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Pain Thresholds...

Posted , 9 users are following.

susie74530
susie74530

Having read many posts, I wondering just how much pain a patient with severe arthritis needs to be in before the NHS will consider surgery.  I have read posts where patients are in such excuriating pain they cannot work, and are suffering financially.  In a situation such as this they will be in all kinds of debt before they can even consider returning to work, and this is going to impact significantly on their recovery.  I am thinking mainly of patient on no hours contracts.

In the US, where I have lived and worked for most of my life, more than likely you would find yourself out of a job!

Surely, a diagnosis of severe arthritis should be enough to justify surgery, without compelling patients to suffer unendurable pain, for weeks/months on end, jeopardise their livelihoods, and then at almost the last minute, in many cases, cancel surgery the day before!

This is inhuman.  The RSPCA would not stand for this, if in the case of an animal....!  Would they...?

Is this common in the UK, now?

Best,

 

2 likes, 42 replies

42 Replies

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  • kevin19230
    kevin19230 susie74530

    Posted

    I too wasn't in excruciating pain. I had no mobility. I had Perthes disease as a child. I'm sure there are many of us on this forum. I'm aware of the age cycle of the replacement.  However looking forward to some improvement in my movement and general day to day living. Quite looking forward to going back to work!

     

  • lyn1951
    lyn1951 susie74530

    Posted

    Susie - Here in Australia, New Zealand, And I presume England there are no charges when you go to a public hospital, Government Funded, it all comes out of the taxpayer dollar. Of course then because it is free, you get all the dead heads using the public system and clogging the system with minor complaints. Imagine Emergency Department filled with vomiting, drunk, self inflicted idiots, torn out fingernail, waiting in line to be served with broken arms, strokes, etc, although triage do try to care for the really ill first, where in a lot of cases they could go the the local GP's clinic, no charges in some of these clinics, in Australia it called bulk billing, some of the Bulk billed clinics are very good, others are production line, but I have also stuck production line service in an expensive reccommeded clinic. Re pain in public hospital system, here in australia pain is not a reason to get into hospital, apparently function is, or thats what I have been told, bet you its the same in England. Why they think that putting off working tax paying patients is beyond my understanding, wouldn't it make economc sense to have got me fixed up, back at work, and paying tax again, I was earning in excess of $1000.00 a week and paying close to $300.00 of that in taxes, unfortunatley my husband being diagnosed with heart failure has put paid to me working since I have been 59. Being brave and appearing at your GP nicely dressed, walking resonably well is not going to get you a referral to specialist, you would have thought for example my case, from about 2000 onwards I was being prescribed painkillers on a regular basis, and x-ray showed moderate arthiritis, that slowly got worse over the next ten years, so by 2008 I was no longer working, couldn't sit on bus for 2 hours to go to work, because at the end of two hours I coudn't get out of seat. Not elegible for benefits as husband was earning too much. Finally 2011 seen by specilist who was shocked by state I was in, not walking without 4 wheeled granny walker, even then had to wait 32 weeks from first appt with specialist to surgery, with right hip basicly broken down.
  • rose0000
    rose0000 susie74530

    Posted

    There are two options really Susie, private health insurance which usually means you can choose your surgeon and the operation date, provided you are medically in need of a hip replacement at that time.

    I also know you can pay privately without insurance it is around £10,000 or thereabouts.

    Or you can go through the usual routes of the NHS. I have to say the hip care is exceptional for patients. They supply aids to your house, come out to check your home and offer community care afterwards, as well as hip school and general care. You will not receive this through the private pathway.

    To qualify for hip replacement you have to have significant damage on your xrays and MRI. For some people they are not in pain, through childhood diease of different reasons, but for others they are in terrible pain. Usually these patients have left it too long for their own reasons, or the GP was slow to refer them etc...

    A diagnosis of severe arthristis may not be enough if it does not show actual damage by xray. There are other ways to control arthristis such as anti inflammtories, biologic drugs that may help a patient without the need for surgery. Surgery may not be needed at all.

    It is common in the UK for most patients to be looked after very well is my view.

    • susie74530
      susie74530 rose0000

      Posted

      Hi Rose:

      Many thanks for your response.  I am due for a third set of exrays on Thursday, for obvious reasons - pain from arthritis.  Had surgery performed in San Francisco for removal of the third distal joint, dominant hand due to arthritis in 1987, where I was initially diagnosed.  So, I have lived with this situation for some considerable years.  As a consequence of the surgery, I lost my living as an Interior Designer as I was unable to do the fine work required on the drawing board - technical drawing.

      First set of exrays, the GP, a locum, I believe, advised that I did, indeed have arthritis in my right hip, but he went on to advise that should I have surgery, I would contract MRSA!  Hardly encouraging and reassuring!  Second set, taken around this time, two years ago, showed moderate to severe arthritis, and I was referred to a physiotherapist, who gave me a set of exerccises to do.  Co Cadomol was prescribed.

      My new GP, with whom I have been for over 10 years, stated that she was happy to put me on anti inflammatories, but for a limited time, only,  I opted out.  I am well aware that there is damage, because it presents during exercise, and is unmistakable.

      As I have spent most of my ife in the US,, mostly San Francisco, I do not have private medical coverage, although I did in SF.  I returned to the UK, to address issues with my elderly and increasingly frail Mother, now deceased.  We were in London and although I was able to locate medical help for her, no GP would take me on as a patient, for whatever reason!  So, the amount of lifting and heaving, moving furniture, etc., that I had to do, exacerbated and aggravated the arthritis.  I was unable to obtain any form of pain relief, other over the counter, and quite frankly the local practices were not interested in my problems any more than Social Services, who became involved in the last year or so of my Mother's life.  Overall, my impression was, that I was regarded as a machine to take care of my Mother, but maintenance and my own medical issues were ignored.  Lack of any form of medical care, least of all any level of concern for my well being, continued for over eight years.

      My current GP does take good care of me, and we are able to have intelligent dialogues as to diagnosis, prognosis and what would be the current best course of action.  The new set of exrays, will reveal all that is necessary to either refer on or not.  I suspect, that due to my current codition, it will be the former, but you never know...!  Not much to be gained by referring a patient on for THR when the condition unsupported by Exray, and the pain experienced is from another cause!

       

    • rose0000
      rose0000 susie74530

      Posted

      Your new GP sounds wonderful, and you seem confident in their care which is good, and I am sure he/she will refer you immediately if they see that your condition needs a THR.

      During the early stages there are so many things that can be done to ward off the surgery, and these are often used successful for a few years. I have had hip pain for ten years now before finally and somewhat painfully making the decision to have a replacement at the grand age of forty.

      Some of ways I knew I definitely needed one were similar for everyone: I couldn't bend, can not put shoes or socks on, can't walk far (longer than 10 minutes) can not bear to stand still and and can not live a normal life. These things can be controlled by various forms of pain relief which definitely be explored but there comes a point when they do not work, and in fact the damage on the xrays points to the need to replace.

      If your joint has a few more years then this is a wonderful thing for you! You are very fortunate. Especially if you can get your pain under control and can enjoy your life. I had hoped never to have the replacement, but sometimes you end up with one anyway. Once you get to that stage Susie, I am sure you will be well care for, please try not to worry. 

      I am not sure how badly your hip is affecting you, and how limited you are in what you can do. It is good to discuss with the doctor what can be done in terms of support.

      Good luck with your xrays, and make sure you ask to have your back checked as well. The pain signals often get mixed up!!!! And the pain presents in the wrong place in that area...It is good that it is free here in England and you do not have to pay high insurance costs anymore, because this kind of care costs a fortune from start to finish. I am always amazed at how much an MRI is, or a simple blood test! My bills are horrific! smile

       

    • cathie38426
      cathie38426 rose0000

      Posted

      European private insurance, which we have to have in

      Portugal, to cover us also in uk, is horrendous.

      Cathie

  • cathie38426
    cathie38426 susie74530

    Posted

    If you are covered by NHS care your gp will decide

    if you need a consultation, or xrays, I think it has

    always been like that. I was bone on bone with both

    hips. A hip replacement will cure arthritis in your hips,

    but not general arthritis pain, caused by ageing.

    Cathie

    • vanessa88276
      vanessa88276 cathie38426

      Posted

      Hi Cathie I'm bone on bone on both hips can you have both hips done at once? I am seeing my consultant on Thursday x
    • rose0000
      rose0000 cathie38426

      Posted

      I am only forty and have had arthritis for years, so you can be younger and still have chronic arthristis, it is not always related to age. 

      General arthristis can now be treated with biologic drugs which will preserve joints, so well worth looking into. 

    • cathie38426
      cathie38426 vanessa88276

      Posted

      You might find one is not is bad as the other.

      if one hip could not support you when you had the other

      one replaced they would, sometimes reluctantly, do both

      at the same time. A consultant's decision, based on your

      xrays and general health. Good luck, you will get a fuller

      picture on Thursday.Take a list of questions written down and have

      someone else in the room with you, because you won't

      remember everything he says.

      love Cathie

    • cathie38426
      cathie38426 rose0000

      Posted

      What I was trying to say was that osteo arthritis of the

      hip bone is one cause for THRs. You must have suffered

      a lot of pain with early onset arthritis. You will benefit very much

      from the THR. Nearly there now.

      love Cathie

       

  • Hailea
    Hailea susie74530

    Posted

    Hi susie

    i waited just under 4 years to have the first one done I was in agony with both but not as bad as now. I am 8 months since having my left hip done and will be going in for my right hip 10 days before Christmas. 

    I am am in so much pain now I went to my pre op in a streacher because I can't walk. I was also on gas and air ( nitrus oxide ) for the 30 mile trip to the hospital because the pot holes and switch backs made me suffer. 

    Good of thing was I phoned ahead and they were waiting for me wheeled me straight in did my tests and shipped me off home again all within 30 mins. 

    • vanessa88276
      vanessa88276 Hailea

      Posted

      Good luck for second op hailea .poor poor you I am in a lot of pain and waiting for my first thr very scared but desperate to get rid of this pain which is getting me down so much :-( and also a lot of people don't actually understand the pain you are in and expect you to do more than you can:-( hope the hip you had done is fine does it feel loads better take care and hope you ate pain free soon xx
    • Hailea
      Hailea vanessa88276

      Posted

      Hi vanessa

      Thankyou

      I am still very scared even though i have had one done. I have actually had my ESA stopped in the last week by the job center because they don't beleive I am in this situation and they class me as fit for work. Yes really.

      I try to do some things like help make dinner by peeling potatoes and stuff like that. But other than wrapping christmas presents and the odd job here and there I can do without having to sit upright I can't do a lot. It hurts too much to even get up to go to the loo some days but you just have to get one with it.

      The hip I have had done is ok. But it is stiff due to lack of mobility.I do get a little pain. But because of the cronic pain of the right hip I can'rt really tell how god / bad it is. I will have to have physio when I can

      after this op. My muscles have disapeared from my calf mu butt and my thigh through imobility. Once I am fixed I am going to take it easy and work up to at least being able to use my gym equipment at home.

      I have lost a lot of weight bewcause I am not eating propperly because of the meds I am on. Not a bad thing I guess but you have to eat to mend and heal.

    • vanessa88276
      vanessa88276 Hailea

      Posted

      Oh my goodness poor you x I have to phone up ESA tomorrow to see if I can get it .I really hope so as am not able to work and my op is not until January:-( I am finding it very hard on the money front :-( x
    • susie74530
      susie74530 Hailea

      Posted

      Hi Hailea:

      Thought I should write and suggest that you ask you GP for a letter setting out, exactly what your medical position is.  

      All the best,

      Susie

    • Hailea
      Hailea vanessa88276

      Posted

      Vanessa.

      Just be warned it isd very, very difficut to get ESA since the government changed the rules. Just tell the truth but becareful what you say and how you say it.

    • Hailea
      Hailea susie74530

      Posted

      Done all that susie

      It was still taken off me. Thje fact that I can sort of sit up in bed they said that I was fit to sit at a dest there fore fit for work. They don't care how you get there or what happenes in a fire I am classed as fit for work.

      Lucky my other 1/2 is my registred carer so I was put on income support and not forced to go to work.

    • Hailea
      Hailea

      Posted

      Meant to say but I am down £60.00 per week which would be very handy to keep me warm in the winter
    • lyn1951
      lyn1951 Hailea

      Posted

      I do not believe yes, yes I do, they are such bas----. Similar with my husband, told us too our faces that the cardiologist letter to our GP which we had a copy of, detailed husbands lack of heart function, was irrelevant, they wre interviewing us to send him back to work, being a carpenter for the previous 40 years how many jobs each lasting a number of weeks if lucky had he found for himself, we had lost count.  Do you have a accident compensation at work, if so contact them, ask if they have a self reporting clause, most of these compensation type insurances, do, get them copies of your specialist letters to GP, and say if I am forced back to work, there will be a claim coming their way within days, maybe not for myself but for the other person I hurt at work. In our case workcover contacted me within minutes of my sending them our cardio's letter by fax. and 2 days later asked back to employment office, when we presented the red carpet was rolled out for us after we gave our names, and we were escorted into the manager's office. Ever get the feeling somebody got their butt kicked.
    • susie74530
      susie74530 lyn1951

      Posted

      Bravo - good for you!  That's one in the rear end for these jumped up little bureaucrats, who are lacking grey matter, common sense and good old fashioned compassion.

      Best to you both,

      Susie

    • lyn1951
      lyn1951 susie74530

      Posted

      Susie -  in australia workcover is a quasi government office, as is centerlink, all funded from the same taxpayer source.  Would have loved to have been a fly on the wall when manager who I had spoken to at workcover had rung the centerlink office to find out what the hell was going on. It seems turning loose one Govt Dept on another, especially when you are quoting the approprate part of the act at them has results, I had worked in a big office previously and knew the self reporting clause was there in the act of parliament. Also and I assume the idiot that told us my husband was going back to work, as far as she was concerned, was the same one who rang our GP and questioned his qualifications, much as I dislike the man, not recommended in his case, again just wish I had been a fly on the wall, I ended up laughing at him/with him,  when he told us of his converstion with centerlink, he must have been having a good day to share that with us, because he was such an oyster otherwise, I always had to treat him with kid gloves. Interesting I found out afterwards that our GP was the one they sent doubtful claimants too when they had doubts they were geninue.
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