Question
QUESTION: Hi Sharon,
        It appears you know what you are talking about so I am hoping that you can help answer my questions. I slipped at work in April 2005, and tore my labrum in my left hip and some other muscles. After multiple doctors (26, yes I really mean 26!) I found a surgeon who had the same problem and had had arthroscopic surgery to repair the tear; he was wonderful because he truly (like you) understood what I was going through. I had been told I was crazy, it was just spasms; turns out the labrum in my left hip was calcified, I had a 9mm cyst, and a bone spur had developed on the socket that was tearing the labral tissue and taking chunks out of my femoral head, plus really bad OA. I underwent arthroscopic surgery in March 2007. They removed the labrum and ground down the bones, but it didn't fix the problem. I just had THA, January 18th 2008, and I am still in horrible pain. I initially (post-op) had a 2 inch leg length discrepancy (surgery leg-left-longer) but it has gone down to about 3/4 of an inch. My new surgeon (did the THA) is arrogant and told me there is nothing wrong with me; I also have constant pain in my left leg, lower back pain, bad knees, occasional swelling, and pins and needles in my left foot. My PT people don't know what else to do with me, because I am so tilted, they suggest a lift but the surgeon disagrees and says I have to wait. I am only 29 years old and want to have kids (any complications with doing this after THA? No one seems to be able to help me with this topic) and I WANT MY LIFE BACK! I still walk with a horrible limp, constantly hurt (had to get off pain meds because I got addicted; and am allergic to everything but 2 pain meds fentynl and demerol), and feel tired/angry/ and unmotivated all the time. I don't know what to do anymore, and the only resources out there are to say how wonderful this surgery is...I am beginning to disagree with them because I feel worse most days than I did prior to surgery (PT makes it worse). I know this is alot, but after more than 3 years I just want a straight answer to WHY? Will this ever get any better?
Thanks
Erin

ANSWER: Dear Erin

First of all after reading your letter, I have to say that if I were you, I'd find a new doctor.  There is never a need for a surgeon who is treating a patient like you to treat you the way you were treated.  Find someone new.

Second, get a lift for your shoe.  If you have a discrepancy of 3/4 of an inch, you NEED lift.  I have a 3/4 difference in my legs and on the days I don't wear my lift I am in pain.  A good shoemaker can make an insert for your shoe for about thirty bucks that is 1/2 inch and you will adjust to the 1/4 inch that is not taken care of in the lift.  You need the lift.  You should feel a difference immediately when you get the lift in the shoe.

You need to have a surgeon who will find the source of your pain and get you off all the pain meds, to a manageable dose of medication.  Fentanyl is very strong and can cause many problems and is a difficult drug to wean off of.  I know that because I was weaned off fentanyl and it was horrible.  But you need to get off that drug once you figure out with a SENSITIVE surgeon, what your options are.

The pain meds play games with your moods and I am guessing that much of your mood problems are due to the pain meds reacting with your body chemistry.

Get to a large teaching hospital. (I don't know where you live but if you are in a big city, find the largest specialized hospital in the area and find out who the chair of the orthopedic area is and make an appointment for the consult to get someone to review your case and get you on a path to healing.

One more suggestion I would give you is to find a competent therapist and get some emotional therapy.  Mental health therapy was a life saver for me during my bad times.  There is a stigma that is absolutely not deserved that people get when the seek mental help.  I disagree.  If I did not have my therapist (and I still see her on a regular basis) to help me sort things through, I would be a basket case by now with all the surgery and problems I have had with my hips.

So, here you go:
1. Get a shoe lift of 1/2 inch
2. Find a qualified and caring doctor to review your case
3. Look into mental health options

I hope I have helped, I really do feel empathy for you. I know that bone pain is the worst type of pain anyone can have and I want you to look for help for your situation.  At 29 years old, your life is just beginning and you need to find a doctor to address your needs.

Best of luck
sharon


---------- FOLLOW-UP ----------

QUESTION: Thanks for the response! However, I just wanted to let you know that I got off the Fetynl a while ago and am not taking anything (although I really feel like I need something for the pain; plus PT and other doc's say that 2 major surgeries on the same hip in 10 months will take longer to heal). I just wanted to know if there is a specific type of therapist that you would recommend (one who can write for meds or not? a trauma specialist? etc)? I also would like to know what the major complications will be getting pregnant and having children? Appreciate you taking the time to answer all of our questions...you are definately a light at the end of the tunnel for all of us.
Ta,
Erin

Answer
Hi again Erin

I can recommend two orthopedic hospitals that are the tops in the United States.  One is the Hospital of Special Surgery in New York and the doctor you want to see is Dr. Douglas Padgett.

The second place, and the place where I was sent is the Anderson Clinic in Arlington Virginia. The doctor there is Dr. Charles Engh.

As far as the therapist, the best place I have been to, that tops them all is Jewish Family Services.  They have the best therapists and they are excellent all around.  You DO NOT have to be Jewish to go to there.  They take anyone and everyone, including close friends of mine have used them and are satisfied.  

Personally I used them when my younger son was being bullied at school and the therapist that worked with him was a godsend.  When I needed medication for depression, they referred me out, to a qualified psychologist, and I still used them for counseling while on medication.  I just started using them again, because I was out of work and also I am turing 50, and it's been bothering me.  So I go regularly for counseling and it's made a huge difference in me.

Another friend of mine uses a Catholic agency and she is happy. It's a bit too religious for me, and Jewish Family Services does not bring religion into the mix.  They have offices all over the country.

You can go to a larger group of therapists, but the one time I did that I was given a counselor and we didn't click and I was not allowed to change therapists so I went to Jewish Family Services and they put me with who they felt was best.  They are compassionate, and caring.

When you get pregnant, you must go to a high risk pregnancy group.  The more weight you gain, the harder it is on your hips so try to keep weight gain to the minimum levels.  Be careful when walking around once you start to show because your center of balance is not quite right with the baby and you can fall and injure yourself.

If your hips do not have the muscle tone, you may have to have a C-section, which, frankly I liked better.  I had regular labor with my first son and it hurt like the devil.  I had a C-section with my second son, (I did not have the muscle tone in my hips to deliver) and it was a breeze to deliver him.

Try and get your hip doctor and your OB/GYN to work together and as long as you are healthy and go by the above guidlines, and any other suggestions your doctor may have, you should be fine.

Don't hesitate to email me with any other questions you may have.

Sharon