THR Metal, illiopsoas, or both?? My story

[Josephine]

You do know you can take both Tylenol and ibuprofen at the same time? A very effective cocktail Tylenol/ibuprofen cocktail

 

[MarkC]

An update. On the 7th day after my injection I felt pretty good. Can tell that the shot has worked somewhat on the leg lift issue (iliopsoas injection). The pain and head was still troubling in the back and side. I did have a massage on the 6th day). Anyway, I decided to work out and then I just got mad and decided I would walk 5 miles (on flat concrete really) to push it. My dog loved it (ha ha ha). Well the first lap around (2.5 miles) was usual nagging pain, by the time I finished, felt pretty good actually. That evening.....wow, best I have felt in 2 years probably. I mean, if I could feel like that, I would be in heaven. I had already decided that I would not take any meds that day and just see where I was.

That was Wednesday evening. Slept like a baby. Perhaps it was the massage taking effect? Interestingly enough, I have had another day that was similar and it was also after a massage. Anyway, Yesterday, I had some pain but not terrible but heating back up. Last night and today I am not pain free but am pushing through. I had contacted my OS and told him that if it continued, I was ready to change out the parts and get it behind me because I did not want to continue to deal with the constant aching etc., if there was a chance of getting past it.

I still feel the same, but I am going to really make an attempt to mentally move on this month (with workouts, movements, maybe even some tennis) and go med free just to see how my hip responds. I will keep updated here. One way or the other, my New Year's promise to myself and my family is that I will not go through another year of back and forth wondering. I am accepting the fact that it may be the metal and that I may have to get it out and that if I have to, I want to do it and move on. I am hopeful that the picture becomes more clear over the next few weeks.

 

[Josephine]

Go to, Mark! They do say that in around 80% of revisions with good outcomes they never do figure out the real reason for the problems. But it matters not so long as you get it resolved.

 

[MarkC]

Wild!! I just read an article in the times about metal issues here in the states. Some info starting to hit the surface now.

Here is my luck...I will eventually work through this without revision, feel on top of the world, then I will get a call saying that the latest study shows I will have to have the revision becasue of some wild metal disease...now that will be my luck:th_heehee:

OK, I shoud not joke like that but I would rather laugh than cry.

 

[Josephine]

Re: , metal, illiopsoas, or both?? My story

Ermmmm - didn't I say this previously ...............

However, to get to your problem - as it happens, I was at a conference just last Wednesday about this very issue and it revealed some very telling points about the MoM issue. First is that the metal ions tests can be very misleading. As is aspiration since the fluid obtained may not really be fluid but liquefied fat of varying viscosity and presence or absence of pseudotumours is also not definitive.

From your history - which was excellently detailed, btw - there are some issues that, from information given at the conference, would seem to be of concern. The principle one reported being that MoM issues are often wrongly diagnosed as ilio-psoas tendonitis. (edited)

I am by no means an expert in this subject but comparing this with the cases discussed at the conference - which bore considerable similarities to yours - I would most certainly want to push your surgeon for a revision were I in your shoes.

Don't cry, my friend, book an appointment with a revision surgeon and get his opinion. Please believe me when I tell you that this issue is best dealt with sooner rather than later. if it should be the metallosis issue, you do not want to hang around and you won't know that until you get an expert opinion.

 

[MarkC]

Yes, I got you the first time. My OS is a revision specialist and his opinion was that at this time, there was nothing pressing for revision. He recommended the injection and to keep a watch on the metal levels if in fact that injection worked and my pain pretty much went away. He has said that he thought the picture would become more clear a few weeks after my injection. I have an appointment with him on Jan 30th..If I feel basically pain free, I will probably cancel and then go back late spring to have metal levels tested again. With the metal ions test not being alarmingly high and all the other tests looking good (MRI, aspiration, x-ray,etc..) I guess we are following the pain trail.

 

[Josephine]

Hmm ... that's what's worrying me. But truly I hope it works out for you. We all need a good new year, don't we?

 

[MarkC]

well, I can definately tell the injection worked on the illiopsoas tendon issue (at least at the point it was injected). I can do leg lifts while lying flat of my back without much pain. However, the pain in the side and even in the upper right buttocks is just as bad or worse. I have called for an appointment with my OS. I have kept a journal of this entire event and see now that it has been pretty constant from just a few months out. Probably is a combo of the illiopsoas and the metal but I am going to tell my OS that I am not much better off for having done the entire thing. I can walk, I can do my workouts, but I cn't do any of it without pain. I have done weeks of psoas-illiopsoas stretches etc.. and I just seem to be at a stand still as far as progress. To be honest, been that way for over a year. As much as I hate to, I am going to push to move forward. I am actually hoping that we will go ahead and release that tenson as well if possible. I know hI have soft tissue issues, but at this point, they are absolutely chronic...I am 19 months out now and am not buying the fact that things need to settle...that is poop. I am 41 and very active and have strengthened, stretched and massaged, and chiro'd with great discipline. I believe I owe it to my family to give the metal switch a shot. I will update when I have my meeting with OS. I hope that my journey will be of some help to others out here.

 

[C Mac]

Hi Mark,

Thanks for checking in and letting us know how it's going. Sorry that you are not feeling better from the injection. It is frustrating to experience so many limitations after having gone through the replacement surgery with the hope of eliminating pain and increasing activity. I hope that you are able to get relief from the switching out of the MoM parts.

Take care,
Cardie

 

[MarkC]

me too, I don't know what my OS will say but we are going to have that "heart to heart" if you iknow what I mean. I am wondering if we will go ahead and release that tendon as well while we are at it. I have read that many people have had both done at the same time. I certaionly don't want to have that tendon released and then 6 months later have my metal ions spike up and have to go back in and switch out the ball and socket...now that would be aweful. The injection has worked a bit for sure but the pain in the side and around the back side of hip is just like always. I am so frustrated and depressed about having to go through another surgery but I just don't see anything else working. I don't want another summer to come and go without the ability to swim for exercise and I could not swim without intense pain last year (when everyone was saying that I should be able to do that no problem). I have done stretches for illiopsoas and actually, it seems to be pretty limber with the Thomas test.

Has anyone out there been through a revision where everthing was solid and they changed the liner and ball? I am wondering about the rehab and such. Seems like it would not be as hard on the body because they don't have to put a metal stem in yourleg or grind out the socket. Maybe wishful thinking but I would love to hear from someone who had this type of revision. Thanks, M

 

[C Mac]

Hi Mark,

Since your surgeon is a revision specialist is he able to connect you with some other MoM patients for support and to answer some of the questions about their experience with rehabilitation?

I also had people suggest swimming for exercise prior to surgery and there was no stroke that was a comfortable movement for my hip -- Duh, what is wrong with people, it is rather obvious that there's a lot of hip movement when one is swimming!!

This came through on my Google alerts yesterday:

broken link removed: https://www.prweb.com/releases/2012/1/prweb9095943.htm

There is a tie in to a law firm as well, of course.

Take care,
Cardie

 

[MarkC]

I should probably ask him. I think that the tendon issue is the main one with swimming. That illiopsoas/psoas inflamation is a bear and the flutter kick is bad news for it for sure. I am betting that I could swim much more comfy now as tht injection has really helped with that front groin leg lift pain. My OS told me that he suspected my pain was a combo of both the tendon issue and the metal and I think he is probably dead on. I go back on the 23rd (got an earlier appointment) and will be interested in his response to what is going on now with me.

 

[Josephine]

I am 19 months out now and am not buying the fact that things need to settle...that is poop

I couldn't agree more.

As for the revision, if they simply changed the cup liner and the head (ball) then it would be a relatively minor procedure as compared to the primary op.

But if they decided to change the entire kit and caboodle, there should be no need for them to do more than a little refreshing of the bone to take the new implants. Nothing more than that. Therefore that also would be relatively minor compared to the original.

 

[MarkC]

thanks Jo, that is what I was thinking. My left one is really bothering me (in a different way .. that old bone pain way that we are all familiar with) and I am going to ask him about that one. I have space there now and he has said that even though it has the same impingement issues, it should hold out a while becasue he can see good space. But it has started to really bother me and I am going to ask him about helping me out with that one. My ols OS told me that it would surely be replaced eventually (same FAIS) as the rt one) and I do not want to go through all the hub bub of meds, injections, etc..to manage pain that can be aleviated by going ahead and replacing that one. I would LOVE to be able to get the revision done and replace the left one at the same time and then just face one rehab. I can't imagine not having that impingement pain on the left side to bother with me. I have thought it best to hold out as long as I could but I am changing my mind by the day.

 

[Josephine]

hmmm - I doubt he would do a revision and a primary as a simultaneous bilateral surgery. But I could be wrong!

 

[MarkC]

that is my guess too. And I may feel different after the revision if that is what takes place..I just know that I don't want to go through the gradual deterioration of the left one while it pains me the whole time. Maybe I can get relief from an injection or something. I only know how it feels now and it is starting to bother me a lot. My guess is that he will say that we will deal with this right one first. I am tired of all hip pain....I know I am whining but I figure I can do that here and at least have people that know what it is like.

 

[Josephine]

Absolutely! That's what we are good at here. Our shirts are drip dry especially for the fed up members!

 

[MarkC]

OK, here is an update. I am writing this here so that if it turnhs out they are related, others will see and maybe learn from it. Shortly after my surgery, my cholesterol went high....unusually so. I have never had high chol. I also noticed that I could not stay warm or that it was difficult to do so. My wife laughs at me becasue I have become so cold natured. My Mother in law was a nurse and said that my hemoglobin would take time to get back to normal (she said this shortly after my surgery). Well, I got tested again and Chol still high...still very cold natured and my pulse rate is 44 bpm. Now I do stay in very good shape with elliptical and circuit training (despite some hip pain) and I have always had a fairly low heart rate. Anyway, I go back to the regular family doc and he tests my thyroid (some type of blood test) just in case becusae my diet is not that bad and I have no family history of heart disease really. He figures I can do some things with diet but wanted to rule out thyroid issues....well....guess what...my numbers were through the roof. They have called me back to go in Monday morning to discuss. There is definately a problem with my thyroid and now they thin that is related to my unusually high chol level...which went up shortly after my hip replacement. Has anyone else had this issue after surgery? It is just so strange that all of this has happened over the last 18-19 months (since I had the surgery). I am wondering now if some of my depression is related and if indeed it is all related somehow. Anyway, I see the family doc MOnday morning to discuss thyroid and my OS at Duke Monday afternoon to discuss revision. When it rains..it pours!!

 

[Josephine]

It's actually interesting how a 'crisis' such as major surgery can spark off a crisis in another area like the thyroid or diabetes. You may even find it settle back down to normal after a few months. Well, that's what your ma-in-law said! :wink1:

 

[alexthecat]

The day after my hip fracture, a young medical resident bustled into my room very importantly and informed me that the thyroid values in my most recent blood test were elevated and I "must have a brain tumor or something." My next blood test was normal and my real doctor concluded that the higher values had been caused by stress. The medical resident then decided that I had congestive heart failure. (I don't.) Idiot.

I don't know what my point is in sharing this except I think it's funny. It sure didn't seem funny at the time though. Good luck, Mark. Try not to stress if you think you are.