Tuesday, November 15, 2011

Follow up with my ortho Surgeon this morning from revision last Monday

Sorry guys but not quite up to being able to publish everyday yet.  Very rigorous schedule in the hospital rehab which consists of at least three- 45 minute sessions per day at the rehab unit.  I am not quite ready to be released but do anticipate being released by Friday at the latest.

Wound is still oozing so staples can't come out quite yet.  I understand the time frame to remove them is 10-14 days poat surgery.

I asked the surgeon about this "large cavitary lesion involving the dome of the acetablulum"  which he wrote about in my  post op reports (and I posted on yesterday) and he said it was kinda hard to picture but if you conceptualized a hole the size of a golf ball in the ilium caused  by the metal, that would be a good representation of this issue.  He said he had another revision yesterday where there were no lesions but the joint had become loose.  (I think they said they conduct only one revision per week here in this hospital out of the 30-50 joint replacements-including knees they do each week.)
The thing that still amazes me is that this happened with not one stitch of  pain!  Also, I noted that even  with the resolution of the Mavrik MRI  protocol, this hole wasn't picked up.  So the most sophisticated scan didn't find this large hole.  I had one of the most renowned Radiologist run my scans. Very interesting what you can and can't see on these scans.

It is always a combination of test results that will lead your surgeon to make a recommendation to revise.  There is no one piece of information that the decision to revise should be based on.  Our decision to revise was based on (1)  the very high metal levels,  (2) the preliminary MRIs that showed some soft tissue damage developing and (3)  a very, very strong opinion to "revise this hip now" by one of my leading 2nd opinion consults who has studied this issue and published extensively on it over the years.  His opinion  was that it (damage shown in the MRI) would only get worse.

This is why you can't rely on pain as a primary indicator for  some kind of problem developing with these metal on metal hips.  Just get tested if you have one of these metal on metal implants.  I love this
Nike (sneaker)  quote "just do it."!!
One final note, I asked my surgeon this morning about the path reports he ordered.   (Results not contained in the post op report.)  Those should be in today. I will report on those in a subsequent post once I have them.  I also pointed out one error to him in the post op report which he agreed was an error.  He had stated that "patient presents with significant left hip pain."  He immediately agreed this was a mistake and he would dictate and addendum to the op report that this get amended. He mentioned that initial op reports can not be changed.  Only addendums added.

I would assume that is still very rare for a surgeon to be conducting a revision on an a patient asymptomatic of pain.

 I have a tremendous amount of confidence in my surgeon. Other than the fact that  I think he is really bright and has a stellar surgical record in the community, he tells me immediately when he doesn't know something. He is also open to exploring new ideas and approaches to reviewing the implications of this problem.   He did his studies at Columbia and Penn.  His undergraduate was in genetics so he is a perfect person to work with in my forthcoming studies on measuring  the effects of the chemicals on your DNA long term...establishing baselines and following them over time.  I will be sharing those investigations with you as they progress.

Feeling much, much better today so hope to back to my daily posts.


1 comment:

  1. Take your time with this recovery ... the surgery was a big deal. We regular readers can do fine with posts when you can, not necessarily every day, until you're back up to full speed. Sending you all the good energy I can. Pam