If infection doesn't show up on any of the tests in the lab, then we wait to see if maybe it will resolve itself.
I am seeing a Dr on the 24th who is actually a board certified Internist and Pediatrican who also has credentials in sports med. he came highly recommend by a Dr friend. He looks at the whole body for healing orthopedic problems in a non surgical way. Perhaps he will be able help me...can't hurt to try it!
So I wait it out, or more like tough it out. Maybe it will go away...



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[KarriB]

I would stay away from sport medicine docs. You need a doctor that specializes in revisions. My OS's bio says he specializes in primary and revision TKRs and THRs. These drs are trained to diagnose problems with replacements while sports medicine drs are trained in sports injuries. The sooner you get this problem diagnosed the sooner you'll be on the road to healing and enjoying your kids.

 

[Irish Joe]

AMR1879, it's a tough time physically and emotionally for you at the moment with your pain issues and worrying about your family. Then experts are telling you stuff that you want to believe. Then we are posting here on this forum adding to your confusion. You must feel like you are running round in circles getting no where and not knowing who to listen to. Please know that we mean well and want the best for you.

!!!!! Just for a moment disregard everything we have posted!!!!!

AND go back to Josephine post of Apr 4. I joke sometimes that she was wrong once (its just a scurrilous rumour) but the truth is that she's been doing this long enough for us all to listen to what she says. On Apr 4 she said that there is no hope of achieving bony growth. That seals it for me. It's a month ago now and you're no further.

AMR I'm not trying to scare you but look at the "what might happen" x-rays above and think that you have been like this for over a month now. I really really want you to get this sorted for you (no1) and your family (also no1) sake before some catastrophic event.

I hope this gets sorted soon.
Take care .
Joe........

 

[Jaycey]

I agree with Irish Joe. This is not going to go away and as Jo says, things could be a whole lot worse. This surgeon is obviously not seeing the obvious. The stem is loose and this needs fixing. Please get help from Jamie to find someone who can address this ASAP. We are all very concerned.