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[THR] Severe pain after 15 months<

Discussion in 'Hip Replacement Recovery Area' started by Dickie 1, Jul 24, 2017.

  1. Dickie 1

    Dickie 1 member
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    Hi there, I have been reading the forum for a while.

    I had a total hip replacement (Anterior) in May 2016. Post-operative pain was horrific and I was on so much strong medication to control the pain, yet I was still in tears with break through pain. The surgeon put this down to my fibromyalgia. The pain settled a little within a month, recovery was steady, but painful.

    I saw the Surgeon at 2 weeks, then he didn't want to see me again till 12 months. I kept gong back to him at 3, 4 and 6 months, when I felt patronised by him saying some people take a year to recover. Well I am not some people. I was training with a PT (boxing), until a couple of months prior to my surgery, I was a really fit person.

    I am not over weight. You would think I would have been leaping out of bed on day 1. The Surgeon each time he saw me said it was the fibromyalgia. At 11 months I sought a second opinion. Despite x-rays, an MRI and a cortisone injection to rule out psoas tendinitis, nothing is showing up on any imaging. Blood tests are inconclusive.

    Moving forward to today, I remain in severe pain on a number of pain relieving drugs to allow me to function. My mobility, reduction of pain and quality of life are no different than I was prior to the op. I have been forced into early retirement as I cannot walk far, use a walking stick and cannot weight bear for 45 minutes at a time. I feel like I am still walking bone on bone and a broom handle is stuck up my thigh.

    The second opinion Surgeon doesn't want to see me before November when a bone scan is to be done. He is colluding with the first surgeon and I feel let down. I emailed the first surgeon last week to say how I was and I have never received any reply, not even from his staff.

    Since a jarring of my hip 10 days ago, the pain has increased and November seems a long way away. My chiro did an x-ray at my request, but I haven't heard back if anything is showing up.

    I have no idea what to do now and feel let down. I continue to do Hydrotherapy x 3 week. I am in pain 24/7 and don't sleep well now.

    Can anyone give me hope of being normal again.?
     
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  2. MyAussieGirl

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    Hi I have seen a lot of threads and comments around by far smarter people than me. I think you may need to see a specialist on OS issues or gone bad. I am not sure on there titles but I be know they do Revisions and my guess is they aren't the puppet of the original doctors. Someone will be around to help you.... I saw you here and my heart hurts for you. I personally would go to one of those doctors. I am not sure which mod here but one can share a list with you of any in your area. Till then know I care :smile2:me
     
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  3. Dickie 1

    Dickie 1 member
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    The thought of a revision scares the hell out of me, due to the severe pain I felt.

    At the start of May this year when I saw the 2nd opinion surgeon, he was suggesting exploratory surgery, which I initially agreed with. I started to have second thoughts, because I was so terrified after the first surgery and went to the GP. The GP said that I had better read the letter that he had sent out. He said in the letter that I was pressuring him to do more surgery, which was never the case. I was following his suggestions only. He also said that it maybe that I would end up worse off and with a less than preferred outcome. Well he didn't even discuss this with me.

    This letter made me so angry. So I sent him an email. It was this email that made me decide to wait the 6 months till they do a bone scan in November. I don't want any person operating on me that isn't happy to. I don't really want a third opinion, just because of cost. The surgeon thinks it is either a loose component or infection is the cause. Thank you, MAG for the reply and support.
     
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  4. Irish Joe

    Irish Joe Sr Bonesmartie

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    Hello dickie.
    Firstly you have my sympathies in relation to your ongoing pain issues. Pain is not nice for both body and mind.
    @Josephine is very busy on the forum helping people with problems such as yours so she will see this soon.
    The thing is if its an infection it needs to be sorted now.
    And.
    If its a loose stem it needs to also be sorted now.
    Does your chiro have anything to do with the 2 surgeons you've seen so far. If not then the xray he gets may be something to go on. See if he can email it to you or get it on a disc and then you can post it up here so someone can have a look at it.
    But I think really that your solution still lies with a totally independent 3rd specialist who has totally no connection with the other 2 and also does revision surgery if needed.
    Hope this helps and I wish you well.
    Joe.....
     
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  5. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    I agree with Joe..and if you never got any relief from the first surgery and in fact have had horrid pain since, it does seem that there is an issue with the implant.
    So sorry that you are still living with pain and I can understand not wanting to do more surgery...but if it is the prosthetic you have got to have something done.
    I'm sorry you have been treated so disrespectfully on top of these complications.
    Truly not fair. Let us know what you find out from Chiropractor...hang in there
     
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  6. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @Dickie 1 Welcome to BoneSmart! Sounds like you are dealing with some nasty pain. I have to agree with what others have suggested. A third consultation with someone totally unconnected to your first surgeon is needed. This needs to be a revision specialist. If that implant is loose you need it fixed.

    Can you get a copy of the X-ray from your chiropractor for Josephine to look at?
     
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  7. cpollock

    cpollock graduate

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    @Dickie1 this is just awful. The bottom line is you are number 1 here and need to get this looked after, as soon as you can. Especially if there's an infection, that can lead to even worse complications. I wish you luck with your third consultation and hope this next specialist can resolve all these issues. I wish you well. Cheryl

    Sent from my SM-T350 using Tapatalk
     
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  8. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Before we start talking about a revision, let's get down to the nitty--gritty.

    First can you tell me the site or sites of your pain using this chart.

    hip-references-horz.jpg



    Next would you answer some questions for me so I can maybe figure out what's going on?

    It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

    1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

    2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

    3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

    4. are you icing your painful area at all? If so, how often and for how long?

    5. are you elevating your leg. If so how often and for how long?

    6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

    7. are you doing any exercises at home? If so what and how often?
    This is the most crucial question so please help me by using the format I have left as an example
    (which means please make a list and not an essay!)

    Exercises done at home
    - how many sessions you do each day
    - enter exercise by name then number of repetitions of each
    etc., etc.

    Anything done at PT
    - how many times a week
    - enter exercise by name then number of repetitions of each
    etc., etc.
     
  9. Dickie 1

    Dickie 1 member
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    Hi Josephine,
    I actually have the x-rays on film, but not disk, so I am not sure how to send you the pictures.
    1. I had the anterior approach which healed well.

    2. Pain levels: constant most of time while sitting about 3-4, however weight bearing increases the pain, so walking etc about 7-8 if I over do it. I can walk about 1 kilometere total in a day.

    We went over to Thailand at the start of June and the increased walking at the airport and on a tour cause my hip muscles to seize up for 2 days. I struggle with stairs and even a slight sloping driveway, like before surgery. It is a challenge. If I over do it my whole thigh seems to have some intermittent throbbing, but not always.

    3. Medication: Targen (slow release Oxcodone hydrochloride) & naloxone hydrochloride 15mg daily taken at 10 am offers about 8-10 hours of relief. By 2-3pm I also have 1 Panadiene Forte 30mg codeine and 1 paracetamol, but around 8pm I take another Panadiene Forte. I also have a script for Endone, but I haven't taken any. I am also on Endep 35 mg for fibromyalgia to assist sleep. And I take magnesium 400mg nocte.
    This analgesic regime takes the edge off the pain, so I can function, to carry out activities of daily living.

    4. No icing since early on, no point, no swelling at all. I do use a wheat pack heated sometimes which can help. I also have a TENS machine when I am desperate for a little relief. This travelled to Thailand with us and was used.

    5. Elevating legs when I sit down. I am quite active, within my limitations if that makes sense.

    6. I have to rest every 45 minutes through the day, any longer than 1 hour, increases pain. I clean my house in short bursts, then rest. I also have a cleaner once a fortnight. I am unable to clean upstairs. Shopping I can manage being aware of times to rest. I use a shopping trolley as a walking frame, use my walking stick or 1 crutch when out or the pain increases. My hip hates hard surfaces. I have to wear memory foam shoes, to absorb the impact of walking.

    7. Exercise: I stopped seeing the Physiotherapist in November last year, as even simple basic exercises increased the pain within an hour. I do attend a heated pool 3 x a week and walk in the water forwards, backwards, sideways and do a few lower leg exercises that the Physiotherapist gave me. Land based exercise, like walking hurts a lot. I am weigh bearing at home without aids. I can walk the rubbish bins out to the road, my driveway is 300 metres, so a 600 metre return walk.

    Pain chart: Pain is usually anterior, not posterior. VR2F or WR2F, sometimes felt at VR1F or XR2F

    I hope this helps you, I so appreciate your assistance and support.
     
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  10. dougie0216

    dougie0216 graduate

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    @Dickie 1 Sorry to hear about your pain. I agree with @Irish Joe, go to a separate facility or a different town. Go far away from the old boys club. Get an honest third opinion. Also Jaycey and Josephine have a lot of knowledge, they should help you get to the bottom of it. Get a third opinion. Best of luck.
     
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  11. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    So, just to confirm, your pain is in these places?

    dickie.jpg


    Weight bearing increases pain? That is suspicious.
    I would imagine
    Just for information, Targin is oxycodone and naloxone and Endone is the brand name of a medicine containing the active ingredient oxycodone hydrochloride.
    Many misunderstand the point of icing. It's not just for swelling. It's also excellent for pain management as well. I would also concur with the use of a TENS but why wait until you are 'desperate'? I use mine all the time.
    It does!
    Okay, got it.
    I'd suggest you don't do the pool work because from all I've read here, it seems to me that you have a loose femoral implant! But to confirm this, I really need to see the xrays as well.
    It's not that difficult! Look here for instructions A few tips on posting xrays
     
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  12. margo

    margo junior member

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    Josephine, I read your replies in awe. I am a retired nurse (oncology). I love how you do the assessment and cut right to the problem and give us aid in problem solving.

    So grateful I found this site.
     
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  13. Dickie 1

    Dickie 1 member
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    xray 2 001.jpg
     
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  14. Dickie 1

    Dickie 1 member
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    Hello there, Josephine, I apologise for the late reply for the xray request, but my mother in law was admitted to hospital a couple of days ago, she has end stage leukaemia. It was a busy few days. I also have my own mother with dementia and life is very busy with them in my limited capacity.

    This is the best I could do to upload the xray, I am not that computer savy and it took me ages. This x-ray was the plain xray that the Chiropractor arranged on the 20th July 17. I have not received any feedback or report from this.

    The pain is also at XRF2 as well, but basically where you highlighted the colours.

    I have been using my TENS machine more as you advised. Last week I felt very depressed, so I made contact with No 1 Surgeon's rooms, he is the one who did the surgery. I have an appointment Monday (Melbourne Australia time), they fitted me in quickly, as I was in tears. Emotionally, after 2 nights reasonable sleep, I am feeling more in control.

    I tend to agree with your diagnosis, as at times getting out of my car, I have to slide out over the ridge of the seat, I have felt this move under me. Well that is what it feels like. The recent jarring incident has not subsided pain wise either.

    Josephine, I know how special nurses are, as I have just retired from a 40 year career as a Midwife and Maternal & Child health Nurse. Orthopaedics, however is not my speciality and my knowledge is limited in that field.

    I very much appreciate the support from the wider forum community as well.
     
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  15. MyAussieGirl

    MyAussieGirl supremo

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    No wisdom here just wanted to send you a hug ... I read your post on mom and MIL you sure have your hands full. Mega hugs
     
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  16. Dickie 1

    Dickie 1 member
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    Thank my Aussie Girl. My own Mum's diagnosis was no surprise to me, but it needed something to be done to gain her assistance. We actually received the news in March 4 days apart. I do what I can for them both, but the drive over to my Mum's really takes its toll. It is what it is, I cannot change it. I appreciate the hugs.
     
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  17. MyAussieGirl

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    I hear you on it is what it is. That's very true but it still stinks and it's so much on you. You're in awesome hands with Josephine she's smart and cool. I am just cool but not so smart. I will add you to my prayers and send extra hugs
     
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  18. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Dickie, coping with your two mothers AND a new hip - you are awesome!
    Well done to post your xray. I've sent you a PM
     
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  19. Dickie 1

    Dickie 1 member
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  20. Dickie 1

    Dickie 1 member
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    Hello to everyone, I went back to the original surgeon yesterday. he cannot see anything wrong showing up on the xray. He could see how I was walking, like a little old lady. He examined me pushed up on my leg from the lower leg, pulled on it, not much pain, until he placed some pressure on the middle of my thigh when I was lying supine, I jumped and displayed how painful it was. He is going to do a CT scan. Cannot do a Bone scan till 18 months is up. He said that loosening shows up early on an xray and it wasn't showing. He also mentioned metallic reaction on the CT slip, but said nothing to me.
    I had a really rough night's sleep with aching from about 2.30am. He said if it is a loose stem, it is a matter of removing it and slipping in another one. I actually thought that a revision was more complicated than the original surgery? Thank you in advance.
     
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    Last edited by a moderator: Jul 31, 2017

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