Today I chatted with my Rheumatologist and he assured me that he's never heard of anyone rejecting prostheses due to Lyme. Also, he said that my hip is going to continue to deteriorate and that perhaps it's better to go ahead with the surgery now while my leg is pretty strong. If I choose to wait a while, I'll continue to get worse and the resulting muscle imbalances will take longer to correct.
So-- there's yet another opinion. Mind you, he didn't examine my hip or look at the MRI or x-rays. This was just the conversation as it pertained to Lyme and the surgery. Dr. V. wanted me to ask the Rheumatologist if people reject the prostheses because Lyme affects the auto-immune system, and also if I would have any difficulty healing because of the Lyme.
BTW, the answer to the latter is that I won't have "trouble" per se, but folks with Lyme do heal more slowly.
Just one more opinion to throw in the stew pot. :)
Monday, July 21, 2008
Did I Mention?
I forgot to mention that not only did Dr. S arrange his schedule so he could spend time with me and Dr. V during the consultation, he is going to assist on my surgery.
Man! Talk about caring. I am so blessed. It brings me comfort to know that not only did Dr. S not just hand me off to someone else initially, he's going to see this case through.
Of course I realize that because this is somewhat uncharted territory he's learning, too, but I appreciate him caring enough to learn so he can help others in the future.
Man! Talk about caring. I am so blessed. It brings me comfort to know that not only did Dr. S not just hand me off to someone else initially, he's going to see this case through.
Of course I realize that because this is somewhat uncharted territory he's learning, too, but I appreciate him caring enough to learn so he can help others in the future.
Friday, July 18, 2008
Still Sittin' On The Fence
Hi again. Well, the trip to Portland went smoothly. The flight was good, on-time, and the rental car was fine. Heck, there wasn't even much traffic on the way to the doctor (it's about 30 miles away).
When I got to the doctor's office I was about 30 minutes early but they took me right back anyway, stating that the doctor said he was was back from lunch and ready to roll if I got there early because he wanted all the time possible with me.
My first impression was a good one. I'd never met this surgeon (Dr. V) before, I'd only been to Dr. S, my surgeon from 5 yrs. ago and his associate who referred me. Dr. V is a pretty cautious man, I can tell, and I liked him a great deal. He did a thorough exam and we talked for a long time. I'm very blessed because Dr. S arranged his schedule so that he could come in the exam room as well. That gave me comfort. It's not many doctors who stay on the case after they bring in another specialist. I'm so used to being passed off like a defective football, it was a rather pleasant surprise!
Here's the situation with my hip-- at first glance on the x-rays it looks relatively normal. The joint spacing isn't bad-- a bit tighter on the left (the bad hip) but all in all, not bad. Certainly not a radiographic hip that would make you think that I'm in terrible pain at all. However, when you look a little closer it makes you go "hmmmm" and scratch your head because it does look a little odd. That's where the MRI and arthrogram come in. I do have another labral tear that's likely caused from the delaminated cartilage on the head of the femur rubbing against it in a very irritating way. Translation?
The head of the femur is rough (from Lyme arthritis which acts like osteoarthritis attacking the joint) and that's catching on the soft cartilage of the acetabular labrum (this is the cartilage that "holds" the head of the femur in place).
I also am "blessed" with severe inflammation-- which is like Rheumatoid Arthritis-- in the joint capsule itself (also from the Lyme). The synovium is really riled up.
So, put the arthritis, inflammation, labral tear, and cartilage delamination all together and what do you have? Yep, a mess.
So, the docs tell me that they like to have the probability of a 90/10 success before they sign off on a THR (Total Hip Replacement). I don't have that, however, they feel that I do have a better than 50/50 chance of getting better. Because Lyme arthritis and THR is an area they've never ventured, they can't promise any better than that. But, Dr. V is a very, very cautious man and the odds are probably much better than 50/50, but because he's cautious he doesn't want to make any false promises.
We don't know how the Lyme will affect healing, the acceptance of the prostheses (because Lyme is an auto-immune problem), or whether it will take away any pain other than what is directly in the joint or not.
So, I'm sitting on the fence, feeling like it's *probably* going to work, but I'm scared it won't. Everyone keeps telling me that with the MIS (minimally invasive surgery) I'll heal quickly and there will be no problems. But, of course, this comes from people who #1 don't have Lyme, and #2 haven't necessarily had a THR.
I'm going to pick the rheumatologist's brain tomorrow. :)
For now, the surgery is scheduled for 9/11/08, but I'm still sittin' on the fence. I have time to continue my research and chicken out if I want to.
When I got to the doctor's office I was about 30 minutes early but they took me right back anyway, stating that the doctor said he was was back from lunch and ready to roll if I got there early because he wanted all the time possible with me.
My first impression was a good one. I'd never met this surgeon (Dr. V) before, I'd only been to Dr. S, my surgeon from 5 yrs. ago and his associate who referred me. Dr. V is a pretty cautious man, I can tell, and I liked him a great deal. He did a thorough exam and we talked for a long time. I'm very blessed because Dr. S arranged his schedule so that he could come in the exam room as well. That gave me comfort. It's not many doctors who stay on the case after they bring in another specialist. I'm so used to being passed off like a defective football, it was a rather pleasant surprise!
Here's the situation with my hip-- at first glance on the x-rays it looks relatively normal. The joint spacing isn't bad-- a bit tighter on the left (the bad hip) but all in all, not bad. Certainly not a radiographic hip that would make you think that I'm in terrible pain at all. However, when you look a little closer it makes you go "hmmmm" and scratch your head because it does look a little odd. That's where the MRI and arthrogram come in. I do have another labral tear that's likely caused from the delaminated cartilage on the head of the femur rubbing against it in a very irritating way. Translation?
The head of the femur is rough (from Lyme arthritis which acts like osteoarthritis attacking the joint) and that's catching on the soft cartilage of the acetabular labrum (this is the cartilage that "holds" the head of the femur in place).
I also am "blessed" with severe inflammation-- which is like Rheumatoid Arthritis-- in the joint capsule itself (also from the Lyme). The synovium is really riled up.
So, put the arthritis, inflammation, labral tear, and cartilage delamination all together and what do you have? Yep, a mess.
So, the docs tell me that they like to have the probability of a 90/10 success before they sign off on a THR (Total Hip Replacement). I don't have that, however, they feel that I do have a better than 50/50 chance of getting better. Because Lyme arthritis and THR is an area they've never ventured, they can't promise any better than that. But, Dr. V is a very, very cautious man and the odds are probably much better than 50/50, but because he's cautious he doesn't want to make any false promises.
We don't know how the Lyme will affect healing, the acceptance of the prostheses (because Lyme is an auto-immune problem), or whether it will take away any pain other than what is directly in the joint or not.
So, I'm sitting on the fence, feeling like it's *probably* going to work, but I'm scared it won't. Everyone keeps telling me that with the MIS (minimally invasive surgery) I'll heal quickly and there will be no problems. But, of course, this comes from people who #1 don't have Lyme, and #2 haven't necessarily had a THR.
I'm going to pick the rheumatologist's brain tomorrow. :)
For now, the surgery is scheduled for 9/11/08, but I'm still sittin' on the fence. I have time to continue my research and chicken out if I want to.
Monday, July 14, 2008
The Journey Begins
I've been researching this hip thing and the only blogs I've come across are ones that were done with the old school style of surgery. That is, with the huge incision, cutting of muscles, and long recovery periods. My surgery is going to be MIS (minimally invasive) so I won't have to face so many of those challenges.
I thought I'd start a blog to help others who might be facing the "great unknown" AKA hip replacement at the young age of 40 (and a half!). It's not all that common to have a THR (Total Hip Replacement) at such a young age, but it's also not unheard of. From what I've learned, the younger you are, the more revisions (more surgeries) you may have to face as you age. Why? Simply put, the parts wear out. But, hey, my original parts have worn out, too, so I may as well get new ones. Right? If I can get a few years of relief from prostheses, I think it will be worth it, even though I'm terrified at the prospect of going through this.
So-- what got me to the point of considering a THR? I've been having hip pain since I was about 7 years old. Why? Who knows. But I remember always struggling to participate in Phys. Ed. class, running was out of the question. Sure, I'm a klutz by nature, but the pain/discomfort far exceeded my limited athletic abilities. I always felt like a goofball-- rather like a crippled platypus trying to vault over a hurdle -- but couple that with shooting, throbbing pain, what 7 y.o. girl is going to really put herself out there? Yeah, I was always picked last for the team in school, but can you blame anyone?
Fast forward to me at age 35-- still struggling with hip challenges. By that time I'd been diagnosed with Chronic Late-Stage Lyme Disease which means I struggle with chronic pain every single day. But the hip? Yowza. It was worsening. Finally I was diagnosed with a tear in the Acetabular Labrum. The only surgeon who was able to help me with that was over 300 miles away so my DH and I traveled to see him multiple times. The Doc was able to remove the torn areas of the Labrum via an arthroscopic procedure. That helped for a good 2 years, but then things started going down hill again.
I was diagnosed with arthritis in the joint after that, but it was never quite bad enough to do anything about. However, over the last 10 months things have gotten even worse in the hip.
I went back to my surgeon (300 miles away) last month and he said that he felt I needed to have a THR. So, in 2 days I'm going back up there to meet with him and another surgeon to see if we can map out a course of action. I'm more than a little worried about all of this so I'm going to whine a little in this blog (yep, you've been warned! LOL), and try to share the experience with you.
I have read some other blogs, as I've said, and the folks chronicled their post-op journey. It was fascinating reading, but because they had the traditional surgery, recovery was a lot harder, more painful, and took longer. I would LOVE to read a journey that more paralleled my situation. Since I can't find one, I'm doing this for all those folks who are facing a MIS THR (that looks like a license plate, doesn't it?). Maybe I can help someone else through sharing my experiences.
So-- the next post will be after I meet with the surgical team. See you then!
I thought I'd start a blog to help others who might be facing the "great unknown" AKA hip replacement at the young age of 40 (and a half!). It's not all that common to have a THR (Total Hip Replacement) at such a young age, but it's also not unheard of. From what I've learned, the younger you are, the more revisions (more surgeries) you may have to face as you age. Why? Simply put, the parts wear out. But, hey, my original parts have worn out, too, so I may as well get new ones. Right? If I can get a few years of relief from prostheses, I think it will be worth it, even though I'm terrified at the prospect of going through this.
So-- what got me to the point of considering a THR? I've been having hip pain since I was about 7 years old. Why? Who knows. But I remember always struggling to participate in Phys. Ed. class, running was out of the question. Sure, I'm a klutz by nature, but the pain/discomfort far exceeded my limited athletic abilities. I always felt like a goofball-- rather like a crippled platypus trying to vault over a hurdle -- but couple that with shooting, throbbing pain, what 7 y.o. girl is going to really put herself out there? Yeah, I was always picked last for the team in school, but can you blame anyone?
Fast forward to me at age 35-- still struggling with hip challenges. By that time I'd been diagnosed with Chronic Late-Stage Lyme Disease which means I struggle with chronic pain every single day. But the hip? Yowza. It was worsening. Finally I was diagnosed with a tear in the Acetabular Labrum. The only surgeon who was able to help me with that was over 300 miles away so my DH and I traveled to see him multiple times. The Doc was able to remove the torn areas of the Labrum via an arthroscopic procedure. That helped for a good 2 years, but then things started going down hill again.
I was diagnosed with arthritis in the joint after that, but it was never quite bad enough to do anything about. However, over the last 10 months things have gotten even worse in the hip.
I went back to my surgeon (300 miles away) last month and he said that he felt I needed to have a THR. So, in 2 days I'm going back up there to meet with him and another surgeon to see if we can map out a course of action. I'm more than a little worried about all of this so I'm going to whine a little in this blog (yep, you've been warned! LOL), and try to share the experience with you.
I have read some other blogs, as I've said, and the folks chronicled their post-op journey. It was fascinating reading, but because they had the traditional surgery, recovery was a lot harder, more painful, and took longer. I would LOVE to read a journey that more paralleled my situation. Since I can't find one, I'm doing this for all those folks who are facing a MIS THR (that looks like a license plate, doesn't it?). Maybe I can help someone else through sharing my experiences.
So-- the next post will be after I meet with the surgical team. See you then!
Subscribe to:
Comments (Atom)