THR Metal, illiopsoas, or both?? My story

[MarkC]

don't t hink my Ma-in-law thinks it is going to right itself now. My numbersw have ben way up for over a year and I have had symptoms of being cold and having hands and feet cold for even longer. I expect it would have resolved itself by now. Naaaah, this seems more of a permenant thing. She made her comment after 3 months...I am on month 19. I don't think my Doc thinks it will resolve itself at all. I just hope that maybe som meds or something can right the thyroid ship quickly. I am bettng I will feel a lot better. Have felt lethargic and depressed for long enough. Maybe getting the hip revised and getting that better will happen around the same time and life will turn in a different direction. I am interested to hear what the docs think and how we move forward.

 

[Josephine]

What encouraging people you have around you!

 

[C Mac]

Hi Mark,

Have you been having abnormal thyroid levels for 19 months and no one looked into it further??? :rolleyespink:

I hope you get some good information at Monday's appointment -- maybe you should get a hard copy of your lab report with all the blood work results!

We are hoping and betting that you will feel a lot better!
Take care,
Cardie

 

[MarkC]

My thyroid level was only checked just the other day as far as I know. The other blood test I had was 6 months ago (for routine physical) and that is when it was noticed that my cholesterol was unusually high. But I have had the symptoms, cold hands and feet, very cold natured, hoarseness (I am a singer and that has been a major problem for the last year), depression, lethargic feeling, etc...for over a year. It is all starting to add up now.

I started having voice problems that were attributed to seasonal allergies but they would not go away and my ENT could not figure out what was wrong. I take allergy shots and have undergone all sorts of different meds to try to get them under control. Now, it seems obvious that this thyroid problem has probably been around for about a year (at least based on my symptoms). All my other symptoms seemed to intensify at the same time which was about 4 months or so after my hip replacement.

This is unbelievable. I have had aches and pains in knees, off hip and such lately and have wondered what was going on ... am I falling apart? I have a feeling that this thyroid condition has played a a MAJOR role in a lot of my problems. I can't wait to get it regulated. Maybe I will start feeling like my old self. I also can't help but wonder if the cobalt in my system is playing a part in the thyroid being so off or what. Not saying that it is but it sure seems mighty coincidental. Funny thing, for the last couple of days, my right hip has felt way better. Another case of going to the OS and it feeling better before I get there. I am sure when I leave it will trouble me again.

Anyway, I am wanting these metal bearings out I think but will see what the doc says about the entire scene now. I have walked and exercised a lot the last couple of days and the right hip has felt much better. I know that injection has helped a TON with the iliopsoas problem ... pain now is more the side of hip (where incision is) and around the back of but radiating. But that has been pretty quiet for about 2 days. It will do that, then it will go down hill for a while, like it comes and goes but I have only had maybe one ot two days where it was not pushing me to take meds for it. I am just praying that maybe this thyroid discovery will really have an impact on getting me back to wanting to "get up and go"!

 

[almostready?]

Hi Marc,
Thyroid issues are definitely related to mood and energy as well as aches and pains. I'd also be wondering if the level of metal ions had an effect on your thyroid. On the flip side, perhaps once your thyroid is corrected, maybe some of those pains will diminish, including the pain on the operated side...glad they found this out!!! At the very least, adjusting your thyroid levels will help tremendously in setting you up for a successful next procedure.

 

[MarkC]

That is my hope as well. As far as the metal issue, it really is the chicken or the egg isn't it? Seems to me that getting the metal on metal out would be the thing to do regardless. That way it is permanently out of the equation. I am betting that my OS wants to get my thyroid regulated first but what if metal is causing it?? I don't know, that is where I think I just have to trust that these docs know more than me and can make good sound decisions. Mondays visits should be very interesting. I will post here and let you all know what happens.

 

[Poppet]

Hi Mark

You certainly have a complex situation, and as you say is it the chicken or the egg..

I think if it were me, I too would be leaning toward getting the metal on metal removed, then see if your bodies chemistry starts to settle.

Good luck for Monday, do let us know, you certainly have been patient with all of this for a long time, even though it has got you down

 

[MarkC]

here you go, after seeing both docs today, this is what I heard

My Family Doc says that he can't believe I am doing as well as I am with the thyroid numbers I have. Says that he believed thyroid is probably the cause of many of my symptoms including aches and pains. Numbers are way out of whack. I also found out that I have underactive Thyroid in my family so that may shed some light. Anyway, he seemed to think that the first thing we should do is get that number in normal range.(1-5 instead of 145!!!!!!) So, off to Duke I went to see my ortho. My Ortho at Duke is not going so far as to link the metal on metal with the hypothyroidism. Says it is possible but that right now, there is not enough info out there to say that...could be but we just don’t know enough yet...and that regardless, we must get that under control first to get a clearer picture. Could not even consider a revision surgery until those numbers are right as it is a danger to have surgery where they are now. He also said that my cobalt levels, although slightly elevated, are well below the range that they would be thought (at this time by the med community) to indicate significant ware that would cause trouble and that there was a much higher health risk with a major surgery than there was of side effects from that level of ions. We are in a gray area here but that is his take. Once we get the thyroid numbers right, we will see what shakes out. He says that with the results of all the tests I have had (metal test, MRI, fluid aspiration etc...), he would not be pressed to revise because they indicate that the hip is in perfect position and there is no excess ware. If I get the thyroid in check and have major pain, then we can justify.

At this time, I have had 4 straight days of my right hip being basically pain free (with lots of activity including tennis....good for me) and that is the first time that has happened so the injection into that major tendon is obviously working. The fact that the injection into the tendon has done me so much good (it seems as of now and especially in the last few days) also throws up a positive sign that perhaps the metal may not be as much of a contributing factor. My hope is that it will continue to work, and if it acts up again, we will probably inject again...if it comes back again, we may release that tendon but that is waaaay less invasive than a major revision. If the whole thing fires up like crazy and Thyroid is good, then we will revisit revision at that time and probably do so. That is where I am.

 

[almostready?]

Good news about the injection! It would be great if the injections plus correcting your thyroid was all that is needed!

 

[MarkC]

I am hopeful. What else can I be. My OS did not rule out mom problems but the tests don't indicate a push for revision and once we found out that the thyroid was so far down, that became the immediate issue. He was very honest and just said that the med (ortho) comm could not say that metal would cause it. We talked a lot about my numbers and the numbers that he had seen and that were out there. I will say that it seems he is up on the latest research (figures he would be as one of the big wigs at Duke) and really is interested in pain level once thyroid is sorted out. He has made it clear that he would revise it that is what is ultimately needed but that we need to be sure that it is. I have no problem with that. If I can stay at this pain level (which is very tolerable and sometimes even free..then I can certainly wait until summer to see what happens with my ion level. It's just a "hurry up and wait" at this point. Wish me luck, I could use some at this point.

I look at it this way, if the ion levels spike up or the pain comes back and is not the tendon but the metal, but my thyroid is at the right level, at least I will feel better throughout the revision (ha ha ha ha).

 

[C Mac]

Hi Mark,

Fingers crossed and wishing you luck, continued painless tennis playing and relief from the thyroid issue with some medications!!

Take care,
Cardie

 

[Jamie]

That news certainly gives you something to work toward, Mark. I sincerely hope getting your thyroid in line does the trick. It certainly can make a difference in how you feel!

 

[MarkC]

well, that did not take long. I can now feel that injection wearing off in the front (illiopsoas). That front leg lift pain is coming back for sure. I am keeping up with it so I have a time table. I am not sure if I will get another injection this soon...if it is offered, I will take it I suppose. I hope this thyroid thing can get dialed in soon becasue if I am offered the releasing of this damn tendon, I am going to do it. So frustrating. Seems like there is no ryme or reason...just comes back. The upper buttock is bothering me more too but I absolutely believe they are all effected. Maybe that entire muscle and tendon combo just is too short or something, I don't know. You would think that if it was going to stretch and compensate, it would have done it by now with all the physio, stretching, walking, etc..that I have done over the last 19 months. Well,. those few days last week were glorious. HOpe they are not a permanent memory (ha ha ha). This just feels like a fight between me and my body.

 

[LisaP]

I just read your entire thread and I am praying that things work out for you. I too have iliopsoas problems (way too short) and that muscle causes pain from your back to your abs, down your thigh and in your groin... everywhere. I HATE THAT MUSCLE. Mine is so tight I cannot walk without a cane. I'm wondering if the reason I'm not having chronic pain is because I don't walk for any real distance. I always stop as soon as the aching begins. My Thomas Test is pretty bad... I'm about 13 degrees out. I'm also 20 degrees out on my side measurement. I go for my 3rd follow up (it's been 5 months for me) and I have LOTS of questions for my OS.

I know how horribly depressing this can be... been crying all night myself... So please come here when you are feeling down and just need to vent to someone. So many of us know how you feel.

Many hugggs, Lisa

 

[MarkC]

thanks lisa, keep me posted on your sitch. I will update here the entire way. One of us will get relief and then share that outcome for everyone to learn from. I have had one tendon released years ago in elbow and it actually worked. I will not hesitate to do it for this one. I think it will be the next step for my guy to recommend at Duke. Injection only lasted a few weeks and it did not help everywhere..but it did help out with that front leg lift pain..no doubt. My only silver lining in this is that maybe that can be resolved and that the metal will not even be an issue. That would be great. I just wish that meds could really numb it but they don't work that great. I refuse to just lay around and do nothing...it hasn't seemed to work when I did that and I do not believe in it. My goodness, you use that muscle like crazy just to WALK. Not going to settle for not being able to be active. I will go down swinging.

 

[MarkC]

Here is an update

Had the second ionjection almost two weeks ago and I think it is working. Not as well this time but I can tell it helps with leg lift. got new family docs (husband and wife team) and they are really trying to help me...wonderful people. Hopefully we can get thyroid dialed in enough by the time this injection wears off. They said my thyroid numbers (THS test) were the highest they had ever seen and could not believe that I was not in far worse shape. Maybe this thing has been going on much longer than I originally thought. Doc said that it can go so slowly that you don't notice and that something like a major surgery can push it along quickly. Also said that there is no telling how much joint and tendon pain I am feeling as a result. So, I am looking forward to getting that corrected with medication. Maybe it will help some. I know this tendon is a bear because I can feel it going back and forth across that cup and it fires it up. Still having pain all around (back side and groin) but not as bad (I suspect becaue of the injection). the last time the ijection wore off, it got ugly quick!! When I emailed my OS he got me another injection and then reminded me to let him know when thyroid was corrected..so I think he expects he will have to do some type of proceedure if this injection wears off that quick.

by the way, my Family doc perscribed tramadol for me to "tread water" while we get my thyroid straight. Uhhh....started going into anaflactic shock (toungue swelling and the whole nine yards). That drug is not for me. I am going to try simbalta for a while to see if that can help with pain and lifting my spirits probably won't uhurt either.

 

[Z15]

Mark,

I hope this team approach gets you the answers and fixes that you deserve. I hope you continue to feel progress in that direction.

Keep us posted...

Z

 

[Poppet]

Good morning (Thurs) from OZ Mark..

Pleaseed to get an update from you, have been wondering how you were traveling..

Pleased you have a new general practice team, you get a fresh perspective on the problem.

Thyroid issues are notoriously difficult to treat until the right dosage of med is worked out and it take some tine to do so. Certainly sounds like it could be part of your problem.

Here's hoping you get good news on your next test results.

You certainly need some good news to lift your spirits, so much going on for you for quite some time now

 

[MarkC]

here is an update...by the way, I want to say how much I appreciate this forum, just great info and great to reach out to people who are in similar boats.

Well, my thyroid test (THS) confirmed that my level has gone from 137.5 to 8.9!!!! This is not yet normal but is a huge improvement. My Doc was extremely pleased. I had an allergic reaction to tramadol so we thought we would try Cymbalta. I have been on it for 15 days or so and tolerate it well but decided to get off of it to actually "feel" how I am feeling. My Doc asked me how I felt and I told her that I did not really know becsaue I could feel the Cymbalta so we decided that I would just get off of it for now. A main reason I wanted to get off of it as well is that I have an appointment at the end of March with my OS and I want to be able to tell him exactly what pain level is etc...

I can say that my rt hip pain (as in all over back, buttocks and all) is some better. I still feel that tendon popping and when it does, it radiates pain like a mother.

I also have another complication that I would love to get advice on. About 3 years ago, I was diagnosed with a "sports hernia" which really meant that I did not have a full hernia but that my lower abdominal muscles had torn or strained or whatever. I was checked out by a general surgeon who told me to rest. Well, I did and it went away and came back several times. Now it has come back to visit me (as if I did not have enough crud to deal with)and I told my OS about it. I hope it will go away. Talk about groin pain..it is very close to the iliopsoas pain but they are different.

Oh yes, for got to mention that my left hip is now aching with that dull ache (the one we are all familiar with). we have a fairly recent x-ray (taken in November) and OS says good space but same FAIS condition of course. I do wonder if that has changed. We may take some new pictures of the left one.

Josephine:

 

[Jamie]

Mark, I'm going to tag Josephine to see if she can comment on your hernia problem. Sorry to hear you have another thing to deal with!