Orthopedic Surgeon Assessment Of My Artificial Hip Joints And Knees
[ Monday May 27th 2024 at 12:35 pm ]
I will try to start from the beginning of the time I spent with the surgeon. I wrote a 2 page letter and faxed it just over a week ago. I explained the impact the pain is having on me, the concern I had that I didn't expect what I had what was needed to endure the teaching environment questions & physical examination and then asked for this specific appointment if it would just be the surgeon and I. The surgeon honored the essence of not involving me in the teaching environment. But he wanted one of his interns to be there while I was talking to him. I could tell by the surgeon's body language that he was asking me permission if I'd allow the intern to stay or was going to force him to leave the room. I was happy enough. With my right knee waking me up at 4AM, making me feel like I was going to puke for the following hour and not sleeping again until 5:50AM I am glad I did this. I needed to save my energy.
The surgeon had read the letter I wrote. He said he wanted to hear it from me but was understanding that I am not feeling great from how the hip is treating me.
I said I've read my MRI report from May 16th 2024. I saw that it eliminated a whole lot of what isn't wrong with my artificial hip. He agreed.
Then he said he wanted to understand the position that I discovered caused the hip to malfunction. I had drew 3 stick people while I was in the waiting room. I drew the position that I realized on 4/11/2024 triggered the hip, what happened on 5/11/2024 while playing a computer obstacle course game when the hip locked and didn't let go and the stance I was using to pick something up off the floor. His response was that this now makes sense. He spent 15 minutes explaining and answering my questions. The explanation of what is going on with my artificial hip was really interesting. In part it was a bit of a history lesson.
I have a ceramic on ceramic artificial hips. Just a few years before my first hip replacement surgery the artificial hip was made out of a ceramic and the socket was made out of polyethylene. The polyethylene is a slightly harder version of what food is packaged in (such as a 4 liter milk jug) with the "2" in the recycling triangle. The artificial plastic polyethylene hip sockets would wear down. If the patient didn't recognize this was happening the plastic bits breaking down would attack the pelvis and act like very aggressive sand paper on wood. It would start to cause erosion of the pelvis bone and create a real conundrum to help the patient get a new hip. In the midst of this medical crisis with the polyethylene hip sockets they went back to ceramic on ceramic hips.
After a few years in medical research they discovered if the polyethylene was heavily radiated at the molecular structure level it would change and became even harder than ceramic. With the molecular structure changed they just don't fail.
This leaves the group of patients who required hip replacement surgery and are left with a ceramic on ceramic hip. I read about this style of hip replacement before I was operated on. The noise I am experiencing is a rare side effect. Depending on which research paper you read 1 in 20 tall people experience this. But what is typical is some noise but not debilitating pain or the hip locking. Once again I've hit the jackpot in getting into the odds of what shouldn't happen but does. It has been this way for years.
I said to the surgeon for my own peace of mind I needed to ask a question. The surgeon in 2013 wanted to do a metal hip resurfacing surgery on me. Just a week before my medical appointment Health Canada issued an advisory again this. It was very strongly worded. The metal hip resurfacing had been rushed into use as a "miracle" treatment for young adults needing artificial hips. But metal was coming off them and causing blood poisoning. In 2012 I was part of a group for adults with the same hip disease I had that are now facing complications as an adult. One of the members had this metal resurfacing and got the blood poisoning Health Canada warned again. With the hip bone disease we both had hip surgeries are so risky. The concern is that the femur will shatter during surgery and then the patient is left with a world trouble. I didn't want anything to do with the metal version. I said to the surgeon today for my own peace of mind would you tell me if I made the right decision for myself. He said yes that I had made the right decision for myself. He was happy to explain (without naming patients) the trouble these metal hips have caused people locally. He has had to replace the metal version my surgeon installed on people because of what I've just described with their blood being poisoned with metal.
I listened to everything he had to say during this 15 minute explanation and answering my questions since I have the metal aptitude to understand. What I really like about this surgeon is that he thinks and reasons outloud. At this time the surgeon's opinion is that replacing the artificial hip will do more harm than good.
At the end of this I said to him "This is all fine and dandy. I don't mean to trump you. But I need to be able to go home and live my life." He wasn't wearing a face mask today. I could tell by his body language this wasn't what he wanted my concern to be. He turned the tables on me (so to speak). He said to me that you've found a cause, you've told me you are avoiding a certain position that triggers this and I need to know what you are in bad shape. I explained was able to slow the hip malfunctioning to every 4th or 5th day and the cycle is happening just frequently enough to keep me in a weakened state. In addition my knees were troubling me.
Then I said could I change the topic for a minute. He was fine with this. I said I wanted his help with my knees and that I reached the conclusion that the source of this was a knee issue. I explained to him that I had my right knee buckle for the 3rd time 4 weeks before the hip issue started. I said when this happens I've typically been taking it easy for about two weeks for my knee to recover. This causes some stiffness in my hips. Then in weeks 3 and 4 I get back my hips back on track. It just didn't happen this time when the knee buckled.
The surgeon thinks the tissues around my artificial hip got buggered up when my knee buckled. He has asked me not to bend over to pick anything up off the floor for several months to just let my hip joints as a whole (everything that makes up a hip joint) heal and recover. If I buy a stool that has a piston that allows it to raise and lower I think this is do-able. I have a reacher-grabber for picking things like a pen off the floor. This is far from ideal. But I do remember my hip reconstructive surgeries from 2007 and 2009. They took forever to heal. What he is saying makes sense to me. I am hoping it makes a difference. Based on what I endured from my 2007 and 2009 surgeries I can't in good conscience push back on this. He has heard me out, he has asked good questions. He has explained his thinking and reasoning out loud. In April's appointment he explained what didn't make sense to him.
Then he said he wants to help my hips by helping my knees. I did need help with my knees. I brought a single photo with me today. I showed him what the knees were doing at the time of the photo and where they are at presently. I explained that the damn knee woke me up at 4AM this morning and made me feel like I was going puke. He originally wanted a surgeon local to me to administer cortisone injections. When I explained the local surgeons to me want me treated at the teaching hospital associated with the university because what is wrong is complicated he chucked and then said he'd be willing to take care of my knees and see me again.
He asked if I wanted cortisone injected into one or both of my knee joints. Presently at the end of each day both of my knees have about ΒΌ cup of swelling. At this stage my knee issues are about equal and I can't name one over the other being worse. He told me to not make any conclusions about the cortisone before Friday. He hopes I'll get 6 to 9 months relief from it. I asked if he trusted me. He didn't think before responding. He said yes. Then I asked if he would trust my judgment on when I'd like to have my next appointment with him. He said yes. He said he used 4cc of local freezing, 4cc of cortisone and 2cc of air so he could confirm the injection went where he wanted it. Immediately following both injections he asked me to relax my legs and let him move them. They started making weird popping noises. He explained this confirms the medicine got where he intended.
While he was injecting the cortisone into my knees I said that I wanted to tell him face to face that I wasn't offended by the Privacy Officer of his hospital sending me a letter indicating the surgeon had made a mistake using implied consent instead of expressed consent when accessing my health care lab information. He explained this is a new system that has just been introduced. He was genuinely sorry for not having explicitly asking me for my consent to look up my patient chart in this system but he figured with the correspondence that happened in the few weeks before my appointment concerning the referral becoming lost and when I advocated for myself he was confident that I would agree to whatever he wanted to do with me. Finally concerning this he explained that he wanted to apologize to me in person and this is why he hadn't wrote his own letter that would be included with the privacy officer's correspondence to me.
Additionally I told him I was trying some container gardening this summer. I wasn't telling him this for idle conversation. I need the surgeon to understand this is all a means to an end for me. I really would like more for my life.
I've found this surgeon just as easy to talk with today as I did on April 10th. I really appreciate that he's willing to reason / think out loud. It is obvious he's realized my mental acuity needed satisfying and that the pain this damn hip is causing me has been very difficult to live with. I appreciated that he spent about 30 minutes with me today.