Thursday, October 05, 2006

The Caveman, the Surgeries, and a New Toy

Cavemen don't do well in hospitals. This is true if the Caveman is the patient and not the doctor or technician or therapist.

Many Cavemen use their talents to gather and remember data and facts, utilize their inherent abilities to solve problems in a sequential manner, and save patients.

But Cavemen who are just the patients have a very difficult time adjusting to being confined to an unfamiliar setting and most of all, being unable to be in their cave for a period of time.

As I am a Caveman, being a patient TWICE in a hospital, for two operations, was not fun, enjoyable, or comfortable, to write the least.

I have avascular necrosis. It is a disease where blood flow is cut off to bones in specific joints of the body. The loss of blood flow to the bones causes them to die, fracture, and leave a person in great pain and lacking in mobility.

I have the most common form of the attack of the disease as it has invaded my hips.

My right hip began letting me know that it was not happy in April, 2006. At first I thought that the recurring sharp pain in my groin was a muscle pull.

I climbed power and telephone poles and moved heavy manhole covers for decades, so I though the pain was caused by pole climbing.

The pain started out to come on infrequently, but gradually throughout the rest of 2006, the episodes of pain grew closer together and lasted longer, as time progressed.

Finally in November and December, 2006, I visited my General Practitioner who thought also, that it was a muscle problem.

It wasn't until I have been referred to an Orthopaedic Surgeon and undergone an MRI did I learn about the disease and what it all meant.

During the first visit to the Surgeon, I explained the symptoms and he didn't even need to examine me. He told me from the get-go that I probably had avascular necrosis, which is often commonly called, osteo necrosis.

In March, 2007 we saw the results of the MRI and the confirmation appeared very visible, even to my untrained eyes, that something was definitely amiss with my right hip.

My left hip didn't look like the picture of health it should have been, but it was nowhere near as bad as my right hip.

So now, what does this Caveman need to do to get over the disease?

Of course, there were no easy answer for that question. My Surgeon told me that because I was so young (51 at the time), a total hip replacement would mean that I would have to probably have a replacement surgery within 15-20 years, if I lived that long.

The Surgeon did offer an alternative surgery that is exactly what a real Caveman would immediately agree to and be very proud of having it in the first place.

The surgery that was suggested to me, and one I quickly agreed to is called a Core Decompression Osteotomy. Big word for a truly Caveman type surgery.

Here's what the Surgeon does. He drills a large hole through the angled part of the hip bone, which is called the femur.

Then he gets a special camera and some cutting and scraping tools and he looks at the dead and dying part of my round hip bone, with his camera.

The Doctor then goes ahead and removes by any means necessary, the dead and dieing bone material.

After the bad Cavebone is removed, a collection of bone grafting material is gathered and placed through the hole, where it is molded into a round end.

A titanium pin is placed in the hole and it is held in by a receptacle and plate portion that fits on the outside of the femur.

Two screws are then placed through two holes in the plate portion and the Cave-femur, to hold everything in place.

Then everything is sewn back up and the Caveman is wheeled into recovery.

Now the good part is that from that point forward, I had some great titanium and other parts in my body. How Caveman is that!

Below are photos of what my Surgeon implanted back in September, 2007.


I know the top photo is blurry, but I wanted to show how the screws are not beveled into the plate portion of the device.

See all the threads on the pin and screws? Yes, they are real. Also on the top of the pin you can see a channel that also seemed to act as a drill as the Surgeon was twisting it into the hole in my femur.

Now, might you be wondering how I can have undergone the operation to place this devise in my body and still be able to place photos of the exact devise on this post?

Well if you guessed that the Core Decompression Osteotomy failed to completely get rid of the dead and dieing bone material in my right hip, you would be correct.

Since my initial recovery period from this first surgery, I had problems with the damn plate portion and the screws that stuck out from the plate portion.

I could feel the tissues in my thigh grow ever more painful as time went by and I put pressure, by sitting, on the area where those screws protruded.

This problem may have been manageable in the long run had that been the only problem.

Unfortunately in November, 2007, just about two months after the surgery to put the apparatus into my body, the old demon of avascular necrosis continued its relentless mission of further killing off more bone matter in my right hip.

The medicine I had been taking since March, 2007 was supposed to ease the drama with my left hip, because it was less involved, and also attempt to keep bone matter from further death in my right hip.

The medicine seems to have stopped most of the progression in my left hip, but for the right hip, it was a dismal failure.

November, 2007 brought a checkup at the Surgeon's office, where I notified him that the old sharp pain in the groin came back and was growing stronger by the day.

Two x-rays, taken during that office visit confirmed that the operation, hardware and drugs that were supposed to clear all the diseased bone from my right hip, had failed.

The only option for this Caveman was no option at all.

A total hip replacement was required. But that is another story for another time.



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