On-line Doctor?

[mannginger]

Following on from the 2 threads re pain.

Is there an on-line doctor or health advice thing that anyone knows of where you can get reasonably quick advice/replies?

I have some fairly serious pain in my hip and having been to the doctors it could take up to 3 months to get a referral to get action for it and was wondering what to do in the mean time.

I have asked a question at "wellbeing" or something like that but they may not reply, and if they do it could take up to a month.

Hopefully someone here could direct me to the right place.

Cheers

Phil

[plotloss]

[url] NHS Direct|www.nhsdirect.nhs.uk[/url]

Matt.

>> Edited by plotloss on Tuesday 1st April 14:31

[CarZee]

[e-mail]

[chim450]

For general advice you could post on here, as carzee points out nubbin is a doctor as am I, and I am sure there are a few others loitering on here who would be glad to give you (and anybody else) a little general advice. NHS direct is a nurse staffed advice line, unfortunately for all but very minor problems their advice seems to be contact GP/ go to A&E etc...

[plotloss]

Its true, thats exactly what NHS Direct said to me last week. Apart from the fact that they ended the sentence with QUICK! which wasnt exactly the most settling thing!

Matt.

[mannginger]

Ok well...

I went to see a specialist (orthopeadic surgeon?) a couple of years ago as it seemed my left knee was twisting, it wasn't but the chap asked me if I had any pain in my hips - yes say I, but not much and put it down to sports etc.

He reckons that my "ball" is too big for my "socket" in the hip joint and it will take "major aggressive surgery" (his term) to solve it. Does this mean replacement or hammer and chisel job?

I feel that at 23 I am too young for the hip-replacement route, so am imagining operation with saws and files and chisels and things!

At the time I didn't have that much pain at all so just left it, but now I am suffering everyday with some pain and it seems to be limiting my movement and walking and excercise.

It hurts when I rest it in many positions for any length of time and also during and after excercise and even just walking to uni and back.

I have been to the doc, but it will take months for a referral to be completed (it took 3 months last time!) and the reason I would like a bit of help is that I want to join the RAF, but don't really know how long this op. will take to recover from, and if I will ever be able to be physically able to join the RAF after the op.

If anyone can make a diagnosis and assessment off that info. I will be a) VERY impressed and b) VERY thankful

Here's hoping

Phil

Edited because I sound like a doddery old weakling who can't take a bit of pain!

>> Edited by mannginger on Tuesday 1st April 15:00

[Fer]

CarZee said: [e-mail]

[e-mail]?

[chim450]

mannginger said: Ok well...

I went to see a specialist (orthopeadic surgeon?) a couple of years ago as it seemed my left knee was twisting, it wasn't but the chap asked me if I had any pain in my hips - yes say I, but not much and put it down to sports etc.

He reckons that my "ball" is too big for my "socket" in the hip joint and it will take "major aggressive surgery" (his term) to solve it. Does this mean replacement or hammer and chisel job?


If anyone can make a diagnosis and assessment off that info. I will be a) VERY impressed and b) VERY thankful

Here's hoping

Phil

Edited because I sound like a doddery old weakling who can't take a bit of pain!

>> Edited by mannginger on Tuesday 1st April 15:00

Difficult to know exactly without seeing X-Rays but I would guess that you probably have got acetabular dysplasia. This means that the socket part of the ball and socket joint has not developed properly and so the femoral head (the ball part of the joint) is relatively "too big" and more importantly is not fully covered by the normal bone and cartillage of the hip joint.
This makes it more likely to dislocate but also means that there is relatively more wear and tear to the joint, causing pain and early arthritis (this can manifest as knee pain).
There are several surgical options, but as you are young joint replacement is best avoided and indeed very few surgeons would consider it at your age.
A nice operation for this condition is something called an acetabular osteotomy, and as your surgeon said is quite a major procedure. Basically it involves making some cuts in the bone around the hip joint and moving the pieces so that the head of the femur is covered better, the pieces are usually fixed with some big screws which stay there.
Hope this helps, without scaring the bejesus out of you.

[mannginger]

When you say "screws...which stay there" Does this mean permanently?

Phil (scared because that sounds like he needs to re-think his entire future if he has this thing!)

[mechsympathy]

Have you seen a decent physio??? There is a great deal in the way of strengthening/control work that you can do which may (but not definitely) help. It's worth a go before you head off to the butchers.

Find someone local on www.physiofirst.org.uk/public/default.asp - its the organisation of private physios, or get your GP to refer you to the NHS. You'll have to wait, and may not get long, but it is free.

[mannginger]

Not seen any Physios yet, altho might do if it would be a good substitute to surgery. I really need to see my specialist though.

The RAF will not take people with foreign objects in significant limbs - which is why I am now somewhat concerned

By the way Chim450 - Is a "clunking" sound (more than a knee click) in certain movements associated with this as well?

I am a bit worried as it sounds likely - especially regarding knee pain. Hopefully I am being a big hypochondriac here, but if it is this "acetabular dysplasia" Would it be recommended to have it sorted? ie: will it get me later on in life if I don't do anything? (arthritis etc etc?)

Thanks for the help.

Phil

[chim450]

mannginger said:
By the way Chim450 - Is a "clunking" sound (more than a knee click) in certain movements associated with this as well?

I am a bit worried as it sounds likely - especially regarding knee pain. Hopefully I am being a big hypochondriac here, but if it is this "acetabular dysplasia" Would it be recommended to have it sorted? ie: will it get me later on in life if I don't do anything? (arthritis etc etc?)

Thanks for the help.

Phil

This is the trouble with giving medical advice on a BBS. Without seeing your X-Rays and examining you it is very difficult, nee imposible to make a diagnosis.
From the information you have given it is possible that you have this condition, though it may well be something else entirely.
That is why ultimately the best thing to do is talk to your GP (he will have a letter from the specialist with your diagnosis, and if not can get that information for you).

(Damn, just did an NHS Direct on you).

Best of luck!

[mannginger]

Yup - I guess I'll just have to wait. Thanks for your help though. Much appreciated, I guess it wouldn't harm having a back-up plan for my future just in case.

Thanks

Phil

[mechsympathy]

mannginger said: Not seen any Physios yet, altho might do if it would be a good substitute to surgery.

If you absolutely need surgery, then physio is not a substitute. (It is probably an adjunct tho.)

However, there is room for manoeuvre here. Hip dysplasia may well lead to an increase in wear at the joint as the surfaces are not well matched leading to increased load. This is the reason (or one of them) that you get pain. Another factor is that you have been wandering around with a painful hip. This will lead, whether you like it or not, to an alteration of muscle flexibility and strength, and your gait and activity patterns will change. This in itself can lead to an increase load on the joint resulting in more pain...Catch 22. It can also contribute to pain in your knee (and back, buttock, leg etc.).

Presumably, during your RAF training you will be expected to do some fitness work? This will put further stress onto your already stressed musculo-skeletal system. You need to optimise you hip, and probably whole leg function, before you start training.

I'm risking all kinds of abuse here, but here goes: Orthopaedic surgeons do surgery. Their main purpose is to decide who needs surgery, and how swiftly, and then do that op. (I know this is a generalisation.) There are a great many good ones, and there are some bad ones. There are ones who will look at an x-ray and tell the patient that they are fcuked, and there are tactful ones. As Chim450 said it is hard to be specific when you cannot see the x-rays or the patient.

Edited to make point about orthopods: They aren't always right. I have had patients who have been told they need hip replacements/knee replacements (who were in so much pain they wanted them and whose x-rays looked shocking) who have cracked on with their exercises and avoided surgery. :disclaimer: This is not always the case, (but is worth a go.)

So get some advice, if you are serious about the RAF, then sooner rather than later.

:hopesthishelps:

Edited to add: Even if its not hip dysplasia, you should still get it sorted.


>> Edited by mechsympathy on Tuesday 1st April 18:03

>> Edited by mechsympathy on Tuesday 1st April 18:08

[seafarer]

I knew a girl on my highschool soccer (football) team who had this problem, and so one of her legs was slightly turned inward. I have trouble with dislocations myself (long ligaments), but I was wondering if you could be helped by excercise to strengthen the hip adductor muscles and by having a lift in your shoe that would position your joint properly in the socket? My dad is 75 and has played handball for about 50 years and wore out the cartilage in his knees. Instead of getting knee replacement, he wears a lift in his shoes so that there's a little space for cartilage to grow back--it puts the joint at a different angle-- (and believe it or not, some cartilage has grown back). Maybe you can find a way to position the joint so there's not as much wear/pain with a lift in the shoe?