Surgery and hypo

[Murphysmum]

I’m going to need a hip replacement in the coming months. It’s fairly major surgery at any rate but as I have complicating factors (childhood dysplasia) it’ll be a wee bit more major.

Anyway, it’s worrying me. Not so much the op itself, more that I cannot seem to get consistently with my thyroid levels. Well, I can, the levels are fine, but how I feel isn’t always. I can a few weeks, maybe even up to 6/8, that I feel amazing but then I’ll dip again.

For me, a dip is always muscle weakness, palpitations and fatigue. I also always have a very low heart rate. I’m active, but I’m not a marathon runner! Even when feeling well and levels are good, I can dip into the 40s very regularly.

Has anyone had major surgery and how did you cope? I’m sure I’d be fine but it’s playing on my mind. I’m worried they’ll turn me away before I even get as far as surgery because of my heart rate for example.

[Jazzw]

I haven’t been in your shoes (yet—wouldn’t be surprised if it happened eventually!) but didn’t want to read and run.

I’m guessing that if you need a hip replacement you’re in pain quite often and that alone can be utterly draining. You know, it might be that the dips have nothing to do with your thyroid hormone levels and everything to do with your body coping with the stress/inflammation etc of having a knackered hip.

I take it you confessed to your doctors about taking T3 in the end? Or not?

As for the heart rate, it is on the low side definitely but that’s normal for you. I’m making some assumptions here about pain etc but are you on pain killers? I’m going to guess yes because my Dad’s having a hip replacement next week and he can’t get through a few hours without them. He’s on the highest dose of co-codamol and I know that that can keep your heart rate low—the codeine in it being an opioid.

Try not to worry. So easy to say, I know. Sending a hug x

[Murphysmum in reply to Jazzw]

Thanks jazz.

Actually, I’m not on any painkillers! Even my surgeon expressed his reasonable surprise at this but did say he sees people with normal looking hips that are in lots of pain, and people like me, who’s x ray is quite impressive, with a hip well and truly wedged into the socket who doesn’t need painkillers!

One can only assume that a lifetime of constant discomfort of some sort has lead to a tolerance.

On that note I now find my pain is elsewhere due to increasingly bad posture and accommodating the lack of range of motion. Now and again I’ll get very bad pain in the hip but it’s very short lived for me.

I have admitted to my surgeon that I’m on T3 and interestingly, he asked quite specifically if I had any issues with my thyroid now or was it controlled. Of course at the time I was feeling very well and so I said oh yes, I’m fine…. Now having a dip or flare or whatever it is we have, I’m reconsidering this answer!

The low heart rate does concern me still but I guess that all be ruled a problem or not fairly early on.

I intend to try to adhere more strictly to a low inflammation diet though I’ve tried this before and in our house it’s just not practical. Anyway, needs must. Secondly I headed to my gp to ask for a referral to our local menopause clinic as hormones are definitely playing into how I feel now. I hope that if I can get some regulation of those, maybe the thyroid stuff will follow.

Sigh…. It never ends does it?!

[Jazzw in reply to Murphysmum]

It really doesn’t!

[Miffie]

My last surgery was when I had a total reverse shoulder replacement late 2019. A procedure my surgeon considered major surgery. No one was at all concerned about my taking ndt or my current levels. I have always found anaesthetists really excellent at understanding hypothyroidism and the fluctuations we have . Your low heart rate will be monitored if they think it’s an issue following your pre op assessment. The chance of being turned down for either of those are very slim. I don’t know enough about your childhood dysplasia to know how much this is affecting the surgery. I did wonder if it’s the reason you are now having a replacement? I was on tramadol and co codamol before surgery so a slow heart beat but all good for the op. I have a heart murmur and left ventricle stuff but nothing to prevent surgery happening.

I was first down to theatre as a I am diabetic so we always go ahead of others due to the worry of complications. Probably the only bonus of diabetes, less hanging around. I expect you will find yourself in the same position due to the dysplasia making this a more major surgery than it would be for most of us.

I had problems during surgery but nothing to do with hypothyroidism or heart. After heavy blood loss and extra time in surgery I needed a transfusion then additional iron. However I was still able to go home on day five following the op as planned.

I have friends who have had hip replacement surgery and who are delighted with the results. Lots of physio ahead for you, with a hip it starts very soon after the op I believe.

Try not to worry I am sure you will find surgical team reassuring and hope you get a lot of benefits from the procedure.

Good luck

[Murphysmum in reply to Miffie]

Thank you for this - it’s exactly the kind of chat I needed! 😊

I’d imagine the type of surgery is similar, in terms of how invasive it is and the recovery time. I suppose things like the blood loss can happen to anyone and I’ve heard reports from other “hipsters” of similar. It’s just plain old luck I think.

Yes my replacement is as a result of the hip never being right. I had an op to reset my pelvis and lengthen my leg when I was six, and although it was very successful, it was always time limited. I’m ten years over what was predicted though abs have lead an active life thus far, so not bad shooting really.

I will need a slightly more complicated op in that I’ll need a socket as well as a femoral head, so it may be longer snd more prone to complications than normal, again I guess that’s luck.

It’s good to hear all was well though, and what you say about the anaesthetist I suppose is why my surgeon asked about how stable I was now in thyroid terms. As I say, I won’t know u til I get to pre op time but it’s nice to know these seen it before and took it into consideration. I suppose that’s partly the cause of my fears - we’re dismissed so often my medics that our trust is a little dented.

Thank you so much for your reply.. that’s fine a long way to settling my anxiety ☺️

[Miffie in reply to Murphysmum]

Glad to help, my surgery was more complicated than a standard shoulder replacement as both ball and socket were replaced. I now have the socket where the ball was and the ball where the socket was. Lots of lovely metal in there, but it works rather well without the pain I had previously. The problem was my bones disintegrated whilst he was trying to fit the first new piece and they had to do extra work as well as finding I needed get a different sized replacement than he first tried to fit. That virtually never happens. I was very lucky to have been in this consultant’s care for a long time prior to the replacement. Not all can do the reverse but it’s his ‘thing’.

I was in a sling 24/7 for six weeks and no movement allowed. Then physio finally started , my girlfriends with new hips were moving them really soon after the op. I sincere hope you are able to do the same, however you may like me be banned from movement until healing rather more underway. Take care.

Always shout out on here when worried everyone is so helpful.

[Fruitandnutcase]

Have a look on this site and see if you can find anything that relates to your question.. I haven’t looked at it closely but I found it very useful when my husband was about to have a hip replacement - he has no thyroid problems though.bonesmart.org