Hip Specialst :-(

Rewter

Just thought I would come on here and give a further update. A bit of a long winded rant so apologies in advance.

Today, I visitied the hip specialist after not visiting him since 2006. Now, though I wanted to understand my options for my hips, and with it being 7 years since my last X Ray, I expected things to have progressed for the worse, I wanted to gain some clarification with regards to my Knees and the GP said they should still be able to disucss this. Guess what, can't help you with that Mr Rewter, you will need to speak to your GP for a referal. Just to confirm, as per my previous threads, I believe that I may well have Osteo Arthritis in my knees as it feels very much like the problem in both my hips.

He first of all discussed injections in my hips for the pain. He did warn me about side effects with infections but did say I could be pain free and sorted for up to 12 months. GREAT. However, I asked if this would sort out my problems in my knees to which he could not answer. This to me needs clarifying as if my knees do have OA, I am not going to be up and about like he believes and to a certain degree, he accepted this.

He then said he would send me for a Rheumatoid blood test. Check your notes mate, my GP sent me for those a few weeks back and game back negative.

I like to think I have a good level head on my shoulders and don't just live in the now. I needed to understand how things have progressed and what the future holds. So, update is my Arthitis is worse, even I could see looking at the X Rays how much more build up of warn away bone their was, but he thinks if I take things very steadilly, I could last up to 5 years tops before they have no other option but to replace. He could not really confirm if I would likely need walking aids somewhere between now and then. Lets be fair, 5 years is not a great deal of time.

Fot the longer term, we discussed how long an hip would last on someone of my age due to a higher level of fitness. 10 years max I was advised and the second one will most likely be as good as the first. Even waiting a bit longer for my hips will see me not walking without crutches or worse as I enter my 60's based on current replacment options.

Due to my future concerns rather than how I am at this moment in time has basically lead the consultant to say that unless I want the injection or replacement, not to come back until that point. I seem to feel like I was not taken seriously just because I am worried about my future life. I am struggling hence me requesting an appointment. He has basically sent me back to the GP and need to see a Rheumatologist. He would not get into any conversations of how I can reduce my walking to prolong the operation as long as possible.

Am I being wrong for thinking about my future health?

dreamdaisy

No, you're not being wrong to be thinking about the future but the trouble is none of us know what that future holds. The assumption may be that the arthritis will worsen but there again it may not. Your knees could well be troublesome due to the hips being 'off' - affected joints throw other joints out of line and thus cause more problems but a new hip or hips could solve that. It's not easy, is it?

Orthopaedic surgeons have a dilemma: younger people demand more from their replacement joints as they have higher expectations of what the joint could mean to them, but then that leads to further replacements as joints are worn out more quickly and so the cost rockets. Hips will last as long as you respect them - abuse them and they will fail but orthos won't replace them just because the patient thinks it's the right thing to do, they need evidence that the joint is beyond all remedy. Again, it's not easy. They have their rules and regulations but in the meantime it's us who have to live with it. I bet they get theirs done ASAP when they get OA! Play by the rules Rewter, it's the only way to get things done frustrating though it is, the NHS is a wonderful thing but it can grind exceeding slow. DD

barbara12

Hi Rewter
You are doing the right things has far as your future health goes, I am waiting for both THR , but I feel every time I go... there are delaying tactics, I have had all the injections going, the second one worked for around a week. and the third didnt work at all, but everyone's different, there was one women on her 4th lot and she said they worked really well.
So I would give them a go, my consultant said the expected time for a THR to last was 15 years, again everyone will be different.
I do wish you well with it all.
Sorry I forgot to say I am 62, I think the delays are down to money.

Rewter

I got the impression that he had very little time on his hands. After the first couple of questions, it became evident that he did not want to chat. After second time I saw him glance at his watch, I know I was wasting my time. Not bad considering I was in that room for little more than 5 minutes!!!!

kellerman

The ortho would find it impossible to tell you your future....he doesn't know.
Just take whatever is offered....now. Live for today and let tomorrow take care of itself.
I don't understand why your going to be referred to a rheumy if you have OA but maybe he thinks you may have some form of RA.
Who knows.
However I do think looking at his watch was just ignorant,even if you were asking him questions he couldn't answer.
Take care. May

emsjane

Hi Rewter!

I am 43 years old and both my hips are badly affected by OA! I have started to notice my knees are beginning to be affected too especially in the winter!

I feel that i am not far away from a hip replacement now.

Over last winter i was walking with a walking stick and finding i couldnt do anything, sitting or standing or walking for any length of time.

I thought it was very rude of the surgeon to be looking at his watch, you should have said, ' oh im sorry, am i keeping you from something more interesting?!?!'

I have read up quite a bit about hip replacements and most of it has been positive. I think if you've got to the point with you existing hip where it is painful all the time, then i don't see what you have got to lose by going ahead with a hip replacement!!

If they offer it to you and you feel it is right, then go for it, i say!!

Good luck and i hope you arnt in too much pain this winter!!

Rewter

Been tested for RA and it came back negative. Do rheumy have nothing at all to do with OA?

With regards to the future, I could live for today, however, due to my age (36), I want to give myself a good chance in later life too so its about finding that balance. True, the Consultant will not know the future but through experiance, I would expect him to give me a rough estimate on time scales to which he could answer this. In my original post, I do not have issues with the consultant not answering my questions other than my knees to which I understand why he could not answer.

My issue is the fact that I was actually disregarded based on my future concerns more than the here and now. Maybe if he was more open to conversation, then I might have been able to talk about all my current concerns but you know when you are wasting your time. I think the surgury running behind schedule might have something to do with it. :idea:

Rewter

Thanks Emma,

Fortunatly, I am not in bad pain all the time . I do get mild to moderate pain most of the time but the real bad pain where I phyically cannot move is not every hour of the day thank goodness

Rewter

Hi May, just had a quick look at it appears that a rheumatologists will treat OA and other things as well

I was woried for a minute that I was about to get sent on a wild goose chase

"Rheumatologists treat arthritis, certain autoimmune diseases, musculoskeletal pain disorders and osteoporosis. There are more than 100 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, fibromyalgia and tendonitis. Some of these are very serious diseases that can be difficult to diagnose and treat."

kellerman

Hi Rewter
I did what I never do and googled this. According to the result it does say a rheumy treats OA.
I am surprised at this as although I know they treat AS and Osteoporosis I have always been told the OA is for your Gp to sort out with pain dullers and anti inflams.
My rheumy wasn't interesed in the OA.
I'd be interesed to know how you get on.Maybe your ortho is more clued up with your condition.I don't think he would refer you unless who thought there was something going on that only a rheumy could deal with.

Please don't think any appointment is a waste of time. Keep a diary of your symptoms to ask him and its always best to write any questions down.
The fact that your ortho was running late is no excuse for bad manners.
Keep us updated. May

stickywicket

To take your last question first, Rewter, no, you’re not being wrong to think about your future health: you’re being sensible but (a big but) your appointment was with an orthopaedic surgeon (I presume) not a clairvoyant. He can offer injections or surgery but nothing else. My own does both hips and knees and he collaborates with the ‘foot’ man but that’s in a big teaching hospital.

Arthritis is a very frustrating business. No-one can say how quickly, or slowly, stuff will deteriorate because unforeseen factors may come in later to alter things. I was warned before I had my two TKRs that they would probably only last about 15 years maximum. That was fine by me. I wanted two decent knees while my sons were young. I figured I’d have less need when I was heading for 60. I got lucky, probably because my RA meant I was unable to overdo things but, even if I hadn’t, I wouldn’t regret my decision. We have tough choices to make and live with, and we also have to live with uncertainty. That’s how it is.

As for steroid jabs – with every procedure they now have to spell out the dangers. It doesn’t mean there is much of a danger. Loads of us have had them and I can’t remember anyone saying they got an infection. If it’s into the joint, it’s aimed at helping that joint. Some will diffuse through the body and just may help other joints. No-one can say.

I think that, by referring you to a rheumatologist, your man is covering all bases and trying to ensure you don’t have an inflammatory form of arthritis. My rheumatologist deals only with my R.A., my orthopaedic surgeon deals with the replaced joints and my GP deals with paindullers.

I do understand your frustration but there are no straightforward answers. Trial and error is what most of us live by. A physio may be able to give you advice on exercises which should help (Or check out AC’s booklet on exercises) Good luck!

dreamdaisy

My rheumatologist ignores my OA because she can't treat it. The orthopaedic chap has ignored it as I'm too young. My GP ignores the PsA as she can't treat it but she can prescribe dullers for the pain for both sorts. As Winston Churchill so nearly put it, I stall between a number of fools.

No-one can predict what will happen with their arthritis or how fast. It will do what it will do, when and where it chooses to do it. It's one of the many questions we ask that consutlants etc cannot answer. As for the time thing, well, our ortho guys average about 35 appointmens per day each, they don't have the luxury of time for any of us as we are too many in number. It may be worth finding out if your chappie does private consultations, in my early days we paid £60 for a 45 minute consult with my rheumatologist, she couldn't tell us anything different but she could spend more time telling us that. DD