neuromd2012 : Welcome to Just Answer. I am an Adult Neurologist and was contacted to answer your question.
neuromd2012 : hello
neuromd2012 : are you there?
neuromd2012 : can you enter the chat?
Customer: yes i am here
neuromd2012 : as this is now almost 5 years old, I would categorize you as havig a failed total hip replacement
neuromd2012 : have you had a bone scan?
neuromd2012 : or any evaluation of your replacement hip
neuromd2012 : you are on 1800 mg of gabapentin a day, and if this is related to the hip replacement,
neuromd2012 : I would consider getting an orthopedic opinion on the status of the joint itself, do you have
Customer: yes i had a bone scan
neuromd2012 : a malunion, or some other process leading to problems
neuromd2012 : as a neurologist, I would not push your gabapentin much higher than 1800
Customer: ?? malunion confussed
neuromd2012 : and would consider a change to a different medication
neuromd2012 : well you prosthesis can have a problem at the femur
neuromd2012 : where the shaft is not in good contact with the prosthetic itself, and the motion within the bone leads to periosteal pain
neuromd2012 : it is called a malunion of the prosthesis
Customer: I have had several opinions on my hip replacement and no one seems to no the problem
neuromd2012 : ok
neuromd2012 : well I am here online, so I am just bringing it up
neuromd2012 : but if you have been evaluated for hip problems, and still have hip pain,
neuromd2012 : I would still feel it is related to the prosthetic, rather than part of your idiopathic neuropathy
Customer: So how do I start to correct this problem
neuromd2012 : well I assume you have tried therapy over the years, has it helped?
neuromd2012 : you can consider other neuropathic medications, like pregabalin
neuromd2012 : or duloxetine, or amitryptaline
Customer: to an extend therapy helps but for limited time maybe 1 day
neuromd2012 : I see
neuromd2012 : is pain the major problem at this point? or your disability, an inability to walk?
neuromd2012 : for the strength issue, if determined that your replacement is as good as possible, you only
neuromd2012 : have physical therapy to try and improve muscle tone and strength
Customer: i want my life back i do not want this pain I have been to so many doctors and no one has a answer for my condition I am at my end I never had this prior now I'm worse and just my balance is of if I try to walk I loose balance and will fall so it.s been very difficult
Customer: I do once a week and follow my excerises faithly 3 times a day at home..i'm confused thou with the damage of my nerve
neuromd2012 : well online, I am at a distinct disadvantage, as you can imagine, but there are other medications for pain
neuromd2012 : foot drop is a known complication of hip replacement
neuromd2012 : you are aware of that correct?
neuromd2012 : has it not come back at all?
Customer: Not at the time of my surgery it was never dicussed with me only blood clots
neuromd2012 : it is a low percentage, just one or two percent
neuromd2012 : hang on
Customer: never heard of foot drop and yes my foot still flops and drags
neuromd2012 : here is a johns hopkins website discussing how hip replacement surgery can be an etiology of foot drop
neuromd2012 : http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/peripheral_nerve_surgery/conditions/foot_drop_injury.html
neuromd2012 : have you tried the synthetic opiates for neuropathic pain, like Nucynta?
neuromd2012 : I hope I was able to give you some useful information.
neuromd2012 : come back anytime if you have questions
neuromd2012 : Dr Frank T
Customer: no what is it??