Monday, February 21, 2011

My appointments with specialists seem to result in more questions than answers.

This week, I went to NYC in order to get the most advanced radiological protocol used to determine the exact damage to my hip and surrounding areas.  The Test was an MRI using the Mavrick protocal.   As I have mentioned in previous posts, I have no consistent pain nor is my implant loose.  My primary concern has been and continues to be my ion levels given I have only one remaining kidney. 

Chromium Blood ion test taken on 1/4/11
Cobalt blood ion test taken on 1/4/11
24 hour Urine chromium test taken on 1/30/11
Other Urine chromium test taken on 1/30/11
Cobalt Urine test taken on 1/30/11
2nd blood chromium test taken on 2/9
2nd blood cobalt test taken on 2/9
Actual result
34 mcg/l
> 10.0 ug/l
21.6 ug/l
29.5 ug/l
Reported normal level
.5 ug/l
Multiple over normal
5-100 x

Radiologist’s observations (preeminent in her field of orthopedic MRIs as a diagnostic tool):
·         Osteolysis exists.  Enlarged iliac lymph nodes and decompression of the wear-induced synovitis creating a collection of metal induced synovitis is found  in the bursa.  The gluteus medius is degenerated and there is a partial tear of the gluteus minimus and degeneration of the hamstring origin.  There is no indication of infection and the devise is not loose.
·         The radiologist is not an expert in the ion toxicity but absent the ion issues, she would likely not replace the hip
2nd opinion from an orthopedic surgeon specializing in revisions:
·         He felt that given I had only one kidney remaining, I should not have been given a  MOM implant to begin with albeit, he is not now nor has he ever been and advocate of MOM implants.  He uses very few in his practice.
·         He said the surgeon who implanted the device was highly skilled and positioned the implant to a near perfected state.  (That was good news but if the toxicity comes from the abrasion between the two metals mostly due to surgical error in implanting them, and my surgeon did a great job with the implant,  why are my chemical levels so high?  I question this whole theory of the MoM rubbing against each other being the main cause these toxic chemical levels.)
·         He suggested that I get a really good university based nephrologist (Kidney expert) to assess the issues with the toxicity and my kidney.
·         His suggestion was to recheck the levels again in 6 months.  He clearly said if the metal levels are 5x normal levels, it was cause for concern.  My levels are way beyond that.
My next steps:
·         Consult with the specialist in metal toxicity
·         Consult with a nephrologist.

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