THR Lateral entry, no restrictions!

[Jamie]

Are you saying that you made some alterations in how you're walking and the pain lessened?

 

[Mutwa]

Are you saying that you made some alterations in how you're walking and the pain lessened?

Yes.

 

[SaraK]

@Mutwa - I was a couch potato all my life and then I had both hips replaced and joined a gym. I now lift weights and did my first powerlifting meet a month a go (little old lady division). I have built up slowly each time I've had a break (including rotator cuff surgery).

Listen to your body. If things are hurting, give the body time to recover and then slowly reintroduce activities to see which cause problems. I have more problem walking or anything else that moves the 2 halves separately than I do lifting weights. So I don't do any Russian twists or anything like that and never lift if thinks are already hurting.

There are different types of pain and each is telling you something different. Listen to your body and what it wants or doesn't want. Consider some yoga or similar activities to complement your lifting and strengthen the rotators. I find stretches after lifting to be very helpful.

 

[Mutwa]

There are different types of pain and each is telling you something different. Listen to your body and what it wants or doesn't want. Consider some yoga or similar activities to complement your lifting and strengthen the rotators. I find stretches after lifting to be very helpful.

Right now, even chin-ups cause butt pain. And that’s been going on for a year.

One piece of good news. X-ray didn’t turn up anything. It’s not a loose implant, but may still be an infected one.

Anyone: what is sufficient to suspect an implant infection? Who should I see? What should the PCP be working up?

 

[SaraK]

When I had a problem with my psoas (which caused rotation issues and pain that increased over time), they did a metallosis blood test and a crp blood test to rule out metal issues and infection before they began testing for the psoas.

If you aren't seeing one already, consider making an appointment with a revision specialist. They can better manage these tests and put all of the symptoms/issues together for an accurate diagnosis.

 

[Mutwa]

they did a metallosis blood test and a crp blood test to rule out metal issues and infection before they began testing for the psoas.

I’ve run into incompetence among the PCP PAs. The one I saw said she’d refer me to Doc X, who does revisions among other things. That was Friday.

Nothing happened. So I followed up. PA is out of office until Friday. She didn’t do the referral paperwork. PA sub then initiated paperwork to the wrong doc, but it’s gotta wait till Friday.

 

[SaraK]

Ugh! Do you have to have a referral? I self-referred to a surgeon my PT suggested. You might also get some names from your DPT - a bit more independent recommendation.

 

[Mutwa]

So far, on calling on my own, I got in with the gatekeeper ortho PA on December 21. I have a previous experience with her. She is unable to explain her own jargon.

Here is the description of one of the doctors that she gatekeeps for.

“He completed a fellowship in orthopaedic trauma at Emory University in Atlanta, Georgia. Dr. X has extensive training and experience in total hip and total knee replacements as well as revision surgery. His special interests include reconstruction of hip and knee replacements, orthopaedic fractures, infection of bones, deformity and reconstruction of limbs-malunion and nonunion, and complex orthopaedic fractures.”

It seems like too many interests for me, and revision is at the top of one of his lists, but he doesn’t mention a fellowship or other training. Thoughts?

 

[Mutwa]

I self-referred to a surgeon my PT suggested.

I texted my DPT per your suggestion. She gave me the name of a doc who is much liked by two of her patients.

 

[Mutwa]

@SaraK Going to hospital Friday where revision surgeon will draw a sample. After analysis, he might inject a steroid.

 

[Mutwa]

Injections didn’t help.

I went to the neurosurgeon yesterday. Looking at my 15 month old MRI, the PA was skeptical. After two docs said I had L45S1 stenosis, PA said it looked perfectly fine. However, she scheduled an MRI of the entire spine.

Hip reconstruction doc found no hip infection.

So here I am with level 6-8 pain, and no one knows what’s causing it, though leftie has disordered scar tissue, a with numbness and some tingling at the scar, with PT saying there’s some palpable atrophy posterior and superior to the trochanter.

But that doesn’t address the sitting pain.

 

[Mutwa]

Pain increased, can’t sleep. Hip revision guy cleared me for neurosurgeon.

Now on hydrocodone pending hearing about MRI, of spine from shoulders down, done last Thursday.

 

[Pumpkin]

Hopefully the MRI will have some answers for you, sorry to hear you are having increasing pain.

 

[Mutwa]

MRIs had.nothing actionable.

Pain manager: L345 get facet injections.
Pain interventionist: Complex regional pain syndrome. I’ll anesthetize some ganglia in the back, a sympathetic block. Go ahead with the injections as well. That’ll take care of some arthritic issues.

So two procedures in two days. First tomorrow.

Meanwhile, pain is spreading. I am pretty much confined to bed, though I can’t get comfortable there. I. don’t want to water off any more nerves.

Surgery sometimes causes this. Has anyone come across it here?

 

[Pumpkin]

Complex regional pain syndrome.

We have an article in the library about CRPS. Complex Regional Pain Syndrome (CRPS or RSD)
We have had members with CRPS, don't think any of them are currently active on BoneSmart.

CRPS is a complex interaction of your body and brain. Suggest you seek out some one trained in pain science to work with you, they could be a PT, OT, or counselor.
Sometimes just understanding how pain works can help reduce your pain. Similar to decreasing the setting the alarm on your house, because it goes off when a mouse walks across your walk way. Sometimes our brain perceives even the littlest thing, like a sheet on your leg as feeling painful.

Your pain doctors should be able to refer you to someone trained in Pain Neuroscience Education.

Keep us posted on how you are doing,
Chris

 

[Layla]

Best Wishes for your upcoming surgeries!
@Mutwa

 

[Mutwa]

Had to choose between the procedures, since both involved steroids. Due to timing, I had to make a decision

 

[Elf1]

@Mutwa hope whatever you have done will bring you some relief.

 

[Mutwa]

I finally found a pain management doc who is interested in finding and curing the source of the pain. We’re now working on a ischiofemoral impingement diagnosis. Though this mostly affects females, it apparently can be an artifact of THR.

 

[Elf1]

@Mutwa happy you found someone who is willing to look into the source of your pain. Please let us know how things go.