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Lost confidence

Discussion in 'Hip Replacement Pre-Op Area' started by anny, Feb 8, 2018.

  1. anny

    anny graduate
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    I was quite on board with being booked in for THR, even though, like many others, it sort of came out of the blue. I believe the surgeon wouldn't be doing it if he didn't think I need it. BUT, and I feel like a baby now, I saw a physio a couple of weeks ago (for a whinging Achilles, probably caused by gait) and she told me that there is no reason (I showed her my hip xrays) for me limping or for being slightly bent over and that I need to stop doing it.

    Well, I feel as if my right hip won't actually release all the way as I walk, and also that I can't quite straighten up out of it. However, my last xray report merely said minor OA in left and moderate in right (the stiff side), with no explanation as to what is actually going on.

    My surgeon dismissed the xray and said he goes on how I feel which is good but he's not enormously good at explaining things. But since the physio's remark I can't help wondering if I'm somehow imagining the symptoms and therefore acting them out. I know - too much introspection and I'm in danger of seeming paranoid :nah: but I think I could do with some of the wise people on B/S to talk me out of it.

    And if I can work out how to add my xray, I would be very grateful if @Josephine could point out the grotty bits please? I think I need my 'symptoms' vindicating (or not!) in b+w.

    hip xray nov.PNG
     
  2. dapplega

    dapplega junior member

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    I empathize with you... :)
    I went through similar second guessing and tried to learn as much as I could about what I was seeing on the x-rays. I think it would be interesting to have a thread where maybe Josephine can show us what we are looking at and examples. I posted my xray here: https://bonesmart.org/forum/threads/depression-post-op-blues-open-for-all.34457/page-19
    My diagnosis was stage 4/bone on bone but it always looked to me like it wasn't quite bone on bone...
    To me, your right side looks worse than the left as it has significantly more narrowing to almost no space... I have a feeling that is more than moderate but will be interested in what Josephine says...
    Good questions, keep asking as you have time before your surgery and you want to feel confident in your decision.
    D
     
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  3. Bumblebee

    Bumblebee senior

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    Aaawww, @anny, you are not a baby, nor paranoid, nor imagining your symptoms. I agree with your surgeon, rather than go completely on your xrays, he is taking into account what you are experiencing and telling him. how many times have you heard a surgeon after a procedure say "it was worse than we thought"? Thats because they don't see everything clear on xrays, etc. So they know they have to take into account your history.
    Getting closer to my surgery date I'm getting cold feet too.:scary:
     
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  4. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    rt-horz.jpg

    Red arrows are pointing to the calcification caused by the arthritis.
    Yellow arrows in right hip are pointing to bone spurs: in left hip pointing to small bone cysts, both caused by arthritis

    In my experience, physios aren't that expert at reading xrays and I feel her comments were out of line.

    These are all indicative of arthritic joints. This is one element of the diagnostic process.
    Another element is the surgeon's examination when he moves the hip around and can tell if there is crepitus - a kind of grinding in the joint or lack of movement caused by arthritis
    The third element is the story you tell him of your pain and other symptoms such as limping, back ache and so on.
    A fourth one might be a score sheet which gives a clear indication of your quality of life. I've attached such a score chart to this post so print it off and complete it. Take it with you to show the surgeon when you next see him.
     

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  5. SaraK

    SaraK post-grad

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    Anny,

    The xrays didn't indicate a problem in either of my hips. First MRI on left didn't either (but 3rd surgeon said it was very poor quality). Second MRI (about 9 months after first) showed femoral head fracture with flattening, several labral tears and bone on bone.

    Similarly, MRI on second hip showed Labral tears, bone spurs and bone on bone. For some reason, xrays didn't pick up these things - don't know if location or what.

    Like so many other things, though, you are the best judge of your body. I knew when my kids were sick even when I couldn't put a finger on the symptom. You know how your hip has changed and how it's changed your life.
     
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  6. newhip126

    newhip126 member

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    @anny

    I’m kind of mad at that physio and don’t even really know what a physio is compared to in the United States.

    I’m mad they took your fears and turned them on you. As if you weren’t already scared and having doubts... saying “stop doing it” is treating you like a child. You’re not enjoying limping around, being in pain. Ninety nine percent of doctors don’t do surgeries unnecessarily.

    I’m not a doctor but as soon as I saw your X-ray, I knew the right side was bad. Josephine pointing everything out helped me too.

    My OS surgeon said he doesn’t operate on X-rays, he operates on people. He goes by quality of life, pain issues, along with his medical judgement.

    I wonder why we all, and I mean ALL, allow one person to come along and throw a hinge in the plans. Has your physio been so outstanding that their opinion matters more than yours and your doctors?? I do the same thing.

    I’m just mad this person did you a disservice.
     
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  7. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    I hope Josephine's input has given you the confidence that you are heading in the right direction @anny . No you are not imagining anything. Your symptoms are real and shame on that PT for questioning what you are feeling. You can't just magically wave this away. Your hips are failing and from my experience replacing them soon rather than later means an easier recovery.
     
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  8. gillycat11

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    @anny,
    Your story sounds so familiar, getting the prospect of a THR out of the blue, but it sounds like your surgeon knows what he is on about.
    You have pain, sufficient to cause you to limp and alter your gait, your hip locks up and I'll bet it's affecting the way you go about your daily life. I agree with the others, the physio should not have belittled your very real physical symptoms and the effect they are having on your quality of life.
     
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  9. MammaT

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    The physio (and I agree with earlier post, don’t know what they would be in US), but in any country she is a twit. I would run far away from her. In addition to images not always being clear and different shots, my os says that it is not uncommon to see things once they are in there- that’s the clearest view.

    Don’t second guess yourself or your surgeon. The hips will not get better.
     
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  10. amb3k9

    amb3k9 new member

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    There is quite of bit of joint space narrowing on the right side and some bone spurs. It doesn't have to be "bone on bone" to warrant replacement. OS now ALL go by symptoms, they don't treat xrays, they treat people. And yes, it wouldn't be good to do a hip replacement on something that isn't confirmed OA because it has been shown this may not alleviate pain. But if confirmed OA (as in your case), then hip replacement is pretty great tx option.
     
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  11. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi @anny
    I'm sorry your expression of physical pain felt invalidated by another's unprofessional comment.
    Hopefully you can move beyond that. No one can feel another's pain. It sounds as though you are formulating a plan and moving in the right direction. I wish the best for you as you journey through.
    Please know we're here for support and will encourage you along the way, you're never alone here.
    A peaceful weekend to you!
     
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  12. anny

    anny graduate
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    Guys, thank you so much for your responses, I knew I could rely on you for support:wow:. At the moment we're in the middle of a rather fraught house sale, so I can't really unload my insecurities on my husband (and, to be honest, I don't think he would really understand like you lot do, he'd tell me to put it out of my mind and get on with it.....but when you're a control freak, as I think I probably am, you need to KNOW, not just accept). My surgeon has no problem making his decision on what I've told him, but it was the fact that he hit the ball in my court to decide if I wanted to go ahead, without giving me any real info to go on. As for the physio, I think she was probably more used to dealing with sports injuries, like the Achilles I was seeing her about, but then she should have kept her mouth shut if she didn't know! Not seeing her again :heehee:

    For our friends in the US, 'physio' is short for physiotherapist.....I did the homework you set me and delved into Google and I think your equivalent is 'physical therapist' (PT?....tho in my world, PT usually means Personal Trainer, as in the gym!).....perhaps we need a dictionary of equivalents, as well as training in understanding our xrays :wink:

    @Josephine.....thank you so much for pointing out on my xray, it has helped enormously in 'validating' how I feel (I hate how many of us seem to feel so apologetic for being less than 100%, but I think it's bred into us!) Can I just ask one more question about the xray, and then I promise to keep everything down to a dull roar :blush:. Having looked at my xray more closely, and having seen several posts recently about Protrusio Acetabuli, is the area of bone between the roof of the socket and the edge of the pelvis quite narrow and if it is do I need to worry? I'm sure it's not protrusio as someone would have said, but I read some old posts from others with it and their symptoms fit mine to a T. I have also read that protrusio is linked with osteoporosis and osteomalacia, both of which I have, so thought I'd better just check :umm:
     
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  13. hikejunkie

    hikejunkie senior

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    I can’t add much to what’s already been said. If someone said to me what was said to you, I’d be questioning things too. I have good days and bad days depending on activity level and on those good days I question what I’m about to do. I don’t even need someone else to get me going! For me, it’s fear based. Hang in there.
     
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  14. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    My dear, you can ask as many questions as you like!
    The thickness of the acetabular floor in your xray is more than healthy.
    Of course they do! They're pretty much a standard picture for a bone-on-bone hip.
    Having those conditions doesn't always mean the AP will follow. It's actually quite uncommon.
     
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  15. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    So glad you are feeling better about your decision! Please let us know when you get this scheduled. Fingers crossed you don't have to wait long!
     
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  16. anny

    anny graduate
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    Thank you @Josephine.....over the past few years I've second guessed doctors for me and family members, and it's turned out they'd overlooked/ignored something until I asked them head-on, so I'm now very cautious and usually double-check where I can rather than blindly trust. Sad really, but then ultimate responsibility for our health is ours, we've gone a long way from our grandparents who relied on the dr to 'fix' them and regarded him as the fount of all knowledge! I'm grateful we have professionals like you who are both knowledgeable AND happy to share their knowledge with us :thumb::) :-) (:
     
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  17. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    I can understand you being cautious.
     
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  18. anny

    anny graduate
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    @hikejunkie what a journey this is....hard not to let it take over your life, especially when it's constantly hurting like hell! It seems a long time still till March, but we'll probably end up saying it's here too quickly :yes:. Just a bit longer and we'll be climbing the upward slope instead of sliding down to the bottom......you'll be there first so I'll keep an eye on you....no pressure:heehee: thank goodness for the forum where we can off-load our worries!!
     
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  19. anny

    anny graduate
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    more than willing @Josephine, thank you.....fire away :)
     
  20. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    I'm so sorry - the questions are for post-op members. My bad!
     
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