THR Ausman gets a new hip!

[Ausman]

Thank you so much @Mojo333! And yes, I would be most grateful for any insights from @Josephine

I have seen some other references to bursitis sufferers describing the source as feeling "hot", and I guess mine just feels really, really hot. But we've checked and checked and it is not infected. But if I had to describe this, it would be as if I had backed into a very hot fire or stove right at the surgery site. It's been frustrating trying to describe I know.

Thanks again for the kind and healing thoughts!

 

[Mojo333]

Oh my stars..that does sound uncomfortable!
Guess you really do ice it up?
Does that help any at all?
Josephine will be along and hopefully be able to impart some good advice!

 

[Ausman]

Oh my stars..that does sound uncomfortable!
Guess you really do ice it up?

I see what you did there! Hot...ice...

Does that help any at all?

Yes, it does. But just as icing anything will numb it temporarily.

Josephine will be along and hopefully be able to impart some good advice!

Thank you and all the Bonesmarters!

 

[Josephine]

Thank you @Layla, @Mojo333, @1stSurgery, and everyone!

Ausman, you will notice that I have removed the coding from your tags earlier. Can you please read this article to see why I did that Multiple tags or alerts in posts

She amended my PT orders to include bursitis and IT band protocols, and recommended high-dosage ibuprofen (800mg 4x daily) and additional icing. None of this seemed to help

I am not at all surprised because there is no 'protocol' for bursitis.

but it felt for all the world like it was "burning" and very painful.

That's not tendinitis, it's neuropathy and is only successfully treated with gabapentin. Who ever those doctors are that are treating you need an update on modern medicine!

 

[Ausman]

Ausman, you will notice that I have removed the coding from your tags earlier. Can you please read this article to see why I did that Multiple tags or alerts in posts

I apologize. I didn't know.

I am not at all surprised because there is no 'protocol' for bursitis.

Well, leave it to my missing comma. I should have said "...amended my PT orders to include bursitis, and IT band protocols...

I'm red-faced, especially considering that I am a huge fan of your very own Lynne Truss, author of the delightful book "Eats Shoots & Leaves"

That's not tendinitis, it's neuropathy and is only successfully treated with gabapentin. Who ever those doctors are that are treating you need an update on modern medicine!

Again I apologize- I'm frustrated too. I will ask my doctor about gabapentin. Do you know about how long gabapentin treatments typically last? I am nearly out of leave from work, and gabapentin is among a long list of medicines my employer prohibits (the same reason I stopped all pain meds last month.)

I will say I did get remarkable relief from the Prednisone course. Does that sound consistent with neuropathy? On the contrary, it seems in my mind to somewhat affirm my OS diagnosis of Bursitis, an inflammation of the Bursae. But I've only begun reading on neuropathy. I ask only because I want to have my questions ready for when I speak with my OS.

But I am still curious if any fellow Bonesmarters have experienced Bursitis of the hip following their THR. Anyone please chime in!

Thank you Josephine.

 

[Layla]

Hi Ausman
Happy Three Month Anniversary!
I hope you had a nice Thanksgiving all is going well with you. Leave us an update next time you stop by.
Would love to hear about your progress.
Best wishes for a great weekend!
@Ausman

 

[Ausman]

Hey gang-

Fast coming up on 6 months. And there is something seriously wrong. The tissue around the surgery site is inflamed and swollen. And a deep ache around my new hip- which baffles me because I don't have a "hip" anymore, right?

But let me back up- I finally made it back to work last month- a job which involves lengthy periods of sitting. In fact, it was the pain during sitting that forced me to take disability from my job last August in order to get my left THR. My recovery has been painful throughout, but I thought I was okay to go back to work.

Unfortunately, the pain and inflammation came back with a vengeance since returning to work. I was even back on my cane earlier this week- something I haven't needed in months. The greatest disappointment is that nothing seems to have been resolved by my THR. Exact same situation I had before surgery- extremely painful hip after prolonged sitting. Except now it is painful all the time to some degree. And my limp, which I thought I had mostly under control, is back and more like a painful lurch.

The pain and inflammation seems to be in the soft tissue around the new hip and surgery site. Has anyone else had difficulty like this at the six month point or beyond- and what was the solution?

And- I am so angry and frustrated- but my OS seems stumped and appears to have no idea how to proceed. He has yet to reply when I told him about my difficulties this past week. Perhaps a different specialty is needed for the soft-tissue complication? Any experience or insights much appreciated.

I know I've been away, but always thinking of my fellow Bonesmart Hippies.

Ausman

 

[Jaycey]

@Ausman So sorry you are suffering this far out of surgery. Do you happen to have an x-ray of your replaced hip?

Sounds like your surgeon has washed his hands of you - time to find someone with feelings for a patient who is not seeing the results.

 

[Ausman]

Do you happen to have an xray of your replaced hip?

Dozens of them! One thing they've done on every follow-up is taken an x-ray. Would you like a copy?

 

[Debru4]

You must be so worried and frustrated. I feel for you! Definitely time for a second opinion and fresh eyes.

Did they ever take X-rays of your back, or an MRI? Prior to my hip surgery, my doctor also had me do an MRI as he said some of the pains I was having could also be back related, and if so, would still be there after my surgery. I was lucky and the pains were from my hip. (The bad ones at least....I still have some occasional back pain, but nothing severe.)

Maybe there is something else going on with you as well, that your surgeon isn't exploring? Hang in there, and keep us posted!

 

[Ausman]

Did they ever take X-rays of your back, or an MRI?

Actually, yes to both. When my hip pain first appeared, my PCP missed the mark and sent me to a spine specialist, who performed xrays and an MRI. I even got a spinal epidural! Nothing helped. It was actually that same spine specialist who finally realized we were dealing with a hip issue and referred me to my OS. OMG what a year 2018 was. I had almost forgotten that month chasing around the spine issue. Sigh...

 

[Debru4]

Well, on the bright side, at least you can eliminate that as a cause. Sometimes knowing what it isn't can also be reassuring.

Sounds like you have to work around insurance challenges as well. That's so hard when you feel like decisions are being made based on what insurance will cover, rather than what the preferred treatment is. But it's an issue a lot of people have to deal with. Many doctors will help figure out ways to work around/through these issues---hope you either have one, or can find one who will work with you on this.

 

[Layla]

Hi @Ausman
I'm so sorry you're struggling this far out.
Here is a link on how to post your most recent x-ray that Jaycey inquired about.
https://bonesmart.org/forum/threads/a-few-tips-on-posting-xrays.23055/
Let's ask @Josephine to weigh in. I've tagged her for you so please check back in case she has question.
Wishing you comfort as you seek relief.

 

[Josephine]

which baffles me because I don't have a "hip" anymore, right?

Of course you do! You don't have a natural hip joint but you still have a hip area!

So can you show me where this pain is using this pain chart?

 

[Ausman]

Hi Josephine-

The pain is at
VL1B
WL1B
VL1F
WL1F

As Marvy described in his thread, I have a painful swollen area about 3" in diameter centered almost exactly around the bottom of my scar (as you may recall this was a lateral left THR). That is primarily the WL1B and WL1F pain, with a second elongated painful area above it at VL1B and VL1F. The swelling becomes more severe and painful during any prolonged sitting- a real problem since that is very much part of my job. It took me most of four days to recover from a pain of 4 to 5 down to the current 2 or so. And this will repeat again when I go back to work next week.

I'll also attach my latest x-ray. Using the scale on the image, I believe the swollen area is from about the 0 to 10cm mark, starting from the top of the scale. Though I am not certain what part of the image corresponds exactly to where on my hip, if that makes sense? In any case, x-rays are not much good for showing soft tissue, so probably not much help.

I could also include an image of my scar if that would be helpful- my wife has kindly annotated it with a Sharpie to show the painful areas to my OS, though right now he is unable to see me until week after next.

Thanks Josephine!

 

[Debru4]

Every time I see an image on an Xray of the artificial hip, and the stem implanted so deeply into the femur, I am in awe of what actually was done!

 

[Ausman]

I agree Debru. I'm only thankful I wasn't awake to see it done!

I was convinced- and still am- that my OS is a very skilled surgeon. I spent months researching my choice. I also think I know now that he doesn't want to hear about soft-tissue issues or post-op pain. And this in a huge Ortho practice with all the specialties.

I am so thankful for Bonesmart for helping me steer a search for a doctor to fix what went wrong.

 

[Debru4]

I think that is the issue in general with specialists/surgeons. They often seem oriented toward surgical solutions, wanting to repair/fix the problem so it is over and done with. Some things are really obvious---black and white, like does the knee/hip need replaced. Other things require are in a gray area and require a lot more detective work, and more holistic or measured approaches.

I think those situations are hard for both patients and doctors. Sadly, it sounds like many surgeons simply step away, gaslight, or tell you to come back in ____months. Wouldn't it be nice if they had more "tools in their toolboxes" (to coin a phrase we often use in education) to assist their patients with those varied soft tissue issues so many of us have before and after our surgeries!?!?!

 

[Josephine]

So your pain ad swelling is about here then?

There is no doubt in my mind that this is Trochanteric bursitis which is pretty common with a THR

 

[Ausman]

Thank you Josephine- yes you identified the spot exactly. And that is a great article you referenced!

After discussing this with you and Marvy and others, I am going to propose exactly this diagnosis to my OS.

Now, why it becomes so severe when sitting is my next question. Marvy described the exact same problem, and ultimately he most recently had arthroscopic surgery to remove that bursa and lengthen the IT band. I will discuss this as well with my OS.

Thank you again!