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Bilateral THR ByGosh ByGolly ByLateral

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sharonslp Thank you for contacting me. Fairly soon at the start of the groin pain, week 6 or 7, I was asking questions in the RA thread, and Josephine did come on and she gave me the link to the iliopsoas syndrome. She gave some suggestions, and at the time it felt better. Then I did an errand or two, and it stopped getting better. This happened to me several times; it did come and go a little at first. To tell you the truth, I haven't contacted her or any other advisor because I believed I should just rest, ice, manage the pain and wait until I saw my OS at my 12 week visit. I did see the OS assistant at 6 wks. and she felt it was soft tissue inflammation, which Josephine agreed with. Please dont be disturbed, because Josephine did communicate w/me in the beginning, and I haven't made much of an issue of it in my thread. I was waiting it out, trying to stay positive and not get too gloomy.

I read the Iliopsoas Impingement link but I don't think I demonstrated those signs when the OS examined me yesterday. The pain is actually hard to elicit. It hurts or more like burns when I bend over, not a knifing pain, mostly a burning feeling, and also when I'm on my feet or walking a bit of a distance. When it's bad, doing stairs can bother it. And my PT couldn't reproduce the pain, either, although all of the maneuvers he did, and the OS did yesterday, made me sore after. It seems to come on a little slowly at first, burning, then into pain after awhile. I'm no longer doing PT, and since week 7, they stopped strengthening and were only doing heat and stim.

I had an anterior approach and no restrictions on flexion of the hip. I had few restrictions at all - no leg crossing, pillow between legs when sleeping. My first PT at home had me doing hip flexion, knee bending at the counter the first or second visit. And the out-pt PT had me doing sideways walking where the knee is brought up high, leg presses, leg curls where the hip is flexed. So I assumed flexion was acceptable. And I'm sure you read that I had a lot of appts. wk. 4 with MDs for a red, swollen inflammed toe and had to walk alot and drive that week. So this started week 5 but it would resolve with rest and ice, only to return.

Iliopsoas syndrome sounds a bit more like it, with the burning pain and the hip flexion aggravating it.

I'm currently taking Meloxicam 15 mg in the AM, Tramadol 100mg AM and PM with Tylenol 500mg to 1000 mg, and Vicodan 7.5/750mg later in the day if needed, usually one a day, sometimes none. I can't seem to tolerate any more Tramadol because it can make me feel anxious and my heart beats faster.

Should I tag Josephine with this info, or do you think I need to add more? Thanks again for your concern.
 
ByGosh. Just wanted you to know I was not even considering that the hip surgery was a failure.. Was trying to come up with a way for you to follow doctor's instructions to walk and not be in agony. You seem to have analyzed this very well. It is frustrating that the surgeon couldn't hear it.
 
Josephine and alexthecat

Could you each read post #321 and see if you have any thoughts for ByGosh.

ByGosh, you did have an anterior approach, and nerve issues seem to be more associated with that approach. My understanding is they usually clear up, but it can be a slow process. Is this possibly nerve-related pain that you are having? You describe burning pain, and I think of nerves when I hear that.

Sharon
 
@sharonsip I don't know. It's burning like inflammed-feeling. I've never considered that. Thanks for your thoughts, though. Perhaps time will tell, after all.
 
LeeApril26 Oh dear, I do understand your point. I appreciated your suggestion, because I've thought of that myself. It's just that the pain clinics that I know of here, at least, are for the patients who have exhausted every possible medical option, and have no place else to turn. These patients, as I've been told, are more at the end of the line as far as any other treatments are concerned, and their pain is unmanageable by their GPs, it's chronic, and it often can't be explained. Maybe the pain clinics are different in NY? But don't worry, I didn't think you felt that way. You're very sweet to come up with some suggestions for me! Thank you again for your consideration! :) I appreciate it, and also everyone else's comments, they are all very thoughtful.
 
ByGosh. I've never been to a pain clinic so can't say. I believe I have nerve pain in my thigh, and I describe it as fireworks going off on my thigh. I don't know what would happen if it kept up, as I get up to walk around and it stops.
 
LeeApril26 It does sound like what I would imagine some type of nerve pain to be. Lots of different pain signals all firing at the same time? I would think that's pretty painful and could drive you crazy! Especially if you couldn't get relief by getting up and walking around. Doesn't make for a very restful night, though, does it? I wonder if ice would numb those nerves and quiet it down. Freeze them into inertia, or something.
 
ByGosh. The ice doesn't seem to stop the fireworks. Does it stop your burning pain?
 
Oh, dear, sweet ByGosh, I am SO sorry ... for the flip, unhelpful comments by your OS. I so wish I had even a kernel of advice or a suggestion, but I do not. I am so ignorant. And fearful of making a suggestion that might not work or that might make it worse. It sounds like you have already picked out another OS to consult, or did I misunderstand? I think that's a great plan. I'm wondering if your walk tonight with your pooch helped? Please let us know. My heart goes out to you. I have had pre-op pains revisit me like angry ghosts, and have tried to articulate to people who tell me how great I'm doing that it's moot if I still have pre-op pain. As you said, we don't go through this surgery expecting the same pain. And yes it's great to pass all the milestones that pertain to recovering from the SURGERY ... but it's about more than that. It's about getting your life back. Maybe you've done this already, and if so, please forgive me for being so simple, but have you Googled within quotation marks "groin pain after hip replacement" to just see what comes up? You might find some clues. Again, I'm so sorry. I really am.
 
I'm so glad you are getting a second opinion. I can't believe how unsympathetic and unhelpful your surgeon was. I saw mine today and could not possibly imagine him being like that. He reassured me that things can get worse for a time with increased activity. He also encouraged me to come back and see him if I'm still getting worse in 2-3 months time. But you seem to be in much more pain than me, I'm pleased you are beng proactive in doing something about it. Keep knocking on different doors till you get an answer, even if it ends up being the "too much too soon" affliction. Thinking of you.
 
ByGosh said:
at the time it felt better. Then I did an errand or two, and it stopped getting better. This happened to me several times; it did come and go a little at first.
Click to expand...
Any tendinitis does that. Have you tried the stretches in the articles? Did they help or not?

If rest and pain meds don't settle it, sounds like an injection of steroids would be helpful.
ByGosh said:
I'm currently taking Meloxicam 15 mg in the AM, Tramadol 100mg AM and PM with Tylenol 500mg to 1000 mg, and Vicodan 7.5/750mg later in the day if needed, usually one a day, sometimes none. I can't seem to tolerate any more Tramadol because it can make me feel anxious and my heart beats faster.
Click to expand...
Well, you're being a bit hit and miss with your meds here.
- the NSAID (meloxicam) only has a 'life' of about 8 hours so one dose a day isn't much good
- same with Tramadol which has a 'life' of about 4-6 hours (unless it's extended release) so a dose twice a day is pretty pointless. Try taking 50mg 4 times a day
- you shouldn't need Tramadol and Vicodin
- 500mg Tylenol is also useless. The working dose is 1,000mg, anything less isn't going to do much

So, in synopsis, try this: 50mg Tramadol and 1,000mg Tylenol 4 times a day, Meloxicam twice a day. See what that does for you.
 
ByGosh I hope you get this resolved soon. We all are holding your hand and hoping for the best:console2: . You said it when you wrote, you had this surgery to get rid of the pain and get on with your life. 6 weeks is a long time to lay on the couch and ice and still have the pain return when you get up and walk around. I have been taking my recovery very slowly. It seems when you are pushed it's not good. I don't know what causes tendinitis or even if that is what you have but a few on here have developed it after they have done really well with in their recovery. When are you going for a second opinion?
 
Hi ByGosh I have been thinking about you. I hope your plan is underway and you will be getting a second opinion very soon.I have read the article and even if conservative treatments don't work there is the possibility of a steroid injection which is very seems to be effective Of course we will improve and as you reminded me we will look to next year if necessary and then anything earlier will be a bonus. My tendinitis is still bothersome but It varies from day to day.I have gone back onto Naproxen which seems more effective than Ibuprofen but I am hoping this is only a temporary measure.I have decided just to carry on with the advice given to me by the physio until I see an OS but will consider seeing a professional who does deep tissue massage if it carries on beyond my 12 weeks.Remember you have had the trauma of having 2 which must have some bearing on recovery and pain but we will get to where we want to be in the end x
 
ByGosh just checking in on you! :) I tagged you over on the pre-op side, somebody wants a bilateral, and you and Seasiren were the only people I could think of. I know there are more, but my brain is fried!!!
 
Peaches LeeApril26 Thanks for checking in with me. Very sweet of you. It was nice chatting late last night, but I finally had to call it a day and pull myself away from my computer. I'm staying up much too late, and then sleeping much too late. Very slovenly-feeling behavior!
I'm not too bad today! No severe pain, and I even went to the pool and walked 5 min, then paddled back and forth with my legs buoyed up so I didn't do any kicking.:) I'm happy, and am hoping I won't have any setbacks because of it.
sandybeach That was very nice of you to come and visit me! Hand-holding is important for all us with this trying recovery! I have my 2nd opinion in a couple of weeks. I'm glad that you went slowly with your recovery and it's going well for you! I'm hoping that this will resolve soon, too. It's very trying to have things drag on so long. I'm glad you ladies understand.
Kim22 Thank you for being so empathetic. My pain seems somewhat better today - we'll see. Of course, I did very little in the way of weight bearing, but still, just like you, I'm very hopeful. We will get better! I think that Naproxyn works better than Advil, and you only need to take it 2x/d, so that's a big improvement. They still give it out in prescription strength of 500 mg, but the over the counter is 440mg, so there's not much difference. I'm still icing, resting ALOT, even though I did make it to the pool for a little water walking and floating. I haven't really walked on the sidewalk, except for 1/2 block yesterday, but I turned right around when it started bothering me. I use the Arnica and massage, too. I hope all of this is doing the trick and turns both of us around for a better recovery! Good luck and let me know how you're doing. When do you see your OS?
zauberflöte (magic flute, magic hip) Hi, how are you doing? You're only 10 days post-op now. You're fairing ok without the Mr? I haven't heard from the new bilateral yet. Poor thing, sending them to ME. I'm a poor example of a quick and easy recovery! But I'll try to go easy on them and not scare them to death.
octopus Hello, artist. How are you doing with your artwork and your journals? Have you found time to do any more? Thank you for the encouraging post! You're very supportive and I appreciate your outlook. I'm glad that your OS was so good to you. How kind and considerate he sounds. And it is helpful to hear from another OS that increased activity can increase pain. After I saw my OS yesterday and told him about my groin pain, resting with ice for about the last 6 weeks, it comes back whenever I do anything, etc., etc. he asked me if I was happy I had my hips replaced! How odd is that? I said "not with this pain". Sorry to disappoint him. Gee whiz!
But how are you feeling? I'll have to pop over to your thread and see what's going on.
 
Thank you for your input Josephine. The stretches were too much for me. I do have one stretch given to me by the OS assistant, and it seems to help because the area isn't as tight and the stretch is easier for me to do. I'll give the ones in the article another try, I wasn't quite up to the hip flexion at the time. I do the leg lift strengthening and the ROM strengthening ones, though.
I'm presently taking the maximum dose of Meloxicam - 15mg. But I can break it in half and take half in the AM and half in the PM and see if that makes a difference.
I tried the full 1000 mg Tylenol and seemed to need less Tramadol today, so that advice seems to have paid off. I will continue with it and spread the Tramadol out in 4 equal doses. That may hold me over better.
Thanks again, I appreciate your help! :)
 
Well, just remember that NSAIDs are actually quite mild pain killers, gram for gram about 60% strength of paracetamol and with the added hazards of stomach irritation. This can can be present even though the patient is totally unaware of it. There have been innumerable cases of people having gastric bleeds because of taking quite moderate doses of NSAIDs while thinking they were okay. I kid you not - always take paracetamol rather than NSAIDs.
 
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