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Revision THR Golfer67 Recovery Thread

I had an appointment with my primary doctor today and she is sending me to The Ortho Neuro Specialty Services department of the hospital that she is affiliated with to try and find out what is causing my swelling and pain. This department of the hospital is something that I have not heard of before but it looks like it might be just what I need to determine what is wrong with me. They are going to call me and setup the appointment; I hope they don’t put me on a long waiting list.

Here is the department

Deaconess - Ortho Neuro Specialty Services

Deaconess Ortho Neuro Specialty Services provides expert care to patients with complex orthopedic and neurological conditions and disorders.
www.deaconess.com www.deaconess.com
 
Hi @golfer67
This facility's particular department sounds to be very specialized and I hope you get in soon to get answers :fingersx:
 
Tomorrow I am going for an ultrasound test of the swollen area around my replaced hip. I hope that this test will provide some information leading to a determination of the reason for my continued pain and swelling. I previously had an MRI of the area but due to the metal in the replaced hip no conclusion was reached. My research tells me that the ultrasound will show the soft tissues in some detail so maybe I will find out something this time.

Anyone else had an ultrasound? Did it tell you anything that the MRI did not?

Thanks

Golfer67
 
Hey Golfer,
Best of luck with your ultrasound tomorrow. I hope the source of your pain and swelling is diagnosed and a plan is formulated bringing you relief. Please keep us posted.
@golfer67
 
@golfer67
I hope you get some answers regarding your pain and swelling. i have had a long recovery as well and it is now 14 mo. since my surgery. I do not have visible swelling and my sleep is okay, though. I think I function fairly well, but not as well as I would have expectEd, and I often have soreness, especially later in the day.

i Have seen several orthopedists including a pain specialist for a second opinion, although my os who is the head of the department at a well known teaching hospital, said to give it time.

All concluded that I have IT band issues and meralgia paresthetica, which has to do with the Lateral femoral cutaneous nerve. Because the pain was referred to my knee, the pain specialist did an ultrasound which showed a healthy knee. He also looked around my implant, but saw nothing abnormal and no fluid pockets. I was offered a cortisone shot by him, but all three doctors recommended pt focused on the quads and gluteus. I have started pt with a group that seems excellent.

if I do not see an improvement in a few months, I am considering going to the Mayo Clinic or HHS for an evaluation.

I hope your ultrasound goes well, and you will see improvement soon. For me, it was quick and really painless.
 
Here are the results of my ultrasound today. To me it looks like they did not find anything wrong. If this is true then why do I have so much pain and swelling? What does edema in subcutaneous tissue mean?


Study Result
Impression
IMPRESSION:
1. No evidence of tendon rupture or apparent ligamentous injury.

2. There is some edema in the subcutaneous tissues. No fluid collection or soft
tissue mass.
Narrative
TECHNIQUE:
Real-time ultrasound evaluation of the left hip was performed. Multiple
grayscale images were obtained.

FINDINGS:
There is no soft tissue mass or fluid collection.

There is some edema in the subcutaneous tissues.

All tendons visualized are intact.
Component Results
There is no component information for this result.

Golfer67
 
I went today to my surgeon for my one year checkup. I didn’t get to see the surgeon but was seen by his assistant. They took x-rays and told me that everything looks just great. When I showed them my continued swelling and complained about all the pain and symptoms that I still have I was told that they don’t know why I still have pain and prescribed me physical therapy and said to come back in two months. Needless to say I am not happy and probably will never go back again I am scheduled to go to the Ortho/Neuro Specialty Services department of the Hospital that my primary doctor represents for evaluation on Tuesday and I have high hopes that this place will be able to help me. I do think that my surgeon is a good surgeon but he certainly does not know what to do about my problem and that is simply not acceptable I did not tell anyone in his office that I may not ever come back so no bridges were burned but I have had enough. I left them with a printed out copy of all my symptoms and told them that I simply cannot take another year like my last one so I am off to the doctor that my primary doctor is sending me to with hopes of finding and curing my problems.



Golfer67
 
@golfer67 I really feel for you, I still had pain issues at one year follow up and basically told the same as you, everything looks great. It's so frustrating, hoping the folks from the Ortho/Neuro services can give you some insight. Really interested to see what you find out.
 
I had my appointment today with the rehab specialist department and you guessed it they want me to go for specialized rehab for eight weeks and then come back to see them. At this point I have no choice but to comply and see what happens but I don’t see how rehab can reduce the swelling and stop the pain any better than all the walking and self-rehab therapy that I have been doing on my own and I know it can’t be any better than the exercises that I do in my heated pool with the water temp around 95 degrees but before they will look for any other reason for my swelling they are insisting that I go for their rehab. So here I go I just hope that the rehab does not make me too much worse.



Golfer67
 
Hello @golfer67
I understand your frustration in going through the motions of something you feel is futile.
I guess if the specialized rehab is something you need to cross off the list in an effort to look deeper, you’re cooperation will not be in vain. I’m sorry you’re still struggling with no answers or plan in place to bring you relief. Let’s hope you do notice some difference over the course of the next couple weeks. Please keep us posted, we’re here for you.
 
@golfer67
I don’t know whether it would help you or whether it would be medically sound for you, but during 12 sessions of pt I have had about 10 minutes of massage of my scar and the surrounding area. At first it hurt mildly, but now the scar is softer and the whole area less sensitive. The pts who do the message have a credential called COMT - certified orthopedic manual therapist. I never have had any interest in massage, so I have been surprised that it is helpful to me.
Helena
 
Well I had my first therapy session today. I am trying to go into this with an open mind and the expectation that the therapy will cure my problems but based on this session I don’t think it will help at all. As I suspected the therapist does not know why I have swelling and he has never seen the type swelling I have before. He is going to work on getting all my muscles looser and see if that helps me. The exercises that he has me doing are the same ones that I have tried on my own in the past so there is nothing new here. Who knows maybe it will work.



Golfer67
 
I do hope you begin to notice some improvement. Your hesitancy in embracing the specialized rehab is understandable, especially since it involves exercises you’ve already tried. I hope you can hang in there awhile longer. Please keep us posted and have a nice weekend!
@golfer67
 
Does your PT clinic offer a Manual Lymph Drainage?
That would be so beneficial for your swelling and inflammation.
You might be able to find a MLD therapist on your own but would be good if they had it where you’re already going.
I can give you some techniques to try on your own if you’d like?
But your best bet is to find someone certified in this technique to help you move that swelling.
 
If you could get an appointment at the Mayo Clinic in Rochester Mn. I think it would be a good idea. They take a more systemic approach. Backs and hips are connected and I wonder if that needs a bit more exploring. I know many people who have had complex medical issues resolved there.
 
Well this week I had a routine appointment with my cardiologist and as part of the checkup he wanted to know how I was doing so I told him about my hip problems. As a cardiologist he has to sign off on most of his patients before they can have a hip replacement so he is very familiar with how his patients do in the recovery phase of hip surgery. He told me that he has never had a patient with the problems that I am having fourteen months after hip replacement. He told me the swelling had nothing to do with my cardiovascular health and that I needed to get to a place like the Cleveland Institute or the Mayo Clinic. Then today I went back to my physical therapist for my fourteenth session out of eighteen sessions scheduled and he informed me that the therapy we have been doing is not going to cure whatever my problem is and offered to help me find a hip specialist that can figure out what the problem is. So that is my story as of today. I am supposed to go on an extended trip and I intend to try and go for the sake of my family. It will be sometime in December or even after the first of the year before I can make my next move if I can hold out that long.
 
@golfer67
Omg sounds like you’ve had a really hard time. I’m sorry this has been so difficult.
Have you discussed the possibility of infection? They can easily look at a few blood markers but the most accurate, I’m told, is to aspirate some fluid from the area and culture it. I had it done on my left TKR that just wouldn’t cooperate. It’s really not that painful - though I told the dr I wanted the maximum amt of anesthetic allowable under NY law!

Not sure where you’re from but it sounds like US. Best ortho specialty hospital is Hospital for Special Surgery in NYC. They have a team dedicated to complex adult replacement and revision cases. Perhaps a consult there would be helpful. This is the kind of thing they excel at - complex and difficult cases. One of them took care of my daughters infected implant (she had bone cancer at 16) They’re incredible people there. I had another surgeon on that team do my LTHR on Sept 13 and will do the right one in January. I have been so pleased with him - he really listens. When you talk to him, the only thing he cares about is what you’re saying and emphasizes we’re a team in this and need to agree on the plan of action. Honestly if he told me to go play in traffic b/c it would help, I would do it! There are ortho specialists for virtually every part of the body snd they collaborate really well on tough cases.

If you’re interested in learning more, get the right contact info etc plz let me know. Happy to pay it forward. There are also a few reasonably priced hotels near the hospital in case you come in from out of town.

Good luck and hang in there
(Btw this recent THR was my 8th surgery there in 2.5-3 yrs. I had a difficult run there for a while. I’ve seen 5 diff specialists and love them all. Running joke is my frequent flier miles there :)
 
I’m sorry to read that you’re likely facing more surgery. I hope you’re able to get an appointment with a good revision specialist soon to at least diagnosis the issue and decide next steps. Fourteen months is a long time to struggle with a recovery that hasn’t been smooth, then add to that the time you suffered with pain leading up to your THR. I hope there is an end in sight for you soon. I wish you the best. Please stay in touch.
@golfer67
 
You shared your ultrasound awhile ago. Did your OS or Gp have any idea about the subcutaneous swelling? Frustrating when qualified professions don’t know what is going on or don’t tell you! Hope things improve.
@golfer67
 
Last edited:
Thanks for the encouragement. No, so far no medical professional can tell me why I have this pain and swelling. The physical therapist however has admitted that no amount of physical therapy will solve my problem and is going to try to find the right doctor or medical facility for me to go to.



Golfer67
 
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