June 20th, 2016 THR

[LMS]

Hi guys,
I'm starting a new thread in the THR section.


So for people who may have not seen the other thread ([/size]Jan. 24/'11 HR in Ontario), [/size]here's my story, pretty much like many others, but maybe it'll help because of my location (I didn't see many from Ottawa).
[/size]
[/size]A quick recap on back history: I've always walked "like a cowboy".  Was in fact teased a lot about it.  We assumed it was because I was in fact a tom boy & was involved with horses since the age of 8.  By age 14, I began having severe, debilitating lower back pain.  Pain was always felt in the SI area as well but doctors didn't see a link with my hips. I had bad sciatica as well. I was in & out of PT clinics throughout my life.  As a teen, I was offered back surgery with a 50/50 it may or may not "cure" me.  Some docs said to stop riding, one doc said to continue doing what I wanted if my time was limited.  Might as well enjoy it & be smart about it.
[/size]
In college, the ITB started acting up in the left leg, making walking painful & feeling like I'd done something to my knee.  The on & off limping started.  By my 30's, I would start getting pain in the left hip.  The episodes would stop as quickly as they would start.  By my mid 30's I couldn't take the pain anymore when I had the debilitating off the charts episodes.   & my mentor noticed I had a blockage on my left side while riding.  She said maybe I should investigate it.

I had asked my doctor about it a lot throughout the years & she would say "Let's monitor it".  When it affected my day to day life  (lying on the floor, writhing in pain & screaming because OTC extra strong meds weren't doing anything...)  So when I pushed the issue, she decided I had bursitis & should get injections & physio.  I declined the injections but did go to a PT of my choice.  He was a client of ours & specialized in sports PT. 

After assessing me & trying exercises that should have helped, he (PT) watched me walking to the table one day & he saw one of the random sharp pains that rendered me to my knees.  He figured there was something else that needed to be seen by a hip surgeon.  He'd heard good things about this doc, there was a buzz about him bringing resurfacing to the Ottawa area.  So at the age of 36, in June 2006, I was sent to see doctor Paul Beaulé.

The x-rays showed a mild case of hip dysplasia, mild OA in the hips & a cyst in the left acetabulum .  I then had an MRA done which showed the damage done to the cartilage on the left femoral head.  Dr. Beaulé offered to do a scope to try & repair the damage done.  It would not "cure" me, there was a chance I could be worse off, a chance I could be the same & a chance I could be better.  All three of equal percentage of outcome.  I decided to give it a go & focussed on the chance I could be better.

I was put on celebrex & was asked to stop all activities so they could have a baseline to work from (eliminating the stressors & triggers).  Though the celebrex was a god send, my pain stopped within 24 hrs!  I started deteriorating fitness wise & started gaining weight.  And I was already always struggling with keeping weight off to begins with.

[/size]I was on a waiting list which was a minimum of 1 year.  In Nov. 2007, I finally had a debridement & micro perf. done.  I was told to stop taking celebrex.  The surgery had gone very well & was sent home that same day.  I was there (hosp) a total of 12 hrs.  I couldn't take the medication that was prescribed (I think it was oxy), the blood vessels in my eyes started rupturing, so I was put on Tylenol 3. Recovery was very long,  after 3 months of physio, I was regressing.  A year post op, I was still on the cane.  Two years post op, I was still not improving as long as I kept being active.  I had to quit my job as a therapeutic riding instructor & continue to modify my activities in my day job (I'm a sign maker & printer) which made it difficult as I couldn't fulfill all my duties.In 2009, Dr. Beaulé put me on the waiting list to get a resurfacing.  After a two year wait, I was finally scheduled for a Jan 2011 HR, only to have it cancelled 4 weeks prior because the x-ray showed my hip in the best shape it had ever looked!  I was still in pain though & my activities had to stop if I wanted to be pain free.Fast forward to 2014, the cane started making it's appearance again.  I asked my doctor if I could see my surgeon.  I was told to continue taking OTC meds & limit activities.  (I was with a new doctor).  I kept asking to please see Dr. B as I was slowly worsening.  I was offered cortisone shots, which I declined every time.  By 2015, my doctor retired & a new one took her place.  I asked again if I could see Dr. B.  and she refused to send me.  So I when I got home after our "meet & greet", I phoned another doctor near me & when I met her, I asked again"can I please see my surgeon!"  She said yes but only after having x-rays done & to consider getting a cortisone shot.  DEAL!X-rays came back showing bone on bone!  The hip was too far gone.  I was upset, frustrated, discouraged, angry.  Right away upon seeing the x-ray, my new doc sent me for an MRI of both hips, since the "good" hip had been very painful for the past 4 years because of taking the burden off the bad hip.  So that was in Nov. 2015, she also ordered an orbital x-ray (I work with metal).  By the end of Jan. 2016, I had my MRI done at the Kingston MRI.  I had to drive to Kingston but it was worth it since the wait period for an MRI in Ottawa was long & they had already lost 2 prior requisitions!  (I was not happy at all with them).
Unfortunately lost of kerfluffle happened & nothing got to Dr. B., so I ended up hand delivering the CD to his assistant, she found the requisition from my doctor & I was booked an appointment for April right on the spot!  Usually you must go through the Total Joint Assessment Clinic first but because of the situation & I was already a patient, went went the opposite way.[/font]

I saw Dr. Beaulé on April 11 & right away he saw that I was no longer a candidate for HR.  Bone on bone, no range of motion & severe arthritis in the left hip.  Moderate arthritis in the right hip but he decided not to focus on that hip for now.  I'm assuming that the pain, seizing & clicking that is happening in the "good" hip will subside once I get my THR as the burden will be taken off of it.  So I signed the papers, filled out a health questionnaire & was put on the 6 to 8 month wait period for surgery.  Disappointed I had to wait yet again but realistically, it was better this way as my house renovations are not done & I had to prepare a way that my sons could look after my horses over the winter & get my hay (700lb round bales) sorted.  I was also still sorting out my blood pressure, we were almost done tweaking with the meds.  I needed to see a dentist & 2 other medical issues.  I also wanted to try to lose some weight.  Being 5'1" at 161lbs... any weight loss would be a bonus.[/font]

I saw a nurse at the TJAC on April 25th & saw the artificial joint they were going to use.  She went through the steps with me of what to expect & how to prepare.  I jokingly asked if I could go on the cancellation list but we agreed that that probably would not happen.  Cancellations were rare & she was pretty sure some people were worse off than me.  Regardless that I wrecked my stomach from taking extra strength & prescription medication every day because of the pain. [/font]

So, my husband, my sons (they are adults, working & going to college) started to make plans for the next 6 months.[/font]

Two days ago, May 4th, I received a phone call from Dr. B's assistant, there was a cancellation, did I want the June 20th surgery slot?  I said yes!  I would be stupid to decline.  Yes I had planned a summer to try & do training with my horses, go off property & meet new people with them for the first time.  And yes, there is a risk I will have to hang up my spurs (as they put it) & not be able to ride again because we may not have a choice on the type & size of joint that will be used based on the condition of my hip once he's in there to have a good look & the size needed.  I will be very disappointed, devastated actually, as I was asked to stop riding 10 years ago & I have been longing to start up again so I could finally enjoy MY horses.  But will it be the end of the world?  No![/font]

So yeah, here we are, 10 years to the month since I was first told about Dr. Beaulé & finally had my hip pain properly assessed to needing to have a THR.  Not how I had planned, not surprised that it's how it ended up.[/font]

In case anyone is wondering, Dr. Beaulé uses the anterior approach, and uses either a ceramic on ceramic, or a metal on polyethylene.  You are discharged the day after surgery.  They usually use a spinal anaesthetic in conjunction with a general anaesthetic.[/font]

I'll keep you UTD as things progress. [/font]

[Quig]

What an incredible story! 


Best of luck with the surgery and I hope you have an excellent recovery. You're on your way to seeing a HUGE improvement in your daily life. Yes, its going to be tough at the beginning and it'll be slow going for a while but considering what you've been through you're plenty tough enough to handle it all...


I hope you're very happy with the results and are pain free SOON. 

[Pat Walter]

I am so glad you are getting a solution to your hip problems.

There is nothing wrong with either the ceramic on ceramic or metal on polyethylene. Many people with those devices are very active without any problems.

You needed a solution and finally one is on the horizon for you.

Keep us updated.  I wish you the very best and will keep you in my thoughts and prayers.

Pat

[blinky]

Ten years of hip pain...you are tough.


I am so glad you will finally find some relief---and you will! Once you don't hurt anymore and can be active again all those other little health issues will fall by the way side, too.


Good luck and keep updating us.

[jd]

Yikes, sorry to hear what you had to go through. That must have been extraordinarily tough!

[LMS]

Yeah, well over ten years of pain, only ten since something was finally done to find the actual cause.  And frustration when you're shouting & no one is listening until it's too late, or actually find the right person to help you. 


Anyhoo...


Just got off the phone with the Riverside Hospital physio department, I'm booked to go to a 2 hr class on Monday late afternoon.  I am to arrive 40 min & go to the lab for blood tests.  Checking the iron if I heard right?  (my phone was dying, so kept beeping)  And I am to bring someone with me so they attend the class as well.  So I nominated my husband to tag along! 


And how is my attempt at weight loss going?  Uhmmm... not too well... it was Mother's Day yesterday, we cooked for my mother & she sent all the leftover food back with us (for our hungry boys  ) and there is soooo much cake & pie!     

[LMS]

Though it would be best to get my teeth fixed or extracted now, I don't think I have enough time to get these looked after before the surgery date (I do think they'll have to extract 2 teeth  ) as I wanted to contact a new dentist (mine is about to retire, if he hasn't already, & we weren't happy with the last 3 failed fixes they did).


I think it can wait until late summer... not sure now.


Has anyone had to get teeth done (fillings/extraction) before or near the recommended 3 month post surgery wait?

[Boomer]

I had an infected tooth a few weeks before my surgery. My surgeon told me to get it extracted and treat the infection. He did not want to do the surgery while there was any sign of infection or possible infection. I had the tooth removed, implant placed and then had resurfacing surgery. No problem, just a minor distraction leading up to the surgery.

Good luck to you.

[LMS]

Thanks Boomer.   


I called the new dentist & they just happened to have a cancellation for tomorrow.

[blinky]

You have good cancellation karma!

[LMS]

I should go buy a lottery ticket! 

[LMS]

My life sure hasn't been boring these past 11 days health wise that's for sure!  I managed to get a sunburn on the face & lips on April 30th.  So bad I got 3 stupid & nasty cold sores (now finally healing & done hurting but still icky to look at), then a few days later I get a UTI.  Fill in doc puts me on an antibacterial medication that makes me have nasty side effects (yay me!  )  & last night I noticed my BP had been creeping back up in the 150's while taking a different BP medication for the past 3 weeks.  So off to the walk in I went this morning to nip this in the bud.


Doc decided to put me back on the coversyl plus (the medication that worked too well) so we could get the BP back in the normal range for surgery day.


Now I have a really sharp pain in the left hip & more crunching happening... Mind you, this is probably due to trying to get the jobs out the door & the house all sorted out.  It currently looks like a hoarder's house that had an explosion in it.  I will be glad when the renos are done!

[LMS]

Dentist appointment went fairly well.  The carnage wasn't too horrific.      I have brittle & sensitive teeth, always have since I was little.  I got the bad teeth/gums genes, my brother got the good genes...  So glad I got it done today though.  I bleed a lot, I have bad gingivitis (though at a glance my smile looks fine)


My broken tooth has to come out (The repair didn't even last a month & more of the tooth had broken off shortly after.  IMO not worth saving) & the one next to it, which I thought was cracked, is indeed cracked.  The dentist will try to fix it but if she can't, I told her to take it out.  I'm not going to spend thousands of dollars on a compromised tooth.  There are two other teeth that need attention (one that was saved 12 years ago is chipping away & the other has a surface decay spot) but I was told they can wait until after surgery.


So of course they wanted to squeeze me in somehow & wouldn't you know it, there happened to be another cancellation just called in for next Friday!  I really should go buy a lottery ticket!  [size=78%]  [/size]

[LMS]

Just want to make sure, I'll be ok right?  If I get teeth extractions 4 weeks before surgery?


I've also put on hold a procedure (colonoscopy) & surgery (ligation).  At this point, I think my husband is the one that will have to go to the "vet's".

[jd]

I don't think there's any issue with tooth extractions prior to surgery -- you might get an ask not to have them for several months after surgery though. Having said that, checking with your surgeon is always the best idea.

[LMS]

I just read through the info package they sent me & it says 2 weeks prior.  Looks like I'm ok then. 

[jd]

Good to hear

[LMS]

Mowing the lawn... not a good idea even if it's a self propelled.  Well at least it answered the question: how much walking on uneven terrain can you do?  Apparently, not much. 


And today: how long can you stand for?  1hr!


And how much noise (crunching, grinding, clunking, clicking etc) does the bad hip make?:  Well, as long as I'm doing stuff, it makes noise tec.



Thank goodness for the good meds & 5 weeks to go!


But heyyyyy, my house will be finally nearly finished all the big renos!  (It's been gutted for the past 6 yrs as we've been fixing it.  It was built 1894 & the last owner did not upkeep it during its last 20 years)

[LMS]

Admitting department at the General called this morning.  I'm meeting my surgery team on June 6th.


I'm about to get ready to go meet the physio therapist, at the Riverside, for the Pre-hab program info session & get blood work.  I haven't been able to get my head in the game work wise all day.  But the office is tidier looking. 

[LMS]

Went to the the pre-hab info session on Monday, the staff at the Riverside were so pleasant as usual!

Got bloods taken beforehand (at their lab).


So the nurse went through the info booklet (that we bring on the surgery day), passed around the THR & HR devices, showed us the items we would find helpful post surgery around the house.  The Do's & Don'ts.  Throughout, we were encouraged to feel free to ask any questions.


After the first hour, we went in the physio room, we each took a bed & we practiced 4 exercises that we were encouraged to start right away to prep the muscles before surgery.  This is to help post surgery when we continue the same exercises.  Unfortunately for me, I wasn't able to do the exercises properly, the pain & lack of range of motion made it too difficult.  I was frustrated.  I was told not to worry too much about it & just keep active at home.  And of course, being overwhelmed by all this build up, I did my best not to start crying.  I wasn't very successful since, I haven't been able to do any type of activity for quite a while & this surgery can't come soon enough, I seem to be going downhill fast hip wise.


Yesterday, I received a phone call from the Transfusion Medicine department (well, apparently they are the whole 3rd floor  ) of the General Hosp.  They booked me for Tuesday next week to go over my blood tests, health & meds & let me know what to do to prepare for the big day.  I assumed that was going to be done at the June 6 appointment. 


But yeah, so far so good, I'm pretty impressed by the whole process so far since we got this ball rolling with Dr. B & his assistant.


And...  it kept niggling at me to find out why exactly I'm getting the THR instead of the HR.  I'm not disputing it, I trust Dr. B's judgement but I would like to be able to answer the question with an educated answer instead of "well I think it's because of this..." & I had a client ask me this question as well as he's starting his hip journey & is hoping he'll be a candidate for a HR.


So I sent an email this morning & not even 20 min later, Dr. B's assistant called me & booked me an appointment on Wednesday (next week) to speak to him directly.  She did ask me if there was a chance I was going to cancel the surgery & I told her no, I'm 100% going ahead with it.  I want my life back!  So of course my OH started telling me I shouldn't have done that (the email) as it sounded like I was second guessing & may back out.  Regardless that I mentioned twice that I was confirming going ahead with the surgery on the 20th.


I just want to know what exactly is going on with my hips, for my own peace of mind.  I honestly didn't have any questions when we met & the appointments are usually so rushed anyhow.  And the information he will give me on Tuesday will have no impact on my decision to go ahead with the THR next month.