Anti Inflammatories Two Years After?

[Rolls]

Hey Windie,
I have a few other posts on this site.  I still have pain 4 yrs post op on my RBHR.  Pain is mostly centered on my upper thigh, when I exercise, I get a tightness like a belt squeezing around my thigh and trocanter area.  I have occasional pain in groan and buttocks.  I have asked thousands of questions, Dr Bose, Dr DeSmet and my new doctor, Dr. Marchand in RI.  No one knows exactly what is wrong.  My metal ions are normal and I had a CT scan to see if soft tissue issues are present.  My doctor performed a Ganz procedure while doing the operation to preserve my muscle mass and blood supply.  So, I firmly believe I have pain by my trocanter that I can't seem to get by no matter what I try.  I know when I don't have heavy work at work, it doesn't hurt and when I don't exercise it doesn't hurt.  So, basically if I sit on my butt and don't do anything, I feel fine.  But, I don't feel whole unless I exercise and feel good about my life.  I need my left hip done sooner rather than later, and I just had a cortosone shot in my right knee as arthritis is getting that as well.  I have tried the exercises in the book Pain Free by Peter Egoscue, and that helped some, but basically from my hips down I need some intervention.  Pain is no fun, I pop Liqui Gel Advils everyday and they give me some relief.  But hey, there is always tomorrow.

[stano]

Windie1,
My new ortho Dr Gross sent me his notes per our phone conversation. I will take these to my regular doctor to forward to the pain specialist, I go tomorrow for the shot, I will let you know if my system works.

stano

[stano]

Windie1,

    How are you doing?  Did you send a packed to Dr Gross? I get my second shot friday, I also  complete my second week of water rehab the same day.  I am leaving the area for two months so I will be doing at home therepy untill I get back.  Hope all is well,

Stano

[stano]

Windie1, how are you doing  ?

    stano

[Windie1]

Hi Stano.  Thanks for asking - unfortunately, things are still not good.  Even though I did one month of physical therapy in June, I'm still needing to use a cane most of the time.  Because I was not progressing well enough at PT, they released me.  I am continuing to do the exercises on my own for another month to see if things get better before I send my packet to Dr. Gross.  This morning though I was looking for answers on the internet and came across Iliopectineal bursitis - it seems to match my symptoms pretty closely so I  started another thread on this web site hoping someone out there has experience with it and might be able to give me some good advice. 

How was your experience with Dr. Gross, was he able to tell you what was wrong?  Is the shot you mentioned for bursitis?  Anyway, good luck with your rehab - hope the pain goes away!   ;)

[Rolls]

Hi Windie,
I just found this Post.  I have been searching for others like me...like you.  I have pain 4yrs post op.  It never felt right.  I sent my xrays to Dr DeSmet and Dr. Bose and both said about the same thing...the two components were not set at "more perfect" positions, meaning everything was a little off, but no real concerns.  My main concern was my doctor performed my surgery using the Ganz procedure, where he breaks my trocanter to bring the muscles over without cutting them.  Then he sets the bone with a plate and two screws.  I had irritation right after surgery, the screws were already loose.  Long story short, he said the loose screw would not damage anything.  Bull-Twinkies.  Anyway, I have had xrays, blood tests and a CAT scan on the area and nothing is out of the ordinary.  I have switched doctors and he doesn't know the root of the pain.  It feels like a band tightening around my upper thigh when I do a lot of activity at work or exercise, also get some groan and buttock pain, as well as pain by my trocanter.  My last remedy may be a cortozone shot to the trocanter area.  It doesn't help that I need my left hip done, (scheduled for Oct with Dr. Marchand in RI).  And my right knee will get arthroscopic surgery in August.  I am still optimistic that it will all get better, I am 52 and not giving in.  I only take Advil gelcaps when my left hip hurts, maybe 3 in morn and 3 at night.
Let me know how things turn for you,
Rolls

[Windie1]

What I find so terribly discouraging is that everything was great with my doctor until he realized that maybe I was not another easy in, easy out patient.  Do these doctors honestly expect that they are all so good at what they do that they'll never have a less than perfect outcome?  They need to get over themselves!!!

Sorry, can you tell I'm a little upset at my doctor?  :-[

[stano]

Windie1,

I did have 2 shots in the bursa sack and 2 months of therepy, I am going to see
Dr Gross at the end of august, yes, he is my new Doc. I still have the same pain with any activity, Rolls comments on the area of pain hit home. Not the way I wanted to spend my 2 year bhr anniversary. Hope it will improve soon for all of us.

stano

[Windie1]

Hi Stano,getting any better?  How long was your relief from those injections into the bursa?  Would you recommend them if my pain turns out to be bursitis?

[stano]

Windie1,

The shots helped for maybe 2 weeks, therepy did not help and yes I put the effort in. I go to Dr Gross the 23 of this month, MRI the 22 at a outfit right down the road from him.  I will let you Know what he says and what the MRI shows.  Went for a walk last night , not bad until I started to jog , maybe 25 yards, then It felt like I got rammed in the side of the buttocks, extreme pain, limped back home.  I am waiting now till the 22-23  to do anything.

[Windie1]

My records were received by Dr Gross' office yesterday, Wednesday so now I'm just waiting to hear from him.  Hope all goes well on the 23rd Stano.  By the way, are you still on anti-inflammatories?

[stano]

windie1,

I have been off anti-inflammatories for 2 months, they stopped working, I do take vicodin but that is only on bad days, 6 days a week.  Make sure you have your list of questions ready for
Dr Gross , I think he called me in 5 or 6 days. Take care,

stano

[Windie1]

Stano,

Just wanted to wish you good luck next week with Dr. Gross.

Windie.

[stano]

Windie1,

     Thank you, I will be leaving Sunday for a Monday MRI and a Tuesday app. with Dr Gross.  How did your  phone conversation go with Dr Gross? Hope all is well, take care.

stano

[ScubaDuck]

Stano-

Best wishes on your visit.  If anyone can get to the bottom of your pain, it will be Dr.
Gross.

TinSoldier has his second BHR on the other coast that same day.

Dan

[Windie1]

Stano,

I still have not heard from Dr. Gross.  His office called me a couple of weeks ago about my x-rays, but not him.  If I don't hear from him by next Wednesday, three weeks after they received my records, I'll call him.

Good Luck.

Windie.

[Windie1]

Hey Stano, how did your visit with Dr. Gross go?  I heard from him Monday evening.  He feels that my psoas tendon is probably rubbing on the edge of the acetabular component of my implant, irritating the psoas.  I asked my doctor several times over the past 2.5 years about exactly that possibility and every time, he said it wasn't possible because of the way he had positioned the cup.  Anyway, Dr. Gross and I now have a plan so I might actually get this resolved before the end of the year. 

[John C]

Hi Windie,
Please share the plan for the psoas problem. I have not had any problem, but some studies have shown incidence of groin pain, possible psoas, as being as high as 18%. The solution that Dr. Gross suggested might be of interest to many others. Please let us know what you two came up with.

[Windie1]

John,
Dr. Gross said that we're going to do this stepwise:
  1) Even though I did PT throughout all of June, he wants me to do one month of strengthening (while lying on your back, do straight-leg raises, raising your foot off the floor 12 inches, hold, then repeat), stretching (stand with one foot about 10 inches behind the other, bend knees, and push hip forward until you feel the stretch though the groin, hold, and repeat), and deep tissue massage (use a massage roller to massage the groin area - the massage rollers are about $15 at most sporting goods stores and on line).
  2) If, after a month nothing has changed, he will order an ultrasound-guided psoas injection.  I will give him the name of a competent radiologist in my area and Dr. Gross will initiate the order.  The radiologist will inject a pain agent in the area where the psoas crosses the edge of the implanted cup.  If the pain goes away, it's a good indication that we're on the right track.
  3)  He can then do a psoas tenotomy (lengthening of the tendon), clean up the edge of the cup where the psoas is rubbing (there could be extruded cement or bone growth at the bone/cup interface), or reposition the cup (if the edge of the cup is too high, extending beyond the surface of the bone).

Because of the metal interference (from the implant) on both MRIs and CAT scans, you can't visualize what is actually happening at the bone/metal cup interface so the doctor won't know the actual problem until he gets inside the hip.

This is how I understand his plan so I hope this helps.  Obviously, this plan is based on what he saw in my records/x-rays and his and my discussion (what hurts, what doesn't, can I do this, can I do that, etc.) so it might change for someone else...  ;)

[Dayton96]

A very interesting discussion.  Windie, thanks for sharing this information with us.  I hope you will continue posting on your progress. 

Mac