Elbow xrays: I hope I'm not banging on too much about... - NRAS

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Elbow xrays

Ginger46
Ginger46
โ€ข24 Replies

I hope I'm not banging on too much about my elbows but I just need to get everything straight in my head before I really need to make my final decision about my elbow replacements as it's scaring the hell out of me right now. This is the only xray image I seem to be able to add to this post, my rheumatologist says she's seen worse. She definitely didn't seem impressed with the idea of an op for me, giving me the "how old is your son" and "you won't be able to lift any grandchildren if he has any". I know that's a very negative comment about her, she is really lovely but that upset me. I think I need to ask the surgeon next time I see him how long could my elbows last before I really need them replacing. It might be another 10 years before out son gives us grandchildren. Now in my 50's I know my age belies the need for replacements but I have read posts from younger people so it gives me a little hope ๐Ÿ˜Š

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I'm not sure I'm quite understanding.... your elbows are eroded, and you obviously have pain. But you also talk about using elbow crutches, so I didn't quite understand whether that is also a cause of pain? And has the surgeon talked about whether you can use elbow crutches after elbow replacements? I know that you are restricted about the amount you can lift afterwards, but don't know about weight bearing.

And if the rheumatologist was dismissive of the idea, did she have other suggestions to help such as infiltrations? And was she able to say what the risk of further erosion was?

In the end only you can decide whether the possibility of reduction in pain is worth the movement limitations afterwards.

Ginger46
Ginger46 in reply to helixhelix

Yes sorry, sometimes it's the way I put things across, I confuse myself. I do still use elbow crutches because of my RA in lower limbs but using crutches exacerbates the problem in my elbows even though I try not to put too much weight through them. If I do have the replacement Ops then the crutches will have to go which is why I will be looking for a mobility scooter for longer distances. No she didn't give any other options or further risks, I see an RA nurse next week so I'll see if she can shed any light ๐Ÿ˜Š๐Ÿ‘

I considered both wrists when my son was around ten and decided against it due to recovery time, both have naturally fused straight and I have adapted. As for the elbow...my left one had been at almost 90 degrees for months and the pain was as bad as I'd known. Last two steroid injections into the joint did nothing, I have since had in the space of a fortnight...Steroid injection into joint, second week into oral Pred for a month and 1/2 of Rituxibab. Almost straight, but not quite and very very slight pulling on joint if stretched only. I think the elbow I would consider without doubt, the pain, lack of mobility and mental impact was a step too far. If it's not grandchildren it may be something else and tomorrow is always today before you know it. No weight bearing but imagine those huge hugs from grandchildren, people are amazing how they adapt. Pain can really mess with your head and as my wonderful consultant says, "Deal with the here and now".

Ginger46
Ginger46 in reply to juneann

Hi thanks for your reply, I started with JRA (didn't call it JIA) when I was 13/14 and that was a rough time, my wrists fused straight at that time and I learnt to adapt, had no choice. It went into remission and came back after my son was born, when he was 3 I had my 1st hip replacement which was revised 7years later because it was a faulty metal on metal joint. I've also had 2 knee replacements and many different medications over the years. The surgeon says it's too far gone for injections, replacement is the only option but he does want to see if going back on Methotrexate may settle it but I'm off that again due to my liver levels shooting back up again. I'm going to do a little bit of fact finding 1st but to be honest I think I'll go ahead with the surgery, here and now is right and I've a very supportive family, my 16 year old son is logical but blunt haha ๐Ÿ˜Š

juneann
juneann in reply to Ginger46

Good to hear back from you Ginger46. My son is also sixteen and can be quite pragmatic when his head isn't in the clouds or kicking a football, as well as very supportive.

I have had a knee replacement since 2011. I'm also in my 50's. I could barely walk. I had two previous surgeries to clean it out with no long term success. So I had no choice but do it. I haven't had any problems but have to keep it strengthened. If I have to get my other knee done I'm going to try stem cells 1st. That wasn't an option for me 7 years ago.

Please ask if this is an option for you to try 1st. I'm not a doctor and don't know the correlation or similarities compared to a knee but it's just a thought to ask before you replace it. If you do, it should all go well. They are getting so technologically advanced in these circumstances. I wouldn't worry too much. Good luck! I will pray for a successful best choice for your elbow.

Ginger46
Ginger46 in reply to Trish1006

Thank you for your reply, stem cells, that sounds interesting, I will ask about that and Thank you for the prayer, I do appreciate that ๐Ÿ˜Š

Here's my guide to what you should do. I have had my right knee replaced twice mainly beause first hospital botched it up. Well i can't kneel on it ever and it is a metal as well,but i have to sit on my bum if i am gardening. I have had false knee since 2009 so think hard before you go ahead as there will be a lot you won't be able to do if you had it done. Speak to your surgeon only you and with help from him can help you here. Good luck whatever decision you make.xxxx

Ginger46
Ginger46 in reply to sylvi

Haha Sylvi, love the reference to your guide, sorry you had horrendous problems with your knee. My initial hip replacement was revised due to being metal on metal, I had cobalt/chrome poisoning. I've had both knees replaced too so I can't kneel either, not easy to get up off my bum too. I know the risks and I won't be taking the decision lightly on this one ๐Ÿ˜Š

premierscfc
premierscfc in reply to Ginger46

Hi ginger46

I had a MoM hip 11 yrs ago and I'm now waiting for the revision surgery as I have the same problem as you.

How was the op/recovery?

On the original elbow thread my right elbow has been damaged/painful for many years and I'm always having it injected. My original rheumatologist told me that if I had it replaced it would only stop the pain and I would be really restricted in what I could do so I decided against it.

The decision is always a personal one and I wish the RA didn't put us in that position.

Ginger46
Ginger46 in reply to premierscfc

Hi thanks for your reply, unlike the original hip replacement where I was awake they gave me a general for the revision. The op was successful but I think it took a bit of getting over, I was a pain in the backside for a few weeks, my husband will no doubt vouch for that. I hope that helps a little, I do get the odd twinges of pain now and again but not too drastic. What worries me about the elbow replacement is one of the components is cobalt/chromium which was a major factor in my original MoM hip, blood poisoning. I don't think that'll be a problem this time as it won't be the same type of movement. I've had RA since 13/14 caused by my underactive thyroid, autoimmune diseases, pain in the backside and everywhere else ๐Ÿ˜Š

premierscfc
premierscfc in reply to Ginger46

When will you see the surgeon about your elbow?

Ginger46
Ginger46 in reply to premierscfc

I think in the next couple of months, I can contact him anytime though xx

I was first offered a replacement elbow when I was in my 40โ€™s because my elbow had deteriorated so badly. This was going to be done at the Nuffield Hospital in Oxford. I was warned that the life of the joint would not be long. Almost at the last minute I cancelled it and interestingly my elbow gave me another 20 years of use, albeit painful. When I went down the replacement route again the pain was severe, both elbows were more difficult to replace because of deterioration and the fingers in my hands had nerve damage and were collapsing because of damage at the elbow. The important factor was I could not stand the pain anymore. I had one done in 2015 and the other in 2017. The moment I awoke from surgery the pain improvement was amazing and I have continued to be delighted with the results. I am 66 and how long my elbows last is not so critical. By waiting 20 years I am sure materials and techniques improved. I think my main piece of advice would be is to find a good experienced surgeon. It is not a common operation and a good surgeon will have an impact on the result. Research how many replacements he/she has done and if possible get a second opinion.

BoneyC
BoneyC in reply to davannh

.... I'm waiting for improved techniques/joints. In 1998 I was 34, two young children, working and mortgage to pay, the thought of revision surgery every 10-15 years and high infection risk put me off. Potentially 2 revisions if I lived to 70 plus, with each revision not so successful, potentially ending up with rigid elbows, unable to drive and do much else. My elbows are already bent, have been for years but there's no guarantee of straightening so for now it's better the devil you know!

With my first THR I was told there was 1% infection risk, I got infected with bacteroides capillosis! Spent 4 months in hospital on IV antibiotics, attached to a vac pump which didn't save my THR. Had that hip removed and had to wait another 3 months for infection to clear before they inserted a second THR - excrutiating pain in the meantime and unable to walk. This is what makes me think it's better to wait for as long as possible, until I get older as I don't want revision surgery every few years for hips, shoulders, elbows & ankles with infection risks each time.

Ginger46
Ginger46 in reply to BoneyC

So sorry to hear you had a rough time with your THR, you were definitely in that 1%. I have already had a few replacements myself so I know what it all entails, hope all goes well for you ๐Ÿ˜Š

Hi there, I think personally it depends on the pain you are getting from your elbow. I had my left replaced in 2014, it certainly took the pain away. I can't though straighten my arm properly but that is a minor thing as opposed to the level of pain.

I think rheumatologists are often fairly negative about surgeries in general. I think they are very wary of some of the new procedures. Have to say I have had bilateral jaw replacement after years of minor procedures which didn't help. The op has been fantastic. I have had several others which have been successful. I think basically it's personal choice and of course, how awful the pain is.

Sorry can't be more help. Good luck whatever you decide.

Ginger46
Ginger46 in reply to dippyd09

No don't say sorry, you have been of help, jaw replacement, wow, last time I had problems with my jaw was before I got pregnant 17 years ago and then it seemed to settle and not had problems since, fingers crossed. I think you're right about rheumatologists, it's probably the guidelines they have to follow, thankyou for your reply ๐Ÿ˜Š

My advice would be to consider carefully wether you feel it would be beneficial. I am 52 and have had both elbows replaced. The left was done in October 2016 and went really well. My recovery was good and my range of movement increased slightly. Pain completely gone. I was so pleased with that one that I was happy to go ahead with the right elbow. This was done in July 2017 and the experience was totally different. Recovery was a lot slower, it took a lot longer for the pain to go. I have nerve damage in my right hand and the range of movement has not improved at all. I donโ€™t regret having them done, but I was aware that I would have to quit my job after the surgery and I was granted Iโ€™ll health retirement.

Ginger46
Ginger46 in reply to Jewels94

Thank Jewels94, sorry to hear you had to retire due to ill health, I admit I haven't worked for 18 years due to my RA so I'm not necessarily losing out that way. I am struggling more with my right elbow to the point sometimes holding a cup of coffee can be painful, feels like it's jarring. Some days I think what am I talking about and then boom, just a little movement. I'm sure there's worse than me but I do think overall I'd rather have the op, my husband has just been looking at the amount of surgeries performed in my local area and it's a big fat 0 but the surgeon I have seen is a specialist so I want to trust him which I think I do. It's definitely a rare scenario to see elbow replacements, I'll be thinking of you and I will post again when I've made my decision ๐Ÿ˜Š

Jewels94
Jewels94 in reply to Ginger46

I know exactly what you mean with regard to the pain. I was the same and there were times when I just wanted to chop my arms off completely. I think Iโ€™d forgotten about how bad it was but remembering now makes me realise it was definitely the right thing for me. As for the ill health retirement, I couldnโ€™t be happier. No more struggling into work and putting on a brave face when I was really feeling like I couldnโ€™t cope. If I m having a bad day now I can just relax and take it easy. Itโ€™s so much easier to pace myself now. Good luck with whatever you decide, if the pain is bad itโ€™s definitely worth considering, just donโ€™t expect miracles with your range of movement xx

Ginger46
Ginger46 in reply to Jewels94

Sorry had to reply to this, chopping my arm, mainly my right off was absolutely a major feeling I've been having. Not been quite there with that recently but it depends on how much I've been doing, especially with using an elbow crutch. The way I was explaining it was like having toothache but quadrupled, absolutely horrendous. I forgot to say, so happy you're happier in your retirement ๐Ÿ˜ก

Just a small comment, both my grandmas and my mum had ra, and way before the pain killing drugs and options for replacement. I nevertheless received huge supportive amounts of unconditional love from all of them. Now I have ra I am so thankful to have had their examples of strength, humour and common sense. The couldn't physically pick me up, and couldn't always physically hug me, but I absolutely have never felt the lack of love and support, even though they are all long gone and hopefully skipping joyfully around in the afterlife. ๐Ÿ˜€๐Ÿ˜€๐Ÿ˜€

Ginger46
Ginger46 in reply to Kathies

Thank you Kathies, so lovely to read your comment about your family, I've always tried to do my best for my family even though it's not always been lifting and carrying but I can give love. That's all I'll be able to offer soon but having supportive and loving family and friends is important ๐Ÿ˜Š

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