PMR & OA

Thanks Nefret.  I know the arms and wrists are PMR (they were the worst at the very beginning of my journey) and I know knees and ankles are OA,  also the fingers,  it's the hips I can't make out.  I never know whether to reduce the Pred or take a pain killer!!!

Sorry to hear about all your operations.  I'm lucky, so far, operations are something I would find difficult to agree to.

I read it wasn't easy to get joint ops for patients over 75 in England, is that not true?   I have't been to England for 3 1/2 years.  I do miss certain things but I can't stand the thought of the journey.  Could fly, of course, but then we would have no car.  My husband is 80 so he would find it difficult to hire a car (again, so I have read)!

Ah well!  Onwards and upwards in 2016.  Can you tell me what happened to 2015?  Even with PMR and other difficulties time just seems to fly by.  I used to laugh when pensioners said they had no time.

I think you are correct about the car hire. I  am aware of someone from Canada being unable to hire a car over the age of 70 although that was a few years ago now so that may have changed. I know of people who have had hip replacements aged over 75 in Scotland but I don't know about England.

I'd see doctor/rheumy about the hips as it may be possible to do a steroid local jab - I had two before my op and they did make it easier for several weeks.  I don't know about the over 75 limit, I was done and dusted in a few weeks and I'm 71.

I'd also like to know where 2015 went - apart from the hip, it seems to have disappeared without a trace! I also have no time to do anything, the days flash past and I have difficulty catching them.  With me it seems to be a case of onwards and slightly sideways.........

 

If you read that in the print media it was probably the anti-NHS lot on their hobby-horses. They say a lot of things that aren't true to scare the living daylights out of the elderly.  Betty, who used to be on this forum and lives in East Anglia, was 80 when she had her hip replacement. The ops are given to those who need them AND would benefit from them. If you are over 75 and already severely immobile for whatever reason there is a question to ask as to whether you will manage the rehab or if it would make a positive difference to your QOL. If a patient is in reasonable health and considered likely to be able to do/be compliant with the rehab they will get a joint replacement. It also depends on their comorbidities - there are things that would rule out such a major operation. 

In your case Constance you need a proper investigation - hip imaging of some sort to see if it is bursitis or OA that is causing the problem. Then you will know if it is OA. Then it will depend on the surgeon when he wants to do the op - they usually wait until it is pretty bad for obvious reasons. As I understand it there are various options in Germany depending on the severity of the damage with partial as well as total hip replacements. Cologne must have a good orthopaedic department surely? Or there must be a specialist clinic local to you?

The Betty I mentioned felt that the pred helped the OA in her hands. It didn't do much for the hip. Nor did it do much for 50sgirl's hip OA. Her GP fobbed her off with "they won't consider you for years, you're far too young" - but when she had a single private appointment (at our urging I might add) the surgeon was perfectly willing to get on with it. Hips are done on the basis of need, not age. Either way round.

Thanks Nefret/Eileen.  I had an X-ray on my hips 18 months ago.  I asked if I could have another one last month (my Rheumy!!) as my hips are getting worse.  The Rheumy said "no point yet", so I presume he thinks you can't deteriate enough in 18 month!?!  Perhaps he's right, I'll stick to swimming instead of walking.

Then ask your GP for a referral to an orthopod. A friend of mine had her hip deteriorate in a matter of a few months - and it doesn't matter what the x-ray says really, it is the symptoms that count. Some people have bne on bone and are still coping, others are in agony much sooner. But whatever you do - do NOT play down the symptoms! I'd maybe accept that sort of comment from a hip specialist - but no-one can see through skin and bone so I'd want to see the evidence.

Is there still that silly system that the first doctor you see in a quarter is the referring partner for the rest of that quarter? 

This is from a site called arthrolink punkt com, the osteoarthritis website:

"This loss of cartilage evolves in 3 clinical forms:

- a slow and progressive deterioration over several decades;

- or, conversely, a very rapid deterioration leading to loss of cartilage in 12 to 24 months (this is known as rapidly destructive osteoarthritis;

- or an intermediate form in which the evolution is punctuated by periods in which the osteoarthritis evolves very quickly and other periods, on the contrary, when the osteoarthritis does not evolve or evolves very little.

Osteoarthritis does not evolve uniformly, it is unpredictable. It can remain silent for a long time and not manifest itself even though the joint looks very damaged on the X-ray. But it can also worsen rapidly over several weeks or months at a stage when the X-rays are almost normal. It is this imbalance between pain and radiographic osteoarthritis which makes it difficult to understand and evaluate."

So - your rheumy is wrong...

 

Last paragraph, I'm not sure.  That was true at one time.  I went to the dentist and then needed a referral to a Urolgist!  However, I see my own doctor once a month and I always get my referrals through him now.  Must check that out!

If I have any real problems with hips I'll go private - at least for a consultation.

Have a good butchers at that link I suggested - it has good info about OA. Just google the name of the site.