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Total hip replacement injury pain vs surgical pain….

by Kathleen Mosko February 4th, 2012

http://kathleenmosko.com/total-hip-replacement-injury-pain-vs-surgical-pain/

Hi Everyone!

It’s me, your food for thought gal! I told you I was going to get back to writing…. I wasn’t kidding… I’ve got a lot yet to say, so get a cup of coffee, you may be here a while! LOL

You can scroll back in my archives and read the “real time” version of my total hip replacement in the May and June 2011 and beyond posts. Here I’ll be dealing with just the issue of pain. The before and after.

This is part two of the injury vs pain saga… as promised, I was going to attack it the same way I got the surgeries, except I felt the ACDF should come last because there’s so much more to talk about with it. So that’s forthcoming in a little while.

Today I want to tackle the total hip replacement I had done.

At my six week checkup after my ACDF with Dr. Smith, I told him Iwas still having trouble with my hip popping out of it’s socket. I reminded him we talked about having it looked at once I was done with my ACDF. He agreed that was next on the to do list and gave me a referral to Dr. Michael Crovetti, a top orthopaedic surgeon who does only hips, knees and shoulders. I was kind of in a hurry to get it taken care of because I was closing in on the end of my insurance year, June 30th. July 1st started a new policy year, and a new carrier which I’d been warned the type of coverage was going to be much different than what I had. (Why does good health always boil down to the insurance companies? WHY?) (see my earlier post about “Critical Information….)

As I waited in Dr. Crovetti’s exam room I was struck by all the informative material and up to date equipment he had for the patient. His assistant was very pleasant and knowledgeable as we sifted through all the pre-exam questioning. She had already downloaded my x-rays onto a computer screen cuing it up for the doctor.

With his hand already extended to me as he walked through the door, this very pleasant doctor introduced himself and immediately took charge, firing questions at me in rapid pace. I hesitated with a few and he waited to allow me the time to collect my thoughts, not in a hurried, “come on let’s go, get the answer out, I’ve got a hundred more patients to see kind of way,” but relaxed and ready to answer the question when I finally asked. It was “Bring Your Daughter to Work Day” and Chelsea was sitting quietly taking in the whole experience of her dad interacting with me. I certainly didn’t mind her being there, how else are children going to learn if we don’t take the time to teach them? I thought it was cool she was there!

What wasn’t cool was how unglued I became when he told me I needed to have surgery. In one of my earlier posts I describe in detail how upon hearing that, for the first time ever, I broke down in tears in front of my doctor. He was so reassuring to me as he said, “It’s ok for now, I’m not trying to rush you into anything. It’s just that sooner or later you’re gonna have to have the hip replaced.” I know he wasn’t rushing me, it was the damn insurance company that played the biggest role in my decision to have it done and11 days later I was under the knife again! That was the end of April and I wanted to wait until after Mother’s Day which fell on the 8th that year, my surgery was the 9th.

My injury wasn’t per se an obvious one. It probably had more to do with the fact that my body for years had devised a way to compensate for my back deformity. Because my back was so far out of whack, it put my hips out of whack, and also my knees and feet. For 28 years I wore prescription orthotics in my shoes. (I’d given up ever wearing sling back shoes or for that matter even just stylish shoes let alone fun kicky styles! Little by little, I’d started dressing like my mom for health reasons.) By the way, I pitched them the day of surgery and have started amassing only “stylish & cute!” And because I can now wear heels I have some pretty darn cute shoes!

As my back became more deformed, my hip adjusted to the pressure and angle I was placing on it. One day it started popping out of it’s socket, and that was excruciating!  I was fine until that would happen, but when it did, I couldn’t walk for days, even to go potty! Bone on bone rubbing against one another, well, there’s just no other pain I can describe to liken it to. I did struggle to the bathroom and little by little it became more tolerable as the laying down provided me relief. Sometimes I was good for weeks and other times it would pop out every day or every few days for weeks on end… I just learned to live with it.

But, I knew it would eventually have to be corrected and when Dr. Smith said what he’d done wasn’t enough and it was still popping out of it’s socket, I had no choice but to see Dr. Crovetti to have the hip replaced. He did say it would only get progressively worse. It didn’t take but a few moments to compose myself long enough to allow my reasoning to kick in. I was in a win-win situation financially because there was no co-pays left. My major medical deductible had been met long ago with the first operation, this would be covered at 100% with no co-pay! If I waited longer for my ACDF to heal further, it would have put me into a new physcal insurance year and a way different policy. There was no time to delay. I called Dr. Smith’s office to inform them of my pending surgical date. I just left a message, it was more a courtesy call to keep him informed.

The Coronado Surgical Center is a private facility which is owned and operated by Dr. Crovetti. Because his name is on it, I was confident that was the most sterile environment I could be in. A lot of things can go wrong in a hospital but the worst of all is if a patient contracts MRSA. I know someone who’s got his name on the business itself is going to take every precaution to facilitate cleanliness in a whole new way. I’m sure that Dr. Crovetti doesn’t want to ever jeopardize his years of training and his volume of investment into something he would take so lightly as a sterile environment. You could eat off their floors! His staff was awesome, young pleasant and very personable! Make no mistake Dr. Crovetti is as competent as they come! I was so at ease. He walked in to my surgical prep area to speak to me just before he operated and afforded me the fact that he’d already spoken to Dr. Smith just moments before. Dr. Smith ROCKS! He was tracking me even though I had no idea!

I can only imagine what transpired during that phone conversation right before my surgery between the two docs. I wonder if Dr. Smith filled him in on me not wanting anything too harmful in the way of drugs and that I was also a singer and to take it easy on my throat with the airway since it was only seven weeks prior I had the ACDF? I’ll probably never know what he said.

Dr. Crovetti told me what to expect and that I’d be up in about three hours after surgery walking… and I was… he doesn’t want blood clots or any unnecessary problems so they get ya moving ASAP! Sure enough, three hours after I returned to my room, they had me dress in the comfy street clothes I’d brought and I got up to walk. Mind you, I had an external pump inside a fanny pack they attached to me while I was under. In it was a balloon-like bulb with a regulator to administer pain killers right to the area of the operation. It was really pretty cool.

That actually limited the amount of oral pain killers I had to be on because it was  being administered right to the sight of the trauma. New technology is AWESOME! This bulb of meds would decrease as the three days Iwas there went by to the point that on the third day, it would be removed right before discharge. I didn’t really need much pain medication by the end of the second week and took myself off it midway through the third week.

HOWEVER, I never deviated from taking my 325mg of aspirin, used as a blood thinner instead of Warfarin or some of those other more powerful drugs with lots more side effects. Dr. Crovetti likes taking the path of least harm approach, and boy am I glad of that! I also wore my compression socks like a religion at home to avoid any possibility of a blood clot. I did BOTH OF these “at home treatments” for the extended period of 30 days, just like Dr. Crovetti ordered. (and then some with the aspirin, see an earlier post that talks about my DVT’s)

I was shocked at how well I was walking after the two weeks and by my checkup, Dr. Crovetti came into the room saying, “I was watching you walk down the hallway and I can’t for the life of me understand why you’re still with that walker!” To that I replied, “Because I do everything my doctors tell me to do and you told me to use it until my appointment today!” He told me I could leave without it, so I dropped it off downstairs where I’d borrowed it from, walking out a free woman!

I still had a lot of stiffness in the hip muscles, remember this wasn’t the first time these muscles were stretched. When I had my XLIF procedure those very same muscles were stretched, pulled out of place because of how Dr. Smith entered my side. Yeah, it was the same side! At least I have one whole good side! LOL The technique Dr. Crovetti used was a minimally invasive procedure. My scar is only about 4 or 5 inches long. Again, all my surgeries were minimally invasive and I wouldn’t have had it any other way! They damage less of the body in order to correct the problem! Instead of cutting through all the muscles, minimally invasive is performed by retracting your muscles leaving them stretched but all in tact causing less recovery time.

As I did my walking the way Dr. Crovetti told me to do and the additional physical therapy paces I was put through, the muscles loosened up. I was on a mission, and time was short.

You see, I had thrown down the gauntlet with Dr. Smith. He had until August 1, 2011 to get me well enough to go to my class reunion and wear 3″ high heels. That date was fast approaching and I needed to speed up my recovery. This was very much an unplanned surgery, but both Dr. Smith and Dr. Crovetti felt my goal was still doable. I held them and myself to the task.

The hardest part for me is the clicking of the one longer muscle that runs along the outside of my thigh. I still have it when I go up stairs and I’m now 9 months post-op, though not as much as when I first started rehab. I found that sitting down and getting back up strengthened that outer muscle if I did the sitting without using my hands or to boost myself. At first I still had to use my hands to boost but it eventually got less and less, testing every so often to see if I really needed the extra help.

Eventually that muscle was strong enough I could sit and stand without any hands and I can now walk up stairs without using the railing. But that’s only come in the last month or so. I still have a slight burning sensation at the scar, but I do believe as time wears on, that will wear off. My biggest concern is that sometimes I get a deep muscle burn, like when you overuse a muscle, but I haven’t done anything to aggravate it. That’s when I get up and do some approved leg exercises and it relieves that burning sensation. If I sit too  long in one place ( at my computer LOL) I can feel the strain on my butt muscles too. It’s not really a pain per se, but rather just an uncomfortable feeling letting me know I’ve sat too long and need to get up and be active for a while! That’s when I usually play with Candi our little bunny!

I have to share with you here that I know I’m one of the lucky ones. First that I had the fabulous doctor I did in Dr. Michael Crovetti. The man who cared what the rest of my life could be, once he fixed my hip. He was a high school and college athlete whose career in sports was cut short by an injury. I do believe it was then, he said, he chose to dedicate his life to others as a doctor helping other athletes recover from similar injuries.  And secondly, that Dr. Crovetti feels compelled to return a person to the highest level of activity possible, because of his progressive, innovative techniques of operating on patients.

TAKE NOTE OF THIS PART!!!

I was writing about my hip surgery healing on my website when in July a man from Australia contacted me about the post I made “Answers for those looking to have or have had an XLIF, ACDF, OR TOTAL HIP REPLACEMENT…” He contacted me initially to comment on how much I’ve gone through and recognized it was with great struggle.  He also shared with me his struggles with a botched total hip replacement and invited me to view his website. https://earlsview.com/ I was absolutely ASTOUNDED at the amount of research this man has put into total hip replacements.

If anyone out there is in need of current information about total hip replacement, I STRONGLY URGE YOU to visit his website. Read everything on it! BEFORE you make your final decision on what type of prosthetic your doctor will use. IF YOUR DOCTOR DOESN’T OR WON’T USE THE ONE YOU CHOOSE, FIND ANOTHER DOCTOR!!! It’s YOUR body, not theirs! Earl has done all the research that’s up to date you’ll ever need because he continues on his mission even after a hip redo in September that had some really aweful repercussions with his body… also, read the stories from other hip replacement patients. BE FULLY INFORMED before you have this done!

Earl is by far the LEADER on the internet with his website https://earlsview.com/ He has compiled the most comprehensive research for all the different types of medical devices used for hips in major countries! I could never do the justice of the total hip replacement as well as Earl has. Over the months I’ve grown to know him and his character, and he is certainly a man of integrity, one who is able to sort through the biases and just give you good information, although, I must say, just by reading his research, I can tell you, you can form your own bias without anyones’ prompting! I can assure you, his motivation was at first purely personal as he wanted to do it right the second time, which should have been done right the first time. Earl’s educational background gives him an edge on his broad understanding about such matters. He has a PhD in Biochemistry, a good solid understanding of things organic.

I personally have a ceramic hip, chosen by my doctor because he shared they’ve been testing it now for over two decades and he can’t tell me when to expect failure, because so far, not one has failed that’s been implanted! I so appreciate my doctor!

I also don’t think I’ve shared with you that my mother had a total hip replacement in the 70′s. Things were much different then. First, after her surgery she wasn’t allowed out of bed for 2 weeks. And, because of the “goo” they used to line the socket with, she was told not to walk on it for a certain length of time, which she dutifully obeyed. Well, her doctor not knowing her as a person, decided to put extra goo in so when she cheated and walked on it it was set to what he thought would be the proper height. She didn’t cheat and she had way too much goo in her and it set higher. From then on she had to wear a lift specially made to her other shoe so she could walk without a limp. My how times have changed! I’m glad Dr. Crovetti is good at math because they use all kinds of math for the correction, or should I say in some cases there’s a machine which puts your leg into a particular position as he inserts the devices. It’s really cool science if you’re into that kind of thing! More awesomeness through modern technology and innovation! AMAZING!

Anyway, that is what I’ve been wanting to share with all of you about total hip replacements. Mine was a great experience, you can read about it further back in my archives but know what you’re getting into. This is one time you get to really call the shots, at least to a degree. Make an informed decision, trust your doctor to work “with” you on this decision. If he doesn’t want to, it may be because he can only do hips one way well. FIND OUT!  There ARE several ways to have a total hip procedure, not all are right for everyone!

I have no pain at almost 10 months post-op, just a slight discomfort I’m sure will go away as I do more living! I knew it would be hard for me to relate to others going through the need to have a redo of your hip replacement and I’m so glad my dear friend Earl Stevens from Australia has taken the time, and made the effort to concentrate all the information you could ever want about total hip replacements at one site! PLEASE VISIT HIS SITE AT https://earlsview.com/

My next post about pain will cover my ACDF post-op pain vs my surgical pain of which I’m almost 11 months post-op for that. That one promises to be a long one so you might want to prepare yourself with a thermos of coffee! LOL

In the meantime, remember to take care of you and yours,

hugs,

Love,

Kathleen

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