THR Need a friend who has been on the other side of a late infection
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BarbieJ
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Here's the thing, with hip replacement surgery it's all good if you have a good result and never are sick. If you have problems you just entered the twilight zone. Nobody can diagnose the problem. My problem is way worse than psoas tendon impingement. Both my hips and both my knees hurt equally now and my back hurts so bad it hurts just to rest my back against the back of a chair.
Dentists and endodontists are trained to save teeth. Not pull out teeth that they cannot identify a problem. None of my teeth, even the ones that were pulled showed evidence of anything, I just start experiencing pain and that's all they can go by.
Actually, other than infection, which I still believe I have, I think I may have a metal toxicity problem.
I have zirconium for the ball, which I believe is considered ceramic, is this correct? Titanium stem which is supposedly biocompatable, and a plastic liner with a cobalt chromium neck that it all attaches to. In January, the cobalt chromium tests did not show toxic levels. Does anyone know of the neck piece being made of anything else? My OS said that part is never titanium.
If infection isn't causing the itching and pain, then perhaps the metal is?
Dentists and endodontists are trained to save teeth. Not pull out teeth that they cannot identify a problem. None of my teeth, even the ones that were pulled showed evidence of anything, I just start experiencing pain and that's all they can go by.
Actually, other than infection, which I still believe I have, I think I may have a metal toxicity problem.
I have zirconium for the ball, which I believe is considered ceramic, is this correct? Titanium stem which is supposedly biocompatable, and a plastic liner with a cobalt chromium neck that it all attaches to. In January, the cobalt chromium tests did not show toxic levels. Does anyone know of the neck piece being made of anything else? My OS said that part is never titanium.
If infection isn't causing the itching and pain, then perhaps the metal is?
Well, if the stem, and trunnion (neck) is made of titanium it will be an alloy, titanium 6al-4v (aluminium, vanadium) this was known as IMI 318 but has been replaced in the last few years by titanium, zirconium and tantalum alloy. The human tissue is far less sensitive to titanium alloys than stainless steel with nickel and chromium. Pure titanium is just not strong enough as a bearing surface. As Jo has said amongst the ceramics, a very hard and tough ceramic is zironium dioxide (ZrO2) known as zirconia, much used in bearing medical devices. However, in cases where there are a number of alloys used it is very difficult to diagnose the route cause - just too many variables, including the carbon based life form! Indeed, some patients just react because there is a large foreign body within them. Such combinations, of course, are subject to extensive clinical trials and experience before put into general release. But, as we now know, such trials are not always sufficient and there is always the possiblity of the OS combining devices from different manufacturers. When they do there is very rarely clinical evidence of such combination.
C Mac
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Hi Barbie,
Here is Glynis' thread, maybe you have already heard back from her privately.
I am sorry that you are having a hard time and that it feels like your system is in rebellion. One thing that I often have to remind myself of when I'm making the circuit of medical professionals is that I will always come away with a diagnosis that is "deficit based." In other words, there will be something negative that is wrong with the system that is being evaluated -- you will not get a pat on the back and be told you are great, everything is fine. I don't mean this as a criticism of the allopathic approach to medicine, it is just the way our system works for insurance reasons and pharmaceutical reasons and others too perhaps.
Personally, sometimes I find that I just have to take a break from visiting with the doctors when helpful answers are not forthcoming and it is adding to my stress levels. I know this is hard when you are trying to get answers to your problems, but if acceptable solutions are not coming your way either it can start to feel quite depressing.
I hope maybe you will find some relief for your stomach with the camomile tea that Poppet suggests. I also take some magnesium supplements at the end of the day as it can help with a multitude of issues one of which is the regularity of the bowels. I have found that when I am not able to be very physically active due to pain issues, my digestive system slows both in terms of my appetite and my elimination and this can lead to experiencing nausea as that system is just sluggish.
I hear you on feeling like you are in the twilight zone of hip replacement. I wish there were any easy answer that would sum it all up for you and get you onto a different track. Please know there are others who are here and have been here as well that are part of the forum. You may feel alone IRL but you are not here in cyberspace
I hope today is a little better for you and maybe you can get a little walk in with your cute Cubbie dog
Take care,
Cardie
Here is Glynis' thread, maybe you have already heard back from her privately.
I am sorry that you are having a hard time and that it feels like your system is in rebellion. One thing that I often have to remind myself of when I'm making the circuit of medical professionals is that I will always come away with a diagnosis that is "deficit based." In other words, there will be something negative that is wrong with the system that is being evaluated -- you will not get a pat on the back and be told you are great, everything is fine. I don't mean this as a criticism of the allopathic approach to medicine, it is just the way our system works for insurance reasons and pharmaceutical reasons and others too perhaps.
Personally, sometimes I find that I just have to take a break from visiting with the doctors when helpful answers are not forthcoming and it is adding to my stress levels. I know this is hard when you are trying to get answers to your problems, but if acceptable solutions are not coming your way either it can start to feel quite depressing.
I hope maybe you will find some relief for your stomach with the camomile tea that Poppet suggests. I also take some magnesium supplements at the end of the day as it can help with a multitude of issues one of which is the regularity of the bowels. I have found that when I am not able to be very physically active due to pain issues, my digestive system slows both in terms of my appetite and my elimination and this can lead to experiencing nausea as that system is just sluggish.
I hear you on feeling like you are in the twilight zone of hip replacement. I wish there were any easy answer that would sum it all up for you and get you onto a different track. Please know there are others who are here and have been here as well that are part of the forum. You may feel alone IRL but you are not here in cyberspace
I hope today is a little better for you and maybe you can get a little walk in with your cute Cubbie dog
Take care,
Cardie
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BarbieJ
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Thanks C Mac, I do feel like either Outer Limits or Twilight Zone. Since the odds of infection are low as are other hip or knee prosthetic problems the doctors don't have experience or knowledge and tests are limited so they are clueless IMO about how to handle me. In the early months I was thrown A LOT of antibiotics. Now my symptoms are so odd, the doctors just throw up their hands or order another X-ray or test.
Right now I would gladly have my life back to just the way it was before all this happened and my badly arthritic hip. I amin the same pain now anyway.
Bumpa my surgical stick labels say high offset neck 12/14 taper Smith and Nephew 71352112 which when I looked it up was cobalt chromium.
Right now I would gladly have my life back to just the way it was before all this happened and my badly arthritic hip. I amin the same pain now anyway.
Bumpa my surgical stick labels say high offset neck 12/14 taper Smith and Nephew 71352112 which when I looked it up was cobalt chromium.
Hi Barbie
Nice to hear from you. First of all, thanks to C Mac for finding my thread. I hadn't been able to find it either! I notice it is closed, but not to worry. I don't have much to contribute these days, but I keep an eye on one or two other threads, especially if there are points to which I can relate.
The story of the diagnosis of my infection is a long one, and, in my mind, quite confusing. I'm not going to pass on all the details, as there are many aspects I don't understand myself, and it will get to be a case of Chinese Whispers if I tell you things which are misleading.
The only really significant symptom I had was a large, softish lump - about the size of a tangerine - which appeared at the site of my incision nearly 18 months after surgery. I had some increased discomfort in my hip and thigh, but nothing I could really call severe pain. The lump was drained twice, then never appeared again.
I think the fact that I was pretty much symptom-free delayed my eventual firm diagnosis. My consultant described me as "functioning": and during that time I went away to Ecuador, staying in Amazon eco-lodges without electricity, and getting in and out of dug-out canoes.
Eventually though, it was found that I did have an infection, and I agreed to the 2-stage revision. Apparently my surgeon found the second operation more complex than he thought, and I lost a great deal of blood. From my point of view, however, the whole thing was much easier than I had imagined.
Well, that's my story. I am now going to stick my neck out, and, at the risk of offending you, tell you that whatever condition(s) you may or may not have, I am 100% certain that you are making yourself worse by your constant worrying. (Actually, Barbie, I really think you know that yourself, if you will let yourself admit it.)
Reading through your thread, your language constantly relates to worst case scenarios. "Possible necrosis of the jawbone", "my body is under attack", "nearly had C diff", "getting my papers in order", "may not be able to attend children's life events".
ALLOW YOURSELF, just for a while, to consider the possibility that some of these bad things just might not happen, or might at some point resolve themselves.
I am not saying that you do not have some as yet undiagnosed condition, or even more than one. I am also sure that your urinary problems are very unpleasant, and are getting you down. I'm not for one minute trying to belittle your very real distress.
I agree with Josephine, and feel that you are certainly depressed. I also notice in your posts that you are still having post-menopausal symptoms, and that your mother died relatively recently. Both these things can have very real and lasting effects. I have had depression myself on more than one occasion over the years. It is hard work to shake it off. Can you ask your doctor for some mild tablets? If you could just get on top of this aspect of your difficulties, you would be so much better prepared to tackle the other things.
Barbie, I am dubious about posting this. I don't know you, and you don't know me. You may be furious at my comments. You may wish to tell me to mind my own business.
I am a very devout atheist, so I don't do prayer, but I genuinely hope you will soon feel stronger and happier.
Glynis
Nice to hear from you. First of all, thanks to C Mac for finding my thread. I hadn't been able to find it either! I notice it is closed, but not to worry. I don't have much to contribute these days, but I keep an eye on one or two other threads, especially if there are points to which I can relate.
The story of the diagnosis of my infection is a long one, and, in my mind, quite confusing. I'm not going to pass on all the details, as there are many aspects I don't understand myself, and it will get to be a case of Chinese Whispers if I tell you things which are misleading.
The only really significant symptom I had was a large, softish lump - about the size of a tangerine - which appeared at the site of my incision nearly 18 months after surgery. I had some increased discomfort in my hip and thigh, but nothing I could really call severe pain. The lump was drained twice, then never appeared again.
I think the fact that I was pretty much symptom-free delayed my eventual firm diagnosis. My consultant described me as "functioning": and during that time I went away to Ecuador, staying in Amazon eco-lodges without electricity, and getting in and out of dug-out canoes.
Eventually though, it was found that I did have an infection, and I agreed to the 2-stage revision. Apparently my surgeon found the second operation more complex than he thought, and I lost a great deal of blood. From my point of view, however, the whole thing was much easier than I had imagined.
Well, that's my story. I am now going to stick my neck out, and, at the risk of offending you, tell you that whatever condition(s) you may or may not have, I am 100% certain that you are making yourself worse by your constant worrying. (Actually, Barbie, I really think you know that yourself, if you will let yourself admit it.)
Reading through your thread, your language constantly relates to worst case scenarios. "Possible necrosis of the jawbone", "my body is under attack", "nearly had C diff", "getting my papers in order", "may not be able to attend children's life events".
ALLOW YOURSELF, just for a while, to consider the possibility that some of these bad things just might not happen, or might at some point resolve themselves.
I am not saying that you do not have some as yet undiagnosed condition, or even more than one. I am also sure that your urinary problems are very unpleasant, and are getting you down. I'm not for one minute trying to belittle your very real distress.
I agree with Josephine, and feel that you are certainly depressed. I also notice in your posts that you are still having post-menopausal symptoms, and that your mother died relatively recently. Both these things can have very real and lasting effects. I have had depression myself on more than one occasion over the years. It is hard work to shake it off. Can you ask your doctor for some mild tablets? If you could just get on top of this aspect of your difficulties, you would be so much better prepared to tackle the other things.
Barbie, I am dubious about posting this. I don't know you, and you don't know me. You may be furious at my comments. You may wish to tell me to mind my own business.
I am a very devout atheist, so I don't do prayer, but I genuinely hope you will soon feel stronger and happier.
Glynis
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BarbieJ
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glynis, no, I am not all furious with your comments, I like them. I recently got off my antidepressants and this will be hard for you to believe, but I am not depressed anymore. Was I after my surgery for most of the year? Absolutely. Getting hit with all of these tooth infections and UTI infection while recovering from a disappointing surgery was more than I could handle.
In the last couple weeks my head feels better.
You are amazing my Amazon lady.
(Well maybe not Amazon but you sound like you are making a difference in the world with your life and work.)
I am happy to hear that you had a successful two stage revision. I definitely like hearing that.
Did you manage okay on the antibiotic regimen?
I truly thought this surgery would give me the ability to enjoy life again. I was so excited to get this done and get on with life that in hindsight i should have not listened to my pre surgery clearance dentist and gp telling me i was fine. I did ask myself, what if they are wrong.
I had more ability before my surgery. One example, I could sit comfortably for hours before. Now I am in pain after sitting for 15 minutes and bedridden if I sit on a hard chair like the ones at school.
Or sitting in a car. I could drive across the Midwest before. I would limp around but I was comfortable as a clam sitting. Not anymore. I can't sit in a car. The drive to Mayo was difficult and was bedridden for days afterward. So, something is not right with my hip.
Also, my skin feels like I have a case of poison ivy itch every day. I had to get off all medication to see if this was contributing.
The itching was only on my thigh, hip and now is everywhere, ankles, face, back.
I am just getting hit from too many directions with no answers.
In the last couple weeks my head feels better.
You are amazing my Amazon lady.
(Well maybe not Amazon but you sound like you are making a difference in the world with your life and work.)
I am happy to hear that you had a successful two stage revision. I definitely like hearing that.
Did you manage okay on the antibiotic regimen?
I truly thought this surgery would give me the ability to enjoy life again. I was so excited to get this done and get on with life that in hindsight i should have not listened to my pre surgery clearance dentist and gp telling me i was fine. I did ask myself, what if they are wrong.
I had more ability before my surgery. One example, I could sit comfortably for hours before. Now I am in pain after sitting for 15 minutes and bedridden if I sit on a hard chair like the ones at school.
Or sitting in a car. I could drive across the Midwest before. I would limp around but I was comfortable as a clam sitting. Not anymore. I can't sit in a car. The drive to Mayo was difficult and was bedridden for days afterward. So, something is not right with my hip.
Also, my skin feels like I have a case of poison ivy itch every day. I had to get off all medication to see if this was contributing.
The itching was only on my thigh, hip and now is everywhere, ankles, face, back.
I am just getting hit from too many directions with no answers.
Poppet
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Be very careful using Magnesium as a mineral to assist with constipation.. When you get loose bowel motions from taking Mg it means you have over reached the dosage amount and need to back off from that dose other wise you will unbalance other minerals, particularly calcium.
Magnesium Citrate is used as a medication for constipation because it can be bought without a prescription from your local pharmacy or retail stores. In most countries, I believe? One can take one to four hours to produce a bowel movement, but if constipation is severe it may take longer or possibly not work at all.
It is important to note that a magnesium and constipation can be related by way of taking excess calcium as a supplement. If this is the case, then magnesium is needed to balance the calcium on the digestive tract.
For this reason some people, such as menopausal women, might be better to take a calcium supplement that also contains magnesium.
Always consult your physician about these types of changes to your diet or supplement regimen.
Taking mineral supplements is a very fine balancing act, they all work in synergy, so if you decide to go down that road tag me and we can discuss it some more
You maybe better to introduce beans into your diet.. I make a very quick dinner dish of cans of white beans, butter beans, two small tins of fresh water tuna and a tomato, olive and chili sauce.. Mix together and microwave... This way you will get good nutrition, protein, plus the necessary fibre in a more natural form rather than isolating one mineral.
Magnesium Citrate is used as a medication for constipation because it can be bought without a prescription from your local pharmacy or retail stores. In most countries, I believe? One can take one to four hours to produce a bowel movement, but if constipation is severe it may take longer or possibly not work at all.
It is important to note that a magnesium and constipation can be related by way of taking excess calcium as a supplement. If this is the case, then magnesium is needed to balance the calcium on the digestive tract.
For this reason some people, such as menopausal women, might be better to take a calcium supplement that also contains magnesium.
Always consult your physician about these types of changes to your diet or supplement regimen.
Taking mineral supplements is a very fine balancing act, they all work in synergy, so if you decide to go down that road tag me and we can discuss it some more
You maybe better to introduce beans into your diet.. I make a very quick dinner dish of cans of white beans, butter beans, two small tins of fresh water tuna and a tomato, olive and chili sauce.. Mix together and microwave... This way you will get good nutrition, protein, plus the necessary fibre in a more natural form rather than isolating one mineral.
Orthodoc
Former BoneSmart staff member
Bumpa, thanks for your earlier comments.
This is a good question.
A quick review can be helpful. The components for hip replacements are modular in nature. This means that they are made of several components that are put together during surgery. For this discussion, lets forget about the acetabular component (socket) and the polyethylene (plastic) components.
The other part of the hip replacement is the stem and head. In all modern hip systems, this consists of a minimum of two components. These two components (the stem and the head) are put together during surgery and can be comprised of different materials. Typically the stem is made of titanium or cobalt/chrome and the head is made of cobalt/chrome or a ceramic.
In most systems the stem is a single forged piece of metal (usually with a coating applied to help with integration into the bone). In this case, the neck may be made of titanium. However, there are other systems that have another element of modularity to the stem. Specifically some systems have an additional modular component to the neck (or trunnion) portion of the stem. In these systems, the neck will be a separate piece of metal that fits onto the stem, then the head fits onto this neck. It is beyond the scope of this reply (for now) to go into the reasoning for using a modular neck applied onto a stem versus a single component for the entire stem and neck.
Ok, now I think I can answer the question. Modular necks (or the trunnion) have been manufactured from both titanium and cobalt/chrome depending on the system. BarbieJ, you are correct that Smith and Nephew does use a cobalt/chrome modular neck in their systems.
I hope this helps.
Orthodoc
This is a good question.
A quick review can be helpful. The components for hip replacements are modular in nature. This means that they are made of several components that are put together during surgery. For this discussion, lets forget about the acetabular component (socket) and the polyethylene (plastic) components.
The other part of the hip replacement is the stem and head. In all modern hip systems, this consists of a minimum of two components. These two components (the stem and the head) are put together during surgery and can be comprised of different materials. Typically the stem is made of titanium or cobalt/chrome and the head is made of cobalt/chrome or a ceramic.
In most systems the stem is a single forged piece of metal (usually with a coating applied to help with integration into the bone). In this case, the neck may be made of titanium. However, there are other systems that have another element of modularity to the stem. Specifically some systems have an additional modular component to the neck (or trunnion) portion of the stem. In these systems, the neck will be a separate piece of metal that fits onto the stem, then the head fits onto this neck. It is beyond the scope of this reply (for now) to go into the reasoning for using a modular neck applied onto a stem versus a single component for the entire stem and neck.
Ok, now I think I can answer the question. Modular necks (or the trunnion) have been manufactured from both titanium and cobalt/chrome depending on the system. BarbieJ, you are correct that Smith and Nephew does use a cobalt/chrome modular neck in their systems.
I hope this helps.
Orthodoc
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BarbieJ
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Thank you Orthodoc, for the first time I believe I am understanding. I believe I had the articulating trunnion neck piece because I had the anterior approach. I guess I flunked hip replacement 101. I will never forget the first words my OS said to me in the hospital after my surgery. I asked him regarding my surgery, " so do I get an A?" He said "or an F." I think his words were prophetic now. I thought he was joking with me then, but I think he knew what I did not.
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GOOD NEWS
Today my insane burning and itching seemed nearly gone! So, just out of curiosity I decided to google the words "itching after stopping cetirizine" and I couldn't believe what I found. There is a connection. Zyrtec (cetirizine) causes people who use it for extended time to have severe itching when they stop, plus nausea, nerve pain, exhaustion and other problems that I have been having. Friday was my first week off of cetirizine and many users posted that at the 5 day mark the symptoms became the most severe sending them to the emergency room. Symptoms start to subside after the one week mark, perhaps lasting a couple weeks.
Today I have hope!
I think this medication has been to blame for much of my problem. I think it truly almost killed me. I am praying this is the start of better days.
Hip still has problems, but one thing at a time, I may be able to handle!
Today my insane burning and itching seemed nearly gone! So, just out of curiosity I decided to google the words "itching after stopping cetirizine" and I couldn't believe what I found. There is a connection. Zyrtec (cetirizine) causes people who use it for extended time to have severe itching when they stop, plus nausea, nerve pain, exhaustion and other problems that I have been having. Friday was my first week off of cetirizine and many users posted that at the 5 day mark the symptoms became the most severe sending them to the emergency room. Symptoms start to subside after the one week mark, perhaps lasting a couple weeks.
Today I have hope!
I think this medication has been to blame for much of my problem. I think it truly almost killed me. I am praying this is the start of better days.
Hip still has problems, but one thing at a time, I may be able to handle!
C Mac
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Hi Barbie,
Well, that is good news that the rash is settling down and that you were able to find a connection between it and that Zyrtec -- YUCK!!
Your last message reminded me that since a few months after my surgery I found it helpful to keep a small daily journal and in it I write about various items likes activity level, aches & pains, medications taken, so on and so forth. Maybe you already do something like this, but if not it might be helpful in making connections for you with some of your issues.
Also wanted to mention to glynis that if you want your thread to be unlocked any one of the moderators can do that for you Jaycey Jamie or bottomshollow and then you can add in to it that summary that you included for Barbie about your situation -- those types of stories are helpful for others to read, nudge, nudge,
Take care ladies,
Cardie
Well, that is good news that the rash is settling down and that you were able to find a connection between it and that Zyrtec -- YUCK!!
Your last message reminded me that since a few months after my surgery I found it helpful to keep a small daily journal and in it I write about various items likes activity level, aches & pains, medications taken, so on and so forth. Maybe you already do something like this, but if not it might be helpful in making connections for you with some of your issues.
Also wanted to mention to glynis that if you want your thread to be unlocked any one of the moderators can do that for you Jaycey Jamie or bottomshollow and then you can add in to it that summary that you included for Barbie about your situation -- those types of stories are helpful for others to read, nudge, nudge,
Take care ladies,
Cardie
That's great news, Barbie. A big step forward.
Come to think of it, I had itching when I was in the Recovery Room after one of the revision ops. A nurse told me it was caused by one of the medications, but I can't remember which. The elderly lady in the bed next to me also had it. There was one spot on her bottom which she couldn't quite reach. She asked one of the male nurses to do it for her, but he seemed to think that was beyond the call of his duties.
Thanks, C Mac, I'll think about your suggestion.
Best wishes, Barbie.
Come to think of it, I had itching when I was in the Recovery Room after one of the revision ops. A nurse told me it was caused by one of the medications, but I can't remember which. The elderly lady in the bed next to me also had it. There was one spot on her bottom which she couldn't quite reach. She asked one of the male nurses to do it for her, but he seemed to think that was beyond the call of his duties.
Thanks, C Mac, I'll think about your suggestion.
Best wishes, Barbie.
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BarbieJ
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GASTROPARESIS
Discouraged to get the results of my nuclear test back which was positive for finding that my digestion is impaired for some reason and only working at 50% of where it should be with digesting. This condition is called gastroparesis. I have been visiting doctors since my hip replacement with digestive problems and stomach pain. I had a CT scan a year ago which did not find any problem. How is this that I was A okay before my surgery and now I have chronic conditions that I never had ever heard of before.
Also today was a tough day with intensely sharp pains at my incision scar on my hip.
Discouraged to get the results of my nuclear test back which was positive for finding that my digestion is impaired for some reason and only working at 50% of where it should be with digesting. This condition is called gastroparesis. I have been visiting doctors since my hip replacement with digestive problems and stomach pain. I had a CT scan a year ago which did not find any problem. How is this that I was A okay before my surgery and now I have chronic conditions that I never had ever heard of before.
Also today was a tough day with intensely sharp pains at my incision scar on my hip.
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