Question
Hi Sharon,

long story, same as everyone else, i am male age 46yrs had this pain for years, then two years ago they (nhs) put a name to it, (arthuritus) had operation never been right since, lots of tablets, for depression,& pain,  can you tell me more about the depression bit??

back in to c back specalist no good, even though i complained of back pain, the the surgeon who did my op, said come in day surgery injection into grion, worked for a week or two, then went back to pain and impingment (sharp stabbing pain).  he said i should have two more injections, then cut my iliopasoas tendon, what will happen if he does this????

is there any where i can get help, what do u advise please,

from a painful patient

kindest regards

Answer
Hello Stephen

I have to say right off the bat is that I am so sorry for what you are going through.  Any type of surgery, that takes away our independance to lead a life where we have to depend on others to do simple daily tasks for us is terribly hard on us emotionally.

First things first.  Whenever you have any type of hip surgery, or surgery that affects your daily living my suggestion is to go to a reputable counselor or physchiatrist to get yourself on an anti depressant until you are able to do your daily living tasks by yourself.  It's not that you are going to be on the anti depressants forever. As soon as you get your life back to normal, you can go off the pills.  In fact, anyone who lives with chronic pain should look into counseling.  I am a big believer in finding a good counselor and going on a regular basis.  Counseling has made a huge difference in my life and I continue to go on a monthly basis.

I had an awful surgery one time.  I had a revision on my hip and was in a body cast for three months.  I could not do anything for myself. I did not go on anti depressants prior to surgery, and after a few weeks I was getting panic attacks.  I had to be taken to a psychiatrist and was given cognitive counseling and was put on celexa for about six months.  It made a huge difference.  I truly believe that THR surgeons need to pay more attention to the emotional side of the surgery, which they currently do not do.  I have an incredible surgeon, but he does not address this problem.  It's only after 8 hip replacements I have found that depression is a real problem that must be addressed.

Do not have your primary physician prescribe your anti depressant.  They do not have the knowledge to do that.  They will try to help, but many times they don't have the background to do counseling and to work the psycho-tropic meds.  Do not feel guilty if you go for anti depressants and do not make excuses to anyone.  Just do it.
It does take a few weeks for the pills to kick in, so be patient.  Going on antidepressants is NOT a failure on your part.  Many people have the mistaken idea that going for counseling and for meds to help is a sign of weakness.  I feel the exact opposite.  It's a sign of strength.  People find a problem, and they fix it.  That's strength.

Secondly, your physical problem....
Before you allow ANY surgeon to cut your illiopsosas muscle, get a second opionion.  Maybe even a third opinion. Many insurance companies will allow you to do that.  I am not sure where you live, but look into the largest teaching hospital in your area and call the office of orthopedics and speak with someone there to get names of surgeons who deal with MULTIPLE problems of the hip.  Then get your second and third opinion.

When you get a THR, the illiopsoas muscle is normally cut (as long as they dont' go in from the front), and it takes months for that to heal.  There is a lot of physical therapy involved, but this is a result of a total hip replacement, not a surgeon going in and cutting the muscle.  Before you let this guy cut ANYTHING, get an explanation of why he wants to do this and what he hopes to achieve from the cutting.  Then get your other opinions.

As for your third point on where you can get help.....
I'm not sure if you are asking for mental health of physical health, and I am not sure what your insurance policy allows.  If your insurance will allow you to go out of network, look into the Hospital of Special Surgery in NYC.  If you live near Virginia, look into the Anderson Clinic in Arlington.  The best surgeon there is Dr. Charles Engh.  If you don't live in any of those places, as I said, look for the largest hospital in your area.  See if you can find support groups for people with joint problems, or arthritis and then ask them for referrals for doctors.

I hope this helps you.

Sharon