Medical hardware removal...?

[jessmarimba]

Worth it? Not? What are your stories? Opinions of health-care professionals on here?

I know one of the screws in my back is slightly bent, but I doubt it has anything to do with the day-to-day back pain. My doctor gave me the option to have the hardware removed at any time I want. But I don't know if it's really worth having surgery again...And I worry that a doctor who stands to profit from cutting me open isn't going to give me a straight answer on whether the surgery is worth it.

(Fortunately the muscles over the screws have grown enough that I no longer get searched every time I go through an image scanner at the airport, or I'd have them out in a heartbeat :D )

[Kiwi Stoker]

I was told to only have the plates and screws in my arm removed because of the following-

Something has moved and is causing real issues with pain and/or movement

Your religion/beliefs doesn't allow you have to foreign objects in your body when you die

The doctor said the risks of infection and of course then having a weak bone while the holes heal over is just no worth it. The airport security people told me that only really large metal implants like hip or knee replacements cause the alarm to go off.

So my metalware is here to stay. If it ain't broke, don't fix it!

[ny biker]

I had a screw in my heelbone after ankle surgery years ago. I had it removed 6 months after it was put in, because it made the back of my heel unbearably sensitive -- one day I accidently hit the leg of a chair with it, and I literally saw stars like when a character in a Bugs Bunny cartoon gets hit on the head.

I was also having problems with scar tissue in my ankle, and the surgeon addressed that in the second surgery.

I haven't had any problems as a result of having the screw removed. They told me the hole would just fill in.

[margo49]

I have 2 plates and 12 screws in one arm that set off alarms. But I am leaving them there - no pain, no worries. They are not doing anything positive now as they have been there since 2003 but they are part of me.
What religions????, btw ...

[jessmarimba]

One vote each way! Thanks to both of you :)

I know in the end it's my decision to make, but I wish it was easier to do internet research. Most people who post on the web about back pain are somewhat hysterical.

I know that the screws tweak nerves on occasion, and not usually in a way that I can replicate. They can test to see if removal will help this by injecting lidocaine around the screws to see if that eases pain. So there's a preliminary option.

The other thing that slightly bothers me is just that I can feel them all the time. Not painfully, necessarily, but I won't sit in wooden or plastic-backed chairs any more. I can't "roll through" my back (like, say, Rolling Like a Ball in pilates). Just imagine leaning against a chair with a small pebble on either side of your spine at your bra line and two more about 3ish inches lower. Worth surgery? Probably not. But years of this?? Hard to project whether it's worth it.

Too bad the spine isn't an area to gain fat first if I just overdosed on the Christmas cookies!

(Oh, and Kiwi - they don't set off metal detectors for me, but they're close enough to the skin that they occasionally show up as a "problem" with the x-ray scanners...and since I'm at close to 80 flights for this year, it's annoying :rolleyes: )

[Kiwi Stoker]

It was a specialist I saw in Singapore which has lots of different religions. Maybe Musilm?

Oh and one other thing (and this is mainly because my plates are on my upper arm) but I have one 20cm scar and another 10cm (repairing tendons). I don't want another scar. Apparently they don't like to open up existing scars.

[solobiker]

I would not do it myself. I work in healthcare and have seen way too many infections with removal of hardware. To me it is just not worth the risk...Just my opinion.

[emily_in_nc]

I've still got a plate and four screws from my pelvic fracture repair in 2005, and have no plans to have them removed. They don't cause me any issues, and my surgeon said it would be safer to leave it in unless it caused me pain down the road (which he didn't think it would, and he is right). They also don't set off metal detectors in airports.

But Jess, in your case, I might consider having the screws removed. I enjoy doing yoga and Pilates, and it would bug me to no end not to be able to do plows, rolling like a ball, etc. Those are some of my favorite stretches. And not to be able to sit comfortably in all types of chairs. I don't know your age, but I would seriously consider whether I wanted to have that worry for the rest of my life.

Obviously there are risks with any surgery, but if my hardware was bugging me for any reason, and insurance would cover the removal, I'd have it removed, I think.

[jessmarimba]

Thanks all. I've been more sore than usual lately, though I wonder if our wacky weather doesn't have something to do with it.

Part of bringing this up might be wishful thinking that no more screws = no more pain. I can easily see how so many people end up relying on pain pills - when it hurts, I don't want to do anything, especially not exercise, even though I know after a class I'll always feel a lot better. On the other hand, I'm absolutely totally and completely petrified of needles, so more surgery isn't high on my list of things to do either! (...I haven't even gone to the dentist for a few years out of sheer terror)

Thank you again for the input. Lots to think about.

[soprano]

Two years ago I saw my husband go through a bad orthopedic surgery. The surgeon and the anesthesiologist *both* screwed up. His recover was rougher than it should have been, and he had to have a second surgery to fix the surgeon's mistake (and guess who paid the bill for that? Hint: it wasn't the surgeon). He's fine now, but it is not an experience that either one of us ever wish to repeat. After that experience I view surgery as a "last resort" option.

If you want a medical opinion from someone who can be financially objective, go to another doctor for a second opinion. This is a totally normal, in-bounds, "done" thing. Your current doctor won't think less of you. I went for a second opinion once on a prescription. My insurance paid for the visit, and I ended up switching doctors because I liked my new doctor so much better.

[ny biker]

Thanks all. I've been more sore than usual lately, though I wonder if our wacky weather doesn't have something to do with it.

Part of bringing this up might be wishful thinking that no more screws = no more pain. I can easily see how so many people end up relying on pain pills - when it hurts, I don't want to do anything, especially not exercise, even though I know after a class I'll always feel a lot better. On the other hand, I'm absolutely totally and completely petrified of needles, so more surgery isn't high on my list of things to do either! (...I haven't even gone to the dentist for a few years out of sheer terror)

Thank you again for the input. Lots to think about.

A dental checkup does not involve needles, and with a good hygienist it doesn't hurt much at all. Not going to the dentist for several years means it's only a matter of time before they have to do painful expensive things to fix your teeth and gums.

I think a second opinion, or even a third, would be very helpful for your back.

[jessmarimba]

A dental checkup does not involve needles, and with a good hygienist it doesn't hurt much at all. Not going to the dentist for several years means it's only a matter of time before they have to do painful expensive things to fix your teeth and gums.

I think a second opinion, or even a third, would be very helpful for your back.

The checkup doesn't, but they'll make sure I pay them to re-drill and re-fill all of the unnecessary metal they've already put in my mouth. Thanks but no thanks. (Though I'll take suggestions from anyone in Denver for a good, medically conservative dentist. All I've heard from anyone here is who NOT to go to).

Thanks, soprano. Chatted with my pilates teacher yesterday and she suggested a practice with a neurosurgeon I'm thinking of visiting.

[Tokie]

You need to have your teeth cleaned to prevent gum disease. That is a different issue than fillings. If you do not take care of your gums, eventually you will develop periodontal disease and your teeth won't need fillings, they will need pulling. The inflammation from periodontal disease is associated with heart disease. And I am getting one of my numerous screws taken out of my ankle this winter. It's head is at a sharp 45 degree angle just under the skin - I can hardly wait! Your back is an entirely different situation. And unfortunately nobody can tell you with 100% certainty if the outcome would be same, better or worse. Wishing you a second opinion that makes your decision easier, and finding a dentist (with an awesome dental hygenist) that you trust! tokie

[OakLeaf]

DH has a dental phobia. He found a dentist who will do his procedures under IV sedation. You might check around, just make sure to get someone with plenty of experience and certification in whatever anaesthesia they use. It does mean you need someone to take you to and from the appointment and stay with you for a few hours afterward.

I think a lot of people who didn't have "Marathon Man" experiences as children don't really understand dental phobia. I didn't, until I met DH - even though I have a phobia of falling, so I do understand the concept of a phobia, unsecured edges are something that I can avoid without too much trouble. Unfortunately, I've learned a lot of people did have those experiences, and it does stay with a person for life.



Anyway, /drift. :cool:

[smilingcat]

My father was an MD. And he always stressed do no harm first!!
Do only necessary surgeries not electives.
There are no such thing as a routine surgery.

He even said that back when, if a person wanted cosmetic surgery, the person who wanted the surgery would have to see a psychiatrist first.

He took a very grim view of too many surgeries. If you are not in any risk with the screws, leave it alone.

[molliewog]

I had 14 screws and a plate in my ankle. I had them removed 1 year after they were put in (the initial injury). Removal seemed pretty routine with my surgeon, especially in patients under 30 years of age. I'm VERY glad I had them removed. Despite being told the hardware shouldn't make a difference, I noticed a big difference in comfort and joint mobility after it was all removed. My surgeon opened up the initial scar on both sides of my leg. Granted, he had sewn up the incisions internally the first time, so the scars after the initial surgery were very tidy, just over a hairline in width.

I missed 3 days of work following the hardware removal surgery. Recovery wasn't bad at all. Sure, it took time for the incisions to heal (about 5 inches each side). I did have to be careful for 6 weeks, as I essentially had a broken leg given 14 screw holes.

Now, your injury and hardware is much different than mine, but I wanted to share my experience!

[OakLeaf]

FWIW, this is third hand, but a good friend of my father's who's been so helpful with all his surgeries, says that an anaesthesiologist friend of his says that on average, it takes a year for the brain to recover from each hour you're under anaesthesia.

Not necessarily something I'd undertake lightly. I think Smilingcat has it right. But if the hardware is causing you irritation or pain, then that's definitely a reason to have it out.

[jessmarimba]

I hate anesthesia. Really I do. It took months after a minor surgery a few years ago to be able to even run normally again.

But I am in agony today, something twinged last night on the side with the nerve pain when I was changing into pjs. I can't figure out what hurts or why it still hurts but I am so happy that my pilates class was cancelled. I haven't taken pain pills since 10 days after the accident and right now I want one.

I just wonder, what happens if I twinge that nerve 30 years from now, and the consequences are much worse? It's going to be a lot more difficult to remove this stuff then.

[Wahine]

I was told to only have the plates and screws in my arm removed because of the following-

Something has moved and is causing real issues with pain and/or movement

Your religion/beliefs doesn't allow you have to foreign objects in your body when you die

The doctor said the risks of infection and of course then having a weak bone while the holes heal over is just no worth it. The airport security people told me that only really large metal implants like hip or knee replacements cause the alarm to go off.

So my metalware is here to stay. If it ain't broke, don't fix it!

+1

Unless your surgeon can confidently say that removal of the hardware will decrease your pain or improve your function, I wouldn't risk it.

[ClockworkOrange]

Hi Jess

As you remember, I broke my back just before you but I was fortunate enough to have one consultant say no to surgery and thankfully he made the right decision.

I am so sorry you are getting so much pain with it all, wish I could offer advice, my only comment is talk it all through thoroughly with your consultant/surgeon.

Take good care and I wish you well with whatever you go ahead with.