THR Metal, illiopsoas, or both?? My story

[Josephine]

If that hernia is recurring, Mark, it needs to be dealt with. It's not a p big op, keyhole surgery these days and I've known chaps with office jobs go back to work after about 5-7 days. You feel like you've been kicked in the groin for a few days but well, you should be well schooled in pain management by now! But don't leave it too long else you might risk it getting complicated, specially if you start getting a bulge in your groin.

 

[MarkC]

got an appointment with an OS who specializes in treating "sports hernia" (it is not a real hernia by the way) next Friday. Referred by my hip OS and they are both at Duke which makes it nice as they all have access to my records. I am really hoping that if I need to have this injury repaired (and I am fairly certain that I will), that they can release my tendon at the same time. I don't want to have to under go two surgeries if possible.

I saw a physical therapist yesterday who checked me over. My right leg is shorter a bit or at least the right side of my pelvis is down. She advised me to wear a small lift in my right shoe. I had been doing that for about a month already. But lately my left hip has really been bothering me (even though OS says plenty of space). I wonder if it is becasue of wearing this lift? It is a 3mm lift which is pretty small. Any physical therapists out there can comment? This one said it would be better for the long run to work on evening out....may be...but dog on if I want to get my left hip going crazy.

Oh and by the way, I am coming off cymbalta now (have been off a few days after taking it for 17 days straight) and I can relate my experience only. It is good for pain....however, it is absolutely BRUTAL to get off of. The withdrawal is like nothing I have ever experienced in my life. All I can say is be very sure you want to use this drug before you do. Life will be hell for a while when getting off of it.

Last but not least, my thyroid is almost to a normal level. Maybe I can enjoy that if I can get through this withdrawal from the cymbalta (uuuuggggghhhhhh!!!!!!!)

 

[dianemarie]

Good luck with the withdrawal, never tried that drug but have had one that needed a long withdraw period. luckily I only took it very short term so coming off was quick.
Good luck with everything.

 

[Jamie]

Mark, your discomfort could be a result of the lift. Why don't you try going without it for a few days and see what happens?

 

[C Mac]

My right leg is shorter a bit or at least the right side of my pelvis is down.

Hi Mark,

My chiropractor helps with this pelvic tilt issue by both adjusting my spine and working on my QL muscle with his elbow --

I wouldn't think the lift would be helpful if the issue is above your hips vs. the length of your legs. It really is all about experimenting with different things to see if anything helps eliminate your pain though... and trying to keep your sanity in the process.... :rolleyespink:

Good luck on the hernia & release surgery, that's great if they can address both issues at the same time. Do you feel better now that the thyroid has settled down?

Take care,
Cardie

 

[MarkC]

It is hard to tell with this withdrawal being so brutal. My Thyroid numbers are bouncing around a bit as well so that makes it tricky.

Jamie, as far as the lift goes, I am not sure about it. When the PT checked me out, she said that I had a pelvic twist. I do have a chiropractor who has worked on this for a couple of years...but these two (scope and trhp) surgeries did not help that process. At one time, I was wearing a lift (before surgeries) and it helped to get them closer. The right side was down 12mm and we eventually got it to 9mm (without the lift). Then I had the scope and that threw it waaaay off. After replacement, it was a little closer of course. Chyro continued to work on it.

The Pt that checked me out the other day said that the right side was down when I was laying down on my back. when I sat up, she said that it went down a little furthur. Then, I I turned over on my stomach so she could check my back and she said that the points she was looking at were fairly even indicating a sort of twist (which I alreadyt knew about). She showed me some exercises to do to help with that. When I stand up, it is noticable that my pelvis dips down on the right side. When I walk, it feels like that right side is shorter and is being "stretched" more when I take a step with my left foot. Would make sense that my iliopsoas tendon is then stretching right over that hip socket aggrivating it (at least that is what it feels like). When I wear the lift, it does not feel as if it is being stretched quite as much.

 

[MarkC]

also, for any PT who can advise me, I think I have an actual leg length difference. When I stand up, the right side of pelvis is down...also lower when I lay down and when I sit up from laying position. The heel lift I am wearing is 3ml whatever that means. It is pretty small. Like I said, my chiro worked on this for a long time before we finally used a slight lift. I know there are some PTs on this board so fire away at questions or shoot with advice. The PT I saw is a friend and did not have a lot of time. I just walked into her office the other afternoon. She seemede very confident after looking at my hips and top of my pelvis in suppine and prostrated (sorry don't know the word but it means face down) positions. She looked at me standing up as well.

 

[Josephine]

Actually we don't have any PTs on here, Mark. Just Alex but she is a fitness instructor.

One thought occurred to me whilst reading your post - have you had your spine checked out for any abnormalities like scoliosis? Just a thought ......

 

[MarkC]

yes, I have a bit of stenosis but the spine specialist said that it was not what was causing my pain (back when we were trying to figure out if it was back or hip). I had all sorts of nerv tests and an MRI of back. My Rt hip has been feeling better through all this thyroid and cymbalta hell I have been through. Maybe that is the silver lining. That tendon still pops over the joint and causes pain but the radiating pain all around the hip is nowhere near as bad (knock on wood). I have been wearing this lift for over three weeks too and wonder if that is helping me. I am going to ask my OS about the lift when I see him and tell him what is going on. I still want to get that tendon released and this sports hernia fixed. Maybe I am on the way to a better place. Just don't want to speed my left hip up any. That will be wild if I find out that I need to wear the lift to correct pelvis tilt (because rt leg is shorter) and help rt hip....and that it would put more strain on left hip...I hope that is not the case. We'll see.

 

[Josephine]

You don't want to speed up the left hip? :th_heehee: An interesting statement.

Once it's got started, Arthur Ritis does what he does when he does it without any input from us whatsoever!
You're just along for the ride! :wink1:

 

[MarkC]

that is for sure. We'll see how it goes. I have no idea what my pain level is now becasue of the withdrawal from this cymbalta....damn!!!! All I have to say is that (and my experience only) I would never take this drug again...no matter what. This has been the worst experience of my entire life...period. I feel a little less "electric" today and hope I am on the downside at least. Yesterday was absolutely horrible. If you have any questions about the drig, just go on line and look up cymbalta withdrawal and start reading. I thought those people were being overly dramatic.....not at all. One guy said he quit morphine cold Turkey after 8 months and it was not as bad as coming off cybalta. I totally believe it. I am on day 6 after only taking it for 17 days and weaning off on the direction of my doctor and it is brutal!!!!!!!

 

[Poppet]

Hi Mark

I can so relate to coming off drugs, not yours specifically.

Your drug has a half life of on average 12 hours, but can range from 8 - 17 hours.

Even at 12 hours half life, it takes a long time to be fully out of your system, as each 12 hours it reduces by 50%..

So depending on the strength and dosage, and the half life formulae, you can work it out as to when it will be totally out of your system.

Good luck and hang on, you will feel so much better when it is gone completely.

 

[MarkC]

I took 30mg a day for 17 days. Then, on the next days it went like this:

day 18 none
day 19 30 mg
day 20 15 mg
day 21 15 mg
day 22-28 none (7 days without any)

 

[C Mac]

Hi Mark,

I hope you are done with your Cymbalta experiment and feeling better.

You wrote about wearing a lift to help with your pelvic tilt on March 9th -- are you still doing this & finding it helpful?

Take care,
Cardie

 

[MarkC]

I am still not done with the cymbalta thing!!!!!!! This is the 19th day since taking it...only took it for 17 days...wow. It has gotten better but very slowly. I think my thyroid issue (probably auto immune issues) have made it slower. If you read about the drug, you know that the drug has been out of my system a long time. What it shnges in the brain can take a while to change back.

Anyway, I am still wearing the lift and think it does help the right side some by not stretching as much when I walk. I am still going to push for getttng the tendon released. It just hurts soo bad when trying to do a straight leg lift...I am not worrying about losing strength. Strength does me no good now becaue of the pain.

On another note, it has come to light that I probably have some type of auto immune desease...lots of people have them. This makes total sense becuyae I have noticed symptyms for a few years. Now, take someone with autoimune issues and put a metal on metal hip in them and bam...your body attacks it and caues inflamation..makes sense. One of my docs thinks I have had this for a while and that the surgery probably pushed it (triggered) into overdrive.

Also, I have an Emergency Dr. friend that talked to a world renouned toxicologist and he said he would not let chromium anywhere near the inside of his body...that was not encouraging. Too late now though.

I am seeing the OS on Monday...will ask him about the lift (if he thinks it is smart or not..will ask him about the release surgery and how the recovery is, etc...may get a new look at my left hip as well.

Havin fun yet?>

 

[MarkC]

also, update on hernia..different OS said it was not a sports hernia and that it was a tear in the inguinal area...may be a hernia at some point but not now...just hurts like hell. I will live with it as I have for the last 3 years.

 

[Poppet]

Hi Mark

I am truly waiting to hear some good news from you, I feel for you - take care, thinking of you.

 

[Josephine]

I have an Emergency Dr. friend that talked to a world renouned toxicologist and he said he would not let chromium anywhere near the inside of his body...that was not encouraging. Too late now though.

A friend who talked to a toxicologist .. hmmm

... sounds a bit like the 'next door neighbour's cousin's brother's mother-in-law'!

I know pharmacists who declare they would never take any number of routinely used drugs, surgeons who would never submit themselves to psychiatrists and orthopods who would never see a chiropractor! I myself would never allow a spinal surgeon within a mile of my spine with a scalpel and would never take drugs like bisphosphonate (Fosamax), have eye surgery or a spinal ......... oh wait - that one went by the board when I had my knee done! :hysterical:

Seriously, I think if that toxic doctor ever needed a joint replacement he'd end up saying "oh to hell with it - millions have already had this done and are okay"!

 

[MarkC]

great point Jo!!! I agree. I am really hoping that once I get my auto immune system calmed down, thyroid in check, and all that, that I will be way better. I think that it is possible that I have had auto immune stuff going on for several years and that the surgery was a big trigger. It would be pretty logical for my body to not like any hip replacement...much less mMOM. I am working with a Holistic Dr. to put out some fires, Endocrinologist for thyroid, etc.... The one thing that has hurt even before the surgery was that illiopsoas and it has not gotten any better (with the popping and radiating pain) except for the breif period after injection. I am going to discuss that with OS today.

My thyroid numbers were soooo far off...unbelievable. I did not know it but had felt symptoms for a while....(did not know they were symptoms) even while being extremely active. Dr. thinks I have been walking around with that problem for 3-4 years. Everything is more complex...just piling on me right now. One thing that is clear is the pain from that damn tendon. We'll see if we want to snip it or not.

 

[MarkC]

what a difference a day makes. Saw Dr. Attarian today. He said that he wanted to test metal levels again (been 6 months). He does believe that the iliopsoas is causing me pain (that is obvious) but he also believes that the metal is playing a significant part based on my reaction to the two injections. He says that if the ion levels come back higher, that will show a trend and that we will revise the hip. If they don't, we are in same situation and it may be possible to release the tendon...but I don't think he believes that will be the case to be honest. He said that if we had to do the revision, it was easy enough to take care of the tendon issue as well...no problem.

He also has a partner Dr. Richard C Mather III who has recieved the latest specific training in hip arthroscopy and is an "expert". They have brought him back to Duke for exactly that reason. Man these guys really specialize!! Since my left hip is bothering me, but is not at a place where it would be replaced, I am going to go ahead and have an MRI done on that one. This way, Dr. Mather can look and see exactly what it looks like and know if there is a chance that a scope would help or not. Dr. Attarian explained that if there were a torn labrum or some very easy fix that could be done to give me more time, they would present that option. He also told me that the first Dr. that scoped my right hip (before I replaced it) was not an expert (yes he said that very matter of fact) and that surgery should probbly never have been done (water under the bridge now). He assured me that they understood I did not want to have a scope and then have to replace months later (as I did the first time) and also told me that the left hip was not near as bad as the right one was (based on my old e-rays and MRI). I have chosen to do the MRI so I will have an answer one way or the other. If it is just bony peaces and becoming arthritic beyond very early, I will just ride that horse as long as I can.

So, I have no idea if I will have one, two or no surgeries...but I will get the results from blood test at Mayo clinic in a week and at least know if the revision is around the corner.

I don't even know what to wish for...but I am absolutely satisfied that I have some of the best Hip Dr.s in the world and they are doing everything they can to give me proper care. I have the utmost confidence in them. I only wish I had gone to them first..would have never had the first scope and probably not metal on metal although they were doing many of those at the time of jy replacement so I may have still gotten one. Oh well, spilled milk. M