A Screw Loose

Monday evening I suddenly felt pains in my right leg.  I had been feeling the right leg was a little weird over the weekend, but nothing to get alarmed about.  But Monday evening’s pains did merit getting alarmed.  Plus there was a major lump just below the point of the hip.  When you have one form of cancer, any sudden lump is a cause for concern.  Walking wasn’t really a problem, but going up or down stairs was painful.  Just trying to stand on the right leg while drying off my left leg hurt.  Normally, such a lump or pain would be the result of doing something I was not supposed to do - where a branch or tool suddenly smacked me in that spot.  But this weekend I had been a model patient.  No heavy lifting, no ladders.  In fact, we had spent most of Sunday afternoon talking with a Stow couple that had been through Multiple Myeloma and a stem cell transplant back in 2004.  Yes, I went for a bike ride on Saturday morning, but I didn’t on Sunday because the roads were wet (and therefore possibly slippery).  I did brushhog the back field Saturday, but that is basically just riding a tractor at relatively slow speed.

I called the Beth Israel hematology/oncology center, the folks who are treating me for Multiple Myeloma.  They said I should come in that day (Tuesday).  I did so.  They took blood samples.  They observed how I walked.  They felt the lump.  They ordered x-rays.  The x-rays came back, and they were interpreted by a Dr Appleton, who is on the surgery team that did my original hip surgery.  They had before and after pictures of my hip, and it was clear that one of the screws from the surgery was sticking out and causing the lump.  Here are the before and after images, before on the left, after on the right:  

Coming down from the top, you first see a fairly long screw that does not go through the metal pad that is joined to the femur with 4 screws.  That screw is to prevent the bone from twisting while it is healing.  The second screw does go through the metal pad.  In the Before image, its head barely shows beyond the metal pad.  In the After image, the head is sticking out significantly.  It turns out that the screw sticking out is not part of the fat long screw that projects into the head of the femur.  Its function is to hold things in place while healing goes on.  Dr Rodriques, who did the original hip surgery and who will remove the screw, said it no longer serves any function, so it can come out.  He has never seen such a screw come loose, but even so, it can come out.

I had long felt slight clicking on the outside of my leg as muscles or fibers in my thigh slid over the screw heads, but this was an extreme form of that.

I am scheduled to have surgery on Friday to remove the unwanted screw.  It will just involve local anesthesia and should only take 15 minutes, so it is not a big deal.  But given all the other things I am being treated for, there are complications.  Is my immune system operating or compromised?  Am I anti-coagulated, and can the anti-coagulation be reduced without danger or blood clots?  Meanwhile going up stairs is a major problem.  I’ll be glad to have one fewer loose screws come Friday afternoon.