Revision THR Constant pain continuing 1 year after THR<^

[Marvy]

@SaraK - no - no one has even mentioned psoas impingement (although that's what I thought was wrong prior to the screw diagnosis).

Wednesday I have an appointment to see a new OS who is supposed to be a specialist in muscles and tendons in and around the hip. I am keeping my fingers crossed that he will at least be willing to investigate what is going on.

My PT kept focusing on the glute medius muscle as she kept telling me that it wasn't firing (and thus getting stronger) and that's what really started this whole new process.....

 

[SaraK]

 

[Marvy]

Well, I had my appointment this morning with the new OS. He agreed that "something" isn't quite right. Of course he had to say "well, it's only been about 6 months since your revision, so we may have to just wait and see". ugh... I am so tired of hearing that.

Anyway, after looking at my MRI, fluid lab results, etc. I had blood work done to rule out any infection. He is also ordering an ultrasound of my hip. Because of the amount of fluid and the location of the fluid, he said he really couldn't make any diagnosis based on the MRI.

I have the ultrasound appointment on October 22nd, so more waiting.... He was very specific in who he wants to perform the ultrasound. It will be an orthopedic/sports medicine doctor whose specialty is musculoskeletal ultrasounds.

I did find it quite interesting though that even though he said he really couldn't see much from the MRI, he did have the conversation with me about the different types of surgery techniques for muscle damage and tears. Why would he even mention that unless he really suspects something? Is that common practice for a surgeon to do?

It was also interesting that he said the fluid was not considered bursitis - because of the amount and location of it. So, this is now the third doctor that has said this to me. But the question still remains the same - what is causing the fluid???

My Trendelenburg gait was also mentioned. Even though I'm "only" 6 months from surgery, he said that I should not be walking like I am (well, surprise! surprise!)...

Now I sit back and wait until the 22nd and then wait again until my follow-up with the OS on October 31....

 

[SaraK]

Fingers crossed for you! Wonder if he's suspecting a tear (causing bleeding?) as the reason for the fluid. Just thinking about the bruising from a more external muscle tear.

I've made an appointment for Monday with a new OS. I'm tired of waiting for a pain doc that thinks more about back and spine than hip to decide I need to be referred (especially since she has never communicated with me on MRI done almost 3 weeks ago and her office never returned call from early morning to set up an appointment). Race is still on!

 

[Marvy]

Hi @SaraK I hope the appointment with the new OS goes well. In my journey they tried to say it was my back (I do have some degeneration in the L4-5 area) and I had a pain injection for that. The only thing it did was make my leg numb so that I couldn't walk for 3-4 hours. So I am glad that you are "moving on"...

It is frustrating that doctors take so long to return calls, etc. But it isn't them that is living with the pain, etc.

I'll keep my fingers crossed for you as well in hopes that you will find a solution! And yes, the race is still on! Although I feel I am moving in snail speed!

Wouldn't it be great if we could ring in the New Year with a pain free hip???!!!! I am hoping that if I do end up having to have surgery that I get it done this year. Since I have had my revision this year, my next surgery would be almost "free" since I have met all of my insurance co-pays and deductibles.

Keep us updated on how your appointment goes on Monday!

 

[SaraK]

I hear you on the almost free. I'm approaching the out of pocket max for the year (again! Last year my 2nd THr of the year was referred to as my BOGO).

 

[Krista]

@Marvy, so glad to hear you are getting the ultrasound! May your new OS get good info from that. And, of course, the reason you have a Trendelenburg Gait is because something is wrong. Any serious damage to tissues that are involved in being able to hold your hip steady while on one leg (like what you need to do when walking) can cause the TG. Hope he can get to the source of it for you. I am still suspecting that you have muscle/tendon tears of some kind in one or more of your gluteals, that are bad enough that they can't heal on their own.

 

[Marvy]

Hi @Krista ! Yes, I am glad that the new OS is recognizing that something is not right. I went into the appointment fearful of him saying that I needed to go back to PT or have another cortisone injection. As so many of us know, it takes finding the right doctor (and someone who will listen and actually believe what you are saying).

Like you, I do believe whatever is going on is a muscle/tendon issue - whether it be a tear or muscle damage (the OS even mentioned tissue transfers, rebuilding muscles, etc. when he was explaining different types of surgery).

I am still contemplating traveling to the OS who reviewed my MRI for a second opinion (or maybe peace of mind??). That OS wants me to meet with not only him, but another surgeon as well. I am trying to tell my family that I can make the appointments just to have them if I need them depending on what the results are of the ultrasound. An appointment can always be cancelled if necessary....

Have a great weekend!

 

[Krista]

@Marvy, I thought I'd mention that a friend of mine recently had an ultrasound and the doctor was able to see her gluteus medius tear. And she just has occasional pain, although she has had the pain for about a year now, and she doesn't limp. So here's hoping that, since whatever your problem is, it's more serious, and that it will show up.

I would definitely set up the appointments, even if you have to cancel them later!

 

[Mojo333]

Fingers crossed for answers, @Marvy !
Hope you have a good weekend!

 

[SaraK]

Ok @Marvy - I'm hoping I'm closer to an answer and continuing to keep my fingers crossed for you. Finally, someone actually listened (or this is one of his favorite things to look for)! One more week and you may get some answers, too. I hope so - it's a great feeling and I so want it for you!

 

[Marvy]

@Krista I am looking forward to the ultrasound on Monday. It cannot come too soon. It is always interesting to read the visit notes from the doctor. In it he put that he discussed "tear of the gluteus minimus". WHAT??? I know that he never mentioned what tendon/muscle had a tear. He only discussed the types of surgeries based on the severity of a tear... He told me that he couldn't definitively make a diagnosis from the MRI due to the fluid showing up..... so obviously he saw something that he wants confirmed by the ultrasound....

@SaraK Oh I am happy for you that someone actually listened to you! Hoping that you get some answers as to the issue and resolution. Maybe we are finally starting to pick up the pace in our race?!

@Mojo333 Thank you! I do have my fingers crossed for answers, but since the OS mentioned the gluteus minimus tear in his note.... I would suspect that on my followup with him on the 31st that I will find out the treatment plan....(or at least I hope).....

 

[SaraK]

Yes, it's sometimes funny to see the visit summary. My OS apparently uses form docs. The 2 op reports are almost identical. Difference may be that they were done at different places. The 3 month visit summary for each hip looks the same even though we discussed other issues with this one. They also say he demonstrated several exercises/stretches including a yoga pushup - can definitely say he never did that! I wonder what his office notes look like - if they're more reflective of the discussion.

Keeping my fingers crossed for you! Sounds like he's looking for something specific, so that's very good news - hopefully it means he's narrowed it down quite a bit. Why don't they understand, though, that they can mention the muscle by name. By the time we've gotten to this point, Dr. Google has done a very good job of educating us about the muscles and tendons in the hip, where they are and what the do!

 

[Mojo333]

Thinking of you and hoping you are staying calm as you wait on "The Plan"
Healing hugs coming your way!

 

[Marvy]

Thank you so much @Mojo333 I am hoping that on Monday the ultrasound doctor will say something and not make me wait until my follow up on the 31st.

Last night we went to dinner and by the time we left I was in such pain I could not get comfortable (I guess sitting on the wooden chairs at the restaurant did me in). I was in bed at 8:30 because of the pain...

 

[Mojo333]

I am hoping that on Monday the ultrasound doctor will say something and not make me wait until my follow up on the 31st.

Me too, @Marvy

I guess sitting on a wooden chair

Oh I can only imagine so.
I've heard folks talk about gel pads
to sit on.
Doesn't it just annoy you too consider buying things you hopefully won't need at some point? Does me!

I obviously am not a medical professional so I am not sure what to suggest.
Are you still icing, I hope?

Keep us up on what they say!

 

[Layla]

Happy Saturday
Want to say Hi and wish you the best with your ultrasound on Monday.
I hope you hear some news and don't have to wait until the 31st.
Sorry your dinner out was ruined by pain. May those days be on their way out.
Wishing you comfort as you await answers.
@Marvy

 

[Marvy]

I had the ultrasound this morning. Unfortunately, according to the doctor, he did not find any tears. He had absolutely no ideas as to why I am having the pain and why the muscles will not strengthen.

Where do I go next? I honestly don't know. At this point, I am at a loss. There are no words left to describe this....

 

[Mojo333]

Couldnt tell what part of the country you hail from...but I can just imagine that this was one time you HOPED there was something wrong...so you could do SOMETHING about it!
How ultra-frustrating.
Do you think a second opinion would be warranted...or possible?
I hate to see you so miserable and deflated.

 

[SaraK]

This sounds odd, but I'm so sorry they didn't find something wrong. Let's see what the surgeon has to say on the 31st. Maybe he has one or two other things to look at. Have you seen a pain specialist. While it didn't help me, maybe it would help you since you do have some back issues. I'll continue to keep my fingers crossed (and will add the eyes as well)!