In May of 2007 at the age of 55, I underwent a hip resurfacing procedure in the right hip with fitment of a Smith and Nephew BHR metal prosthesis at Claremont Surgical in Cape Town, South Africa.  I had extensive and expensive rehabilitation and physiotherapy however I  never fully recovered and have suffered endless problems as follow:

• In 2008, my leg became swollen and the doctor fearing a thrombosis injected me with blood thinning medication.  I had a CAT scan which showed a bursar in the hip area which was collapsing the main vein – I then had a procedure to remove the liquid from the bursar but one week later the swelling returned.  I was advised to see a vascular surgeon who admitted me to hospital and inserted 2 stents, the first one collapsing under pressure from the bursar.

• In 2009 my leg again became swollen another scan showed the bursar had become tumerous and was pushing the vascular bundle against my pelvic bone and the stent had collapsed.  I was admitted to hospital where both orthopaedic and vascular surgeons operated – the stent being repaired and the tumerous mass being removed and the area around the prosthesis cleaned of debris.  The tissue was found to contain metal debris and I was found to be suffering from metallosis and an infection around the prosthesis.  I was put on a course of strong antibiotics to which I had a severe allergic reaction.  I was told no further operation on my hip was possible until this infection was cleared.  Since I can no longer afford the operation anyway I have not returned.

• From 2008, I was suffering from acute anxiety and depression which required hospitalisation and medication for several years.

• My one leg now being shorter than the other I have had stability and balance problems – unable to walk any distance because of pain and discomfort.  I believe this instability also contributed to a fall in 2010 and a second fall in 2011 – this time breaking my ankle.

• Lately I have noticed a marked deterioration in my sight as well as short term memory lapses and confusion with time lines.

I had no idea that all my problems mentioned above must clearly stem from the BHR metal prosthesis in my body, until reading an article in a magazine.

I would like to point out that besides the pain, discomfort and constant worry about what would happen next to my hip and the constant reminder because of the “clunk-clunk” when I move in certain ways, the time and the expense has taken its toll and today I have been unable to find a job and have neither pension nor savings nor medical aid as I am effectively destitute all being used to pay for the endless medical bills since my hip replacement.  I am now relying on my son for a living and am currently homeless, moving between various friends.

I approached a firm in South Africa who are involved in a class action against Du Puy.  They agreed to add me to the action as I did not realise there were a number of manufacturers of these prostheses – however on investigation they discovered I was not fitted with a Dupuy prosthesis but a Smith and Nephew “Birmingham” prosthesis. I subsequently went on line to find out what was being done to assist people who are suffering from the failure and after effects of this prosthesis in a case against this manufacturer as is being conducted against Du Puy and Johnson and Johnson.  I don’t see any cases being handled in South Africa and would like to ask your advice as to my next steps.

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Avoiding Arthritis-Related Depression and Anxiety

What you can do to keep depression and anxiety away when you’re dealing with arthritis pain.

By Marie Suszynski; Medically reviewed by Cynthia Haines, MD

The word arthritis literally means “fire in the joints.” No doubt, day-to-day arthritis pain will inevitably take a toll on your spirit. Almost everyone with chronic pain has mood changes, and about 30 percent become depressed, according to the National Pain Foundation. Depression, in turn, can increase arthritis pain. Similarly, the anxiety that dealing with a chronic condition can cause may negatively affect your perception of pain.

Here’s a rundown of anxiety and depression symptoms and what experts advise as part of your arthritis treatment to keep symptoms at bay.

Arthritis Pain: What Anxiety and Depression Look Like

Anxiety and depression that result from arthritis pain can take away your zest for life, but in different ways. Here’s how each of these conditions can present themselves:

Anxiety. “An anxiety disorder is a fear of fear,” says Mahmoud Ahmed, MD, a psychiatrist at Marshfield Clinic at Sacred Heart Hospital in Eau Claire, Wisc. “There’s an overwhelming feeling that something bad is going to happen. The person is preoccupied with unreasonable fear.” The anxiety can be generalized, from worrying about finances to relationships, or it can result in panic attacks. Some people with anxiety, when confronted with certain situations, experience severe physical symptoms, such as a pounding heart, or a sense that they’re going to die, Dr. Ahmed says. Having arthritis pain leaves ample room for anxiety. You may fear losing your job over limitations caused by arthritis, or you may worry that certain activities could increase your pain, like taking walks or playing golf.

Depression. When arthritis pain gets very bad, some patients have reported that it can feel “akin to a death sentence,” Ahmed says. When those feelings lead to depression, you may feel sad, worthless, helpless, hopeless, irritable, restless, and tired. You may find you’re not interested in some of the things you once did. You may have trouble concentrating and making decisions, find yourself eating too much or too little, or that you either can’t sleep or sleep too much. Some people with depression contemplate or attempt suicide.

Arthritis Pain: Avoiding Anxiety and Depression

Here are positive steps you can take as part of your arthritis treatment plan to keep anxiety and depression from taking hold of you:

Manage your arthritis pain. Anxiety and depression often follow chronic pain, so your first priority should be pain management, says Jackson Rainer, PhD, a psychologist who specializes in arthritis and dean of the graduate school at Gardner Webb University in Boiling Springs, N.C. A rheumatologist or pain specialist can help you find the right combination of medications and lifestyle changes to keep your arthritis symptoms in control.

Talk to a psychotherapist. Sometimes having arthritis pain leads to insomnia and to distorted thinking, Ahmed says. You may avoid getting together with friends because you don’t want them to see you when you’re irritable. Or you may not want your family members to see you when you can’t participate in your usual activities due to arthritis pain. A therapist can help change the way you think about arthritis so you can enjoy life, Ahmed says.

Consider taking an antidepressant. Research has found that taking a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant that helps your mood by allowing more of the neurotransmitter serotonin to circulate in your brain, makes pain medication more effective in certain patients, Dr. Rainer says. Rainer says he too has seen an improvement in his arthritis patients who take an SSRI along with a pain medication. SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro), fluvoxamine (Luvox) and citalopram (Celexa). Ahmed believes in being conservative in prescribing antidepressants, however, because every drug has side effects and could interact with other medications you’re taking. Work with your doctor in deciding if an antidepressant is right for you.

Get moving. Exercise can help to improve your mood and ease arthritis pain when it’s done within your physical limitations, so view it as an integral part of your arthritis treatment by exercising at least every other day, Rainer says. And choose activities that are comfortable for your body, such as water aerobics, swimming, tai chi, yoga, or simply walking short distances at a time. If you have more advanced arthritis, physical therapy can help keep you in motion.

Banish stress. Stress can add to arthritis pain. Ahmed advises his patients to remove as much stress from their lives as possible: try to get enough sleep, clear out an overscheduled calendar, and do what it takes to make your life simpler. That may mean accepting just 1 invitation instead of the 10 you receive over the holidays, and learning to say no when there are too many demands on your time.

Hang on to the things you love. Of course, your ultimate arthritis treatment goal is to lead a full, satisfying life. So, you might need to make adjustments to continue doing the things you want to do. If arthritis pain keeps you from playing 18 holes of golf, play 9 instead, Ahmed says. Rainer had a patient who wanted to continue working but arthritis pain in her hands made it too difficult to type on the computer, so she installed voice recognition software to cut down on the amount of typing she had to do.

Dr. Rainer’s patient wouldn’t let her arthritis pain control her life and neither should you. If you think you might be suffering from symptoms of depression or anxiety, let your doctor know. He or she can help you to get the treatment you need to feel well again.

Learn more in the Everyday Health Osteoarthritis Center.

Last Updated: 03/05/2009

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Arthritis Patients Often Have Anxiety and Depression Too

By ALEXANDRA SIFFERLIN | @acsifferlin | May 1, 2012 |

As if arthritis pain weren’t enough to deal with on its own, a new study finds that one-third of American adults with arthritis also suffer from anxiety or depression.

Arthritis affects an estimated 50 million Americans and is the number one cause of disability worldwide, according to researchers from the Centers for Disease Control and Prevention (CDC). Both depression and anxiety are common among people suffering from chronic disease, but while physicians know to look for signs of depression, they often fail to consider anxiety.

The new CDC study suggests that doctors pay more attention to anxiety symptoms, since they are actually twice as common in arthritis patients compared with depression.

The researchers surveyed 1,793 adults 45 years or older with doctor-diagnosed arthritis or other rheumatic conditions, who responded to a previous CDC Arthritis Conditions and Health Effects Survey. The team assessed the participants’ anxiety and depression based on their responses to emotional well-being questions from the Arthritis Impact Measurement Scales, such as: “During the past 12 months, have you sought help for stress, depression or problems with emotions?”

The researchers found that one-third of the survey participants reported having either anxiety or depression, and that 84% of the patients with depression also had anxiety. On average, 31% of the participants had anxiety and 18% had depression.

“People with arthritis face a lot of challenges associated with the physical symptoms. If you’re worried about your livelihood and your ability to perform at your job, this can be very stressful,” says lead researcher Dr. Louise Murphy with the Arthritis Program at the CDC in Atlanta, Ga.

What was even more concerning was that only half of the study participants who had anxiety or depression had sought mental health care for their symptoms.

“When we looked at the characteristics of the people with anxiety, there was not a specific group that popped out which suggested that all people with arthritis have a risk of anxiety and depression,” says Murphy. “Knowing the significant complications they can create shows there is a need to address anxiety and depression on a wider scale.”

Since so many arthritis patients are not seeking mental health treatment, physicians are missing opportunities to intervene and improve patients’ quality of life, says Murphy. Pain, disability, anxiety and depression can become part of a vicious “symptom cycle,” and breaking that cycle can provide both physical and psychological relief.

“If health care providers can start screening people with arthritis for anxiety and depression, they can interrupt this cycle by treating the emotional aspects of the disease, which will allow them to better treat the physical aspects,” says Murphy.

The CDC also encourages patients to share in their treatment by enrolling in programs for exercise and stress management. “Physical activity has strong health benefits and these programs can help people with anxious about exercise,” says Murphy.

Recommended programs include Walk with Ease, EnhanceFitness and self-management programs like the Chronic Disease Self-Management Program and the Arthritis Self-Management Program, which are all offered nationally.

“Everyone has a role in addressing this problem,” says Murphy. “Overall this study shows we need to start taking a broader approach in dealing with arthritis and addressing the mental health symptoms and not just the physical symptoms.”

The study was published in the April 30 issue of the American College of Rheumatology’s journal Arthritis Care & Research.

Read more: http://healthland.time.com/2012/05/01/having-arthritis-often-means-suffering-from-depression-and-anxiety-too/#ixzz25HxCGh6T

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