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RA Hip Replacement

I am hopeful that my summer long saga of pain and futility are drawing to a close. My surgery is two weeks away. I am grateful to Ruth and her practical approach to problems. It is reassuring to me. After all my worry and anxiety,  I know I will be fine.

I have only one more item to check off my list. It is an appointment to see my surgeon’s PA. My dentist gave me a pass. I had no oral infection. My primary met with me and did his part. I participated in a two-hour hip class which was informative but also made me anxious. I met with the anesthesiology nurse. I passed all my labs.

My worries

My RA will become a worsening problem as I will be off Medrol and meloxicam starting Sunday. My RA feet are badly affected as are my ankles. My tendons in my legs are also a problem when I walk. My hands, wrists and shoulders are also problematic. After taking the hip class, I became concerned that I wouldn’t be able to do such things as get up on my elbows to do the maneuvering to get up out of bed. I was reassured by the class nurse in a follow-up call that my recovery period would be tailored to meet my needs and all would be well. I am okay with it as much as I can be.

I am a planner. It isn’t always a good thing. I realized that although sleeping on the affected hip worked for me, after surgery I would not be sleeping on my incision. So, I decided to practice sleeping on the opposite side, the unaffected side. It was a bad decision. My pain quadrupled. It was unbearable. It was so bad that when I laid down I couldn’t get up to brush my teeth and put my nightgown on. I slept in my clothes with my socks on. So, after spending two days in pain beyond belief, I went back to sleeping on my bad hip. My pain level is much better.

The walker is another issue. My RA Doc ordered a walker when she saw me limping down the hall. It is a great walker. It has helped me stay mobile.  It has a bench that is handy for carrying things like coffee or laundry. I enjoy my walker for the freedom it has given me. After the Hip class, I realized that I would need a different walker. Oh no, I thought, one more learning experience. So, I bought the correct walker and I practiced with it. There was no place on it to carry my laundry or to carry my coffee. So, I decided to do what I had been told by many health care professionals and Ruth to do. And that is to work with today only. The rest will take care of itself. I am using my favorite walker and am sleeping peacefully on my bad hip. I am good with that. My exercise into preparedness was futile.

My last worry is about going home. I am expecting that I will be discharged from the hospital three days after my total hip replacement surgery. I have prepared the home front as best I can. My son, who is also handicapped, will help me the best he can. It may be possible to have home healthcare or it may be possible to extend rehab for a few days. But it is all maybe.  Not for someone who is a planner. I am into month five with this problem. I’ll be glad when it’s all over. So will Ruth.

Silica as a risk factor for rheumatoid arthritis

Silica, the earth’s most abundant mineral, is made up of oxygen and silicon. It is a part of many, many processes including mining, pottery making, glass making, and granite work including tombstone making. The lung disease caused by crystalline silica dust is called silicosis and has been known since the time of Hippocrates. It is an inflammatory disease.

In the fifties after many studies, it was learned that autoimmune diseases including rheumatoid arthritis could be caused by exposure to crystalline silica. The connection though proven is not well understood. Rheumatoid arthritis is also an inflammatory disease.

On becoming the bionic woman

I wonder how many of us are walking around with replacement parts. Joint replacement has become common and it is successful surgery. I have several friends who have both knees replaced or both hips replaced and they are fine with it. And now, I am about ready to embark on my first joint replacement.

My left hip will be first on the chopping block. This is a bad visualization. I am trying hard not to think about what the surgeon will be doing. It is scary and gruesome. A Frankenstein thing. Instead, I am focusing on the bionic woman thought. I will be in much better condition once I complete the rehab process. I will have a fabulous new joint. Won’t I be lucky? I will.

I have spent the summer in extreme pain. My doc had a tough time identifying my hip issue. After all, my hip had good range of motion without pain. An MRI revealed my hip deteriorating badly plus a bad labral tear with pieces loose in the joint. My pain progressed from mild to excruciating. At first it was random and then it was whenever I moved plus random.

Putting on my bra pulled on the hip in some bizarre way provoking extreme pain. Weird, but true. Dressing was a major effort much like the RA challenges of dressing. When I was at my worst with RA, dressing was an exhausting, painful process. Now I have the same issues with my hip.

Next, I was sent to an orthopedic surgeon. The surgeon was chosen by my doc because she thought I would have the surgery quicker than going to the alternative. Wrong. I couldn’t get an appointment sooner than six weeks out. Six more weeks of pain. When the day arrived, my appointment was brief. He sent me to have a hip injection which was scheduled in another five weeks. What this doctor said made no sense to me. I asked for a second opinion. The next surgeon’s appointment was scheduled in another six weeks. I have been on Norco or oxycontin the whole time.

I had the hip injection. It was an easy procedure. Efficient and painless. Did not help. Expensive. Finally, I arrive at my new orthopedic doctor’s appointment. I was fearful that I was going to be left in severe pain for the rest of my life. He introduced himself using his first name. Instantly likable. He simply said to me that I needed a hip replacement. I was so relieved that I had no questions. I was basking in total relief. A solution at last.

A friend asked me why it takes so long for people to have hip replacements. There are two big reasons. First there seems to be a shortage of orthopedic surgeons so it takes forever to get appointments. Second most insurance companies require patients to have a hip injection or to try physical therapy first. All of this takes a great deal of time. Injections and PT are not going to solve the problem of a worn out joint so why they are required is questionable and a waste of time.

My surgery is scheduled for October fifth. Now that the surgery has been approved, there is a lot to do. I was sent a check list. I have a two-hour hip class scheduled. I had a dental appointment Tuesday to be sure my mouth is clear of infection. I have appointments with my primary, nurse anesthetist, and doctor’s PA.

I have been on Actemra for the last two months. It is helping but will have to be stopped until sometime after the surgery. Meloxicam and Medrol will also have to be stopped. I will stay on the methotrexate and Plaquenil.

Wish me luck. My concern is how this surgery will affect my RA and maybe how the RA will influence the outcome of surgery. My body is in a constant state of inflammation. Although the severity of it varies, it is always there. Tough on the body.

On the brighter side, I do believe in the helpfulness of modern medicine. With all its weaknesses, we are much healthier because of it. So, as I move closer to my first joint replacement, I appreciate the fact that my joint pain will be gone and I will have a healthy useable hip. First steps on the way to a bionic body. I wish my RA joints had it so lucky.