Hip Replacement with Severe Balance Issues….this could be interesting.

Today….what I learned at my doctor’s visit, my concerns, and how I’m preparing for everything.

I was really shocked when I saw the CT scan of my hip.   Here’s a little quick sketch of what I saw:

by w. holcombe

by w. holcombe

As you can see, in late September I had a perfectly round head on my femur, it looks normal.  The CT I had taken on February 13th, showed the femoral head collapsing.  It is amazing how fast this condition has progressed.  No wonder the pain has progressed so much.  As my doctor said, I’m have a square peg in a round hole.  My leg is now shorter than the other, it is throwing every thing off.  The pain in the joint is very bad.  I haven’t talked about it, but I haven’t been able to walk much.  I can’t walk at all without a walker supporting my weight.  I spoke to a new friend who has this in a number of joints and she said this pain is comparable to bone cancer.  Wow.  I don’t think mine is that bad yet.  Some days I think it gets up there though, but not all the time.  It does ache all the time, I hover around a 7, it never goes below a 5…and that is rare…it does spike to a 10, but I’m lucky it doesn’t stay there long.  It is a very sharp pain when I move or try to put weight on it.  I can’t take narcotics.  They make me feel like things are crawling on me.  I can’t take NSAIDS because I’ve had an ulcer.  The most I can take for pain is Tylenol, and I don’t want to take too much of that, it can damage your liver.  So, I meditate, and I really baby my hip.  If I could take narcotics I could probably move around and do more.  As it is, just the trip to the doctor on Monday left me in so much pain I didn’t sleep much on Monday night, and Tuesday was so bad I couldn’t get up long enough to get myself lunch.  I simply couldn’t do it.  Luckily, Stuart had gone to work very early and came home early, so I got something to eat and much help for the rest of the day.

I got a LOT of information from my doctor.  He told me that many people could have received the same amount of steroids I did and never acquired Avascular Necrosis (AVN).  Guess I’m just lucky.  *grin*  Some people may just have a predisposition to it.  Of course, thinking back, I have had a whole lot of steroids.  He also said this is progressing fast.  There are some other treatments for this, but most are just stop gaps and you end up having to have a hip replacement anyway, and if your femoral head has lost it’s shape, like mine has, you can’t do most (if any) of them.

So, hip replacement is a GO!  I don’t have a date yet, waiting for the appointment setter to call.  I’m sure it will be a little while out, because of things that have to be done before hand.  I have a whole packet of things to be done, things to help you understand more about the procedure and things that are going to happen afterward…..it’s very thorough.  If that weren’t enough, there’s a class, yep a class to explain everything you may have questions about; the procedure, home health care, physical therapy…just about everything.  Don’t know how I’m going to sit through a class without excruciating pain, but I’m going to try.  Stuart said he’d go alone, but I think I should go.

There are a lot of people who have joint replacements, obviously, for them to have a class.  They have really thought of everything.  There will be a home health nurse that will come out twice a week to check my blood because I will be on coumadin to reduce the chance of blood clots.  This has to be monitored closely. (often they just put people on a high dose of Aspirin, but again, I couldn’t do that because of the ulcer thing) A physical therapist will be coming to our home to work with me instead of me having to try to go out to physical therapy.  My doctor said that PT is mostly just walking.  There will be post op services coming out to help set up the house for us, if I didn’t already have one, I’d be getting a walker (I may be getting a new one if they can get me one that fits in the bathroom), a tub bench, and a 3 in 1 bed side toilet.  I wondered what the 3 in 1 was, that means it works a bed side toilet, or railing to hold on to use your own toilet, or to use as a raised toilet seat.  Funny thing, I have one of these back in Durham, Stuart got it a long time ago thinking it might help when I have vertigo, but it didn’t, if I could sit up, I could go to the bathroom.  (you can’t really sit up when the world is spinning like crazy!)  I’ll also get a grabby thing to help me reach things so I won’t bend my leg more than a 90 degree angle.  Also, a special thing to help me put on my socks and shoes.  Stuart laughed, both of those things have been his job for a long time.  Due to my dizziness I can’t pick things off the floor, I was shocked that my doctor knew this!  I haven’t been able to put on my socks and shoes since September.  So this will be a relief for Stuart, and make me feel much more independent.

OH, I forgot to tell you more of what my doctor said about the surgery itself.  I will be in the hospital 1 – 2 days.  I won’t have anesthesia, that doesn’t mean I’ll be awake during the operation, but I won’t be put under a deep sleep.  I’ll have a spinal block.  So I won’t feel all icky, I won’t get sick, and I won’t have to worry about them putting a tube down my throat.  It’s kind of cool.  He told me that most people with this condition tell him that the pain they have now is instantly gone after the surgery.  How cool is that?  He said I will be sore from the incision but I probably won’t hurt worse than I do now.  He said first off there will be a lot of local anesthesia that will take a few days to wear off and that’s when the incision would hurt the worse.  He has been impressed that I have been able to tolerate this much pain without pain medication, so I think I’ll be able to do it.  However, I won’t be babying this, I’ll be working it hard with the PT.  So much more Tylenol.  Maybe a Tramadol now and then, but even that makes me feel funny if I take it too often, but I can take it every couple of days.  He said he will make my legs the same length….yay!  He said I may out live my hip replacement.  All I can say about that is…..life is unpredictable, so no biggie.  I could get this hip replacement and get hit by a bus in a week. No one knows the future.  *shrug*

I’m not afraid of this hip replacement surgery.  I really haven’t been afraid of the surgery itself.  I’m afraid of the hip replacement surgery in conjunction with the rest of my stuff.  Having a severe balance disorder with sudden vertigo that comes on without any warning could be a very big complication to my recovery.  As my doctor said, we can try to plan and prepare for everything, but this is something we simply can’t change.  It’s something we have to hope luck will be with us.

I’m already a VERY CAREFUL person.  I use a walker all the time.  I stay close to walls so if I do have a vertigo attack I have something I can grab and try to fall easy, just slide down the wall.  However, I still fall, OFTEN.  I fell the last week in such a position that if I was recovering from hip replacement surgery there is no doubt I would have dislocated my hip and possibly fractured it.  I simply let go of my walker to sit on the couch and suddenly got dizzy…..WHAM!   This wasn’t even full fledged vertigo, this was just a tilt of the world.  If I was hit with bad vertigo there would be no keeping my balance no matter how hard I tried.  I can’t tell up from down the world is spinning so fast all around.

This is my concern.  Recovering from hip replacement surgery with Severe Meniere’s Disease…or “more than Meniere’s Disease”  what ever they want to call it.  A severe balance disorder and sudden onset vertigo.

Perhaps I should get a Bubble Wrap Suit???  Too hot?  Probably so.

Stuart is going to take time off to be with me during my time in the hospital.  Of course, if he’s completely bored he can work while he’s there.  My doctor said the room I’ll be in is big and has a day bed so Stuart can stay right there.  Since I have a special diet, we can pack me up some food and they will warm it up for us there.  He said he wouldn’t trust the hospital to get it right.  Yeah, I wouldn’t either.

Stuart will most likely be able to work from home for most of my recovery period.  At least for the most difficult part. We don’t know yet, because we don’t know when things will be, or how long it will be.

Going to get our house more prepared.

Not going to worry about my balance problems and my recovery.  I can’t control the future, so no need to worry.  Just be aware and extra mindful of every step I take.  Prepare as much as I can….but worry….no.  Be afraid…no.   One moment at a time, right?

image from sayw.com/quotes

image from sayw.com/quotes

 

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6 thoughts on “Hip Replacement with Severe Balance Issues….this could be interesting.

  1. Wendy, I need to email you. I have been so wrapped up in something here at home, I haven’t been on the computer much. Happy to hear that once the new hip is in, you won’t have pain.
    mo

    • mo….no worries about the email. Take care of you. Yep, this pain should be gone….may have a slightly different pain but nothing like this!!! A different kind of joint, is well, different, so I will have to watch out for somethings. I’m grateful this can be done! I’m grateful for so much. Including you! 🙂

  2. Woohoo!!!!! I bet you are going to be so excited once you get the surgery done! I would talk to the doctor at length though about Cumadin and the Vertigo you suffer from. Bumping into things will not be good for you!

    I’m so glad they are doing a spinal block instead of putting you out. I don’t understand why more doctor’s don’t use that instead of knocking someone out. When I had E, by C-section, I had a thingy (like a spinal block) so I wouldn’t feel any pain and Valium (ask for Valium it’s awesome). I felt nothing. Not even them cutting me open, sewing me back up, or them pulling E out.

    As for your walker, if you don’t have one like this, look for Walmart #: 552604506, I highly recommend it.

    Keep up updated! hugz

    • Terry,
      There will be a nurse coming out to our house twice a week to monitor the coumadin, so they don’t get it too high, just enough so I don’t get a blood clot. She will also be watching out for bruises and everything.

      I think they can only do the spinal block if they are working on certain areas, but still I don’t think a lot of doctors do it. I have Valium for my vertigo on an as needed basis. I don’t really notice it doing anything, but I take as little as possible, just enough to help me when I need it. As much as I have to take I sure don’t want to get addicted. 🙂 I will still be unconscious during the surgery, so I won’t see any of it, but it won’t be that deep anesthesia like you get for most surgeries. I’ll have to ask exactly what they will be giving me. He said I wouldn’t be awake when they did the spinal block. (it is the same kind of thing you get when you give birth).

      Day to day, this is my walker http://media.drivemedical.com/consumer-nitro-ad.html and I love it. I also have a very utilitarian walker. It is doesn’t roll really and is very steady for times when I really need that. But I love my Nitro. When I’m out and need get dizzy and need to sit fast, bam, it’s there. Stuart said if I have to have a walker he wanted me to have one that was cool. It’s also very maneuverable.
      But the utilitarian is easier in the house when I need to put all of my weight on it and not move. I’m hoping to get one that is only 20″ wide so it will fit through out 22″ bathroom door. Tiny thing, why it’s smaller than a bedroom door is beyond me! I found a “junior” walker that will work. If they won’t cover it, we may just buy it, it’s not expensive. It fits someone up to 5’7″ … I’m barely 5’5″ so it will work.

      Found out yesterday, my surgery will be April 14th.

      About going to John Hopkins. Right now I’m supposed to go to the Vestibular Clinic….I have a physical in April…but it is so soon after my surgery I think it will be postponed and that means it will be in August because my doctor is having a baby and will be on maternity leave. I want to talk to her about the auto-immune stuff. I really need to get this straight first. This is too much spinning around in my head. Most of what I have don’t have anything to do with auto-immune disorders. Meniere’s might. My AVN is cause by over corticosteroid use. It can be associated with a certain type of lupus but normally it isn’t associated with autoimmune disorders. That being said, they often have no idea what causes this in most people, and the one girl I know who has this has many auto-immune diseases. So that leaves me with many unanswered questions, but it also leaves me looking for the right person to ask them to??

      But right now, I have to just concentrate on recovering from this surgery. Then I’ll focus on the next step.

      Thank you so much for caring.
      BIG HUG back to you!!!

  3. If the surgery removes the pain, and fixes leg length, you may find walking easier as you recover from the surgery. I have one leg slightly shorter than the other, and noticed especially when I f***ked up my back. And in yoga. If both legs are of equal length, that should make the walking better.
    I mention this because with less pain, stronger hip, even leg length, you wouldn’t be struggling with walking and vertigo. If you are waking more “normally” you may fall less.
    Good luck.

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