Wednesday, December 15, 2010

My Big Open Question

There have been many reported incidents that have required an immediate hip replacement.  It appears that there is general agreement that 13% of the patients who received that hip fall into that category.  These patients are experiencing consistent pain and can’t function without a replacement.  What about the patients who are in my category…intermittent pain and symptoms or no pain and no symptoms.  Further, what about the patients who are currently asymptomatic?  Is action required only when you are symptomatic with consistent pain? 

In an effort to answer this question for myself, I have ordered the medical studies conducted on these implants to try and get clarity on this question. 

Examples:
·         If you aren’t experiencing pain, don’t do anything.
·         If you leave this device in, eventually it will cause irreversible problems
·         If you aren’t experiencing pain and the hip is properly placed, your fine.
·         It is difficult to get agreement among the Orthopedic surgeons on what exactly the proper placement is…more on this in a subsequent post.
·         If you aren’t experience pain and your blood levels of Cr and Co are high, we have to monitor you.
·         You don’t need an MRI if the ultra sound and the blood tests are returned with no evidence of a problem.
·         MRI s are the best method of detecting damage caused by this MOM hip.

Get the picture?  Talk about conflicting information!

I personally have found the conflicting information quite distressing and I am close to concluding that no one knows the answers.  In light of that, I thought it might be prudent to examine the studies myself to at least highlight the constancies and inconsistencies I find.

Yesterday, I sent out a note to some of my friends in the medical community whose opinions I value as being objective and informed and was surprised to receive a first answer back yesterday. Based one observation, the first MD thought I should strongly consider removing this hip.  This is a conservative MD.   I would characterize her as smart, cerebral and thoughtful.  Gee, her response  really made me think.

So, I will begin reporting on what I find in my search to help make this decision:
As a patent who is not experiencing constant pain but who has the following symptoms, should the hip be removed?  Yes or No?:

·         Intermittent problems with the hip which sometimes last up to 2 weeks where I have resorted to a cane to improve mobility.
·         Images that show the presence of metal pieces surrounding my hip
·          The presence  of progressing Osteolysis involved in the acetabulum
·         Previously noted fluid collection in the left hip bursa.  It has dissipated now.
·         A hip placement that is “perfect” according to the orthopedic surgeon
·         Blood levels not yet received on the metal levels but let’s just assume they are not at what might be termed toxic levels. (I will report on those results once I get them.)

From what I have read thus far, my hunch is that many more people fall under this category than those that are suffering continuous pain.  It is also my hunch after reading what I have in the last month  that big problems might result from leaving this hip in place.

After having spent a month combing the web news stories, blogs and other sources, I am ready to dive into the medical literature.  While I have no medical training, I am very interested in what I find in reading the studies myself.

More as I uncover the studies.

Connie

3 comments:

  1. I had my depuy mom joint removed on 7/9/12 & I am totally amazed at the change in pain, that I am having in just 7 days.
    I have had the old one for over 6 yrs. & it was so painful 3 or 4 yrs. ago,....... I was going to pain management clinic & taking morphene.
    I didn't need a recall letter to tell me, there was something wrong with it. I don't type,...... so this is very tedious for me to do.
    The surgeon told my wife, he had to graft bone & remove some muscle, from the damage caused bythe CR & CO & the fact that the cup was loose, when he got in there at surgery. Supposed to be on ''toe-touch'' ONLY,...NO weight bearing at all, for 6 to 8 weeks.

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    1. I, too, could only toe touch for 8 weeks post revision because of extensive bone and muscle loss. An xray after 8 weeks showed the new parts appeared stable so I was able to start weight bearing and out patient PT.

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  2. Good luck with your recovery! Yes, you may have needed a bone graft as the metal eats into the bone. I had a hole the size of a golf ball than needed grafted.

    Humm, typically the protocal post surgery is no bending to the toes. Might want to check with your surgeon again.

    It is important to avoid three basic positions:

    -Extreme bending or flexion of the hip beyond 90 degrees
    -Crossing Legs
    -Turning the operated hip inward toward the center of your body

    For the first 6 weeks you must:

    -use an elevated toilet seat
    -avoid sleeping on your stomach
    -avoid sleeping on the operated hip
    -place pillows between your legs when sleeping on your back or unoperative side
    -avoid crossing your legs at any time
    -avoid sitting on low chairs or couches- sit only in chairs with arms where your knees remain lower than your hips
    -avoid leaning forward while sitting
    -avoid flexing your hips more than 90 degrees or rotating your foot and leg inward
    -avoid picking up objects from the floor or bending to put on your socks and shoes

    Best of luck.

    connie

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