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Author Topic: Rock-Climber with L1 to S1 Spinal Fusion w. Nerve Damage, now Hip Arthritis  (Read 17615 times)

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Roboclimber

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Hi All,

In May of 2010 I had a revision of my existing L1-L3 Spinal Fusion as a result of increasing pain due to a stenosis at the L4-5 level. Now I am L1 to S1. The original surgery in 1982 was done in Montreal, and was done as a result of injuries sustained in an MVA. It's a long story, but 5 spinal surgeries later I am still suffering, despite a VERY active lifestyle, and great care from my GP (Dr. Sartekin). My recovery in 2010 was quick at first, but eventually it came up last week that I have mild arthritis in both hips (worse in my right). I had Bilateral CT Guided SI Joint cortisone shots (#2 in R side, #1 was in March), to eliminate issues there (those joints look good, according to Doctor), and I am realizing I am likely looking at hip arthritis and further treatments (X-rays show it, and my hips are useless).

I see my surgeon - Dr. Dvorak (VGH), awesome guy - November 8th. I can't work, I can't play. My life has gone so downhill I won't be surprised if my wife throws in the towel because I am driving us both crazy.

What is the current state of affairs in Vancouver to get Hip Resurfacing? Is it covered...especially if I have a BlueCross plan? BTW, if you want more details, I will post anything that will help me...or anyone else, but I am curious as to who the best surgeons are, and in particular, those working out of VGH. I have many questions, and I have already done a lot of reading, but this is a good start.

I can be found on Facebook, with pics and more details of my life and past surgeries. I just want to get my old life back..even if it is just the one I had 2 years ago!
« Last Edit: November 10, 2011, 02:47:03 AM by Geoffcreighton »
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

Roboclimber

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Re: Rock-Climber with L1 to S1 Fusion, Nerve Damage, now Hip Arthritis
« Reply #1 on: November 05, 2011, 01:43:37 AM »
I should add that I am 51 years old....but I completely "get" the octogenarians walking the way they do in the supermarket - except that my Dad is 84 and super-active: no history of hip arthritis in the family. Sad that his son is getting beat up this way.
« Last Edit: November 10, 2011, 02:46:27 AM by Geoffcreighton »
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

Roboclimber

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Re: Rock-Climber with L1 to S1 Fusion, Nerve Damage, now Hip Arthritis
« Reply #2 on: November 08, 2011, 11:49:39 PM »
Saw Dr. Dvorak today. He informed me that no one is BC is doing resurfacing anymore. I am now talking with Dr. Antoniou's office in Montreal. I am desperate to get my life back into gear. Any thoughts on this?
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

DGossack

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Re: Rock-Climber with L1 to S1 Fusion, Nerve Damage, now Hip Arthritis
« Reply #3 on: November 09, 2011, 01:49:24 AM »
Geoff-

I posted this reply on another thread also.  I met a Dr. Yao that has done BHRs.  He has an office in Whiterock.  He didn't indicate he wasn't doing them anymore.

Best wishes.

Dan
LBHR, Dr. Pritchett, 8/1/2011
fullmetalhip.wordpress.com

Roboclimber

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Re: Rock-Climber with L1 to S1 Fusion, Nerve Damage, now Hip Arthritis
« Reply #4 on: November 09, 2011, 02:22:31 PM »
Thanks for that reply, Dan.

An ortho at RCH wrote the following to me 2 days ago:
 
I'm not sure if anyone does that in the province anymore. Big hype in the US and was here but high complication rate with little or no benefit. He should have a regular total hip perhaps with alternative bearings. Trevor and I do them and any of the guys at VGH. Also, Rick Kendall in Richmond, Bob Froh or Sean Brown in Surrey. Burnaby guys (the younger ones) are good for that too.
 
Yesterday, I saw my spinal surgeon -Dr Dvorak - who has gotten me a referral with Dr. Panagiatopoulos at Lion's Gate. Should only be another year before I see him.  :'(. Yesterday Dvorak echoed the above statement, calling resurfacing "a fad" that had come and gone in these parts, as far as he knew.

I am getting quite a different story from back East, where past patients of Dr. Antoniou seem ecstatic with the results, and the office has been very responsive. I am hoping to be a candidate for the resurfacing, and Dvorak said I need both hips done.

Interestingly, my GP, Dr. Sartekin, is the one who spotted this a year ago, whereas all the physios, chiros, and other medical "specialists" never pursued the obvious after one hip came up positive in December 2010. As a result I have suffered and wondered what the hell is going on for over a year. At least now I know. It says wonders about having a GP who knows your history. Still, hip arthritis is supposed to be one of the easiest forms of arthritis to diagnose, so I am just a little disapointed in the half dozen medical experts who failed to figure out what was going on.

When I asked Dr. Sartekin why he thought resurfacing is not done out here, he replied half-joking "because Vancouver is a hick town". I had to laugh. What is becoming clearer is that surgeons here had some bad results with resurfacing, complications occurred, and everyone got scared off.
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

mellord

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Geoff - I'm going to try to track you down on Facebook. I had a resurfaced L hip four years ago - feeling really good with no restrictions (other than normal fear of RPs ripping, etc.) A mutual friend here in Adks has a total hip on one side and a resurfaced hip on the other. I can get you in touch. Don Mellor

Roboclimber

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Hey Don,

Saw a Doc in Montreal here who says I have some Avascular Necrosis and need a THR. He is also a specialist in resurfacing, so maybe not much choice, I guess. Still exploring options. Good to hear you are still kicking around!

Geoff
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

sdunn4

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Geoff,

I traveled to SC from the Adirondack area of upstate NY for a resurfacing; you may need to travel to avoid a THR!  I just finished my "winter 46" 1 1/2 years ago and love to water- and snow ski, along with an occasional sprint triathlon.  No serious rock climbing although my sons and I climber Roger's Rock on Lake George with a guide several years ago- that gave me newfound respect for serious rock climbers!  I just figured that at age 52 I wanted the freedom to engage in all active sports and I sure love to snowshoe / cimb the ADK High Peaks.

Good Luck finding the right doctor and the right solution.
52 YO Rt Hip Biomet Dr. Gross, 10/24/11

Roboclimber

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Hi All,

I am almost 3 months post-op (BHR R hip; Dr. Antoniou), and the right hip did seem like it was going well...although I think I might have overdone things over the weekend climbing outside and then in the gym. I managed a pretty steep 11c and other 5.11's in the gym (all on TR), but I still feel pretty fragile.

I have been climbing up and down a long set of stairs (kind of interval training), and using a stationary bike. Using rock rings, gymnastic rings, and the local community centre, too (although public pools gross me out so I don't swim). This may sound great, but 3 months out I feel like I have a very long way to go.... and then I have to get the other hip done!

Last week, Antoniou's office called me to tell me the hospital couldn't take any more out-of-province patients. I wrote a letter to the hospital ombudsman... and it worked! The hospital decided that several of Antoniou's patients are under his care, and we have rights. Now I want to get in and get the other hip done before they change their minds again.

I am surprised how long the recovery is actually taking me, and I am HURTING today. Of course, I am dealing with the back thing described above as well, so I am not a "normal" hip resurfacing....but still. I am guessing it will be another 3 months or so at this rate before I feel healed.

My back has been tweaking a lot over the last month, requiring a return to Tramadol and occasional Percocet. I get these shooting pains down my left leg that I believe are caused from damaged, scarred nerves from my back. When my hips hurt and muscles tighten up everywhere (guarding, spasming) it seems to set off a chain reaction and then my back gets into the game.

Anyway, perhaps there is someone out there who finds this info useful. Let me know if you want to know more.
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

hernanu

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Thanks for checking in Geoff, and good for you to fight for yourself the way you have.

At three months, I think it's pretty normal to have soreness. I know that at three months, I had a ways to go to feel fixed, but I felt MUCH better than I had, so I tempered my expectations. Another three months to feel a large improvement is probably pretty on target.

Sorry about the back, but once the hip is able to fully pick up its uncomplaining share of the load, it may feel better. I had shooting pains down my undone hip after my first was done, I think due to the OA and the extra load it was bearing because my recouping hip felt so sprightly. I was doing things that I hadn't done in a while, so my formerly good hip became my recalcitrant child. Until I got that done, haven't had those shooting pains since.

Your situation is different, but getting the second fixed if it needs it can't do anything but help. Good luck.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

Roboclimber

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I am now 5.5 months post-op from BHR R hip. I am scheduled to have left hip done August 17th. To be honest, I am not sure what to think. My BHR right hip is far from "normal", but I am doing a lot of activity: hiking, stair intervals....no running, because I can tell that I can't do it. The undone hip bugs me so much, though, that it seems to overhadow everything. Then there's the back and the associated nerve damage, so it's a mess down there. I am making the best of a bad situation/ history, and I have done a lot with a messed up body, all thanks to great surgeons and medical care over many years.

Sitting is tough, but it seems to be coming more from undone left hip. Still, the BHR is giving me issues, and I am not sure if I should be expecting more at this stage....or what.

Here I am, about to go in for another surgery. The first week post-op in February ignited the scarred nerve tissue in my back (swelling, guarding set off this sciatica-like pain - not new) and the shooting pain was crazy for 7 days. Likely I will have to go through that again, and this time I am going to make sure I get enough pain meds before I go in for surgery :o as the hospital was severely lacking in this regard - despite my ample form-filling and e-mails prior to surgery about the pain issues I have been dealing with in the last few years. No question, Canada's health care system needs to be brought into the modern age, but this seems to be less about surgical skill, and more about modernizing the administrative capabilities and systems the hospitals and health care system uses. It is embarrassing to be filling out the forms I have filled over and over, and to be relying on fax machines, etc.

This is hopefully the last surgery I will have to contend with for a long time. :o

Two questions I have for anyone interested:

What have you been told you can do with regards to exercise 3 months post-op? Use pain as your guide?... I often don't know if i have done too much until the following day, so I am curious what others do.

When have you been told you can do as advertised and hammer on those  BHR joints - if you choose to do so? 3 months...6 months?... a year?....

There is a lot more to this story, and the politics getting my hips done has been like nothing I have ever seen or heard of before... and I have had a lot of surgeries. So many different sets of instructions from GP, specialists, physios. If you ask me what the surgeon instructed me to do, there isn't much coming from him - he is too busy, and I am lucky to be under his care. Perhaps sad, but I am thankful to have been operated on by him: the hospital almost pulled the carpet out from under me for hip 2 because I am out-of-province, and BC doesn't have a great track record with hip-resurfacing.

Several surgeons looked at my history, x-rays, and MRI's - including Bose. no one agreed on what I should pursue as an option. I have no idea if I have done the right thing pursuing these surgeries, but I could not deal with the status quo last year, and something needed to be done. I really hope the BHR's were the right choice.


Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

hernanu

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Hi Geoff, good to hear from you again (missed the earlier post), congrats on the upcoming!

I know you had a rough time from the back / scar tissue last time, and you may need to face that again this time, but I think in the end it will be positive, as you'll be able to eliminate two sources of problems from the overall equation. Maybe that will make things easier overall, once you have two strong replacements for the worn out parts.

Where the congrats comes in is that, as a bi-hippy, I understand that interim period when one hip is going gangbusters and the other is getting much worse in comparison. I waited three months between surgeries, and I'll tell you - the last few weeks were hell. It seemed like the unoperated hip just gave up the ghost when the other was now so energetic.

I have a completely uneducated, yet massively correct  ::) theory that since a kind of balance has been reached in the configuration, movement, etc. of your body due to the OA, the imbalance introduced by one hip that is now in the correct shape / place puts even more pressure on the other hip (don't tell anyone, I hope to get the first hippy Nobel prize).

The surgery fixed all of the imbalance, since I had two hips moving correctly even if weak, and I was able to recuperate strongly the second time, since that massive pain was gone.

So this won't fix the back problems and all, but it will relieve the pressure that the bad hips were putting on it. I can't help but think that it will overall benefit you, relieving the hip component from your back, shoulder and leg muscles. Before the surgeries I was so tight on my back and shoulders that massage therapists thought I felt like a rock. My doctors thought I had spine issues, so they sent me to have those nice electric pulse tests all over my back and arms, coming back with no issues, just all of the symptoms. Those were cleared up by the HRs, so to me, I would hope for you that they relieve their component to the point that your pain is greatly reduced or (maybe, hopefully) eliminated.

I understand the depression, especially when having dealt with pain for such a long time. I dealt with it for seven years; it was affecting so many things in my life, that I realized after the surgeries that people were becoming stressed around me because they saw the pain in my face, in my attitude, my shortness of temper and overall demeanor. That was lifted after my first and eliminated in my second.

One thing you might want to look at is a counselor, someone to talk to and at the least provide a safety valve for your feelings and to help you with strategies to help you cope with the recovery and other issues. I used one for about a year during the time I had both surgeries, and he was excellent to talk over the feelings I was experiencing. The OA and the surgeries put a lot of stress on us, there is absolutely no reason not to use a professional to help treat this just the way we use physical therapists to help us mend and heal our muscles. It's worth it, and may help to depressurize things at home.

It sounds like you have realistic expectations, one year to be standing on firm ground about returning to all activities, no reason you can't have a great life after this, I am certainly enjoying my hips right now.

Really good luck - I feel good for bi hippys who are on their last surgery, the feeling of being done and just getting well afterwards was excellent for me.

« Last Edit: July 28, 2012, 03:43:40 AM by hernanu »
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

Roboclimber

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Thanks for that reply, Hernanu. Your words offer me a lot of encouragement as I have little to compare to. I thought I was in good physical shape and have wondered about my particular healing experience.

I had a bit of a rough last week, and I realized that for 30 years I have been describing my nerve pain as a shooting pain, like sciatica...but I have never had sciatica, and my pain is more localized in various numb parts of my left leg (those areas that were affected by the nerve root damage at the L1-L2 junction). I usually get the pain in my foot, or my thigh, and this week I have had it every night, usually around 3, but Tuesday I started off my day with a lightning bolt in my thigh at 8:30 a.m. It is true that this is a back thing, but when the hip starts to ache and the associated muscles tighten up (spinae erectors, etc), it seems to affect my damaged nerves in my back....and the burning pain starts. It's horrible pain, and it can be hard to control.

This is a surreal existence, and without your words of encouragement I would be doubting that I will ever come out of this. In fact, most people who know me don't realize how worried I am, as I think I hide it well. Except for my wife, my doctor, and one or two others, everyone assumes things are well and going great. That masquerade creates its own problems, and I am pretty tired of it. I have seen a counsellor, btw, and I continue to see someone to discuss my situation so that I am not continuously dumping the same crap on my wife all the time.

Anyway, barring unforeseen circumstances I will be in the OR on Friday the 17th. I think just knowing that I can move forward instead of sideways after this surgery  is very encouraging. The idea that I could return to where I was 5 years ago seems fantastical and improbable, but I keep working out and fantasizing about it. Not much choice really, I guess.

I read about the different healing rates and i realize that likely what I am dealing with in my operated R hip is healing soft tissue. I saw my GP this past week, and it sure would be nice if all physios and doctors could get on the same page with my direction of treatment. My doctor's advice is to forget the physio work and leave the workouts and exercise alone. Well, he is about to get his way for a couple of weeks!
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

Spanielsal

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Hi Geoff, wow, you really have been going through it. I just wanted to wish you luck with your upcoming op. I'm day 5 of my second hip, recovery is good, just stiffness and incision pain now. You 'll do great, good luck on 17th!

Sal
I'm a Hippy Hybrid!  L HR Cormet 2000 - Mr Villar, 12th June 2003 and R Corin mini hip - Mr Villar 7th August 2012

Roboclimber

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Saw Dr. Antoniou yesterday, and he seems to feel that I can work weights on that new hip w/o danger. Doesn't sound like he is a big fan of running, though, and I have been discouraged from doing this - at least for a a few months longer. Anyway, surgery tomorrow morning at 8. I can't wait to get this month over with...
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

hernanu

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Good luck tomorrow, Geoff!

I wouldn't fuss about either running or weights, both are months away (a full year for running for me, both a personal choice and my surgeon's restriction). I got back to light leg presses at the end of my outpatient PT (about 3-4 months), under PT supervision and very careful with it. My take on it was to concentrate on healing, light lifting and flexibility the second six months and just healing, walking and some flexibility for the first six. Worked for me, others had different experiences.

Excited for you to get rid of the hip OA pain, and wish you much lessened in other areas. Let us know how you are after.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

Anna

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Good luck Geoff!!! Let us all know how it goes   :)
RTHR - 08/08/2013 -Mr johan witt, London

Roboclimber

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Whew!...it's over. Sort of. Surgery was completed on August 17th, and I was in ICU awake by noon.

The surgery went well, as the resident I talked to said the bone all looked good, and they saw the region of wear and tear that was causing me grief. However - once again - I had to have a general anesthetic, as opposed to a spinal as my fusion is too large. The big difference between the two is for that both times I have had this the first 90 minutes coming out of it is a suffer-fest of extreme proportions: I came out of a general anesthetic with NOTHING for pain, and it it takes a while to get that morphine pump doing it's job. Or maybe the ICU staff is lame... why can't they just give me a shot and stop dicking around? It seems completely unnecessary and stone age. I was in a bad way for a very long time.

I went in on the Friday and was discharged at 2 pm Sunday. I only needed the walker for the first day up, and I am already getting around with just one cane if I am in the house (2 for outside). Incredible, and very different from the right hip.

But...I have had a return of the cursed nerve pain and I swear to God it's like every medical person I talk to is hearing about my medical history for the first time. None of the nursing staff had anything in my chart about previous spinal surgery (uh- like 5 of them), and when I tried to explain the source of pain and discomfort I usually got very well-meaning but innexperienced responses about what would help.

The pain meds issued to me were completely inadequate, and I went through the 20 5 mg tabs of oxycodone I was given in 2.5 days - as I had these burning nerve pains in my foot (related to my back injury), and I still do. I tried to talk to the Head Nurse before leaving the ward when I received these lame meds about getting more, but she made it clear I would have to speak to Antoniou if I needed more. So of course, I did, once the pain started getting bad the night I left the hospital. It all just seemed so unnecessary after what happened in February. That said, they loaded me up with enough meds now and hopefully that will get me through what has been a tough period with pain. But pain medication is the new bogeyman, so anyone with chronic pain has to deal with this ultraconservative nonsense.

As happened in February, I have been soaking the bed with night sweats, and I am a little constipated. I'm not very hungry, and it's tough to sleep.

It's a beautiful day so I am going out for a walk. I hope to be back in the weight room next week, and I have already returned to desk-work part time. I still look at climbing magazines and fantasize about a return to that great sport: I have done it before, so I might as well do it again - just to show it can be done.

Lots to look forward to, and I hope anyone going through anything like my experience finds this information useful.

Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

hernanu

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Geoff, congrats on the second!

I had a general, but in my case the anesthesiologist was so good the first time around - I woke up making bad puns, but no real pain, that I made sure to ask for her the second time around. You have extra needs, though, so I can see that's harder to handle, especially if they are not taking those into account.

You're still early, only 5 days along, so although you sound like you're doing well hipwise, it's the other back pain that's blindsiding you. I can empathize with your frustration, sometimes you feel like there's no long term memory within some medical heads. With all of the manipulation that happens, and the muscular trauma, I can see why your nerves get more inflamed. I don't think you'll get the total impact of the HR in lowering your pain for a bit. I really hope it helps.

I am a fellow bed sweater (glad I spelled that right). I typically set one beach towel lengthwise, one sideways, crossed and wore t shirts, etc. That was the only way not to completely drench the sheets. It went away after a month or so, I think it was caused by the anesthesia myself, but can't quantify it.

I think you'll get back to it, if just to be stubborn, but I hope you do it with dramatically lower pain. Keep in touch and congrats again.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

Roboclimber

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Thanks for that feedback, Hernanu. I am still dealing with pain, although the intensity has dropped a bit and likely I aggravated the situation with two much sitting in bad chairs.

2 days ago I went for a walk outdoors that lasted 1.75 hrs. Admittedly, it was a bit excessice, and I was pretty tired afterward. However I desprerately needed to clear some of the cobwebs from the previous night's pain debacle. Again, this is nerve pain, I would expect anyone with a spine nerve root injury might experience what I am going through. I am 1 week post-op, and really doing well for the most part. Once I can get past this next couple of weeks I should be good.
Rock-Climber with L1 to S1 Spinal Fusion (w. S1 to S4 nerve Damage); R Conserve+ Dr. Antoniou Feb 17,'12. L Conserve+ August 17, 2012 with Antoniou. Revisions to Synovo Cups in 2015 by Dr. Pritchett: R On January 12, L on June 9th, with femoral unit revised, too (TARA prosthesis from Biopro)

 

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