bone updates: your hips can mess with your spine and your bladder

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Avascular Necrosis (AVN) can affect any joint or bone. I have it in my right knee and tibia. Biologically broke my right tibia three times in the last year and a half. Basically the blood supply gets cut off to your bone or joint and it dies. No, I can't do the things I enjoyed prior to my hip replacements. I was an avid inline skater, I can still skate, but it's painful pushing outward, so my days of getting insane adrenaline from grinding a rail down a 30 flight of stairs is over. I still snowboard, but nothing extreme. A lot of quad strengthening is required. The worst part is dancing. I used to love to dance, but hopping and jumping, not happening. But it's the little things you take for granted pre surgery. Like putting on socks, crossing your legs, sitting Indian style, those aren't happening in fear of dislocation. And you can feel your hips say to you, I'm not happy. I will say the pain after surgery was much less than when my hips literally collapsed beneath me! As for the back surgery, I had previously had a micro discectomy at L5/S1 and it was no big deal, so I didn't fear the fusion. I wish they hadn't nicked my sacral nerve, but it's is what it is.

 

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@ChefMike6329

Egads, sounds like you’ll need a knee replacement, too, then. What will/can they do for your tibia?

Your story makes me feel like osteoarthritis is nothing compared to osteonecrosis!

My favorite position is sitting Indian style. It gives me good back posture. I’ve sat like that since I was a baby. I have really “open” hips and am really flexible. I dread losing that thanks to joint replacements. That’s part of why I am dragging out my knee and hip replacements for as long as I possibly can. But my back pain from my hips is so bad that I’m probably going to get my hips done before my knees. I’m going to try hip injections first; I haven’t had those yet. I’ve had knee injections quarterly for the past 14 years, but they don’t really help any more, especially not in the winter with the storms. Thank you for telling me the truth about what it’s like after hip replacements. The news does not please me! Does your back feel any better, aside from nicking your sacral nerve? At least you didn’t end up with fecal incontinence!

L3-L4, L4-L5, and L5-S1 are my worst vertebrae. L5-S1 give me sciatica that gets bad enough that one night I woke up to go to the bathroom and I couldn’t feel my foot so I accidentally stood up on my ankle and broke my foot horizontally and vertically. Had to get surgery including plates and screws. Now my foot hurts constantly and always will, all thanks to L5-S1 which I first tore during a scorpion fall while snowboarding. At least I was having fun when I did it!

I like skating sounds like fun; sorry you can’t do it any more.

As a female, I’m expected to cross my legs. My back likes the stretch when I do. After hip replacements, I’ll feel unattractive like a man when I can’t cross my legs afterward. Bummer.

 

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Thank goodness for that! A knee replacement will definitely be in the future, hopefully not anytime soon. As for my tibia I've been doing trial therapy with Eliquis (blood thinner) knock on wood, it's working. Well at least the disease hasn't progressed in the 5 months I've been on it. It's weird being 46 with a handicap placard, I sometimes use it. Most days I can walk easily with a cane, rarely I have to bust out the motorized scooter (which is camo btw).

 

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@ChefMike6329

Sounds like a stylin’ scooter! Sometimes I wish I had one. I’ve had a handicap placard since I was 42; I’m 47 now. I don’t mind using it at all though I get some weird looks. I saw a documentary that said only about 4% of disabled Americans use a wheelchair, so you definitely have the right to use your placard.

Are you able to work? How do you put your socks on?

Great news that Eliquis is helping you! I hope that continues to prove true.

Knee replacement recovery is way worse than hip replacement recovery. You don’t even get to stay in the hospital any more, even if you live alone. The pain is ultra horrible for two weeks to the point that you really can’t sleep. The first three months continue to be a painful hell with PT 3x/week. You have to take three weeks off work. Then you still have extra pain and recovery for the next two years but eventually, supposedly it’s worth it. Everybody I’ve talked to about it, which is lots and lots of people, says it’s absolutely worth it, and they only wish they had it done sooner. The only exception is my aunt, who threw up viciously when she took the pain meds so she couldn’t take them and thus, had to be in pure pain through recovery. Because of that, she won’t get her other knee done, and she can barely walk. I really feel for her.

People our age aren’t supposed to have joint replacements; that’s stuff for 65+ years old. Sorry you had to start that stuff at age 35.

 

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P.S. Somebody has to stay with you 24/7 for the first week after a knee replacement. You can’t kneel or squat any more afterward or you’ll pop your replacement off your femur and have to get it done all over again.

 

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I'm sorry you had to go through that. I did hear that knee replacement was totally worse than the hips. I stayed in the hospital for 8 days as I had them bilaterally done. Then I went to inpatient rehab for two weeks and then home being monitored 24/7 for a week. As for your aunt, that's a horrible pain to persist. Did the Dr give her phenergan or atleast zofran to deal with the nausea? I had to take phenergan to endure the pain meds.

 

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@ChefMike6329

That’s a great question about my aunt. Her doctor also could have given her Ondansetron or Compazine for the nausea. Those work great for me. I don’t know if they weren’t strong enough for her. I’m not that close with her. There’s a rumor in my family that what happened instead is that she actually got addicted to the pain medication and therefore doesn’t want to start it again. Maybe one day I’ll get to ask her the truth.

Your hip replacements sound horrific to me but I’m glad you got to be in the hospital and then rehab. What I’ve been told by multiple knee doctors that I consulted with before choosing the one to do my knee replacements is that sometime during Covid when the hospitals were full is when they decided that knee and hip replacement patients no longer get to stay overnight. Insurance stopped covering hospital and rehab stays. And of course, in the past 10 years since you’ve had your hips replaced, now they don’t give adequate pain medication anymore because of the whole misguided opioid “crisis” hysteria. Less than one percent of people who take opioids end up abusing them, but they punish all of us just for that one percent who screw everything up for the rest of us. Following a knee replacement, I was only going to get 40 500/325 Percocet!!! Six doctors told me that. So that would only be enough to take one every six hours for 10 days, yet they’re telling me the pain is bad enough that I might not sleep much for three months?! Not sleeping is not a good way to recover. Your body needs sleep to recover! One doctor told me that’s all they could do and I said, “No, its definitely NOT all you can do. Medications much stronger, like Fentanyl, exist. What you mean to say is that you actually just refuse to treat the pain adequately. Don’t tell me there isn’t methodology with which to treat the pain; I’ve read multiple books about the treatment of chronic pain. Far more powerful pain medications exist but you simply refuse to use them because you don’t want your medical malpractice insurance costs to increase. That means you don’t actually care about the welfare of your patients.” He was pretty stunned that I talked back to him but it didn’t make any difference. The solution to that crap is to get established with an actual pain clinic before getting a replacement, which I did. They don’t hand out opioids like candy, either, but they’re a little more lenient than surgeons.

 

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Question, what test would they do to find out if you work on your knee?

 

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@ThatFLGuy

Do you mean what test do they find out if you have osteoarthritis in your knee? You visit an orthopedic surgeon. They examine your knee movement to feel if it catches on your muscles. They start with a regular x-ray, which can tell them quite a lot, and then, if it looks really bad, they move on with an MRI to see the details. You begin with hydrocortisone injections for treatment, which usually work really well to treat the pain for three months. They’ll also prescribe (useless) physical therapy. Actually, when I started getting the injections, they worked 100% for six months (now 14 years later, they only help 20% for six weeks). There’s also an hCG injection called Euflexxa that you can try, but that doesn’t usually work for anybody and no insurance company pays for it. It costs thousands of dollars so it’s not worth it; I don’t recommend it. I tried it and experienced zero relief. The next step is arthroscopic surgery (3-4 small incisions in your knees) to shave off bone spurs and maybe do a meniscectomy so your disc isn’t catching on your bone spurs. Then after that, it’s time for knee replacement.

My experience with orthopedic surgeons has been really positive. Compared to back pain, there’s a lot they can do to help you. The needle for the knee injection is not really painful; it’s just awkward, like an elbow funny pain. You’ll get major pain relief by the time you walk out the doctors office door, and then you’ll have even more relief within three days. They’re so amazing! I definitely recommend getting your knee checked out if it’s hurting you because there’s so much they can do and if there’s something you can fix to make your life easily better and suffer much less pain, I think you should do it. The more you ignore knee pain, the more you end up damaging your hips, pelvis, and spine by limping even though you don’t realize it.

 

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@ThatFLGuy

If they don’t find osteoarthritis, you might have a torn ligament. Some of those require major surgery and major recovery (if it’s the ACL) but sometimes they can repair that with an arthroscopic surgery. Recovery from arthroscopic surgery isn’t too painful and only hurts for 3 to 6 weeks, but it’s not excruciating.

 

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@snow
I can and do walk on my right leg. Going up stairs hurts most times but going down is very hard. Like I have no support once my knee bends even a bit.

I tend to us my left leg more going up and down.

 

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@ThatFLGuy Sounds like you definitely have something going on with your bone or a ligament. Pain when going down stairs is a primary sign of both kinds of damage. Going down is definitely harder than going up!!! I recommend getting it checked out. If you don’t want to go to an orthopedic surgeon or don’t have one in town, you can probably talk your primary care physician near where you live to order an xray at your small local hospital. That’s a good place to start.

I had kind of been ignoring my knee pain from age 19 to 35 until one day I was backpacking down a trail and I went around the bend and my knee just collapsed and I fell to the ground. Then I got stung by a wasp in my armpit, lol! So I understand that collapsing feeling. Maybe sometimes does your knee(s) lock up instead of collapsing? Like they won’t bend, especially during a storm?

One thing you can do immediately is to take the stairs one step at a time. Put your left leg down and then put your right leg on the same step and then repeat for each step. That way you’re not putting all of your weight onto your right knee when you go down. You can also go down the stairs at an angle and that can help you. Like face your body in a diagonal. Try it facing different directions until you find what feels easier, less painful, and more stable.

Ice, heating pads, Aleve, Advil, and Tylenol may give your relief. I remember you have some restrictions on taking those but I couldn’t get out of bed without them. I prefer Aleve because it lasts for 12 hours. I take the liquid-gel capsules because they work faster and are easier on your stomach, liver, and kidneys than the hard pill form.

If things get really bad, you can always try a cane; they’re inexpensive. If your right knee is the bad one then you would use the cane in your left hand as you walk to help stabilize your movement. After trying a cane, a walker is the next step but they’re bulky and a pain in the butt.

Did your knee pain come on suddenly or gradually over time? If it came on suddenly, I would suspect it’s ligament tear. If instead it has come on gradually in your life, then it’s probably osteoarthritis. There’s a chance that if you have poor nutrition absorption because of your G.I. problems, that might affect your bone density. That’s definitely something to talk about with your doctors because it’s pretty serious.

One thing about osteoarthritis is that it usually hits both knees at the same time. Do you have pain in both knees? I know your right knee is worse, but does your left knee hurt too? Usually the right knee gets the most damage because you use that knee more often if you’re right-handed.

 

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@snow

I was in a car accident on my Birthday in 2014 and did not get my knee checked out after it swelled up that day. (Didn't know my car insurance would pay for the ER visit)

Well over the years it has gotten worse.

Had a bunch of falls from my knee now working when I need it to.

Now, My left leg is not good either. I broke it bad when I was a kid and it was decided to just let it heal. I was in a cast for a long time and they even sent my X-rays to different hospitals to see what to do.

Speaking of X-rays. My PCP office has one there and I will be asking to get one when I see my PCP.

 

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@ThatFLGuy Yeah, sounds like a great plan!