THR Uneasy about surgery next week

[FraidyCat]

I'm having an impossible time communicating with my surgeon about my pending surgery (scheduled for early next week) despite multiple attempts to reach him. ("Support" staff haven't been helpful in the least.) A couple of months after an initial office visit and a phone conversation, in which my OA in three joints (both knees and L hip [R hip was replaced in 2016]) were discussed with regard to sequencing of surgeries, at which time the surgeon indicated that all three would, sooner or later, need replacement , I'd asked that a current X-ray be ordered because my previous X-ray had been done months earlier at another medical facility and had indicated only "mild-to-moderate" OA. I'd been told the surgeon would discuss the new X-ray with me, but no such conversation has materialized and each time I request a response I feel "unheard."
The new X-ray report reads as follows: "Moderate to advanced left hip joint osteoarthritis. There is marked joint space narrowing, subchondral sclerosis, and spur formation."
My hip pain has worsened over the three months since the office visit; it mostly takes the form of a constant pulled-muscle-like sensation in the groin, which varies in intensity (though it's not been acute).
I would merely like the surgeon to confirm that the symptoms and X-ray findings indicate that THR is appropriate at this time or whether it would be better to wait until the pain is more intense and the X-rays show more advanced OA (i.e., with "moderate" no longer a descriptor). My rheumatologist believes that I should go ahead with the surgery.

I suspect that I'm ruminating too much and that my usual anxiety is what's clouding my resolve. That said, I'm unused to silence from a surgeon when I've asked for reassurance/clarification. I should add, though, that the surgeon did request a CT scan of the hip as part of my preop screening, which I completed last week. Perhaps his having ordered the CT is a sign that he's paying attention (albeit not responding to my attempts to reach him) ...

Any input would be much appreciated.

 

[Mojo333]

Hi @FraidyCat
Welcome back to the forum.

I'm sorry you haven't gotten a response from your surgical team but I'm with your rheumatologist... go ahead and get this done.
There was a lot of backup of hip surgeries, and orthopedic surgeons have huge workloads so having a date for next week is great news.

Our nurse emeritus, Josephine, likened replacing a decaying hip joint due to OA to replacing a rotten tooth.
It won't fix itself, and the fact that you aren't yet writhing in pain and have been active and mobile sets you in a much better place for recovery.
Xrays, as you know, only tell "most" of the story, and my surgeon told me After how bad my hips actually were when he got in there.

I know preparing for surgery creates anxiety and doubts, but you know there is alot of support here!

I checked out your old recovery thread and look what your first post-op remark was:

Hello from "the other side." I had the surgery on Friday and returned home from hospital yesterday. Surgeon said hip cartilage was almost completely degenerated, so guess I made the right call.

I think you are making the right call now too.

Let us know what your actual Surgery date is and we will add it to your signature.

 

[Boofit]

I should add, though, that the surgeon did request a CT scan of the hip as part of my preop screening, which I completed last week. Perhaps his having ordered the CT is a sign that he's paying attention (albeit not responding to my attempts to reach him)

Hi @FraidyCat . Your surgeon ordered a CT scan. A CT scan is a more detailed study of the Hip joint than a simple Xray, so I do think this is indication that he is taking your condition seriously.
I believe that after reviewing the report of your CT scan, your surgeon will be in a much better position to determine whether you need a THR right away.

Fingers crossed that you get your THR soon. My personal experience is that my condition went downhill quite rapidly during the last few months before the surgery and I was on a cocktail of painkillers to get on with my daily life. I am grateful my surgeon told me I had to do the operation in June!

 

[subie2021]

My OS told me that some people have little to no pain even though imaging shows that the hip is a mess, with advanced deterioration. Then there are other people in terrible pain with imaging that shows only minor to moderate problems.
On my latest post-op visit, the OS asked about my un-operated hip. Xrays 'don't look that bad'. But he went on to say that making the call for replacement not always about imaging showing severe disease any more and that quality of life is a major consideration.
To me those words were a huge relief, knowing that I wouldn't have to spend precious months or years in pain as I did with my first hip. And I was surprised he even talked about it, since I've found him to be not chatty or talkative or particularly freely communicative. He generally addresses the problem in front of him and not much else.
For what it's worth, if it makes your situation seem more 'normal' I saw the OS only twice before surgery. There was the first appointment from referral from pain management where he advised and scheduled the hip replacement; the next time was the pre op visit where I spent more time with the patient advocate than with the surgeon. It was important for me to bring in a list of questions and concerns and address them, because casual conversation isn't his style. Just because my surgeon didn't talk a lot or treat my situation like an urgent one, didn't mean he was dismissive of my pain and I appreciated that.
Best wishes for whatever you decide.

 

[Layla]

I agree that since the CT scan was ordered by your surgeon that he’s more up to date on your case than he’s communicated personally. However, I do understand any frustration you’re feeling. I will leave a Score Chart that may make you feel more
confident about your scheduled surgery date.
Score Chart: How bad is my arthritic hip?
I hope today is a good one!
@FraidyCat

 

[FraidyCat]

Thanks very much for the helpful input. My surgery date is June 28.

 

[FraidyCat]

Updating my post of yesterday: The surgeon called me today. I don't think the lapse in communication was his fault: it seems there's been "staff turnover," "technical glitches," etc. He was very responsive to my concerns, and for the first time I learned what my CT scan had shown--together with X-ray, the hip is now bone-on-bone and the OA is definitely severe enough to warrant the surgery.

So in place of my previous confusion and unaddressed questions, I'm left with only apprehension, which I know is "normal" given the circumstances.

 

[Jaycey]

Glad you finally connected with your surgeon. It's a tough diagnosis - but perhaps this further confirms that hip need to go!

Not long now!

 

[Layla]

So in place of my previous confusion and unaddressed questions, I'm left with only apprehension, which I know is "normal" given the circumstances.

Yes, it is normal. We’ll be here for you all the way. So lean in when you feel the need and we’ll support and encourage you. Wishing you a peaceful weekend.

 

[PolarIce]

You got this. I think this is the right thing to do without a doubt. I remember how anxious i felt all the way until surgery and if I was doing the right Thing. Not a day goes by that I am so grateful for this new hip. This uncertainty is normal, but I know you’ve got this.

 

[Layla]

Hi Fraidy Cat,
Hopefully by the time you read this you’re resting easy and your pain is under
control. Please join us on the recovery side with an update when you’re settled in at home. We’d love to cheer you on as you move through recovery.
Hope to see you there soon!
@FraidyCat

 

[Zoebichon]

For 31 years, I worked as an X-ray technician in a big, busy hospital. During down times, I used to love to read the radiologist reports on patients I had radiographed.

One thing that always stood out to me was patients who reported having moderate pain, the radiologist would read the X-ray as mild. Patients with severe pain had moderate readings. Bedridden patients finally got a severe report!

Don’t wait that long!

 

[Bangradancer7]

Hi,

How did things go? Hopefully you are on the mend. I would love to hear how things turned out.

 

[Mojo333]

@Bangradancer7
FraidyCat has a thread on the recovery side.
Here it is. You can click on this below and it will take you there!

THR - Continuing pain after one week

My surgery was last Tuesday and seemed to have gone well. The acute pain seemed to be changing to an aching but tolerable pain after about three days. Then without any apparent reason the knife-like pain recurred; it kicks in with any weight-bearing whatsoever. I’ve been preoccupied dealing with...

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