Hip Replacement

[Beauport]

Hi all - think my question to you is quite straightforward? Anyway here goes.

I badly need a hip replacement and was recently advised by a private hospital (which carries out certain NHS operations) that they cannot perform the op because of my cirrhosis. They are therefore referring me back to the NHS hospital. I quite understand the reasoning behind their refusal to operate, given that they don't have the same resources directly on hand as the NHS has in the event of an emergency.

Now I'm fretting a bit about a possible emergency - What sort of emergency might occur? I do have a low platelet count, for example, so could experience excessive bleeding.

I'd be so grateful to hear from anyone with cirrhosis who has had surgery unconnected with, but complicated by, their condition. If I'm being a pathetic whimp please say so!

Many thanks.

Carole x

[Millie09]

Hi Carole, first off, I have cirrhosis 10 yrs now, f4 end stage fibrosis, I have osteopenia in my hip and two prolapsed discs middle to lower back.

On my last visit to my previous doctor and orthopaedic assesment, I was told my hip will get worse as I have cupping of the actabulum, where i have abnormal bone growth,.

Eventually I will have surgery.. but i cant get my head around why private health care are not equipped for emergency? Doesn't seen right if you pay for the privilege? . The only emergency that could happen to me is a total break of the hip, so i have to be careful.

I have had oral surgery, at hospital on many occasions but not even that was complicated post minor surgery even with stitches. You have every right to be worried, it's only natural.. having never been private I assumed you get priority care ? .i know transplants you can't but anything else you would do ?

[Beauport in reply to Millie09]

Hi there Millie - I wasn't actually going to be a private patient, but a NHS patient in a private hospital. Yes, I know it's confusing! I chose the private hospital because the assessor in the musculo-skeletal dept. at my usual hospital offered me a choice and I thought the private hospital would have a shorter waiting list.

I believe private hospitals don't undertake any risky surgery. They won't deal with cancer ops, for example, or heart surgery. But you do find private surgeons with clinics in NHS hospitals with two separate patient lists.

I feel for you Millie, I really do my love. You must be in so much pain and yet you never moan and are always ready to offer help to others. God knows my hip pain is bad enough - I can't imagine what you must constantly feel.

One of the things I love about this forum is that all its members are both courageous and caring. Life is often a massive struggle but we battle on and still have time for each other.

All my very best to you Millie, as ever. Go girl! xx

[Brett11 in reply to Beauport]

They won’t operate on my hernia because of cirrhosis. It’s annoying.

[Adelou in reply to Brett11]

Husband went in 3 X times for his hernia, sent home twice due to low platelet count & ascities

[Beauport in reply to Adelou]

Did they operate on the third attempt Adelou?

[Adelou in reply to Beauport]

Yes successful operation the 3rd time for the umbilical hernia, healed quickly

[Beauport in reply to Brett11]

Oh God. I'm in a lot of pain - can't take too many painkillers because of the cirrhosis ..... Did they tell you exactly why they can't operate on your hernia Brett? What might happen if they did? x

[Brett11 in reply to Beauport]

They were worried that I could bleed to death . They will only operate if it becomes life threatening. I can never win. My hernia is the size of a football in my stomach. It looks like a triffid.

[kyia]

My partner has cirrhosis and had to have an emergency operation for a strangulated umbilical hernia. His liver had been compensated prior to the operation and afterwards became decompensated again from the stress caused by the op.

[pip-lit]

I too need two new hips. The surgeon said that they should go ahead, but referred me to the anesthetist consultant for a second opinion. They said that because of a number of addition factors (breathing difficulties, spinal problems,lack of red blood cells) the only way that the might perform the operation was with pre-op blood infusions, at least a week in ICU with a crash team on duty and support from the local centre of excellence dealing with liver failure. The prognosis wasn't good with high chance of liver and kidney failure leading potentially to death. I got a second opinion and they were even more damning than the first. Recently I visited my liver consultant, who said that there was a good chance his hospital (regional centre of excellence for liver complaints) were likely to perform my operation, with a liver specialist on hand as it were. Every case is different, Good luck with yours.

[Beauport in reply to pip-lit]

Oh good God! I didn't realise just how risky surgery could be. Will speak to my GP tomorrow and ask her to refer me asap.to a hepatologist rather than my gastroenterologist, in whom I have little confidence.

Many thanks piplit and good luck with your surgery. Do keep me posted.

[Brett11]

Any operation causes major body trauma which can cause your liver to get decompensated again. Your body is busy trying to heal itself so there is less focus on helping your liver.

[moonbeam4]

Don,t be put off from needed, life improving operations.., Obviously with cirhosis we have a slightly higher chance of bleeding due to our blood clotting times, however, this is easily resolved by having plasma on hand in the operating room. This is much easier for them to arrange in a NHS hospital, maybe ask for reasurance and explanations from your GP if you have a good relationship. Beat wishes to you. MB.

[Beauport in reply to moonbeam4]

Moonbeam, thank you so much. At last a positive response! I was truly having serious doubts about my op.

I gave spoken to my GP and she was very reassuring. I also have a consultation with my hip man next week, and an ultrasound shortly. My platelets are currently 132, which isn't too bad.

So I may yet survive!

All the very best to you Moonbeam.

Carole x

[Mags72 in reply to Beauport]

Hiya, I'm curious to know whether you got this done, if u dont mind me asking? I'm in a similar situation of needing a hip replacement and having cirrhosis. My last check up my liver was doing good n I don't drink alcohol at all now.

[Darsmum100 in reply to Mags72]

Hi Mags - the op went well and I didn't need any blood transfusions. However, I am concerned about the huge quanitity and dosage of analgesics I had to have after the operation 3 weeks ago. I'm only now, this week, able to cut down on the pain killers as the pain has eased substantially. In hospital I was taking morphine, 100 mg paracetamol and 30 mg codeine every few hours. I'm trying to arrange an appointment with my liver man asap after Christmas, but am obviously not holding my breath!

Good luck Mags - make sure you gather all the information you need before you go ahead with the surgery. This is NOT easy - I fail to understand how the gastroenterology dept and the orthopaedic dept in the same hospital cannot liaise! Let me know how you get on. xx

[Mags72]

Oh I'm glad the surgery went well for you. X I hadn't really gave it a thought about cirrhosis and surgery. And now the thought of it and reading the bad reports is scaring the hell out of me. So it's nice to hear yours went well.

[Darsmum100 in reply to Mags72]

Good luck with your op - stay in touch.

[Mags72 in reply to Darsmum100]

Thankyou darsmum, I will post updates.

[Mags72 in reply to Mags72]

And speedy recovery to you.x