In May 2005, being barely able to walk, I went to my GP and asked to be referred to my first Orthopedic Surgeon. At that point, the OS said to me that he has seen worse with people with no pain and like me very little arthritis with lots of pain, but also I had bone spurs on my right femur head, which were probably the biggest problem. I was given 3 options, medication, Cortisone injections, or THR. I was only 48 and THR just seemed too early, as he agreed also, being as I would probably have to do it again in 20 years or so. The option was medication. I was trialed on just about every anti-inflammatory there is. The only one that took the pain away slightly was Mobic, but barely. In August 2005 I had my first Cortisone injection under fluoroscopy, which for me was the miracle. Pain free at last. My OS made the statement that is how I will feel after a THR.
My injection maybe lasted with pain free symptoms for about 8 months -- April. After that I was on Mobic and tried to live with the pain. It wasn't as bad as it had been before. Then summer came and outdoor activities intensified. I found if I tried to garden, I was out for 3 to 4 days with such major pain. Then I went back to the OS and asked if I had a THR, would he use the Stryker, because I had heard that was titanium ceramic and had a longer life span... He said no, there was not enough evidence. I also asked him to cut off the bone spurs, no again, they would grow back. At this point it was time for a 2nd opinion.
I went to another OS to ask about THR, bone spur removal, etc. This OS told me the same story. THR was my only option, but try to wait with Cortisone injections and medication. This was on 10/9/06 I called my first OS and scheduled another Cortisone inj. for 10/11/06. On Fri., 10/13/06, I was out walking my dog early in the a.m., feeling very fine with this new pain-free hip with the Cortisone injection, wanting to get back into some usual routine, and saw this water in the roadway.... I was on the sidewalk and down I went. I had slipped on some "black ice." And, of course, I fell on my right hip with my leg bent under me... ouch did that hurt, but I said. Ok... let's get up I think I can. I got up on my hands and knees. This was very early in the a.m. and I was in a new subdivision that was being built, so there were no people around except for the construction crews. Then I slowly rose to my feet and slowly walked off the ice. I was able to walk home (yes, silly me forgot my cell phone) very slowly, but I noticed something just didn't seem right with my foot/ankle.... When I got home I could barely walk up my stairs and took off my shoe. My anke/foot was swelling up. I called my friend, who is a nurse, and asked if she thought I broke something, and if so, how could I have walked on it. She said "when in doubt, wait it out," and told me the 20 minute on, 20 minute off with ice. I did this for about a half day, and lucky me I am able to work out of my house.
In the afternoon, I took a picture of my foot and emailed it to my friend. She called me and told me to call the ER to see how busy they are and to have it checked out, because it didn't look very good. Got to the ER, had an x-ray, and yes, broke my fibula (outside bone) right at the bottom near the ankle. Why was I able to walk home... it is not the weight-bearing bone I was told, the tibia (inside bone) is. I had to go to a different OS at my OS office on Monday, as my OS was on his honeymoon. Was put in a boot cast and back to him in six weeks. At my six week check-up my original OS told me that I should go off my anti-inflammatory Mobic, as it will impede bone growth. This I did. And, because of the Cortisone and the Mobic I was on, it took about one year before my bone was healed. At this time, my right hip is again bothering me and so unbelievable painful. I again could hardly walk.
This is when my brother-in-law told me about a new procedure hip resurfacing. A few months later I read an article about someone in my hometown that had hip resurfacing done by an OS and he sounded just like me with all the symptoms. My insurance changed in October 2007, and I was finally able to go and see this new OS. Yes he did hip resurfacing, and from your x-rays you look like a good candidate. But, I will warn you, the fittings are in 4 mm increments, and if there is not one that will fit, I will have the THR ready for you. Ok, I said, but right now I'm in lots of pain, can you give me a Cortisone injection. If I wanted one that day, he did it, but he did not guarantee it, as it is best to do under fluoroscopy to hit the right spot. Made another appt. with him to talk more about the setting up the hip resurfacing surgery. However, the injection did not take at all so on 11/11/06 was in the hosp. getting another injection under fluoroscopy. This one worked, and the OS told me to make an appt. in early Dec. so I can get on the surgery schedule.
I then found this site. I saw that if you had a metal allergy you should alert your MD. So when I went back to the OS in December, he asked me how I was doing, which my response was great, as I was pain-free, and he said ok, then, we will go with the injections. I said, wait, I'm here to schedule a hip resurfacing, and oh, by the way, I have sensitivity to cheap jewelry and have to make sure I wear nickel free jewelry. Well, this shed a whole new light on the story. First I need to be tested by blood draw by Rush University to see how sensitive I am, and second if you are sensitive, and seeing how the Cortisone injection are working for you, he wanted to keep giving Cortisone injection. I asked him aren't those harmful and will eventually break down the cartilage. He told me my cartilage is breaking down anyway, and who are you listening to your friends, the internet. You should listen to your MD. Right there is when I decided he was not the OS for me, even if he did do hip resurfacing.
I then came home thoroughly and completely downhearted. I talked to another friend of mine, who is also a nurse, and she said.... go see Dr. Eugene Lopez. She looked up the Smith & Nephew site and said he was on it. Believe me, she said, you will like him, and he will give it to you straight. She told me she would go with me. Not only is she my friend, but I also work for the case management company she and my other friend started. So I made an appt with Dr. Lopez for 12/10/06. He was most helpful. He trained with Mr. Ronan Treacy in Birmingham, England. He is very excited about this procedure, as it is what us "young active" people are looking for. He said from the x-rays I look like a good candidate for the hip resurfacing. He said he would not bale out on me and do a THR unless there was absolutely something very wrong that is not seen on x-ray that he finds when he is in surgery. As far as the metal allergy goes, as I had already ordered the blood kit from Rush University, he told me to go ahead and take the test. Luckily, my son is able to draw blood, so he was able to do that, and we sent it off and waited for the results. In the meantime, I scheduled my surgery for 1/22/08, my donation of 1 unit of blood, my preop blood work and EKG, and my preop physical with my GP.
When the results came back from the metal allergy blood sensitivity test, it showed that I was highly sensitive to nickel and somewhat sensitive to cobalt and iron. Great, cobalt is a major metal in the BHR. Before I spoke with Dr. Lopez about these results and what I was going to do with them, I was able to find out, through research from my wonderful aunt, that my grandmother, who also suffered from metal sensitivity, had bilateral knee implants made from cobalt chrome. Dr. Lopez called and explained to me that the orthopedic community is 50/50 on the metal sensitivity issue. He told me about the metal ions in the blood and that it was a rare incident that metal implants cause problems, that there is really no clear-cut answer. I told him I also had read a lot of info on this site. I had also called the lab that was doing the metal sensitivity study, and they, too, have not been doing this study long enough and still do not have clear-cut data. Dr. Lopez told me he had just done a surgery on a woman who had metal sensitivity, took the blood test, but she and her husband had opted for the THR instead of the BHR. Well, based on all this mound of information from Dr. Lopez, this site, and what my very good nurse friend had told me that because of the uncertainty of this whole issue, she felt it was better to go with the BHR because there is no evidence based studies only theories and hypothesis about metal allergies.... So I have weighed the evidence and the decision I made with the objective data... hip resurfacing here I come!!!!!!
I will definitely keep a posting going about how everything goes. I hope this will help someone out there weighing this option. I can only say that I am thoroughly looking forward to my pain-free life. I know compared to some of you all, my pain has not been suffered as long as yours, but that's why we need the pioneers out there looking for new techniques to help us all. Talk to you on the "other side" as they say. I'm hoping to see if Dr. Lopez will videotape something or even submit pictures.
Bye, Elaine
