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No surgery for me

Discussion in 'Hip Replacement Pre-Op Area' started by Gidget, Jan 25, 2018.

  1. Gidget

    Gidget member
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    Hello. I’m a 61 yo female. I have pain in both hips though a lot worse on the right.

    I have had cancer (now in remission) which left me with scarring to the spinal cord from healed lesions. As a result I have mobility problems. I use a walker around the house and a wheelchair outside.

    In 2011 I started getting worsening of right hip pain. MRI showed a labral tear, mild OA and tendinitis and bursitis. I saw an OS who refused surgery as I was still undergoing chemo. I had an injection into the bursa.

    Fast forward 2015, hip pain worse. Had an X-ray which showed moderate arthritis (both hips) and bone spurs. I was given an intra joint injection (R) of cortisone. I received slight relief which only lasted a few weeks.

    My pain is usually moderate and sometimes more severe but my main issue is the “giving way” which has caused me to almost fall on a number of occasions. My GP ordered another XRay and an ultrasound of R hip a week ago. They showed moderate to severe OA with osteophytes with severe muscle atrophy (unable to visualise the labrum). My GP seems to think I should just start using my wheelchair all the time because he doesn’t think I’m a candidate for surgery. I have other medical problems and require hospitalisation for a week each month for intravenous treatment for bone marrow failure. With this treatment there is uncertainty how long my life expectancy is...it “could” be normal...we don’t know.

    I insisted and have been given a referral to an OS.

    Now that I’ve bored you, my question is...as the pain in my hip doesn’t ease with sitting, staying in my wheelchair isn’t going to solve anything...am I being unduly optimistic to think my hip can be repaired? Would the combination of a tear, OA and atrophy be sufficient to justify a THR or is the fact the OA is only moderate to severe and not severe a deal breaker?

    I was supposed to see the OS next week but I have to go into hospital for 3 weeks so now I’ve got an appointment 20th Feb.

    Hoping for the potential to keep what mobility I have.
     
  2. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    Welcome to Bonesmart.
    Will tag @Josephine for her thoughts. She is our forum medical advisor...
    I wouldn't even know how to advise with such a complicated situation.
    Wonderful that your cancer is in remission!
    I'm certain that makes it all the more distressing about the hip.
    Hoping you can get some answers and know that I am adding my prayers.
     
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  3. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    That's the usual and most effective treatment for a TB
    Ordinarily, that combination would certainly qualify for a THR but your situation is somewhat complex and I think maybe your cancer treatment will be a contraindicative. However, I really think your GP is not the one to opine on this. You should talk to a hip surgeon of quality and see what he has to say. He might not think it such a problem as others do.
     
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  4. Gidget

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    Thank you Mojo and Josephine. I’m a glass half full kind of person and I will always be positive about my future. I’ve been told a number of times that I was going to die in the short term and I’ve proved them wrong using sheer grit. I’m going to do my best to show that repairing my hip is a good option. I’m not afraid of hard work and physio before and after to get the best outcome. I’ve already booked in for routine inpatient rehab to give my muscles a “tune up” and do balance exercises, I do this for 2 weeks every 6 months. I’ll ask the rehab Doc and PTs to focus on my hip muscles this time as well.

    Fingers crossed for my OS appt in Feb.
     
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  5. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    :fingersx: for you too.
    Your determination and spirit are inspiring.
     
  6. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    That's not necessary. Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.
     
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  7. Gidget

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    Hi, this post is more a diary entry than needing advice although I do have a couple of questions.

    I’ve noticed on here that people are having problems putting on shoes and socks. I don’t have that problem. I can flex my hip almost to my chest. My main problems are weight bearing while walking (sharp groin pain and hip giving way) and pain on internal and external rotation and very limited abduction. The pain and stiffness when trying to move after being at rest sometimes is awful. Would this mean I don’t have the same problem as all of you?

    Also, my right hip is more painful but X-ray shows my left hip isn’t great either, should I raise the possibility of bilateral? That way only one anaesthetc and recovery. I think the Docs main concern is the operation risks rather than the hip and functional outcome?

    Anyway, I’m in hospital for my usual cancer remission maintainance...no biggie. I spoke to my specialist about my hip and he’s happy enough (slight exaggeration) for me to be fit for surgery but he’s not sure an OS will agree to proceed because of the risk of complications. In the meantime he’s going to increase the dose of IV medication I’m getting to try to improve my bone marrow function and get me fitter in case I do have surgery. He’s also taking the opportunity while I’m here to get the PTs involved daily to strengthen my muscles around my hip and core to maximise my chances of surgery and recovery. I’m hoping if I show commitment to preparing that the OS will agree to help me.

    Hope you all have a lovely day. It’s dropped from 34C here to 23C and dark and drizzly....beautiful to lie in bed and read my book. The hospital cafe is going to deliver my coffee frappe soon. Yum, lots of cream too. I’m lucky??? that I need more calories than most people to stop my weight dropping. I can indulge in treats. Never thought id have this “problem”.
     
  8. SaraK

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    Mine was much like yours. The weight bearing movement (and side sleeping) became very painful but the muscles had flexibility. Before surgery, I could do the pigeon yoga pose (distant memory for now on my 2 month old hip but could do it again on my then 7 month old hip before surgery).

    Even if you have that flexibility before surgery, you may have restrictions after surgery or the muscles may be traumatized and swollen and you may not be able to do it for awhile after.

    Each person and each hip is different in how the pain presents. I had different things wrong with my hips but the pain was similar - go figure! So if the same problems means the same thing wrong with your hip compared to others, that might be the case. If the same problems means that we all have dodgy hips that need to be replaced, sounds like that's already been figured out. The surgery and the process are much the same for most problems with the hip but there are some structural issues that require some additional work.
     
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  9. Gidget

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    Updating for my own benefit. The PTs came every day I was in hospital and ran me through exercises to strengthen the gluteus medius and TFL. I was also told I have a very obvious Trendelenburg gait due to my spinal ataxia and that it’s probably not correctable. I also have a fixed inversion of my feet due to spasticity which should have been splinted a long time ago but it’s been too long and it’s not correctable either. The PT didn’t seem to be optimistic with my chances of having surgery due to my other gait and mobility problems. He seemed to think I would just be offered pain relief and intra joint injections which I don’t want to do. I’ve already had lots of steroids with my other problems and I’m on the cusp of osteopenia and osteoporosis. I don’t want more steroids.

    Seeing neuro on Tuesday and being admitted to Rehab for muscle/balance tone up on Wednesday for 2 weeks. See OS on 20 Feb.
     
  10. Mojo333

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    Oh Gidget. I know you have to be awfully frustrated.
    I would be much more interested in what OS thinks, though well-meaning, rather than PT.
    Please let him know all of your concerns and please let us know how it shakes out.
    Not knowing how all of your current issues affect surgery potential...but hate that you're struggling.
    I'm hoping you can get some possible solutions.
    Hang in there, we are rooting for you.
     
  11. MammaT

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    Hope your current plan works out. I admire your courage and making choices you think are best for you.
     
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  12. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi @Gidget
    I'm so sorry, you've been through so much.
    I wish you the best with your upcoming appointments with the neuro and orthopedic surgeon.
    Hopefully between the two of them and rehab you're able to settle on a plan that will soon bring you relief.
    A peaceful weekend to you!
     
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  13. Gidget

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    Thanks. At the moment it’s just a waiting game. I’m happy to have a few days at home with my little dog. She’s my constant friend and very entertaining too (extremely energetic and tiring but worth it).
     
  14. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    Our canine pals are so comforting. My little Mojo it's sweet and warm but at the moment he had the worst breath!! Needs a tic tac
     
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  15. Gidget

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    I know the smell. When Lily finishes off the cats tuna...phew! It’s just after 9.30am here and Lily has been playing ball with my 90 year old father (he lives next door). Now she’s exhausted and having her morning nap. She’s a really good dog when she’s asleep.
     
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  16. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    Same, we have a knotted sock that Mojo beats on my ankles until I either throw or tug of war with him.
    Now he's just warming my lap...with his stinky breath. Gotta love them.
     
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  17. SaraK

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    Little Mojo needs carrots to eat!
     
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  18. Gidget

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    Wish my little girl would lie quietly on my lap. Feeling a bit jealous.

    Lily won’t eat carrots but loves apple, watermelon, rice and peas. Just been to the shops in my wheelchair with Lily on my lap. She tried to take over the steering...not going to happen! Plenty of pats from shop staff. Spoiled little thing.
     
  19. Gidget

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    I was admitted to Rehab this morning. The Rehab Doc says that I shouldn’t even try to walk any more and to use my wheelchair all the time. The OT agrees, no more walking. Apparently it’s too dangerous and if I fall I’ll break something and it would be “disastrous” to use their terms. I’m devastated.

    I told the Rehab Doc about my hip and appt with the OS and she says she knows him very well and is going to call him and ask him to come and see me in Rehab. She says that she doubts the OS will think it’s worthwhile doing THR but might offer some other form of treatment. At the moment, I really just want to put my head in the sand and pretend the world doesn’t exist but I’m a realist and i have to face whatever happens.

    Going for my first gym session this afternoon with the PTs.

    I’m going to work damned hard to prove I’m worth trying to keep me walking, mobile and independent.

    Watch this space!!!
     
  20. Mojo333

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    I'm oh so sorry the news you got was so harsh. Don't know all that's involved but I think it warrants all the 2nd opinions you can obtain from all sources
    I'm watching...
     

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