For Mich

[nutty]

www.dailymail.co.uk/news/article-2752478/I-feel-robbed-life-Thousands-patients-seek-1million-payouts-faulty-hip-replacement-joints-leak-toxic-chemicals-leaving-agony.html

[The Walk of the Penguin Mich]

It is really too bad that it is such a biased article, Nutty.  I hate it when articles are published like this when there is such shitty research behind it.

I had a metal on metal hip (MOM), it was the first one that became infected.  I received my hip in 2007 and when it was installed, I KNEW that while the science was behind the hip, the time was not.  If the woman in this article did any research whatsoever, she would know this as well, it's all over the internet.  

Not everyone leached metals, when my infected hip was removed, the surgeon said that there were NO signs of metallosis.  Unfortunately, that is one of the problems with this design in that surgeons have no idea as to which patients are going to respond badly to the metal, and which patients are not.  Topical metal tests are useless here.  There are still a lot of people that had MOM THRs and are still going to be able to take advantage of this because they are some of the lucky group.  The numbers I read are that less than 10% respond badly to MOM THRs.

The theory was that if you were young and active (I was 47 at my first THR) this was the hip for you.  The 'gold standard' of hip replacements entails having a polyethylene liner installed between the ball and the cup, and when you get one of those, the liner needs to be periodically replaced every 10-15 years.  So if you do the math, getting a hip replacement at 47 and getting a liner replaced every 12 years or so, you're looking at another 6 surgeries over your lifetime (2 hips, 3 revisions each).  Each surgery adds to the scar tissue and becomes harder and harder to rehab from.  It sucks.

This is no nefarious trick by the manufacturer and the article makes them seem like the bad guys.  NOT SO.

[The Captain]

Sept 18, 2014 12:13:40 GMT -5 The Walk of the Penguin Mich said:

It is really too bad that it is such a biased article, Nutty.  I hate it when articles are published like this when there is such shitty research behind it.

...

This is no nefarious trick by the manufacturer and the article makes them seem like the bad guys.  NOT SO.

Mich - If you don't mind me being nosey and asking...you had two failed replacements, correct?  And at a young age also.  I've always wondered why.

(FYI my grandmother had a double hip replacement in her early 80's.  She healed fine, just never did the PT so ended up wheelechair bound anyway.)

You can tell me to pound sand if I'm getting too personal.

[The Walk of the Penguin Mich]

No problem.

I had 2 perfectly functional hip replacements.  One was done in 2007, the second in 2011.  I used to hit the gym regularly and could walk for miles after I rehabbed the second hip.

In December of 2011, right before Christmas I got sick.  Now, I don't get sick....ever.  Yeah, I get a cold every now and then but that's about the total extent of illnesses.  At the time, I was working flat out crazy as I had a study going on with a timeline.  My goal was to get the study done, I had a foot high data collected on my desk and the game plan was that I was going to take 3 weeks in WA with TD over Christmas.  I could work part of those weeks crunching the data as I didn't need to be in the lab.

I was exhausted.  I would crawl home from work and fall onto the sofa and fall asleep.  I was working 6:30 to 6, every single day - I hadn't even unpacked from going to NY at Thanksgiving.  I'd get up at 9, fall asleep and sleep until my alarm went off at 5 the next morning.  Not hungry.  Was off coffee (which should have been a huge cue).

I figured that I was just too old to be working flat out like this because lab work can be really physical and this was.  So Friday, I crawled onto the sofa, fell asleep and figured that I would be an absolute slug all weekend and get caught up with sleep.

Saturday evening, I could not bear weight on my left leg.  At this point, I began to suspect I had an infection somewhere because until then my joints didn't hurt.  I went to the ER Sunday morning.  A CT scan found an abscess over my left hip.  Blood work found bacteria in my blood.  At this point though, my right hip (the one done earlier that year) didn't hurt.  My left hip turned out to be infected.  I thought back and a few weeks before, I had a boil right at the point on my hip where the abscess was.  I suspect that some of the bacteria were internalized and formed the abscess.  

To treat an infected joint, they have to remove the whole joint.  The metal of the hip does not have a blood supply, so if you get a biofilm on it, there is no way of antibioticing it off of you.  Bacteria will gravitate to these areas in your body because there is no blood supply, so they can exist and grow very nicely without your immune system trying to get rid of them.  Standard treatment pull out all the metal, replace it with a spacer (antibiotic impregnanted acrylic)  and 2-3 months of IV antibiotics.  At this point, they were hoping to save my right hip as it had shown no signs of being infected.

After 3 months of IV antibiotics, my infectious disease doc didn't like my blood numbers.  She was following weekly blood work of inflammatory mediators in my blood and they were not going down as my infection resolved.  So she took me off my antibiotics and pulled my picc line.  3 days later, I could no longer bear weight on the right side (which had handled all of my weight for the previous months).  Right hip was infected.  Back in the hospital, picc line reinstalled, joint removed, spacer installed and another 3 months of IV antibiotics.

When both hips were determined to be free of bacteria (they aspirate the joint), they reinstalled one hip and then the other.  But the multiple surgeries and infection left me with a buttload of scar tissue and bone loss.

So what it boiled down to was that I had 2 perfect surgeries that were ruined because of a minor skin infection.  Sucks, huh?  The prostheses did NOT fail.  The surgeries did NOT fail.

[bean29]

  Mich,

Thanks for the info.

Sorry this happened to you.

[The Captain]

Mich - thanks for going over the detail.  That's kinda what I thought from bits and pieces you've posted here and there.  Hate to say this, but that is some of the worst luck I've heard of.

Glad you are doing (somewhat) better now.

[The Walk of the Penguin Mich]

Hate to say this, but that is some of the worst luck I've heard of.

You're not saying anything that I haven't said.  I can't think of it this way though....

I consider:

1.  I had a treatable infection.  Mine was sensitive to antibiotics, and relatively 'cheap' ones.  Regardless, my pharmacy bill for the IV antibiotics was pushing $1000/week.  I know others that need antibiotics that cost 10x that much money - or that they've got a resistant infection where. nothing's available.

2.  I knew what was going on and what had to be done, so I positioned myself such that I could get the best treatment I could find in the US.  It wasn't easy, and I wound up needing to check myself out of one hospital AMA.

3.  I had decent insurance, and deliberately had chosen a more expensive insurance because it gave me more options.  Had I not, I would not have been able to acquire the best treatment I could find in the US.

4.  I knew which surgeons were good and where I needed to go.  The surgeon who did my first THR is on my FB page and he called me when he found out what was going on.  He directed me to the best that he knew that was available.  He couldn't help me, because he had walked away from his orthopedic practice to ride a bike.

5.  TD.  He came to KY and helped me break out of the hospital.  He packed me and my cat up and flew us directly into Seattle.  We went directly to the ER of the hospital where I was directed from the airport.  My case was a royal pain in the ass to the ER doc, but she was great.

6.  I had a very good infectious disease doc and a very good surgeon that I chose from the research that I had done.  He did my second hip, but was in London when I landed in Seattle (thus the reason why I needed help from my first surgeon to find someone else temporarily).  But he took over my case when he got home.  He was also honest enough with me to let me know that if he could not have handled things, he was willing to hand me off to someone better.

[milee]

Mich, I've never known the whole story about what happened with your hips and I'm so, so sorry you have gone through all that. You've done it with such strength. I'm glad TD was there for you and that you're so strong, level headed and smart about making good choices for yourself. As tough as it will be to start another career, I have no doubt that you will kick ass in that just like you kicked ass through this series of challenges.

[taz157]

Sept 18, 2014 15:41:19 GMT -5 milee said:

Mich, I've never known the whole story about what happened with your hips and I'm so, so sorry you have gone through all that. You've done it with such strength. I'm glad TD was there for you and that you're so strong, level headed and smart about making good choices for yourself. As tough as it will be to start another career, I have no doubt that you will kick ass in that just like you kicked ass through this series of challenges.

Yeah that!

[Wisconsin Beth]

Sept 18, 2014 15:41:19 GMT -5 milee said:

Mich, I've never known the whole story about what happened with your hips and I'm so, so sorry you have gone through all that. You've done it with such strength. I'm glad TD was there for you and that you're so strong, level headed and smart about making good choices for yourself. As tough as it will be to start another career, I have no doubt that you will kick ass in that just like you kicked ass through this series of challenges.

  And give TD a big hug from us for helping you break out of the hospital.