Tag Archives: meta analyses

Hip replaced again–not metal; recovery–reading, gardening, patience…..


Feb. 19, 2012

I haven’t written in the blog for a while as I recover from major surgery. My metal-on-metal hip replacement had caused “metallosis” in my joint, similar to the lungs of metal-workers not wearing masks. The balloon of fluid  grew to obstruct circulation to one leg, which swelled progressively over 2 months. An ER visit eventually pin-pointed the problem (two of my regular doctors were consulted first–no clue). So back in mid-December I had the metal parts removed, and now have ceramic and plastic, which seems to be the “standard issue.” Turns out Johnson & Johnson have been aggressively marketing this DePuys hip in this country, since it’s been removed from the market in countries where they keep a nationwide database on implanted medical devices. With all we pay in this country, we keep no national statistics like this. After the surgery, I had time to skim Google, and in no time found two meta-analyses of data on this type of hip from Switzerland and the UK, both of which do keep nationwide records. They provide insurance for everyone there, so it benefits citizens, as well as their country’s economy, to keep people well. In this country, be contrast, profit is everything. Since medical device companies can now provide lobby money (bribes) to not only law-makers, but also our Supreme Court justices, citizens in this country receive care that would not be tolerated in nations who provide insurance for all. Am I angry? You bet. Had I happened to be living in Canada, for example, where they also have insurance for everyone, and keep nationwide records, I would not have had this type of hip replacement since they’d had considerable trouble with it, and had stopped using it the year before mine was inserted, here. About 15% or more metal-on-metal hips need to be removed in less than 5 years. Now, why didn’t my doctor at Duke know about this from the conferences he must have attended each year? Data goes back at least 15 years documenting  the serum collection in the hip causing the muscles to be pushed out of place and thinned as they stretch around 2 pints or so of liquid that doesn’t belong there. In my case there was also the development of granulomas around each nano-sized piece of metal, destroying both muscle and bone.  My blood stream sports cobalt and chromium levels hundreds of times higher than normal, which is nearly zero, and no one knows the long-term effects of this. I wore a brace for 2 months, and will be on hip precautions for the rest of my life. I’m walking with a cane nearly 3 months after the surgery and still taking a small amount of pain medication. That’s why I haven’t added to the blog.

I haven’t been able to do very much but read, walk, and knit. I’ve watched my gardens grow up in weeds, the crocuses fighting for light. I’ve developed some long-handled tools, since I can’t bend over. The first was a steak knife duct-taped to an old broom handle, with which I could saw off the tap root on weeds after I’d loosened the dirt around them with a 4-pronged cultivator on a long handle. It took 2 weeks to fill a cat litter plastic can with those small weeds–extremely frustrating, and painful after only 20-30 min. because of the torque I was giving back and hip. The doctor refused to order PT at first because he was afraid even gentle exercise would dislocate the hip. I begged for PT and OT after 5 weeks, and finally he allowed it. They came to the house for only 2 visits each, since I had a visit with the doctor the following week, and he ordered the brace off, and said I could flex the hip slightly more, up to 70º so that I could drive, sort of, still leaning far back, and sitting on a high cushion. To my dismay, I learned that I had been doing far more than either of them advised with the restrictions he’d placed. Since I had not been allowed PT/OT, I had no way to know that, and tried to moderate my gardening within the “don’t bend, don’t sit” rule. Turns out the one I wasn’t aware of was, “don’t twist!” After doing the prescribed walking, and seeing all my gardens neglected, I decided if I could walk I could use a rake and cultivator, so set to work, a little at a time, to do enough work that I wasn’t leaning over the railing on the deck and sobbing in frustration. I didn’t want to disturb my husband, who works from home. When he thinks I need something, he’s right there, and I couldn’t have him sacrificing his work for my flower gardens. He’s been very supportive, but after 2 months of this dependency, I really do feel like a burden. My feeling, not his.

The the 5-pound “spica brace” I wore for 2 months, 24/7, including having to put it right back on, soaking wet, it after I’d washed it in the shower. It does not come apart–no spare parts to wash and wear. It takes more than 9 hours to dry, whether on a sunny day when I spent most of the afternoon outside, or a cold day, when I turned round and round in front of the wood stove, changing towels under the wet brace about every 15-30 minutes, blotting it somewhat from the inside. By bedtime it was still damp. I found not a single experienced person to tell me how to wash the brace–the sales person suggested spraying it with lysol or covering the smell with scented powder. I also have asthma, so neither of those would have worked. After the brace started smelling like an unwashed street person, those remedies would not have removed the emanations. The only time for two months that I went out was to doctors’ appointments. I wore some elegant muu-muus given to me by an elderly friend some years ago. She’s now gone, but I thanked her every day for those gowns to cover the brace. Clothes of any sort were out.

I’ve been so distracted with struggling with daily activities and pain that I haven’t even written anything since the surgery. I had started working on a story for the Creative Nonfiction Journal 6 months ago, which I continued working on and submitted that a month after the surgery, well before deadline, but I haven’t been able to free my mind from these daily struggles to create. Maybe this blog entry will be the key to open my mind to the world of words again.

I’ve done lots of reading, however. I’ve started going along the shelves of my own library here, beginning with some very old books that were my mother’s, and just getting lost in another world. I’m now nearly done with Gene Stratton Porter’s “Girl of the Limberlost,” an early environmental critique about saving swamps and wildlife from farming and oil wells, with excellent character development. Taylor Caldwell’s “Tender Victory,” 3 books about the Trapp Family Singers, including the last one, “Maria,” a memoir by–yes, Maria von Trapp. That was a positive experience, as she, the elder mother, reflected on mistakes she’d made over the years, and decisions she’d made to continue a productive life when the children grew up and moved on, and the singing group dissolved. Frank Slaughter’s “Daybreak” was sad, about psychiatric care in the ’50’s, methods, successes and failures–and a final positive ending to bring it together on a positive note. “Moloka’i” by Alan Brennert is a Holly Springs Library book club reading this month. This topic reminded me of readings in the last 2 Trapp books, when they’d visited this former prison island of leprosy patients in Hawaii, the book covering 80 of the 100 years before sulfa drugs came along to cure leprosy. Still piled beside the bed are a Pearl Buck story about her father, “Fighting Angel,” Elizabeth Gouge’s “Green Dolphin Streeet,” and “Intern,” by Dr. X. And when I’ve completed that stack of old friends, Sue Grafton’s latest, “V is for Vengeance” awaits (a Christmas gift from my mother-in-law), as well as the book my daughter in CT sent me at Christmas, which I’m enjoying a little at a time, Michelle Edwards’ “A Knitter’s Home Companion.” So if I’m not writing, I really am reading.

Also I’m knitting. I figure if I have to tote a high-density foam pillow wherever I go because I can’t sit on a “regular” chair (remember–only 70 degree flexion–not the 90 degrees I’d have to do in a chair–the risk of dislocation of the new hip is high because of the damaged muscle the doc needed to remove, and the remaining muscle stretched to ribbons around the large sack of water in the joint–so no flexion…) I made the pillow case a pretty one–knitted a round lace doily from the Austrian lace pattern book a friend gave me when we were in Styer some years back, the graph pattern translated by a German knitter in our H. S. knitting group. I’ve knitted 2 pr. of socks in lace for myself, knitted wool roving slippers for a friend, a scarf for a niece, Christmas bell ornaments for my own “steel magnolias,” friends who have been strong and resilient helping me recover. I’m working on my 8th hat for the New Hill knitting charity project, have completed two more baby sweaters for friends at church, one in my own wool, in case one of the families wants to be more “natural” than acrylic “throw-it-in-the-washer” sweaters.

I hope I’ll be able to spin before long–I do miss that “therapy” of repetitive motion, and the soft fiber flowing through my fingers into yarn. I’m very glad I had a great deal of yarn spun before this surgery so I could entertain myself as I recover. Shearing is coming along in about 2 weeks, and I’d like to have a workshop on that weekend, if I can be on my feet enough to manage. We’ll see…

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