Revision THR Constant pain continuing 1 year after THR<^
- Thread starter Marvy
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zauberflöte
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@Marvy just checking back in, I am devastated to hear about how your life has contracted. Yes to any walking aids you want on vacation-- people will accommodate you, and perhaps even renting a wheelchair once you get there? And I'm glad you've got that appointment coming up, even if it is a month away. I cannot imagine your pain, I'm so sorry that you have it!!
@Marvy. I feel so bad for what you are experiencing. What a horror show. I totally hear you on the mental impact of not being able to exercise. I am a very active person and am having some issues post op as well and the mental impact of the pain and not being able to be active is impactful in ways that other people do not understand. People that haven't experienced chronic pain have no clue what it's like. It's like people that don't know what depression is like also can not relate in any way and the "pull yourself up by your boot straps" comments just don't help. Anyway, I had the same thought as zauberflote about getting a wheelchair for your trip. I'm sure you don't like the idea of that but if it keeps you from being in pain while out and about, it would be worth it. I don't know where you are going but if you can't rent one, perhaps you could contact some churches in the area to see if they have a loaner closet for medical equipment.
I have never heard of such a thing as OS offices not allowing appointments until patients are a year out.
Anyway, thinking of you and hoping that somehow the pain lets up a little. Things sound really hard for you. I'm glad you have the support of this forum at least. Hugs to you.
I have never heard of such a thing as OS offices not allowing appointments until patients are a year out.
Anyway, thinking of you and hoping that somehow the pain lets up a little. Things sound really hard for you. I'm glad you have the support of this forum at least. Hugs to you.
@zauberflöte, thank you for checking back in on me. I really appreciate it. We are supposed to go to San Francisco on vacation with a side trip to the wine country. I am definitely going to bring my cane.
@bikergirl Every OS office seems to have the 1 year policy no matter how much pain you are in. Their reasoning is that it takes a year for your hip to heal. I guess they think that if you have any issues that you need to go back to your original surgeon. I was shocked to finally find one that would make an appointment. I hope the doctor is as nice as the nurse was when I made my appointment.
It's still 3 weeks until my appointment with the revision surgeon. Their facility is designed around people with knee and hip issues - she said that even the chairs in the waiting room are different. They also asked me if I had the name and "part number" of my hip. I know the brand and type, but not a part number so they were going to contact the hospital. The nurse said that if I can't walk more than a few blocks at this point, that definitely something is going on. She also asked if I had anterior or posterior and when I said posterior, she said good as that is what the surgeon I requested specializes in.
My OS refuses to acknowledge anything so I have given up on them. They did call and ask if I wanted to schedule a hip injection and I said no. I did not tell them that I was going to another surgeon. I don't think they need to know.
We went to a small car show yesterday and I walked about 6 blocks, then we went to dinner. By the time I got home my hip ached so bad I went straight to bed. I woke up in the middle of the night and my hip was still burning and aching.
I have used heat, which helps some, but when my hip cools down, then the pain returns. I've also tried some gels and heat patches, but it's almost as though it can't get down deep enough in my hip to make much of a difference.
I'm tired of just sitting around. Hopefully in 3 weeks I'll have at least some idea of what is going on.
@bikergirl Every OS office seems to have the 1 year policy no matter how much pain you are in. Their reasoning is that it takes a year for your hip to heal. I guess they think that if you have any issues that you need to go back to your original surgeon. I was shocked to finally find one that would make an appointment. I hope the doctor is as nice as the nurse was when I made my appointment.
It's still 3 weeks until my appointment with the revision surgeon. Their facility is designed around people with knee and hip issues - she said that even the chairs in the waiting room are different. They also asked me if I had the name and "part number" of my hip. I know the brand and type, but not a part number so they were going to contact the hospital. The nurse said that if I can't walk more than a few blocks at this point, that definitely something is going on. She also asked if I had anterior or posterior and when I said posterior, she said good as that is what the surgeon I requested specializes in.
My OS refuses to acknowledge anything so I have given up on them. They did call and ask if I wanted to schedule a hip injection and I said no. I did not tell them that I was going to another surgeon. I don't think they need to know.
We went to a small car show yesterday and I walked about 6 blocks, then we went to dinner. By the time I got home my hip ached so bad I went straight to bed. I woke up in the middle of the night and my hip was still burning and aching.
I have used heat, which helps some, but when my hip cools down, then the pain returns. I've also tried some gels and heat patches, but it's almost as though it can't get down deep enough in my hip to make much of a difference.
I'm tired of just sitting around. Hopefully in 3 weeks I'll have at least some idea of what is going on.
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Well, I just got off the phone with the office of the revision OS. They had a cancellation so now my appointment has been moved to Thursday!!!!
I am looking forward to going and (hopefully) getting some answers and a direction of what needs to be done.
I am looking forward to going and (hopefully) getting some answers and a direction of what needs to be done.
zauberflöte
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Just curious, was it a "small car" show, or a small "car show"?
@zauberflöte
I think it was a bit of both!!!I think with my original OS, I will just "ride off into the sunset", never to call his office again...If I did call and voice my opinion, I honestly don't think he would care as he did my surgery, got paid, and since I can stand and walk a few blocks, nothing is his responsibility....
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zauberflöte
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@Marvy OS might care about his reputation though....I'm thinking I may have inherited from my son his combative attitude NO, that's not what I was really thinking-- if OS were shown not to have fully investigated one of any number of complications of which he is aware but you may not be, then he'd be in a sticky spot with the next group of patients. Ah well... what I really care about is that You get the care that You need! 
NO, that's not what I was really thinking-- if OS were shown not to have fully investigated one of any number of complications of which he is aware but you may not be, then he'd be in a sticky spot with the next group of patients. Ah well... what I really care about is that You get the care that You need! @Josephine - I apologize for direct tagging you, but I would appreciate your thoughts and comments on what the revision OS had to say.
I did have my appointment with the revision OS. He said that in looking at the x-rays, everything really looks good. He did review the CT images as well. He told me that in his opinion, one of the screws used in the cup is way too long. This has resulted in the tip/end of the screw to be in the "muscle belly". His suggestion was to do surgery to remove that screw. He said that since the bone has grown, he could just remove the screw (he'd actually remove both screws in the cup) and not replace them as they weren't needed at this point. He would also replace the liner with a different type (he called it a normal or neutral liner. what I have is a lateralized liner). In addition, he would also remove the head and put in an elongated head to fix the leg length discrepancy. He would not plan on replacing the stem, unless once he got in there and when he pulled on it, it pulled out without effort. So he would have a stem in the OR "just in case". If it needed to be replaced, it would be with a longer, uncemented stem.
He wasn't sure why a lateralized liner was used unless there were problems during surgery. Does this sound right? I was told that it would last a lot longer due to the extra poly in the liner.
In regards to the screw causing my pain, he did admit that he is not 100% certain that the screw removal would fix my pain. However, he had a case of a gentleman that had hamstring pain, he removed the screws and the man's pain went away. He didn't want to get my hopes up and said it was a gamble...
Other than removing the screws, he had no answers as to why I have pain. He also mentioned that my leg length discrepancy was not the cause of my pain. He will not operate solely to correct the leg length discrepancy.
He informed me that a revision has a higher chance of dislocation. I forgot to ask him if the higher dislocation chance was just during the recovery phase or for life. I hope it's just during the recovery phase.
I now have a decision to make - should I take the chance, have the surgery and at the very least, have my LLD corrected even though it may not resolve the pain?
Should I wait and try to get another opinion from someone else? Which could possibly be in January.
I really don't want another surgery, but would like to get my life back.
Thank you Josephine!!
I did have my appointment with the revision OS. He said that in looking at the x-rays, everything really looks good. He did review the CT images as well. He told me that in his opinion, one of the screws used in the cup is way too long. This has resulted in the tip/end of the screw to be in the "muscle belly". His suggestion was to do surgery to remove that screw. He said that since the bone has grown, he could just remove the screw (he'd actually remove both screws in the cup) and not replace them as they weren't needed at this point. He would also replace the liner with a different type (he called it a normal or neutral liner. what I have is a lateralized liner). In addition, he would also remove the head and put in an elongated head to fix the leg length discrepancy. He would not plan on replacing the stem, unless once he got in there and when he pulled on it, it pulled out without effort. So he would have a stem in the OR "just in case". If it needed to be replaced, it would be with a longer, uncemented stem.
He wasn't sure why a lateralized liner was used unless there were problems during surgery. Does this sound right? I was told that it would last a lot longer due to the extra poly in the liner.
In regards to the screw causing my pain, he did admit that he is not 100% certain that the screw removal would fix my pain. However, he had a case of a gentleman that had hamstring pain, he removed the screws and the man's pain went away. He didn't want to get my hopes up and said it was a gamble...
Other than removing the screws, he had no answers as to why I have pain. He also mentioned that my leg length discrepancy was not the cause of my pain. He will not operate solely to correct the leg length discrepancy.
He informed me that a revision has a higher chance of dislocation. I forgot to ask him if the higher dislocation chance was just during the recovery phase or for life. I hope it's just during the recovery phase.
I now have a decision to make - should I take the chance, have the surgery and at the very least, have my LLD corrected even though it may not resolve the pain?
Should I wait and try to get another opinion from someone else? Which could possibly be in January.
I really don't want another surgery, but would like to get my life back.
Thank you Josephine!!
@Marvy so sorry you are having to make this decision. So hard to face another surgery. If it were me I would go for the surgery. Sounds like a very logical approach.
There is always a risk surgery won't work. But it sounds like your surgeon will make very attempt to get you to a better place. How soon could you have the op?
There is always a risk surgery won't work. But it sounds like your surgeon will make very attempt to get you to a better place. How soon could you have the op?
Josephine
NURSE DIRECTOR EMERITA
Why on earth would you feel it necessary to apologise? That's what I'm here for!
I really couldn't say, Marvy. Sometimes I wonder why these surgeons do the things they do!
I've heard of cases like that too.
It would be for the duration of recovery.
I'd also go for the surgery. All that he is planning to do will be beneficial and well worth the punt.
zauberflöte
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sounds like the new OS has a head on his shoulders-- I can't say what I'd do in your position, but I like the things he told you anyway!
Sometimes people schedule just to get in, and then back out-- I actually had to do that twice with the hip I just got in July.
Sometimes people schedule just to get in, and then back out-- I actually had to do that twice with the hip I just got in July.
Last week I decided to do the doctor suggested injections to the femoral and obturator nerves. I was able to get 2 days of pain relief. Then the pain returned and it seems worse than before the injections.
I keep thinking about the psoas muscle as being the culprit, but no one else does. No one has suggested an injection to the psoas to rule it out either.
However, because I had some pain relief from the femoral and obturator injection, the pain management doctor did say that the issue points to the hip joint - muscle, tendon, etc. They want to now do an ablation which will deaden the nerves and give me "up to a year" of pain free time. the pain management doctor also said that this is not correcting the issue. The revisionist says that he has seen the pain come back much worse after having an ablation.
The revision surgeon still thinks it is a mechanical issue. I am scheduled for a revision next month where he will remove the screws and correct my leg length discrepancy. He did say that my symptoms sound like a loose stem, even though the x-rays look fine.
I do not see the surgeon again prior to the surgery. The pre-op appointment is with the PA.
The pain that I am having is in the same location as prior to my THR (on the line between L4F and L5F D-E-F-G), but is now worse, so I don't see how it can be the screws in the cup.
![[Bonesmart.org] Constant pain continuing 1 year after THR<^](https://bonesmart.org/forum/attachments/upload_2015-6-9_13-35-17-png.31797/ "[Bonesmart.org] Constant pain continuing 1 year after THR<^")
I'm second guessing the revision surgeon and my decision to have another surgery....maybe I'm just overthinking this too much....
I keep thinking about the psoas muscle as being the culprit, but no one else does. No one has suggested an injection to the psoas to rule it out either.
However, because I had some pain relief from the femoral and obturator injection, the pain management doctor did say that the issue points to the hip joint - muscle, tendon, etc. They want to now do an ablation which will deaden the nerves and give me "up to a year" of pain free time. the pain management doctor also said that this is not correcting the issue. The revisionist says that he has seen the pain come back much worse after having an ablation.
The revision surgeon still thinks it is a mechanical issue. I am scheduled for a revision next month where he will remove the screws and correct my leg length discrepancy. He did say that my symptoms sound like a loose stem, even though the x-rays look fine.
I do not see the surgeon again prior to the surgery. The pre-op appointment is with the PA.
The pain that I am having is in the same location as prior to my THR (on the line between L4F and L5F D-E-F-G), but is now worse, so I don't see how it can be the screws in the cup.
I'm second guessing the revision surgeon and my decision to have another surgery....maybe I'm just overthinking this too much....
Gone again
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What a nightmare. I'd go for the revision also I think. November isn't to far off but when your in pain it seems forever. Best of luck.
zauberflöte
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yeah, nightmare is the word. I don't have a clue. Prayers for clear reasons and decisions!
YoungHippy
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On the ablation: It is not a fix for the problem, but it is good for pain control. What they are doing is ablating (or damaging) the nerve. So until the nerve regenerates you have pain relief. They do say it can last up to a year, but the average is about 9 months. I don't have any personal experience with it being used for hip pain. My mother has had it done for her lower back pain, and the got 8 months of pain relief. Not complete pain relief though. She still had some pain, but it wasn't the crippling, disabling, "the pain is all I can think about" pain.
That being said, I would go for the revision, see if that helps. If necessary you can revisit the ablation idea later.
ETA: I think the revision surgeons idea that the pain could be worse after the ablation wears off comes from the fact that when we feel better we seem to get the idea that we are superman and do all kinds of things we shouldn't be doing that cause worse damage.
That being said, I would go for the revision, see if that helps. If necessary you can revisit the ablation idea later.
ETA: I think the revision surgeons idea that the pain could be worse after the ablation wears off comes from the fact that when we feel better we seem to get the idea that we are superman and do all kinds of things we shouldn't be doing that cause worse damage.
@Gone again, @zauberflöte and @YoungHippy, Thank you for your thoughts and comments. They are much appreciated.
When it comes down to it, I know I "need" surgery, but I don't "want" surgery. I'm sure I am not alone in feeling that way.
@YoungHippy, you are exactly right about the ablation and the pain being worse when it wears off as I would be one of "those" people that would be pain free and overdo things. I have missed hiking, biking and going to the gym so much.
I have filed for Family Medical Leave to start the day of surgery. Unfortunately, my boss is really giving me a hard time about being gone. Sorry, not sorry. I need to take care of me. This will probably cost me my (current) job though.
I received a call this morning from a revision surgeon's office that I had contacted a while back. They now are willing to see me next Monday. I am debating on if I should get a second (or third) appointment. My family thinks that I should not as I already have a plan from my current revision surgeon. But I am the type of person that needs to have multiple opinions and then weigh the pros and cons. Yes, I cannot buy a birthday card without reading all of them in the store to find the right verse.....(sometimes that can be good, but sometimes it is a curse!)
Hope everyone is having a good Monday!
When it comes down to it, I know I "need" surgery, but I don't "want" surgery. I'm sure I am not alone in feeling that way.
@YoungHippy, you are exactly right about the ablation and the pain being worse when it wears off as I would be one of "those" people that would be pain free and overdo things. I have missed hiking, biking and going to the gym so much.
I have filed for Family Medical Leave to start the day of surgery. Unfortunately, my boss is really giving me a hard time about being gone. Sorry, not sorry. I need to take care of me. This will probably cost me my (current) job though.
I received a call this morning from a revision surgeon's office that I had contacted a while back. They now are willing to see me next Monday. I am debating on if I should get a second (or third) appointment. My family thinks that I should not as I already have a plan from my current revision surgeon. But I am the type of person that needs to have multiple opinions and then weigh the pros and cons. Yes, I cannot buy a birthday card without reading all of them in the store to find the right verse.....(sometimes that can be good, but sometimes it is a curse!)
Hope everyone is having a good Monday!
zauberflöte
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@Marvy go with the method of decision making that works for you, sounds like. Nobody "wants" surgery when they know what's coming. And pooh on your boss who thinks he is also the ultimate boss of FMLA. You will find a much better job if he does can you!
You know, you sound like my husband in the "read every verse". Except he was paralyzed by indecision. He once told me, back when we were courting, of a night he'd come home from work, walked into the kitchen, spent an hour staring at the two cans of food in his cupboard, then had a glass of orange juice and gone to bed. He now swears (40 years later...) that he never told me that story. Ha!
You know, you sound like my husband in the "read every verse". Except he was paralyzed by indecision. He once told me, back when we were courting, of a night he'd come home from work, walked into the kitchen, spent an hour staring at the two cans of food in his cupboard, then had a glass of orange juice and gone to bed. He now swears (40 years later...) that he never told me that story. Ha!
@zauberflöte - I must say that I sound like your husband. I too have been in his situation with the food... I am glad I am not alone!
