DEAR DR. ROACH: I had a knee replacement about six years ago. At the time, I was in considerable pain, and it dissipated slowly after the operation. After about six months, I still had some pain, but the surgical doctor I used had retired. So, he just gave me my medical history and closed his office. He was a one-man operation.
I still had pain, but it was tolerable. However, had I known I would be left with more pain than I had before my operation, I wouldn’t have proceeded with the operation. Recently, I saw another orthopedic doctor who took X-rays and said that everything was excellent and looked good, but I still have pain and stiffness in my knee.
I now need a hip replacement on the same side. Is there anything I should be asking, or can some sort of MRI or other scan reveal an abnormality with my knee? I’m really afraid of being left with more pain than I have now. — A.S.
ANSWER: Being left in more pain than when you started is an unfortunate outcome with a joint replacement. Usually, there is a reason for the pain (such as an infection) that can be found and sometimes corrected. But it sounds like you have been one of the unfortunate ones in whom the operation really was a failure — at least in terms of pain, which is a very important outcome. The ability to do more activities is another major benefit that is hoped for and expected with a joint-replacement surgery.
Approximately 20% of people have persistent pain after a knee replacement. I am by no means an expert, but patients with persistent pain often do get an MRI to look for surgical complications, including loosening and instability.
One other condition that I saw in one of my own patients was metal hypersensitivity; my patient was known to be quite allergic to nickel, and the surgeon put in a nickel-containing prosthesis. She continued to have pain until it was removed and a new prosthesis was placed.
DEAR DR. ROACH: I am 56 and have been experiencing frequent urination lately. I have to urinate almost every hour, and I also become thirsty very often. The more I drink water, the more often I urinate. What could be the possible health challenge? — A.T.
ANSWER: Frequently urinating small amounts of fluid generally means a urine infection, an overactive bladder, or prostate problems in men, but I think you are specifically talking about large amounts of urine output.
The classic combination of excess thirst (“polydipsia”) and excess urination (“polyuria”) is a sign of diabetes mellitus. With diabetes mellitus, high sugar in the blood cannot be adequately removed by the kidney and is excreted through the urine, bringing water along with it. This forces the person to drink more, which leads to salt and water imbalances. (Diabetes insipidus can also cause similar symptoms, but is much less common.) These conditions can be easily tested for with the most basic metabolic tests.
However, I have also seen people, both interns and patients, who “chase their tail.” What goes in must come out, so the more you drink, the greater the need to urinate. Many people believe that the more water you drink, the healthier you are, and that’s just not true.
I very frequently see patients in trouble from excess water drinking. (This is much more likely in older people, those with kidney disease or those taking medications that affect the ability of the kidney.)
* * *
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
(c) 2024 North America Syndicate Inc.
All Rights Reserved

Copy the Story Link

« Previous

Meds are still necessary after kidney transplant from years ago

Next »

Unapproved drug in the U.S. helps control Type 2 diabetes