Right side replacement ....

 I have a few struggles accepting that my right knee and hip need replacement. Now, this is not to say I didn't realize it would be necessary. I am a very "black and white" thinker when it comes to my rheumatoid arthritis diagnosis and the fact that I do not have the RA factor in my blood makes me wonder.....do I really have this. Then, I hear my doctor's talk about the condition of my joints. All agree that there is no reason for my joints to be in the poor condition that they are in. Thankfully it is just my knees and hips that are affected (fingers crossed forever). 

I knew after my left total hip replacement in September 2020 that the time would come to make a decision on what would be first......the right knee or hip? Following the surgery, I continued to have periodic appointments with my surgeon, Dr. Sherman or his awesome PA, Ryan. I would space these appointments about 6 months apart and always requested x-rays of both the knee and hip. Each time the comment would be; "let me know when you are ready".

I always felt that the knee was giving me more pain than the hip. At one appointment in early 2021 I had a cortisone injection in the knee. This was done by Ryan and at the time he suggested a referral Dr. Dong who is a specialist in Physical Medicine and Rehabilitation at Upstate Bone and Joint. A recommendation was to have a series of cortisone injections from the outside of the hip to the knee. I did some research and spoke to professionals that I have worked with and trust. My decision was to forego the injections and prepare for replacement.

On March 10th, I met with Dr. Sherman. New x-rays were taken and as he walked in the exam room he asked how soon I wanted surgery. As we talked he stated that he typically does the hip before the knee. The reasoning is that you definitely need the use of a good hip in the recovery of the knee. Trust me, I remember! 

I explained that my knee pain was worse than the hip.....he conceded and agreed to replace the knee first. I signed all paperwork to move forward with this! He also gave the hip a cortisone injection to calm it down.

Well.....my hip had different thoughts! So....with my left hip replacement I experienced a lot of groin pain. This is very typical and actually a "marker" for replacement need. My right hip had more lateral pain. Dr. Sherman explained that where the bone-on-bone was most prominent, the ball of the hip was gliding with my pelvic bone. It was actually causing great inflammation with every movement; so much that a bubble was visible in the x-ray!

Less than a week later, my hip was "screaming". The pain expanded from the external area to the groin. Every step brought on pain and as with the left hip, sleep was becoming more challenging. I called Dr. Sherman's office to ask if the surgery could be changed to the hip!

I am sure Dr. Sherman was laughing and shaking his head. It was reported to me that he said "sure, both have to be replaced anyways; we will make the switch".

I was able to schedule with the office staff and we chose 4/21/22 for the date. Then it was full speed ahead with pre-op appointments.

Clearance from my PCP, Dr. Smith was important. The office scheduled me quickly and all went well. I have been going to my PCP for over 18 years so he knows me pretty well. He has been through every joint replacement with me. He also understands my challenge in accepting my RA diagnosis. He always takes time to talk with me regarding this and reminds me that clinical assessments indicate that the RA is real. He also supports my decision not to begin biologic treatment for RA at this time. As he explains, the damage present will not be resolved by beginning biologics therefore he suggests waiting until replacements are completed before making a final decision. He reports that goal is to prevent further damage and at this time the only other areas that seems to be affected by RA are my hands and they are status quo.

I had the pre-op visit at the hospital, Upstate at Community General Campus. There were a gazillion questions to answer but we got through it. I was excused from the "joint replacement class" which was great as I had a lot of things to get in place at work before taking leave.

The next and very important pre-op appointment was the CT scan. This was done very close to surgery date. The purpose is to develop data to assist the Mako robot. It also provides more details, beyond the x-ray on the total condition of the joint. Although I am not a medical professional, it was clear in the details that my hip was "ugly"! 

Count down to surgery day............