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I'm back but not better

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RockMan

new member
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Feb 7, 2009
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Location
Nigeria
I'm sorry for being away for so long. My family wanted me to concentrate on being well hoping it would make me get better but it didnt seem to work out. This is a continuation of my initial thread at https://bonesmart.org/forum/showthread.php?t=2611

It's about 5 months now, i'm not any much better. My knee is still very stiff although i see a physio therapist twice a week to force it to bend as prescribed by the OS. I think it was been forced too hard yesterday as i've been feeling some serious pain on my hip which gets worse when i try to move and it's also swollen. I've not been able to move out of my room since then due to the pain and funny movements i feel on my hip when i attempted to.

The surgery wound is not any better. The OS saw it 4 days ago, he put me on a new set of antibiotics and asked me to come for a procedure where he'll clean up the wound. I don't have that much confidence in the hospital or doctor to go back there for the procedure.

I've not been able to go anywhere else because of the difficulty in moving around hoping with time i would get a little better to handle it.

I've been very depressed lately and still confused. I found an OS in india which i contacted through https://www.hipsurgery.in. He said the hip will need to be revised by first taking out the implant, treating the infection then putting in new implants.

I don't know how i can make it that far to india considering my current state but i'm thinking i should try. I don't know if i'm making a good choice or if there's is a better option because i'm just looking for a place that can really fix my problems and not just attempt to fix it. I'm really considering treatment outside the country. Please help
 
RockMan.....is it possible for you to come to the USA? Surgery is more expensive here, but at least you could get some personal recommendations from forum members who have had surgery from the doctors they'd be recommending. As far as I can recall, there is only one forum member who has had surgery in India. You might want to contact him directly in a PM....his name is nickji. I would be pretty concerned about a potential surgeon who thinks he can diagnose a problem via email. Just be careful....

I have to agree that it would be difficult to maintain confidence in your current medical team as they have not been of much help to you.

Please post when you can. We care about you.
 
Please what is the cost of such treatment in the USA. I understand it's about 3500 Pounds in india which i think my family can afford.
 
I've heard of that surgeon and his aftercare leaves a lot to be desired.

Plus, having something like that treated at a distance is not to be advised as it's unlikely to be a once only procedure. You'll need intensive follow-up
with blood tests and xrays to make sure it worked. You may also need a period between taking out the present prosthesis and putting in the new one. During this, a spacer of antibiotc impregnated bone cement would be used along with intensive course of intravenous and oral antibiotics.

Please don't even consider going abroad for this treatment.
 
Rock....I'll defer to Josephine then. She knows far more than I do about the medical aspects of what you are contemplating. If she thinks the risk of going out of your country to get help are too great, I value her opinion.

I know when you posted before, I did some Googling to see what hospitals and doctors might be available in Nigeria. Please tell me where you are located, who your current doctor is and what hospital and clinic you are currently involved with. Maybe we can help you search out someone in country who can help.

I am so sad for your situation and hope that you can get help.
 
Rats! I forgot that you are in Nigeria, Rockman. I'm so sorry!

The point being that you have now had this infection so long that a course of antibiotics is not going to do much good. It needs to be treated as I described in the earlier post. It also needs to be treated by a revision expert. That doctor/surgeon sounds as if he's still working on 1970s protocols.

With your permission I would like to contact some people and see if they will look into your case - would you be agreeable to that?
 
Please do contact anybody that can help. I'm located in Port Harcourt, Rivers State, Nigeria and the hospital i had the surgery done is Rehoboth Specialist Hospital. The Surgeons name is Dr Ekere. Thank you.
 
Okay, I'll get back to you via pm as soon as I hear something.
 
Hi Rockman,

I'm going to take my courage in both hands and disagree somewhat with Josephine. Please remember that she has lots of experience and I don't have any, so my 5 cents worth has to be taken with a large dose of doubt.

I also see that Josephine's going to contact some people, so again, her help is surely going to be more useful than anything I can offer (no, I'm not being modest, just realistic).

However, I do have one thing that might be worthwhile, and that is that since leaving England in 1970 I've lived my whole life overseas, and that includes three years in your home country of Nigeria (Kaduna was my base) and 23 in South and S.East Asia (including India and Nepal).

Everything Josephine says about having surgery abroad is absolutely right, but if I had to chose between the Indian or Nigerian health systems, I am fairly sure that India has a better international reputation. In fact, the best Indian hospitals are widely thought to be as good as anywhere in the world.

As Josephine says, follow up is critically important. So if India is your only financial option (don't forget Thailand - probably better, though certainly more expensive), you need to plan to stay there for a long time - Josephine would know how long, I'm sure. If, for example, you needed to stay for three months, and chose the best hospital in Goa, then you could reckon on a budget of about US$500 a month for food and guest house room, and that could include a 'helper'. Some people manage to live on US$300 a month, but that would be pretty basic. Costs for an uncomplicated THR (again at the best hospital) are about UK£4,000. In your case I have no idea what the cost would be, but surely quite a lot more. Flights to Goa from Europe are quite cheap (around UK£400 - £500 return are easy to find); I don't know about the cost of flights from Nigeria.

So, if you are able to stay long enough in India for all the necessary follow up work, then I do believe that it's a reasonable option to have your surgery done there. There is one further point: the monsoon is about to begin, and infection rates go up in the hot weather, plus 45 degrees and non-stop rain are no fun, so the ideal time to be in India for an operation is between October and March.

Everything I have said also applies to Nepal, where there are a couple of international standard hospitals in Kathmandu. The advantage is that the monsoon is much cooler and less wet, so any time of year is suitable. I don't know if there are any expert hip surgeons in Nepal, so you'd have to check. It would also be more costly both for the hospital and for general living, though house-sitting in the monsoon is always possible in Kathmandu, and often free.

I want to emphasise again that I don't know anything about surgery, follow up, complications etc . etc. so I am definitely not advising anything about that aspect of your needs.

Whatever you decide, best of luck

Nick
 
Excellent advice, Nick. I'm not infallable! Far from it. But upon reflection, I think your insight is good.

I would think that 3 months would a minimum as one should be waiting on blood results becoming normal after the impant has been removed.

But I
would strongly caution against any surgeon who suggests taking out the infected implant and inserting a new one in the same procedure. Under the circumstances that this infection has already been present for some months, that could very possibly be a waste of time and effort, not to say money.
 
Nick, thank you so very much for providing your thoughts on RockMan's situation. I was hoping you would post since you have been through a surgery in India and are familiar with the conditions in tha country. In the past I have been impressed with your unbiased and honest posts and I felt you could contribute to this discussion.

Jo, if you are able to get some assistance for RockMan through your contacts in Great Britain I hope you will post at least some of the information here on the forum. I am interested in seeing what can be done and my prayers are that something good will finally come RockMan's way soon.

God bless you all.....
 
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