BoneSmart® Hip / Knee Replacement Forum
Joint Replacement Patient Advocacy
and Online Community
  1. Announcing BoneSmart's NEW Joint Surgeon Locator tool

    We are pleased to now offer a tool to help you find just the right surgeon for your needs. If your surgeon is not listed, please let us know and we'll get them added.

    Read more about this in this announcement:

    Dismiss Notice

High Metal numbers with RTHR. Very worried.....

Discussion in 'Hip Replacement Pre-Op Area' started by Greg, Jul 8, 2014.

Thread Status:
Not open for further replies.
  1. Greg

    Greg junior member
    Thread Starter

    Member Since:
    Jul 7, 2014
    Age:
    50
    Messages:
    30
    Gender:
    Male
    Location:
    Raleigh, NC
    Country:
    United States United States
    Hi everyone!,
    My name is Greg and I am new to this site. A little background: 10/13/2009 I had an Anterior RTHR with Biomets MoM implant. I was diagnosed with AVN in both hips with the right being far gone and left requiring core decompression wihich has held up well. All went well with RTHR and I thought things would be fine.

    So, last August, I was walking and my left leg started hurting really bad. After a lot of tests we determined that the AVN had not progressed but I had a labral tear in the left hip and I had a herniated L5-S1 and two buldging lumbar discs. As you all know, with hip and back pains its a bear to figure out what is causing what?

    While going through Steroid Injections and PT my right hip started making noises and I had pain in the hip. Without going into the details we finally got to the Metal testing and my cobalt and Chromium levels are high. Cobalt is 48 and Chromium is 45. The tests say that normal folks should read between .01-.09 and anyone with a MoM implant should be under 10. So, as you can imagine, I am losing it right now. I see my Surgeon next week and he doesn't even know I have these results. As far as symptoms, I do have some pain in the hip but fatigue and weakness seem to be the biggest issue right now.

    I have read a lot on this and some of the issues that can happen at levels I have are very alarming. Has anyone been through this yet or know anyone who has. Any advice or words of wisdom?

    Thanks!
    Greg
     
  2. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

    Member Since:
    Jun 8, 2007
    Age:
    78
    Messages:
    84,911
    Gender:
    Female
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    Hi Greg and welcome to BoneSmart. You are in a pickle! I would strongly suggest that you find a hip surgeon who a) specialises in (meaning does a lot of!) hip revisions and b) has some experience with MoM issues. You do not want a run of the hill hip surgeon to see to this for you. And as for your numbers, they would be enough to have me scampering to the nearest such specialist to get that hip changed to a different type. And it's much,much better that you get it done before the symptoms get any more significant and tissue damage starts occurring.

    I doubt this is what you wanted to hear but since you have this blood result, you do NOT want a surgeon to say "Let's just sit on this and see how things go"!

    We have a lot of information about the MoM issue, much of it unique to us because I attended meetings at the Royal College of Surgeons in 2011 where this was original discussed
    Metal-on-Metal Hip Replacements: Solving The Uncertainties Dec 2011

    Metal-on-Metal Hip Implants: FDA Safety Communication

    Metal on Metal ion levels: safe upper limits for MoM hip resurfacings set by scientists
    Metal-on-Metal issues and DePuy recall: regulation of joint prostheses in Australia
    Metal on Metal warning (old but ongoing news) (thread in hip pre-op forum)
    Metallosis: what is it?
     
  3. beachgal

    beachgal post-grad

    Member Since:
    Jun 11, 2014
    Age:
    66
    Messages:
    1,320
    Gender:
    Female
    Location:
    Mississippi
    Country:
    United States United States
    @Josephine, you are a Godsend. What would we do without your calm reassurances and honest evaluations? Thank you for all you do.


    Sent from my iPhone using BoneSmart Forum
     
    • Agree Agree x 1
  4. Greg

    Greg junior member
    Thread Starter

    Member Since:
    Jul 7, 2014
    Age:
    50
    Messages:
    30
    Gender:
    Male
    Location:
    Raleigh, NC
    Country:
    United States United States
    @Josephine Thank you so much for the post and the links. I am going to review them tonight. I spoke with my surgeon this evening and he said we need to replace the hip without a doubt. I am going to his office on Tuesday to further discuss which approach, what product should be installed, when to do it, etc.. He is a Revision specialist and he isn't the same surgeon that did the first one. I do have an appt with a hot shot at Duke Orthopedics on August 20 and he will be my other option. This surgeon said I should replace this within 1-3 months which is relatively fast in this business I think. I am planning to move on this by Sept 1.
     
  5. younghippie

    younghippie senior

    Member Since:
    Feb 1, 2014
    Age:
    42
    Messages:
    492
    Gender:
    Female
    Country:
    United States United States
    Sorry you are going through all of this, Greg. Hope all goes well! You're in my thoughts and prayers.
     
    • Agree Agree x 1
  6. MajorHeidi

    MajorHeidi Sr Bonesmartie

    Member Since:
    Dec 5, 2013
    Age:
    60
    Messages:
    3,584
    Gender:
    Female
    Location:
    Virginia
    Country:
    United States United States
    Greg, as you are hearing, the sooner the better. I also feel for you.... Stick with this site, its great
    support!
     
    • Like Like x 2
  7. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

    Member Since:
    Jun 8, 2007
    Age:
    78
    Messages:
    84,911
    Gender:
    Female
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    Perfect!
    I'd pitch for sooner rather than later if it were me but then, you haven't seen the evidence I've seen. A lot of tissue damage can be done in 3 months.
     
  8. ARHip

    ARHip senior

    Member Since:
    Dec 20, 2013
    Age:
    58
    Messages:
    287
    Gender:
    Male
    Location:
    Little Rock, AR
    Country:
    United States United States
    Greg,
    I had revision of a MoM in January. There is light at the end of this complicated tunnel. I was replaced with a ceramic/polyurethane ball. If I can help, let me know.


    ARHip
     
  9. Greg

    Greg junior member
    Thread Starter

    Member Since:
    Jul 7, 2014
    Age:
    50
    Messages:
    30
    Gender:
    Male
    Location:
    Raleigh, NC
    Country:
    United States United States
    Thanks! How is it going? Was the rehab much harder or about the same? I am trying to move quickly to get scheduled.
     
  10. Greg

    Greg junior member
    Thread Starter

    Member Since:
    Jul 7, 2014
    Age:
    50
    Messages:
    30
    Gender:
    Male
    Location:
    Raleigh, NC
    Country:
    United States United States
    @ARHip I just left the Surgeons office and we have scheduled my revision surgery for Aug 6. He is going to use the Metal prothesis in the leg as long as all is well with it and he did say I will have Cermanic on Poly implant like you mentioned above. He told me that things will depaned heavily on whether they can use the current prothesis and if they can't will it come out without the need to fracture the bone. He was very honest and said I am looking at anywhere from 6 weeks to 3 months depending on best case to worst case in terms of full recovery. He also said this will be less weight bearing early on versus last time but that also has a lot to do with the need to fracture. Sound similar to you?

    Also, @Josephine I did confirm that he is a revision specialist and not only that he is a revision specialist but one of the top revision specilists in the Raleigh-Durham area so I feel good about him. He also has dealt with MoM revisions, etc..

    The next three weeks are going to be long! I am kind of freaked out because I recently divorced and my parents are passed and my friends and family all work or live in other cities. My current girlfriend is awesome but she is taking her parents to France from July 30- Aug 20 so I will need help at home from about Aug 9 to 20 without her (not sure where it will come from??). I sure hope he doesnt have to fracture the bone. The xrays looks good but he says until he gets in there we just dont know.
     
  11. alexthecat

    alexthecat MODERATOR Administrator

    Member Since:
    Mar 1, 2010
    Age:
    52
    Messages:
    10,012
    Gender:
    Female
    Country:
    United States United States
    You know, they have to warn you about everything that could happen... even the things that are very unlikely. I think fracturing your femur to remove the prosthesis is one of those unlikely things.

    Try to stay busy and not worry too much. Good luck with your surgery. I have ceramic on poly too, BTW.

    Sent from my XT1060 using Tapatalk
     
  12. beachgal

    beachgal post-grad

    Member Since:
    Jun 11, 2014
    Age:
    66
    Messages:
    1,320
    Gender:
    Female
    Location:
    Mississippi
    Country:
    United States United States
    @Greg, why not consider a short-term stay at a rehab facility? Even for the first 30 days, it would take one large worry off the table. With your circumstances, I would think it would be appropriate.


    Sent from my iPhone using BoneSmart Forum
     
  13. Greg

    Greg junior member
    Thread Starter

    Member Since:
    Jul 7, 2014
    Age:
    50
    Messages:
    30
    Gender:
    Male
    Location:
    Raleigh, NC
    Country:
    United States United States
    @beachgal I was thinking about it and spoke to my surgeon about it today. I was hoping that Wake Medical Centers Rehab facility would take me but they only take special cases (stroke, etc). Pretty much all other options are just skilled nursing facilties and I would be laying around all day. I am vey familiar with all of them because I had to check my father into a few of them when he was near death and I think I would go crazy in those places. I wish we had more options but the surgeon really wants me to press friends and family to come.. I am working on it already so we will see. I think I need to plan for the worst and hope for the best. Meaning, having sleeping arrangements on all floors, same with things like raised toilet seats and on and on... My girlfriend and I are going to start working on it now and the OT will come over and help plan I hope.
     
  14. beachgal

    beachgal post-grad

    Member Since:
    Jun 11, 2014
    Age:
    66
    Messages:
    1,320
    Gender:
    Female
    Location:
    Mississippi
    Country:
    United States United States
    @Greg, agree, nursing facility is no place for you to recover and rehab. Your plans to get various places set up in your home is smart. Perhaps a home health nurse /aid can stop by three days a week until your SO returns from her trip. That way you'd have help with shower/bathing and other personal needs. I'm sure family and friends will step up. Frankly, I'm trying to do my surgery "under the radar " as I don't do sick well with an audience! Once you get the hang of how this works, you'll be fine. Good plan!


    Sent from my iPhone using BoneSmart Forum
     
  15. ARHip

    ARHip senior

    Member Since:
    Dec 20, 2013
    Age:
    58
    Messages:
    287
    Gender:
    Male
    Location:
    Little Rock, AR
    Country:
    United States United States
    @Greg, if you track down my posts (click my icon and go from there), you can see my weekly diary. The first couple of weeks were the most difficult, but I think by the third week I was walking a mile with just a cane. I hope your doctor does not have to remove the post in your leg. That would greatly lengthen your recovery. My doc removed and replaced the ball. Bone graft was needed behind the cup and tissue was removed, but no more. I kept to my meds as needed, not letting pain be a problem, and used ice packs regularly. First week or so I used a walker. If you are alone, be VERY careful bathing until you are real steady. The heat can weaken you more than you expect. I was off all Rx pain meds at 4 weeks and at 5 weeks I was back to work full-time. I was slow, but steady. I do a lot of driving and a lot of walking.

    In some ways the revision had less pain than the first surgery, but at 6 months now, I think full recovery is longer. Have hope for a good recovery, and be thankful you will be getting rid of those heavy metals in your blood. After 10 years of rising cobalt, I think I have effects that will never heal. Hope I am wrong, but I wonder.


    ARHip
     
    • Agree Agree x 1
  16. Jaycey

    Jaycey SUPER MODERATOR Moderator

    Member Since:
    Jan 27, 2010
    Messages:
    28,792
    Gender:
    Female
    Location:
    Yorkshire
    Country:
    United Kingdom United Kingdom
    @Greg , gosh I hate to see anyone suffering from MOM issues. It's great that you are moving ahead quickly with this.

    You should be fine on your own post op. I was alone for most of the time in the first weeks. Put everything you need within reaching distance. As ARHip recommended, don't shower until you are feeling very confident on your feet. Ask your surgeon's office about an Occupational Health person. They may be able to assist you in making your home new hippie friendly. I hope the time flies for you!
     
  17. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

    Member Since:
    Jun 8, 2007
    Age:
    78
    Messages:
    84,911
    Gender:
    Female
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    Excellent!
    I don't see why. Lots of people who live alone have to cope on their own after surgery. It's perfectly doable.
    Oh please! A fracture is by accident. If he has to do anything like that it certainly won't be by accident! He will carefully cut or osteotomise the bone which is an 'on purpose' and will be repaired if necessary. Mostly the osteotomy is remedied by using a slightly longer stem which will transfix the cut place and make it secure.
    It's stem not 'post' @ARHip
    It's not the heat that weakens one, it's the Energy drain.
    Now that I can agree with! Seems illogical but most 'routine' revisions are less bother than the primary as there is much less bone cutting.
     
  18. PA Gal

    PA Gal member

    Member Since:
    May 17, 2014
    Age:
    66
    Messages:
    145
    Gender:
    Female
    Location:
    Pennsylvania
    Country:
    United States United States
    I am recovering alone (from regular THR, not revision), and I would just agree with other posters about having everything handy and within reach. I also got enough paper plates/plastic flatware for the first few weeks to cut down on kitchen chores & mess. You can get those pre-moistened bath cloths at Walmart until you can safely shower - they are refreshing and your skin doesn't dry out. If you live in an area where you can order food delivery (either prepared/deli from the grocery or take-out), you should be good for food. Is there a teenager in the neighborhood, local Boy Scout troop, or from a local church who could stop in a few times a week to do household chores, run errands or whatever? It's summertime, there are some teens who are still willing to work to earn some extra money, LOL! I was fortunate to have friends available as I am in a rural area without all the resources of a city. It's a shame the timing was all wrong re: your girlfriend's trip as I'm sure you would like to have her support during the surgery and in the first week. I wish you the best. It sounds like you've got a good surgeon.
     
  19. Greg

    Greg junior member
    Thread Starter

    Member Since:
    Jul 7, 2014
    Age:
    50
    Messages:
    30
    Gender:
    Male
    Location:
    Raleigh, NC
    Country:
    United States United States
    Well, I am about 8 days from surgery now. I am driving myself nuts because my recovery depends on multiple scenarios. Obviously, with revision surgery due to metallosis there is no telling how much tissue damage I might have and there is the chance he will have to remove the stem perhaps fracturing the bone. Of course, I would be unlucky and talk with a few people recently who had this procedure and they all had leg fractures...:( Living in a 3 story home with no adult gauranteed to be here for much time when I get home is stressing me out. I am hiring a CNA to come by 3 hours in the morning and 2-3 hours at night but I am still uneasy. God willing he can use the stem and tissue damage isnt that bad. I think I will do very well with that scenario. I am also concerned about reversing the rehab I have done on my left labral tear and a herniated disc with two bulging discs in Lumbar. I really need to take it easy with rehab or my back will be a mess. OK, I am rambling and just stressed out. Hurry up Aug 6!!! :rotfl:
     
  20. Jamie

    Jamie ADMINISTRATOR Administrator

    Member Since:
    Mar 24, 2008
    Age:
    70
    Messages:
    55,558
    Gender:
    Female
    Location:
    Kansas
    Country:
    United States United States
    Greg, I don't want to add to your concerns, but I must ask if you have spoken with an attorney regarding your metal on metal issues. Depending on what brand of implant you have, there are settlements in the works to help cover the costs of this revision surgery and you really should make yourself aware of your options. I suggest you contact a personal injury attorney near you to discuss the matter. Usually they will want the surgeon to retain the removed implant material and you would want to make those arrangements with your surgeon now.

    As for your surgery, it sounds like you've done an excellent job putting things together in a short period of time. Good for you!! I have a good friend who just went through this same thing a couple of months ago. Her revision went without a hitch and she's doing just fine. And....she lives by herself in a two-story house. All worked out well.
     
Thread Status:
Not open for further replies.

Share This Page