So, ive been thinking a little (not too much though, it hurts my brain)
Im 29. Im hoping to have a THR at some point in the near future. All I ever hear from surgeons and people in the medical profession is 'your too young to have a THR. You need to wait as long as possible'. In my eyes, im too young to waste my life away. Im too young to be in pain every day and im too young to not be able to do all the things I want to and should be able to do.
What I would like to know is ... why exactly am I too young? Does the fear of the operation going wrong come into play at all? One surgeon told me that you can only have so many revisions and that a revision is never as good as the first. If every THR I get lasts say 20 years then im looking at revisions at the ages of 50, 70, 90 ... 110, 130 ... ok, perhaps not. I may not even make it to 50. Id probably only be looking at 1 or 2 revisions. How many THR's can one person have in a lifetime? Whats possible? Do they even know? If I have one now then am I looking at a significantly less active life when I hit 50? Is revision surgery from a THR to another THR really that complicated and does it create significant risks?? I can see some bonuses for you BHR guys and saving that bone.
In all honesty, I want my life back now as I could die tomorrow. Id be a bit peed off if I hobbled around in pain for the next 5 - 10 years only to turn up at those pearly gates at the age of 40. Plus, come 20 years time, perhaps technology will have moved on and revsions will not be an issue? Any knowledge or thoughts?
Anna :-[
... and just an after thought, could you imagine if hip replacements didnt exist. Thats just not even worth thinking about. We hippys are, I believe very lucky we have options ... even if they are slightly scarey.
Anna-
I'm 50 and that comment from people about age and having a THR is the most common thing I hear when they find out what I've had done, I got it today-again.
It used to be ' What's wrong with your leg, you're limping a bit arn't you?'
Now it's ' What, a hip replacement? Thats for old people isn't it?
It amuses me as I wouldn't dream of saying that to someone but thats the view people have.
I saw it like that up to last year, when like you, my life was being taken over with OA-and thats the bit they don't get. As you say, you need your life back now, at 29.
Not hanging around for years delaying surgery based on the lifetime of of the hip joint that you get.
Who knows what advances there will be in revision surgery in 25 years?
I'd have definately taken a resurfacing if it were possible but like you, my poorly bones needed immediate attention and I took the best option available to me.
You're on course for the same.
Mr Treacy told me it takes most people 1 year to mentally accept that they have a hip replacement,
and I think there's a huge acceptance required beforehand of what we need well before the surgery.
In the lead up to my THR, I could go from being ecstatic about it to absolutely dreading it within hours and I don't think I'm alone there.
At 7 weeks post op, I'm enjoying pain free recovery and wouldn't change a thing.
Keep focused on the pain free future and all the things you will be doing again, try not to dwell on any negatives-it worked for me!
Anna, one thing I see in all of your posts is your love of life. That type of vibrancy and happy lack of dourness is a refreshing and invigorating pool of happiness in you.
I think all hippies to some degree are wells of hope, striding on despite the harsh turn we've been dealt. There are few people who are not hippies who understand the battle we've fought and are fighting still. The lovely thing is to see those we love and who love us try to help and be what we need in our struggle and recovery.
The rest of the people won't understand, they see us young and can't see beyond that to where this is an affliction like any other. Someone who wouldn't dream of saying the same about a handicapped person seems to have no issue with remonstrating with someone who has arthritis. In some respects, it is accepted to be so cavalier with it since we don't bear our wounds externally and they have no concept of the pain involved.
So in my pain, I grew to trust those people who understand or who try to understand. The rest of the people, including old and trusted friends who just don't get it I put on a shelf until my struggle is over. I cut them some slack, they are not capable, so they need time out, living on my shelf until I get to a point where they can be friends, although I do remember their lack of capability.
Take your opportunity for life. I've never understood waiting in increasing pain for some future time when you can minimize the number of revisions. Life is meant to be lived in its full measure, not in some limbo of pain. Like ruby mentioned in another thread, trust in your surgeon, keep up your spirits and in due time (wishing a quick turnaround for you) you'll be fixed and listening to us boring you with calls for patience :) . Until then, my heart does go out to you, but I know you'll fight to a good conclusion.
We all could go tomorrow, or we could last much past our expected expiration date. The great part about being human is the lack of that knowledge - you're right, why not make it as happy and beautiful as possible?
Let the Anna awesomeness continue.
Anna try not to think about how long it might last and think that once done you will be pain free again! You might end up with one of the THR's that last over 40 years! Look at that lady who mr McMinn has on his website! She was even younger than both of us and her THR is and I quote "as good now as the day it was put in!" live for now not for 20 years time.
I still worry that I will need multiple revisions in my life time but I will cross that bridge when I come to it! For now I'm just happy that I'm on the mend and will be able to do the things I love again.
Danny xx
Hey, thanks guys.
Im glad you all agree with me! Most of my friends and family tell me I should get it done asap as they 'want Anna back' but its the professionals, the surgeons, the physios, the ones who know all about OA, who all say wait. I just dont understand it which is why I was wondering whether a revision is a greater deal that what I believe it to be.
Mike - I was walking down the river in York a few months back and a guy actually stopped and asked me if I was ok and whether I needed an ambulance. I tried hard not to laugh at him but it made me realise how much I probably limp without even realising it and perhaps how much ive got used to the pain. People ask me all the time now ... and when I tell them I need a THR they just laugh and think im joking. I also go from being 100% positive I need this, to being absolutely terrified and talking myself out of it. Im not gonna back down now though.
Hern - As always, you are right and thankyou for your kind words! I suppose ive started with a little shelf too. Theres alot of people who have no idea of hippy pain and I tend to avoid seeing them now. Its not that I dont like them anymore or that I wont still be friends with them in years to come, but the physical and emotional pain I go through when I meet up with them is just not worth it. I get dragged around, left behind, comments as to why I cant keep up or get called lazy (One thing Im positive im not is lazy!) and I just end up feeling sad. As selfish as it sounds, I dont need that right now.
Danny - Live for now hey. I will text you. Hope you are a little happier too :)
And now to the other end of the spectrum - My 88 year old granny is going in for her 2nd THR on 06/10/12. Shes unbelieveably fit for an 88 year old and has absolutely no health problems whatsoever. I certainly cant keep up with her! My parents expressed their concerns about her going for the op at her age and stated that perhaps she should just leave it and live with it. I told them I 100% back her and to not write her off! Why should she put up with the pain? Enjoy and take every singe breath of life hey?!! She has only waited a month to get her date for an op .... im still waiting ad its been 8 months now. To me, I think that just shows the difference age makes and the fact that surgeons just do not agree and do not want to operate on youger patients.
Anyway, please wish my granny all the luck in the world!!! ;D
Anna
I'll say a prayer for your gran Hun! Xx
Good luck To your Granny, Anna, it won't e long before the pair of you are racing each other! I'm very much of the live in the moment kind of girl. I really think that to some surgeons who can't feel the pain you are in and don't know the limitations you have in your life, they see putting off the surgery as the right thing. BUT, it is only you who can weigh up your pros and cons, it is only you who should make that decision - yes a fully informed one - but the buck should stop with you. You are so young with your life galloping on around you and you should be in it. Push and push and push some more until you have a surgeon who respects you, who will allow you to be the decision maker in your own future. I think your new surgeon Mr Witt is that man, he does thr on young patients and he WILL help you. He's also one of the top guys in the world treating dysplasia. Go for it girl, with our head held high. Our Tigger needs her bOing bOing back. Xx
Anna, what your surgeons have told you was the same story I got for a good 2 years. I was constantly told that I was too young.
In the end I flipped in the doctors office and wanted to know why and was told that I'd have to keep coming back in to have it replaced and it was down to having the same scar re-opened or something. At that point, it was just before I discharged myself from my awful surgeon down here, I was at my wits end in pain - if I could have gotten onto my knees and begged him to fix me, I would have done!!
I just didn't understand why they are so flippant at leaving us in pain, just because we're younger than the standard THR candidate. I think it's almost barbaric. You wouldn't treat an animal that way. In my view now, looking back, I think it was more down to money and my local trust not wanting to spend however many thousands it costs to do THR's given how many I might have had to have in my lifetime.
I think it boils down to having the right surgeon on your side. Mr T was prepared to give me a THR if a BHR wasn't possible once he opened me up. Even when I first saw Mr Bache he was trying to tell me to wait - wait for my hip to go completely, nice eh?
I'm sure you're in good hands with Mr Witt especially if he's so experienced with your situation xx
bOing bOing
So is reopening the scar an issue? Hmmm I need to google ......
"Revision hip replacements are more complicated surgeries and the outcomes are not as good as the first hip replacement. Technical problems include the quality of the bone and the ability to adequately secure the revision hip replacements into position. Furthermore, removing the old hip replacement can necessitate more extensive surgery. Together, these problems often require the revision hip replacement to be much more complex. Careful planning by your orthopedic surgeon is needed to ensure he or she will be able to construct a hip that will allow you to adequately recover.
Another problem with revision hip replacement is that the surgery itself can be more complicated. Patients tend to be older, and less tolerant of long surgical procedures. The procedure is technically more difficult that primary hip replacements, and the effects on the patient are more significant (longer surgery, more blood loss). Because of this, revision hip replacement must be carefully considered and planned. Involvement of general medical doctors, anesthesiologists, and the orthopedic surgeon are all important."
So basically, a revision outcome will not be as good as the initial replacement and the surgery itself is more complex and carries more risks. Hmmm.
Anna;
When I met with my surgeon before the decision to get my hips resurfaced, he explained revisions and re-revisions of THR's, he showed the actual devices used for HR and THR and THR revisions. Each THR revision has a longer "spike" and there is more bone removed with each one, and a deeper channel is required to hold the new device.
With all that being said, if you are miserable, my 2 cents is that doing a THR or BHR at any age with a reasonable expectation of overall improvement, is the thing to do. Life is way too short to be miserable, and although any decision for an implant is a big decision, living in constant pain isn't living. Of course you have to be comfortable with the implications and future risks. The worse I got, the more I became comfortable, and I am incredibly glad I got both done.
With the quality of surgeons in your neck of the woods, you should have a great outcome.
Good luck,
Dan
Great Post Dan
the loss of bone is what made me push for a Mini-hip. the thought of revisions scares me but i am really enjoying living without pain. Anna, you have to make your decision based on as much info as possible but from the sounds of things, your quality of life is much lower than it should be.
have you written down cause and effect of activities on your hip? have you noted how much or little sleep you get? have you kept a diary of pain or pills. these are all things that might mean stuff to your surgeon and might affect his decision process. i told my surgeon that a walk on a good day of less than a mile caused such pain that night that ordinary doses of medication had to be retaken at 4 am. 1 hr ironing had the same effect. your hips are different to mine, your case is different. but a list of things (like the ambulance offer) might help.
only 30 more days to go.... I'm confident that Mr W will sort you out. sending very very positive vibes. xx
(man, typing on the proper keyboard is really great! i've been using my ipad and have been getting more and more terse as the typing is so difficult!)
Anna-
There's a definate distinction to be made about what we ( of the bad hips) want, and what we really need.
Nobody would choose hip surgery but its not an age thing, it's what we need to enjoy a decent quality of life.
I replied to a post from Spike the other day who was concerned about his revision to THR aged 62 (I think),
I was concerned about having it at 50 but the alternative was awful-you know it-keep taking strong painkillers, keep trying to get through the day.
I don't think there is such a thing as a 'correct' age. You either need it or you don't.
Can I park a bit closer? Do I have to walk right back over there? That's gonna hurt, no I won't bother. Dance? Well, I used to!
That's just me, but none of that should apply to someone at 29.
Reclaim your life, get the surgery you need and enjoy the freedom it will give you.
One eye on the future, yes, but no way should you let your hips give you such a miserable time now when there's an alternative.
We need this London hippy convention to happen-think of the support and and advice we could all give-I'm up for it!
Hey, thanks guys.
Dan, that makes perfect sense. I remember Sal saying I should ask for the possibilities of getting a replacement with a shorter stem. I shall ask Mr Witt when I go see him and quiz him regarding stem length. Does anyone know if there are implications of getting a short one?
Sal / Mike - you talk sense as always. 'Can I park a bit closer?' - yup. That rings some bells. As does getting half way round the supermarket and remembering you forgot something on isle one. Sigh. Ah well, one month to go till I hopefully get some answers. Mike, are you still above water? :o
My brother in law (and Sal) got the Corin mini hip.
It's been excellent for him, no problems, less invasive as far as bone loss than a full THR. I think there are equivalents with the Birmingham BHMR, others I'm not sure of, but they seem to be effective. You might bring that up to your surgeon as a possible alternative, maybe that would cut down the impact of a later revision if needed.
BMHR:
(http://www.hipresurfacingindia.com/medical_images/BMHR_New36.jpg)
Corin minihip is on the left, the two on the right are the revision increments that can be used with this system:
(http://www.coringroup.com/images/uploads/2657.jpg)
Oooooh, I see. Thanks Hern :)
Its something I will definately ask my surgeon about ... although my hips are so odd im not sure whether it would be a possibility. Definately something to look into though! Thanks
Am so jealous Hern, I tried to post that pic only to fail utterly! Technologically challenged! Good stuff tho, Anna, the silent hip is of the same idea and also the delta motion, I think. Jon Conroy in Harrogate is working with the silent, I believe.
It s definitely worth asking, lose less bone, stay mobile for longer, all being well.
Jon conroy is a good surgeon and a nice bloke. He was my scope surgeon. The problem with the silent and maybe the BMHR and mini hips is they need the right anteversion in the femur to be able to work (from my understanding and I'm just an interested patient not a surgeon!) I believe the stem Dr Bose uses has one of the longest and best track records and that's the corail.
Sigh :-[
That was my worry Danny. My anteversion is all wrong hense why I cant have a BHR. Oh well, I can still look into it
Anna
Hi Anna,
Here's my 2p input... No one should be faced with this at 29 years of age, but i think to some extent you have answered your own question here. Whatever time we get here is luck - you will be aware of this more than most - and you can be rubbed out in any number of weird and wonderful ways in an instant. As others have commented, you come across as a vibrant, energetic person who is now effectively 'imprisoned' because of your hips. Who knows what the future holds, but if there's a chance you get your life back for the next 15-20 years, then i'd seize it with both hands... You don't seem like the sort of person to be fobbed off in any case.
I think surgeon experience and skill will again be a big factor in revisions - as well as the placement of the original device - but who knows what advancements will be kicking around in the orthopaedic world in 15 years time?
Me? I'm treading water right now, still in pain, but not bad enough to go touting for a BHR just yet. But i've squared it away in my head that there's one in my future at some stage - whether that's six months or six years, who knows?
Anna-
I think when you meet with Mr Witt and he gives you your options based on his vast experience, you will find it far easier to accept.
When I met Mr Treacy convinced I would get a BHR, he drew some lines on a print of my x-ray to show me where the head of my femur was and where it should be. He explained how the necessary guiding equipment couldn't be used and because of the twisted femur, going freehand would be very difficult.
Although disappointed at the time, I soon got round to thinking that I had to put myself entirely in his trust, and I knew he would give me the best hip I could get anywhere in the in the world.
I think Mr Witt will give you that same confidence that comes with carrying out many difficult hip operations and you will feel at ease with your decision.
I ended up looking forward to my surgery as it got nearer-I was happy about my decision to proceed and thought only about the future from that point.
Looking at those x-rays now of my old twisted, bone on bone hip, I'm so glad I did it. Well, glad Mr T did it, I should say!
The floods in York are going down!!!
Well put mike. Anna were all thinking of you and like I've said before if you have an op in London I'll happily come and meet you!
Mike how high are the floods? I remember in I think it was 2001/2 working at the gallery and parts of cifford street were flooded!
Danny
I think this flood is as bad as any I've seen in York. Clifford Street was closed at one point with water right across to the tower!
I went over Ouse bridge on Weds night when it was at it's peak and the water level was about 18" from the top of the door of the Kings Arms pub.
Thankfully, its on its way down now.
I remember back then it took me 4hrs to get home from York city centre to easingwold back then! Thats the only thing I don't miss about york!
Thanks guys,
Dav0 - exactly how much pain are you in if you dont mind me asking? Whats made you put it off?
I think you should organise this hippy convention when I get my op in London! Then I get lots of visitors! Ha ;D
Anna
It must be so frustrating for you Anna to have to suffer the levels of reluctance to go ahead with surgery just because of your age. I've given up on responding to the 'your too young' comments. No one volunteers for this, it's not cosmetic surgery! Hope your get a result soon. By the way my mum had two THR in her 80s and they give her no trouble, so hope all goes well with your gran. Ka
Thanks Ka .... 26 days till my next appointment :)
Not long Anna, you aren't SOooo young as hips go, there are loads done now. Don't be put off. 25 days nearly!
Keep your chin up. xxx
Live for now hey :)
Love the quote Anna!
Its 1am in England. I have to be up for work in less than 5 hours and I cant sleep. Partly due to physical pain and partly due to what I presume is depression. I cant cope with the mental side of this anymore. Im exhausted.
Stay strong Anna you are a strong person and you will get there in the end.
I remember some really really dark days just after my key hole and know what your going through. Every day is one closer to your solution. XXX
We are all here for you Anna, every one of us has walked along the path at some point, just dragged low by pain and the complications it adds to your life. Write it down, let it out. This phase will be short lived, and we are all rooting for you. Xxxxxx. Mr W in 16 days, now that my maths is right....... Not long Hun
Anna
Just get through the days up to you're appointment the best you can.
When you know exactly what's happening you'll feel so much better.
Not long now, stay strong.
Mike.
Thanks guys
It's always darkest before the dawn Anna. Quite literally sometimes. Thinking of you.
Cost and Statistics.
I wonder how much it is down to the pressure on hospitals to have the right figures? If you have a THR when you are 80 you are much less likely to have a revision. So they save money by doing less and the figures look better, if every THR was done on an 80 year old they would probably have near perfect Stats.
As for the THR itself McMinn does a shorter shaft on his THRs to start with and the one they mentioned I would need would be MOM large head, so in that respect similar ROM to the BHR. He said he wouldn't even have to change the cup. But I have seemed to have dodged that one so far.
Jas
Thanks Ka :)
Jason, I think money and figures will play some part in it all. Its sad, but unfortunately its true. I am going to write a list of questions for my appointment in a few weeks time. One on the top of my list is regarding stem/shaft length. It seems key to future revisions and saving that precious bone. .... if anyone can think of some good questions then let me know!! I wrote a massive list when I went to see Mr Treacy but I seem to have lost it :o
Anna
Anna I wouldnt place too much emphasis on the length of the stem. The new "mini" stems are a new concept and are un proven. I would be asking about the stem with the best longterm track record. I suspect that might be the corail stem.
Danny xx
Hey Anna,
I'm not much help to you, but stay strong, you're doing wonders and although it seems like you can't take anymore, you can. Look how far you've come already. We're all here for you. Text me any time... I'm generally up till all hours these days! xxx
I will look into it before my appointmet Danny, thanks :)
Ruby, we need to sinc our sleeping patterns. If we try get our hips to behave and sleep, say, between 2 and 4, then the rest of the time can be spent chatting!! x
LOL That's why I text you at about 1am this morning, I was wondering if you were awake! x
Well .......
Today I had my appointment to see my new surgeon (The appointment ive waited 5 months for). I made to 500 mile round trip only to find my surgeon was unavailable (I love the NHS!) So I spoke to his collegue. The converstaion went along the lines of;
Doc - "You have severe dysplasia, over 50% of your femoral head is outside the acetabulum, your femoral head is mushroom shaped, you have significant artiritis and numerous cysts, basically your f****d" (Ok, he didnt quite use that word)
Me - "Oh, so are we gonna do a THR?"
Doc - "Yeah, the waiting list is quite long so were looking at around february"
Me - "What kind of prosthesis would you use?"
Doc - "I dont know, I will have to ask the surgeon"
Me - "what about the stems? Lengths etc? Short stem / mini hips blah blah blah?"
Doc - "I dont know, I will have to ask the surgeon."
Me - "Right, what about long term restrictions?"
Doc - "No impact sports and stick to the 90 degree rule."
Me - "The 90 degree rule? No I mean, what about long term / life long restrictions?"
Doc - "Yes, we advise the 90 degree rule for life to eliminate risk of dislocation"
Me - (A little speechless)
90 degree rule for LIFE?!!! Has anyone else heard of this for a THR? Im not so sure whether the guy was just being really cautious, whether (as danny suggested) they use a prosthesis with a small head or whether its my specific case.
So .... after a day of travelling and alot of money later, its been confirmed that I need a THR. Other than that im just totally confused, fed up and wondering whether im perhaps getting a wooden hip. Any ideas?
He is going to discuss my case with my surgeon on tuesday and will get someone to ring me with a decision..... but I still have a million and one questions and am left wondering whether I will get a chance to ask them.
On a plus note, thanks to Ruby who came with me to hold my hand .... and feed me with wine ;D
Anna :-[
Other than the fact that the doctor you saw was very nice in the looks department, he didn't appear to give you the answers you so desperately need.
As I said to you, I think it's a positive that something is going to be done to help you, but you definately need to be well informed and comfortable with what will go ahead before February turns up. You deserve and have the right to know what they're putting inside you.
And you're welcome for the wine and hand holding, shame about the food eh? ;)
Anna,
That is unbelievably dissappointing. Incredible and just not good enough that you wern't told in advance you would be seeing someone who couldn't answer your questions.
The only thing I can suggest is to arrange a phone call with the main man, or an email with your list of questions.
Keep forcing the issue, Anna-be the one who shouts the loudest and they will hear you.
I asked about restrictions at my 6 week check and was told there's only one-no heavy running.
Running for a bus was fine as was kicking a football around in the garden, just no pounding the streets.
No mention at all about 90 degrees. Mr Treacy said my hip would allow me to 'crawl into awkward spaces' knowing thats what my work involves.
Sounds like you say, this guy was being overly cautious.
The guy was very nice, and polite and made time for me so Im trying not to complain too much, im just really disapointed. It was such a long way to travel and I feel I have no real answers. ... although, on a plus note, at least I know they will operate.
Mr Treacy knows what he is talking about Mike! I just dont get this 90 degree rule. It makes me wonder whether they use a different prosthesis.... and if thats the case then I really dont want it! I need to speak to the main man. I will see what happens next week and then perhaps see about emailing him or trying to get another appointment. Its just all a bit annoying :-[
I've never heard of this 90 degree rule being a permanant arrangement. Something just doesn't add up there.
After you've heard from someone next week, why not ring Mr Witt's secretary and ask whether or not it would be possible for you to have a phone call with him, rather than do all that travelling all over again, plus the expense too.
Sounds like a registrar who's not very clued up to me. Find out what device he uses ie which stem which acetabular and femoral components I'd be asking for a large head device as they don't dislocate easily like a small ball hence the 90 degree crap
It is all a matter of difference between ball and cup. Sounds like he is quoting from his medical text book which deals with small metal ball and large plastic cup. I think more and more surgeons are trying out large head THR's now. It is such a shame you got to see the Monkey and not the Organ Grinder.
Jas
Thanks guys,
I think I just need to see whats said next week and then try get more answers .... whether that be by email or paying to see the man privately. I think you are right Jason and prehaps I was jumping the guns a bit yesterday ...... the guy I spoke to didnt know what prosthesis I would get so I suppose couldnt advise on restrictions and was probably reading from the text book.
I guess the waiting continues .....
Quote from: Anna on October 26, 2012, 06:42:29 PM
The guy was very nice, and polite and made time for me so Im trying not to complain too much, im just really disapointed. It was such a long way to travel and I feel I have no real answers. ... although, on a plus note, at least I know they will operate.
Mr Treacy knows what he is talking about Mike! I just dont get this 90 degree rule. It makes me wonder whether they use a different prosthesis.... and if thats the case then I really dont want it! I need to speak to the main man. I will see what happens next week and then perhaps see about emailing him or trying to get another appointment. Its just all a bit annoying :-[
Hi Anna:
I would try to make sure they don't use a 28mm plastic on metal cemented implant. Apparently from what Dr. Su said (in response to the Lancet article) this is still commonly used in England. Maybe that implant is OK if you're getting your first hip replacement when you're 80, but (IMHO) is bad news for young people. From what I've read a 36mm ball is the (approximate) cutoff point at which dislocation stops being much of a problem (although it can still happen in rare cases). I know someone who had the 28mm ball implant in his fifties who dislocated his hip three times: the first time at more than six months after surgery just bending over to pick something up off the floor. I have a 40mm ball and am fairly confident that it will not dislocate even though I am rock climbing fairly aggressively on it (I was kneeling down on the floor within about a week or so of surgery -- although I'm definitely not recommending that you do anything I did/do!).
Tim I'm fairly sure that the majority of surgeons here in the uk would only use a cemented THR if the bone quality was very very poor.
Quote from: Dannywayoflife on October 29, 2012, 09:55:26 AM
Tim I'm fairly sure that the majority of surgeons here in the uk would only use a cemented THR if the bone quality was very very poor.
Yeah, I really don't know, but in the Lancet article (see abstract: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60989-1/abstract (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60989-1/abstract)) the researchers say the data on THRs is between 2003 and 2011 and they clearly say they are comparing results (five year revision rates) in young patients of HR with patients who have a "28 mm cemented metal-on-polyethylene stemmed THR". Based on this data they recommend HR should not be done in women.
Hey Tim, thanks for the input. I think you are right in the sense that surgeons in the UK still use the old plastic on metal, however I think that is predominantly for older people .... my 88 year old granny has just got one!
Im hoping, seen as my surgeon specialises in dysplasia, young adults and sporting injuries, that he uses the most up to date devices. I will definately not be agreeing to anything though until I know the in's and out's. I will be asking about larger heads as dislocation is a huge worry for me with all the silly sports I do. I think perhaps the guy I spoke to just wasnt prepared for all the questions from me. I suppose alot of people just go in and agree to whatever they are told. Now I have had a few days to step back and think about what was said, I think I just need to speak to the surgeon himself and grill him. Im pretty sure he will have the answers I need to hear! :)
P.S. Im loving the rock climbing pictures Tim. Its nice to see and gives me a bit of hope! Keep them coming ;D
I like that attitude, Anna - just take control of things, it'll pay off in the long run.
Thanks Hern ;D
That's weird about the 90 degree rule for life. Maybe it's specific to more extreme dysplasia, such that without totally rebuilding a pelvis, the shallower ace might require more control by the operator (you) to keep from dislocating. You should at least talk to Treacy so you have confidence in what they are telling you. Sorry. On the good side, sounds like you've got a new friend. That's pretty cool Ruby, being supportive like that, for real, not just on the forum.
Tin - the more I think about it, the more I just think that it was just the surgeons assistant who didnt really have the knowledge. I will find ot though when I talk to the surgeon himself. Fingers crossed.
.... and yes, you are right. Ruby is awesome! ;)
Anna,
I too was told that I was "too young" for THRs, I had begun to have severe pain as I was 5 months pregnant at age 28 (as soon as the pelvic bones begin to shift in pregnancy). First I was told it was normal to experience twinges, but they of course were NOT twinges. I underwent P T for a number of years, off and on, took anti-inflammatories after 2 pregnancies, then got to the point of pain med. I also was looking rather worse for wear in my gait and walking was so much pain I would rather not do it. I even had to do DisneyWorld from a wheelchair, which if you are in pain does not feel like a happy minnie mouse experience. MRI's should be done, although they cannot be conclusive in many cases (mine failed to show congenital malformation of hips). Finally, at age 46 I found an orthopedic surgeon who said why not get these out and see if you can have a better quality of life. It is something I longed for. I was excited and full of hope. Now, let me just caution you that although no one should tell you that you are too young for hip replacement as they are NOT walking in your painful steps each day and truly have no idea the coping skills and the coping your knees and other muscles and bones have had to do to get through each step each day. I imagine you have had alot of hot hot baths to ease the discomfort, hot pads on the painful points in the evenings, referred pain to where you think you must be crazy, it must be your KNEE after all that is injured, that sort of thing. I would say to you that you need to be emotionally ready, know that you will be confined to home a while, it will be painful (a different sort of pain, almost a welcome relief because it is so different and the old pain is gone), it may limit your mobility in some activities for life, no more horseback riding or hang gliding for instance lol, you never know what your limitations may be. It certainly will affect you in some ways for life though, at least mine has. BUT, it for me, was absolutely the right answer, even as I am now in a bad situation with metal on metal metallosis, and needing a revision. I will get my revision and I will revisit you in this forum and let you know if I still think revision is a viable option to withstand again and again for younger people who want to remain active and not miss a moment of life! Please get the best surgeon possible, PLEASE!!!!
Hey Kayeah,
How has your THR affected you for life? What problems do you still have and what are your restrictions? I suppose everyone is different. As Sally said, Nick Skelton had a hip replacement and a year later he won olympic gold in the show jumping! Theres always hope ...... but I suppose you have to expect the worst and prepare for all eventualities so you wont be dissapointed.
Does that mean we should all take up show jumping? As I heard just today :-
"Horses - dangerous at both ends and uncomfortable in the middle"
True Phillwad, but also fun ..... and fun things are always worth doing no matter how uncomfortable! :)
Live life, Go Anna! just make sure it isn't too uncomfortable!
Well, THR is unique to each individual, so restrictions vary as well. I am unable to wear any sort of heel. I could probably wear 1/2 inch for a while (less than 4 hours definitely, maybe less than 2) as it pitches me into an uncomfortable position and aches all down my lower legs along the outside. I also don't try to ride bicycles as it thunks, but again I doubt yours would. I am generally weaker so walking up steps and down them is more concentrated. I guess the things I could mention about restrictions, as I try to write them may mostly stem from the wrong hip replacement for me which doesn't affect others as it would me. You could ask your doctor about the heel thing, as at your age that is a great big issue for some, but not in the big scheme of things where it would preclude you from going through THR. I believe from watching others have the minimally invasive surgery for THR that the muscles bounce back much easier as they are handled differently than the traditional method with a long incision. I would find out from Dr. if you are a candidate for minimally invasive for sure at your age. I will not expound on my restrictions here as they will not be the same for you, and therefore do not apply to you. The doctor should be very forthcoming though with what he has seen patients experience in the past from your type of THR incision and also the implant chosen. Let us know how you get along after!
Kayeah,
I would absolutely love any excuse not to wear heels!!!!!! That really is just not a factor that I would even think about. Im more bothered about the pain, my quality of life and restrictions.
Thanks for your help Kayeah, I will definately keep you updated :)
From what I've seen at York Races, not many women can wear heels for long anyway!
By the end of the day they all look like its hurting really bad-not that I've tried them myself of course. :o
Ha i remember York Races well! There are always some interesting sites at the end of the day! ;D
Hi Anna Sorry you had such a dissapointing response from your most recent consultation. Try and see the main 'man' it makes such a difference, and in my experience just gives you more confidence in the prognosis. February will be here in no time. I am 12 weeks out now and just feeling so much better - and so will you :) Ka
Ha, of course not Mike! :o
Thanks Ka, im glad everything is going well for you :)
Hey all,
Just thought I'd say a quick hello and update you on my journey. Its been exactly one year since I decided it was time for my THR and asked to be referred to the surgeon ....... I have moved nowhere. People keep telling me that we are lucky in the UK to have the NHS but I really cant see any positives right now. I haven't heard from my surgeon in 5 months and when I ring I just get told that im 'on the list'.
Physically, my right hip has pretty much gone in my opinion and my left is on its way out too now. Although I keep wondering whether it can get any worse .... it seems it always can. I got off the turbo trainer at home the other day, swung my bad leg over the back and as my leg was at its highest, my hip just made a cracking noise and hurt like mad! I was stuck for a couple of minutes with my leg on top of the bike till I eventually had the courage to try move it. Its been hell ever since so I've no idea what I have done to now :(
I pretty much live my life counting down the days till I can go biking as its the only thing I can do now that I love. I don't think that's really a way to live... but at least I have something. I'm really not sure what I would do without my bike! My friends all seem to have disappeared .... I'm not sure whether its because they want to do fun stuff that I cant do, or whether its because I'm just grumpy and not much fun to be around anymore. One of my best friends on new years eve told me he thought I put on my pain when I wanted to ... if only! I wish everyone could spend a day in my body just so they could understand.
Anyway, I gotta stop moaning as its day off today which means I get to play on my bike .... lets hope I can get off it this time!
Hope you are all well,
Anna x
Anna - I am sorry to hear that you are continuing to experience pain while waiting for a solution. I hope you have a brilliant bike ride today!
Anna, I really feel for you.
People don't understand at all what it's like. There's no outward sign of our injuries, and when people hear about the pain, their eyes glaze a bit, lacking understanding. It is a lonely thing.
I had plenty of people evaporate on me. Some, including family offered to help during and after the recovery, but were not there when the rubber hit the road. I really had only four people who were there throughout; two of those were my parents, one was a cousin and the last a friend who although living in another city, called often and traveled to meet me. The remainder happily greeted me at parties so long as I was smiling.
It's really not the physical help, but the understanding that is lacking. Before the operation it's not believing you are in severe pain and the irritation that you see in their eyes. It's why seeing spouses on here periodically is such a great thing - you know there's one more good support for a hippy.
Your friend who thought you could put your pain on is being an ass. If he walked a mile in your hips he'd be cringing in pain and whimpering like a tiny little girl.
Being grouchy is part of being in pain, unfortunately. You can only carry a happy tune for so long while someone is chopping at your hip. Some times you just have to vent or be ticked at the situation. It's normal.
I'm glad you have biking, it's good to have that outlet while you wait.
The snap on your hip could be a muscle pull, seeing as one of the things that happen is that our muscles become incredibly tight. If so, let it rest as much as possible and see if the pain subsides.
I probably don't fully understand. A year ago you started things, you are on a list, but not scheduled for a procedure yet? Seems like there should be some path forward, but don't know enough about it. Are there any advocates in the health system that could help?
You'll get there, Anna - don't let this drain that huge spirit I've always seen. I know it's a low time, but when you get scheduled and go through, it will be much better.
Hi Anna,
I've been wondering how you've been getting on, I feel for you trying to make your way through our system.
I don't think I've heard of anyone on here that has a straightforward route through the NHS.
5 months without progress is bad news. I remember that you had a really good GP who helped you a lot- is there any chance they could push your case again and try to get a date for you?
I hope you hear something soon.
I'd have to agree with hern about the grumpiness, when I look back how fed up and depressed I was with OA pain a year ago it makes me feel sad that I was such a miserable bugger around the house.
I can only see it now that the pain has gone,though.
Your mate that said you can turn the pain on and off has no idea how it makes you feel-like you say, if only!
All I can say is keep looking forward to the day when things change for you,Anna.
Keep pushing our silly system as hard as you can and keep coming on here for some support-everyone here knows what you're going through.
Thanks guys, I had a good day biking :)
Hern, you always manage to put into words what I am thinking :)
Hopefully my injury is just a muscle pull. Fingers crossed. I think I will have to go back to my GP. He did say he was willing to ring up and see what was going on but said it probably wouldn't do much difference. I just cant believe how long everything is taking. Its so frustrating. I feel like I've just been waiting for the postman everyday for a year. That's the hard bit. I could do with booking a week on a beach but I know as soon as I book it, I will get an appointment and either miss it or lose the money on my holiday! I'm just living in limbo. If they gave me a date a year away, at least I could make plans and try enjoy myself.
I guess everyone will just have to get used to me being grumpy for a while longer!!!
Anna
Quote from: Anna on March 02, 2013, 03:35:51 AM
I guess everyone will just have to get used to me being grumpy for a while longer!!!
Anna
Damned straight Anna!!! Do what you need to do, your time is coming.
Thanks Hern :)
NEWS!!!!!! I HAVE NEWS!!!!!!!!
I got a call today. I'm booked in for my right THR on Tuesday 16th July! FINALLY!!!!! So very excited. Hopefully it will be the start of a pain free life :)
Its only take me 14 months of fighting with the NHS! I'm exhausted. Lets hope the appointment doesn't get changed or cancelled now. I don't know the full details yet and I'm going to email my surgeon for some advice etc as I still don't know what device he will be using but he's one of the top, if not the top dysplasia surgeons in the UK so I'm pretty sure I am in safe hands.
London bound on 2 1/2 months! Whoop whoop. Best get prepared ;D
Anna
At last!! :) who`s doing yours?
;D ;D ;D Johan Witt at UCLH
Chuffed!! ;D ;D ;D
That's awesome news Anna! Please keep us posted! X
Finally Anna!!! All of that hard work paid off.
Excellent news. Will raise an appropriately sized tankard to Anna tonight.
Thanks guys ;D
.... I hope an appropriate sized tankard means a super sized one!!!! ;D
Definitely... probably both hands...
Congratulations, Anna.
You never gave up and you've done it. As you say, the start of a pain free life is in sight.
You're under a top surgeon who will sort your bones out, it's all good from here for you now.
You'll be in top form for the start of the party season!
I'm looking forward to your updates, great news.
Thanks Mike :)
I will keep you all updated. Eeeeek, I cant stop smiling ;D
Good news Anna good luck
Best give you all an update ......
They have cancelled my surgery in July ..... as expected. I think the only reason they gave me a date is because I put in a complaint to my MP after waiting 14 months of getting nowhere with the NHS. I think the hospital have panicked. I received a long apology letter and a surgery date and then shortly after when I asked why I was not getting the EUA (Examination under aesthetic) which was planned prior to making a decision re THR, they cancelled my surgery date and booked me in for the EUA. Does that make any sense at all or am I jibbering?
Basically, the long and short of it is that I have no surgery booked now. I have the EUA next Tuesday 4th june. They will put me to sleep and pull my leg around to see if the hip still fits into the socket properly. They will also inject some dye to see what the cartilage damage is like. I will hopefully then get a decision as to whether we are going ahead with the THR or something else. Sigh.
In the mean time, I have been quite active lately with my biking. I have also attempted skiing which I managed on lots of pain killers but suffered greatly after. I'm on 60mg co-codamol at the min which makes me a bit monged out but is allowing me to walk a bit further and keep with the biking etc. The pain is getting increasingly worse and noticed a lot more if I don't take my meds. Especially when driving and sitting and my hip is 'giving way' quite alot. Ha, I've seen a few horrified faces lately when I've gone to stand up and almost stacked it on the floor in pain!! I try not to take my meds before driving as they do make me spaced out a bit but it leaves me in quite abit of pain ... especially as its my accelerating hip and I don't have an automatic car! I'm really stiff too but I'm determined to keep going and am refusing to give up my hobbies. I kinda feel like I don't have much left to preserve or destroy so I'm just giving my hip hell and doing all the things I probably wont be able to do with a THR ..... like bungy jumping and learning to jump on my mountain bike! Kinda loving that! :)
Anyway, starting to get a bit nervous for Tuesday so wish me luck!!!
Anna
Good luck with your examination under anaesthetic next week.
It's quite a shame they didn't keep your original operation date too because realistically there is plenty of time to analyse your hip and prepare for surgery.
However, you are in the system and things are happening so let's hope that this is the start of your approach to get on the operating table.
Good luck Anna! I can't wait until it's all done for you.
I'm thinking of you mate :)
Thanks guys, I will let you know how it goes!
Evant - they cancelled my surgery date but gave me a new one a few weeks later on 8th august so fingers crossed that will remain the same. I guess I will find out on Tuesday! ???
Phew, its over ;D
Finally home after a long and painful 4 hour drive this morning. I have a manual right hand side drive car and its my right hip which is bad! Driving is becoming a mission. I had a tip though to place a rolled towel / jumper under my thigh and it really did work and relieve some of the strain and pain from my hip.... just incase anyone is having the same problem! Hip is more achy than usual but not too bad ... although as soon as I got home my lower back went. I am now sat in bed feeling sorry for myself again! Why does a poorly hip affect everything else .... bad back ... bad knees .... bad shoulder ..... aaaaargh!!!!!!
Anyway, I get my results from my EUA in a week or two so fingers crossed I get the results I want
Hope everyone is well today
Anna :)
Hope you get good results, Anna! Crossing fingers here which makes it adventuresome to type. ;D
I think some of the bad everything else will let up after your surgery.