In pain, confusion and uncertainty after 4 months

[jimbo]

Jamie and all, I'm headed for Albuquerque, NM to see kids and grandkids over the holiday weekend, so I'll look "out there" for anyone who looks like he or she does revisions. The 7 year old grandson expects to go fishing, so I'll look for anyone in scrubs around the fishing hole.
-hope everyone has a comfortable-in-recovery weekend. Jim

 

[Jamie]

Have fun, Jim. You deserve it!!!

 

[sunshine]

Yes, Have a great time and hope you gets lots of fish and have a fish fry. Ummmmm
Be careful!

 

[Josephine]

God bless - safe travelling!

 

[sunshine]

Oh Jo ,
That avatar is so funny!!!:hehe:

 

[Josephine]

Your pusscat with a melon hat is an avatar - my chap scooting off on his hols is a smiley!

Same as this one

 

[Buttercup]

Jim

I'm sorry to hear you are still having difficulties with obtaining a diagnosis. After seeing the pictures of the prosthesis that Josephine supplied, and returning to your first post I have a couple of questions/observations that maybe Josephine can clarify.

1. The pictures show what I understand to be a prosthesis where the femoral component is (eventually) held in place by the growth of bone around it which makes me wonder if you were weight-bearing on it too soon? The first hip replacement I had was of this uncemented type and from memory I was not weight-bearing on it for at least six weeks, and then only partially. Unfortunately I was not told not to lift anything heavy, which I did, and consequently the prosthesis moved down in the shaft of the bone. I have had a lot of thigh pain because of this 'pistoning' action.

2. Quote from your first post:

"The OS points to the x-rays to say that all looks well with the new joint, but I continue to experience pain at the ishial tuberosity and in the gluts around the joint. The subsequent effect is that I am in pain and cannot bear a load on the hip joint."

If I understand correctly the ischial tuberosity is where one of the large thigh muscles attaches.(Josephine?) If your prosthesis is unstable the muscles will go into spasm as they attempt to stabilize the joint. That spasm can be very painful and may feel as though the pain is coming from the bone, when it could actually be muscular. Maybe if a dose of Valium or something similar, strong enough to relax the muscles, relieves the pain, that may give a clue as to the source of the pain. ( Josephine can tell me if I'm raving).:pzld:

My second THR has a cemented shaft and an uncemented ball and socket, the so called 'hybrid hip'. It is a great success and, given your age, I would think this is the type you should have had ( If you don't).

Good luck with your hunt for a revision specialist, Jim.

 

[Josephine]

Well, fact is that many surgeons don't go with the non-weight bearing thing as they tend to believe the weight bearing increases the bone/implant bonding. As far as I can discern, the evidence for or against either is somewhat underwhelming! It's certainly a fact that the strength of our bones is in direct proportion to the load bearing they are asked to accept. Hence why it was expected that the as first astronauts put foot back on terra firma, they would be rewarded with a fracture in bones made soft with weightlessness. It remains space travels biggest problems.

As for the muscle attachments on the ischial tuberosity, it being a relatively small area, the attachments there are of relatively small muscles like the quadratis femorus and the gemelli. I doubt they'd contribute much to the picture.

 

[jimbo]

Josephine, Thanks for the input. My hip sure hurt when I tried to put weight on it in the early months. I seemed to "get hurt" in rehab when they wanted me to stand on the new hip alone. But I also thought "no weight, no gain". So I remian confused about those days.
I am trying to determine (-waiting for a call this morning) whether a scheduled appt. tomorrow is really worth the trip. If surgeion #2 is out of gas, I would just like to take his refferal and move on. Of course I haven't made it to the Buddy Holly Museum yet...
I did pretty well on the trip last weekend (a 4 hour drive in one directionJ). I did enough pirate sword play stationed on the couch with a 6 year old grandson to satisfy him, and I bonded somewhat at some distance with a 14 month old kiddo (he remains glued to, or keeping track of his mother and father). He will be all over me soon, and I hope to get everything fixed by then.
I used a wheel chair to get around in an art exhibit at a museum there. I enjoyed the arm workout, but my hip and legs got stiff sitting in the chair (should have moved them more).
-keep you all posted when the next move appears.
Thanks again, Jim

 

[jimbo]

Everyone,
Well, I didn't have to make the trip to Lubbock this week, becasue there was no need. Surgeon #2 said he would think about who else I might see and call me. I'll give him until the middle of the week to respond.
Jim

Beyond Disabled

I fall into a chair as she rushes in
To correct my mistakes, clean up my spills
Or clear the path in front of my walker and my frustration.
I shove the impeding frame aside to make room
For her spontaneous, marital efforts.
Then I have to tell her about something I forgot-
Some object I still cling to that I left in another room,
And she must go get it for both of us to move ahead.
I fumble the exchange from walker to crutches going out the door
And stagger the stairs to accompany her in her wake and pace.

It's the same way in public too.
Ordinary citizens open doors and blocked avenues of intention for me.
I watch on some perch or a standing stall before them,
Their helping hands grappling, romoving the barriers before me.
I praise them, still sounding of eventual recovery and competence
Through a public face, but my will and my expectations
Are breaking down-down and around in a mind-sinking, resisted release
To a lame-laden, inglorious acceptance,
Slowed and lowered, reliquishing to another insurgent vision
Of a compassionate, supportive universe.
06-02-2010

 

[Josephine]

Oh, Jim - that almost had me in tears. Isn't it amazing how eloquent poetry is when ordinary words fail us?

 

[Pat29627]

That poem says it all.

 

[Rohanknitter]

:agree:

AND
:gphg:

 

[Jamie]

Jim, those words really do touch my heart.

 

[sunshine]

Great Poem Jim, Good luck with new news from Doc ...

:gphg::dogkiss:

 

[Buttercup]

Hi
Joephine wrote:
'As for the muscle attachments on the ischial tuberosity, it being a relatively small area, the attachments there are of relatively small muscles like the quadratis femorus and the gemelli. I doubt they'd contribute much to the picture.'

This area is actually where I did have a lot of pain and movement restriction from muscle spasm, possibly because my hip problem was the result of a sudden injury, not a slow deterioration of the bone. Unlike Jim's condition, the pain there went away after the surgery but was constant up till then. The spasm severely limited movement of the hip joint. I still think it might be worth ruling out if nothing else is helping.:sct:

 

[kathall]

Jim,
Did you have the prothesis move down the bone shaft due to heavy lifting on your first hip replacement? Or was that Buttercup? I think that is what has happened to me but from coming down hard on my foot. Your positive attitude is very inspiring.

 

[Josephine]

Kathy, I just posted to you in your thread about this. It's not at all likely it that happened that way.

 

[jimbo]

Josephine, Jamie and all,
Well, this has been a tough week so far. How to begin?....
1. Well, on Sunday I went out and "played" (I sat on a cushion and put some pavers down) in the yard and by that night I couldn't move. I had to take Monday and Tuesday off and began to get around on Wednesday but not without hip pain and that excrutiating upper hamstring pain.
2. On Wednesday I called surgeon's #2 office in Lubbock, and his nurse said he was considering referring me to someone in San Antonio (My first thought was that I did boot camp in the heat of San Antonio in June years ago and that I didn't want to go), but I realized I was willing to do anything at this point. -still waiting to hear from him.
3. And THEN I went to see my primary doctor for a standing 6 month appointment today and brought him up to date on what's happened since I saw him in December.
He poked around and said that it was unlikely to be the hip replacement itself as I would more likely feel it through front and groin area. He seemed confident that it pertained to muscle issues and rattled off a number off conditions, some involving the upper hamstring. He recomended evaluation for pain management treatment and lined me up with a clinic in Lubbock in the later part of July.
Now I think that would be just great-take a couple of shots and get back to normal.
I'm ready to try it. But I've learned to take things one day and one piece of informaton at a time. I'm inclined to look in the library here for more stuff about muscle issues.
Thanks for your attention, Jim
P.S. I didn't have the prothesis move down the bone shaft, but it been the dickens keeping my shirt from sliding up with the crutches.

 

[Josephine]

lol - aw bless! Well, it's something, isn't it? And something's better than nothing - just! I'll be a-prayin'!