Stretching Exercises Pre Op

Hi Cathie:

The physio exercises were designed to prolong use of my hip, and maintain, at least, some degree of flexibility.  I have noticed that my right leg, which is the one that is affected, turns out slightly toward the right.  It has always been like that, and it is a worry, as I am not sure how the surgeon will handle this.

So far as hip pain is concerned, it is not chronic.  However, I cannot stand for long periods of time without pain.  I cannot walk very far without pain, and limp very badly. The hip collapses on meform time to time, and is obviously unreliable.  Certain movements of the hip joint cause intense pain.  But, I am unsure why you would want to know this. Perhaps there is some sort of slide rule of agony that I have to reach before surgery is considered to be appropriate?  

Maybe it is because I have been very religious about keeping up with the exercises, that I am not in excrutiating pain, and do other exercises, such as push ups as well.  

Maybe I am not "entitled" to hip surgery, because my pain is not excrutiating?  However, I have had three sets of xrays, each one worse than the previous.

I was initially diagnosed with degenerative osteo arthritis in San Francisco in l987,some 28 + years ago, and was aware of problems with my right leg, well before that.  San Francisco is built on seven hills, and so I got a lot of exercise, and I was running over seven mles a day,

At age 74 years, I am in relatively good shape, but certainly unable to undertake any cardio vasular workouts because of the hip, which is why I am doing all I possible can to keep the muscaluture around the hip and my leg well worked.

Regards,

Susie

 

I asked how bad your pain was because I did not

know how bad your pain was. I am glad you are coping.

I have no idea what criteria the consultants use re operations,

people's experiences vary so much.

Cathie

Hi Cathie:

Yes, that is what I am finding.  What is so unclear is why some people experience more pain than others.  The only suggestion tht has been made so far, is that the GPs either wait too long before referral, or the patient waits too long before addressing thie wonky hip, by which time, they are in so much pain, they have to see the "doc."  Fear of the "white coat" being one of the reasons people put up with pain until it is totally disabling.  

Probably a combination of many factors, inclding the infamous post code lottery for surgery! 

Best regards,

Susie

I think xray is the first step. Pain is usually why people

have xrays. It is often unclear if it is the spine, or

sciatica or bursitis etc,or osteoporosis,  and as a result patients

go down many different routes before they get an operation. 

The NHS appears to be very fair in most cases

Cathie

 

Hi Cthie:

I was first diagnosed with degenerative osteo arthritis in San Francisco in 1987.  Since then, I have had three sets of xrays.  In 2013, the xray showed moderate to severe arthritis, right hip.  I am awaiting the results of the third set taken last week.  My condition has deteriorated, and I am fully aware of where in my body the arthiitis is located and it is not bursitis or osteoporosis.  It is located in my right hip, without doubt, and it is severe.  My GP examined me recently, and that is when the decision for further xray was made, with possible surgery, was made.

Certainly no hint of osteoporosis as my bone density is high, and I have never broken a limb, and there is no history of limbs being broken on either side of the family.  My mother lived on until almost 99 years, and was healthy and strong when she died.  

My former partner was an orthopaedic surgeon, and he was the first person to diagnose me.  We formed a relationship post surgery.  He advised me of the arthritis in my right hip in 1987, and I have lived with it since then, until it is now requiring attention in the form of potential surgery.

 

Hi Cathie

When I read of people being in excrutiating pain I do feel almost guilty. my story began as a year or two of lower back pain and I was seeing a chiropractor but it was bearable just annoying, then in Oct 2014 I started to get pain down my right leg I went to my GP as I thought it was sciatica was treated for that but 3 months later was no better so I went back and happened to mention that it was very painful if I moved my leg sideways, she then sent me for a hip xray and recommended physio which I did for about 2 months and I was given an excercise booklet. As it was getting worse I went back to my GP and asked her to refer me to a consultant. 4 weeks later I saw the consultant and he said my hip was bone on bone and that I could have injections but that wouldnt last long so I would be better having the op. Luckily I get BUPA as part of my job package so a month later I had the op, I feel lucky that I was able to have this done so quickly and not have to wait years as I know it would have only got worse.

Hi Julia:

I had been seeing a chiropractor for a few years.  It helped for a while, as he was moving my hips around, but I am well beyond that, now.  I do recall, about six years ago, the masseur siad that my right hip was "sat."  I had no idea what that meant, until I realised that what he meant was that the arthritis had deteriorated to the point where there was no movement in the hip joint whatsoever, and I was walking from the lower back and pelvis.  It was from that point that I started having the exrays, although my former partner had advised me back in in 1987 that I was showing signs of arthritis in my right hip.  He ws an orthopaedic surgeon in San Francisco, and that is going back to 1987.

Hi Susie

When I had my daughter in 1980 at the age of 25 I was told my pelvis was tilted but didnt really think that was important. For years I had lower back pain which was chronic rather than acute so I just dosed up on painkillers if it got bad and although I had a few xrays over the years no one really diagnosed arthritis just wear and tear. 2-3 years ago I went to a chiropractor who said my spine was a bit crooked and after a few weeks of intensive manipulating I was going every month. It wasnt until I saw my consultant with the xray which was taken back in April that he told me my  pelvis was badly tilted and it was now bone on bone and had I been suffering from lower back pain!!

Hi Julia:

A genetic condtion can create problems all over the place!  I try hard to avoid pain killers as they mask pain, and I am one of those people who feels the need to know what my body is doing and why. 

My spine and neck are out of kilter, and I have visited a chiropractor for several years.  Unfortunately, I can no longer afford almost £250 a month on my pension.  The one thing I find with chiropractors is that they do not give a diagnosis or give a prognosis!  I have difficulty with that, as they are taking my money, but not giving me answers.  

In your final sentence you say that the consultant diagnosed the tilted pelvis, but said that it was bone on bone.  Was he referring to the hip joint?  If your pelvis was tilted, it would most likely have had a very negative effect on the way you were using your hip joints?

You have been put through a lot, and some ofit ay have been unnecessary.  My daughter has a problem with her lower back, but from what I understand, she has lost cartilege.  I am uncertain what the solution to that is going to be, as she is also experieincing sciatica from time to time.  Spines are not the easiest part of the body to operate on.  One of the orthopaedic surgeons at my former partner's practice in San Francisco travelled to Canada to have two or three vertebrae "Welded" together.  I guess, that in the profession, they know where the best man is for that particular type of surgery, and that's where they go.

Yes it was the hip bone sorry wasnt too clear on that haha. Yes I agree with you about chiropractor think I kidded myself it was helping and my husband thought I was mad spending £40 for 10 mins and although I am still working was a lot of money, My friend had her vertebrae welded a few months ago.

I have slight scoliosis as well my lovely nan had a hunchback due to it and my poor mum spent several years as a child in a leather corset to try and straighten her spine (it was in the 30s though) and she still has a slight hump, I think that is what caused my pelvis to tilt, My daughter is the same but it seems that each generation it has got less serious so hopefully my grand daughter wont have any problems.

Best wishes 

Julie

Hi Julie:

Unfortunately, these probems do seem to run through the generations.  I was a WW2 baby, but had a very strong and healthy Mother.  She gave birth to me at the age of 40, and then went on to have my sister at the age of 43, with no problems at all.  However, she said that she had a staff of no less than 10 doctors milling around her when she gave birth to me.  I guess they were very interested in how an older prima gravida would manage!

The only problem that I have other than the arthritis is a sensitive digestive system. To the best of my recollection, my Mother did not have a day's illness during her life, although as a child, she had Scarlet Fever.

She spent her final days in a nursing home, against my better judgement, and the staff were astounded that at the age of 98 she overcame not only flu,but the pneumonia that followed.  Within days, she was sittig up in bed talking very knowledgeably with one of her grandsons about football!  They do not make them like that, now!

Given the above, it is very much in my better interests, as I have not aged at the normal rate, to keep myself in as good nick as possible as growing old and being feeble and frail is not something I would wish, should I live as long as my Mother.    I know of a number of 80 to 90 year olds who are still jogging.  However, post THR low impact is recommended as high impact, such as jogging is not good for the new hip.   

So, we need to keep as nimble and "nubile" as possible!!  Difficult, as I do notice a stiffness that I need to remedy in some way.  I have put a lot of this down to the problem with my hip, but am determined to find a way through it,

All the best,

Susie

Hey Susie,

As far as pain goes, I think each person can have different amounts of pain based on how bad their hips are. Each person also feels pain differently too. Another thing about hips and pain is that we all don't have the same diagnosis. For example, I was diagnosed with Avascular Necrosis which is where the blood supply gets cut off to the bone (avascular) and then the bone dies (necrosis). They say that it is only second in pain to bone cancer and just as destructive. Anyways, I have now had both my hips replaced by the age of 38. I had the problem where both of my legs turned out like you have mentioned. When I woke up each time from surgery, I realized that problem was fixed. So I don't think you need to worry about that. When the new hips are put in, the leg is then properly aligned. With the flexibility of the hip. I could have done as many exercises as I wanted, but I would continue to lose my flexibility or range of motion due to the damage of the bone. Sadly, for my condition, they recommend to stop weight-bearing to help prevent any further damage. That's great, but having it in both hips, that wasn't really an answer for me. Susie, there is something that I have realized since I have been sick for the past 12 years and also working in the medical field, we should never compare ourselves to anybody else. Our bodies are unique to each of us, just as our problems with them are too.

How true, great advice there CanadianGirl.

You are so right CanadianGirl in all you say. The pain 

you have had has made you very wise..

keep battling on,

Cathie

Hello CC:

So far as pain is concerned, I agree with you completely.  The degree of arthritis is certainly going to influence the amount of pain we expereince, and there are added complications, such as those you describe, that is unique to your situation, and adds another element.

It does depend upon how each of us experience pain and our psychology forms part of that.  

What I have been trying to focus on, is why so many patients are describing situations where surgery is delayed until they are either walking bone on bone or restricted to a wheelchair!

Yesterday, I received the verbal results of my third set of exrays and will be posting on this later.

All the best,

Susie

 

I wonder if it's because of insurance. I got a copy of my report from doctor and he seemed real explicit explaining everything we did before I decided on surgery. Even though I was bone on bone I had the injection which did nothing, therapy which didn't help so I went with surgery. I am in US and use Blue Cross insurance and maybe these companies expect doctors to try other means, which to me is stupid but in saving money they spend more it seems.