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M.L. ~Hi and welcome to drug watch radio I’m your host M.L. today’s show is about hip implants specifically metal on metal implants. These are hip implants where 2 metal pieces rub together like a ball and a cup or a neck and a stem. Today I’m speaking with patient advocate Joyce Courtney Peterson. Joyce is a hip implant expert with drug watch she got her bachelors of science from university of fl and has extensive experience in elder care. Welcome to the show Joyce.

J.C.P. ~Thank you Michelle happy to be here.

M.L. ~Well first of all you know we hear a lot about the hip implants now. There’s commercials for them, there are things from the FDA warning ppl about specifically metal on metal implants. Can you tell our listeners what exactly you need to watch out for and why these are a problem.

J.C.P. ~Yes, I’d be happy to explain that to ppl. I speak with hundreds of ppl that have had problems with their hip implants and hip implants are increasingly common in the United States approximately 400K hip implant surgeries are performed each yr. and by the year 2015 that number is expected to rise to 600K so we are dealing with a huge part of our population. For the most part hip implants are performed on more elderly ppl however for accidents or other illnesses hip implants can also be performed on young ppl, middle aged ppl, and so it crosses the section of our population basically to all ppl. So it is impt that everybody understands what are the dangers and the consequences of possible hip implants.

M.L. ~Yes and I believe that most ppl also assume that it’s usually just like you said the elderly ppl that get them but isn’t it true that today more and more younger ppl are getting them that are say maybe in their 50s as opposed to much older than that

J.C.P. ~Yes, I’ve even spoken to ppl in their 20s that have received hip implants bc they’ve been involved an accident. For the most [part] hip surgeries are to restore mobility from fractures for the elderly or fractures which occur from an accident or degenerative conditions such as arthritis and for many ppl they do restore mobility and give them extra yrs of mobilitym6

M.L. ~Yes so we want to be clear that we’re not saying that all hip implants are bad right

J.C.P. ~No a lot of hip implants are life saving and also they save ppls quality of life but for some ppl implants are a real problem and can lead to severe very severe medical problems

M.L. ~Alright now you mentioned there the severe medical problems what kind of complications do you usually hear from ppl that call in

J.C.P. ~Well we get across the board of the population for the most part it is elderly ppl. But I have spoken to lots of ppl young ppl who have had car accidents or even horse back riding accidents that they have need to have a hip replaced. But hip implants usually last about 15 yrs and the irony of this is that most of the metal on metal hip implants which are the ones causing the problems were given to the younger ppl b/c they were believed to last longer so b/c they were young rather than making them have one or 2 more revision surgeries in their lifetime they gave these new metal on metal hip implants to the younger ppl but the irony is that these were the active ppl and now they are the ones who are suffering the consequences of sort of an experiment of metal on metal rather than the normal type of hip implants

M.L. ~ I see so the idea with these implants was that they would actually be more durable and last longer, right?

J.C.P. ~Exactly that was what they were touted as that if you are an active 40 yr old and you want an hip implant you should certainly have a metal on metal such as a Striker but as I say ironically the majority of those have caused great medical problems

M.L. ~Alright, now you mentioned the brands, you said Striker, are there specific brands that ppl need to watch out for

J.C.P. ~Yes, the first problem that I became very familiar with was a brand by the name of Depew. And studies have shown from the Depew studies that about 13% of the ppl that had Depew would need revision surgery to fix that within the 1st 5 yrs, however that was in my opinion a deceptive finding b/c Johnson and Johnson who is the parent company for Depew revealed later that the hip is expected to fail in 40% of the patients and if that has been revealed it probably is even greater than that so that was the first type of hip that caused a great uproar; the Depew ASR and then there is also a Depew Pinnacle which is a metal on metal which is causing a great deal of problems to a great deal of ppl. Approx. 33K of the Depew ASR were implanted but that was recalled in 2010 so the yrs of those implants are from 2005 to Aug. of 2010

M.L. ~Now with those implants, what was the reason that they gave that they recalled them?

J.C.P. ~They were saying that there was high revision rates but there was also another complication which was known as metallosis or too much metal in your blood. Too much metal in the blood is very dangerous for ppl that have had the Depew ASR b/c metallosis can cause illness.The ions travel in the blood and can cause things like kidney function impairment, visual impairment, audio impairment, heart problems and possible cancer. They just don’t know the extent of the damage that is caused by too much metal. So what the doctors are recommending b/c of they don’t know they’re asking these patients to have these hips taken out of their body. So not only do they cause pain and immobility but they also cause this metallosis and then don’t forget that you have to go through another surgery and surgery in and of itself always carries risks.

M.L. ~Def. and also the revision surgery is way more complicated than the original surgery where the hip went in to begin with, isn’t that right?

J.C.P. ~Unfortunately Michelle that is very true and patients have to understand why… I’m not a dr. but I can explain to you in the way that I best understand it that When a patient has an implant that causes metallosis b/c of too much metal the tissues and the bones surrounding the implant almost die so they become black very black and it causes the implant to become very loose b/c there’s really no structure to the tissue and the bone to hold the prosthesis to it so it’s kind of like eating chicken is a very gross example But it falls off the bone and that is what these implants are doing they’re basically becoming so loose and in many times even detached and they fall off the bone which causes you know severe pain to the patients. Now if you have such damaged tissue and bone it also cannot heal as well as the original healthy tissue and bone so your rehab takes a lot longer. Also, unfortunately sometimes when the Drs. Go in to remove the prosthesis they break other bones such as the femur bone and that also increases your rehab time and your pain so I have heard figures that it’s twice as long or three times as long and I have talked with patients who say yes it is much worse than the 1st rehab that I went through

M.L. ~Yeah, as a matter of fact I believe there was a story done recently on a woman that had 2 striker implants for both hips and when she was forced to get revision surgery what you were saying happened she had a hip fracture and she was forced to basically to get an entire metal rod placed in her leg to fix that… that’s def. a serious issue

M. L. ~We’re going to take a quick break and we’ll be right back with more drug watch radio

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M.L. ~Welcome back to drug watch radio I’m your host M.L… and also another thing that you mentioned that ppl don’t usually think about is that this metal does travel to other parts of the body and does damage other organs not just the hip so…

J.C.P. ~Well that’s exactly correct and any patient that is considering whether or not to have revision surgery should study the effects of metallosis which they can do on drug watch.com and many other places on the internet. But These metal on metal implants are causing just great problems with the metallosis. It’s a very sad situation.

M.L. ~Now say a loved one or maybe a patient has one of these hips, what should they do if they’re concerned?

J.C.P. ~Well the best thing they need, the first thing they need to do is call someone and see what type of a hip they have. If they have any of the problematic hips and I’ll list them for you then they need to get proof of that from the dr. that did the surgery or if the dr. won’t give you the proof from your operation rpt. From the hospital that did the surgery so, once you are able to establish what type of hip you have then we can help you at drug watch to determine whether or not that hip is a problematic one. Now you have to be careful b/c it’s like General Motors makes Cadillac and Cavalier Depew makes many diff. types of hips… so the problematic Depew hips that I’m aware of are the Depew ASR and the Depew pinnacle both of those are carrying a great deal of complications and implant failures. so if you have one of those you should call one of the patient advocates at drug watch and we’ll be able to help you. Another huge amt. of population has been injured by another type of hip known as the striker rejuvenate hip. Those hips have been recalled and are extremely Problematic. Approximately 20K of those were implanted b/n ’09 and ’12 but they were recalled in July of 2012. Now the drs. Are supposed to give all their patients written notice of this and ask them to come in and also be tested for metallosis but we’re finding that that is not occurring in every case and in fact even though it was a yr. ago almost that the letters were supposed to go out I am talking to patients everyday that either just received a letter from their dr. or haven’t yet received a letter from their dr. so its incumbent upon you to see if you do have a striker rejuvenate. Now you have to understand that these manufacturers are very powerful for ex. Striker had 8 billion dollars in annual sales in 2012 so you can’t trust the manufacturers of these hips to do the right thing by you.if your dr. suggests to you that you speak with a representative of the manufacturer of your hip I wouldn’t do that b/c many times we have spoken to patients who have done that and it has not been beneficial and in fact often times the manufacturer of a hip tries to get the patient to sign off for, in return for paying for revision surgery or paying for the actually the deductible of their insurance from the revision surgery and that is just not right and it isn’t fair. So you have to be very careful who you speak with. Now if you speak with a member of drugwatch.com we can give you instructions on how to proceed. It isn’t complicated but you do have to speak with ppl that are trying to help you rather than ppl that are trying to get you off the books as one of their bad hip recipients. It’s very sad to think that you can’t trust everybody but in this world today you have to be very careful who you sign with, who you talk with and you know speak with ppl that will be able to help you

M.L. ~Now you also mentioned something interesting there about how manufacturers will try and get you to do things under the guise of maybe trying to help you. They also want the hips back, right sent back to them is this right, and what are they, what does a patient do if they are concerned before they go in for hip revision surgery?

J.C.P. ~The hip has to be protected and the chain of possession has to be proven. Now what the manufacturer wants to happen is for the hip to disappear… b/c believe me from the ppl that I have spoken with that have seen their hip after it has been removed they were shocked to see that it was all black from the metallosis. It doesn’t look like it should and so that is really impt that the hip be preserved. Now the mere preservation of the hip by the dr. or by the patient is usually not sufficient. b/c You need an independent person that’s business it is to preserve medical devices to do it in the correct way and we can help you get that

M.L. ~Now what happens though if this does happen? Say Depew or Striker gets the hip back what can a patient do at that point?

J.C.P. ~That hip could disappear and I have spoken with ppl who you know they don’t want the hips to remain visible. b/c if this goes to a jury and the jury sees the hip it is much more likely that the patient would be awarded a large amt of money. They have hired ppl to actually go out and try to collect patients and do this. This is not in your best interest so you have to understand that and be ready to say no I’m not going to do that right now I need to consider my options. The options are to have a legal representative take over for you and get this out of your hair which is a much smarter option than to trust somebody who’s already made a defective hip that has injured you and required you to go through surgery again.

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M.L. ~Welcome back to drug watch radio I’m your host m.l.; now when ppl call in and speak with you can you share some of the stories that you’ve heard from them and what you’ve been able to do to help?

J.C.P. ~Well one sticks out in my mind it was a young girl she was from New York and she had received a Depew ASR and she needed emergency surgery she was in terrible pain, it was infected and she truly needed the surgery and it was scheduled and she called me and she said that the dr. said unless she spoke with the representative of Depew and they agreed to pay her deductible that the dr. wouldn’t operate at which point in time the young girl said well I have good ins. Can’t you just take my insurance payment and the dr. said no b/c you’re offered the deductible by Depew and I want you to speak with them so she did speak with them and they wanted her to sign off all of her rights in the future in rtn. For a $2,500payment of her deductible and we got right away on the phone it was at night time and the next morning and that evening we worked and we got to the representative of Depew a law firm that we had recommended to her from N.Y. handled it and got Depew to pay that, got her operation but she didn’t wave any of her rights. I think that was really trying to take advantage of the young girl in terrible pain and in terrible shape. That’s one of the ones. Another one is a cowboy that I spoke with from AZ who owned a horse farm and he loved to ride horses and he was rather young he was in his 40s; he had broken his leg from a horse accident and had a striker and he had suffered for about 2 yrs with the pain and the metallosis and was going to have to have a revision surgery. And we got him help too and then last week there was an elderly lady who also had a striker. She was in her 80s and I felt really badly b/c I spoke with her husband she was not going to be able to be operated on again b/c she wouldn’t have been able to survive a revision surgery. So here’s a lady who in you know, a couple of yrs ago was promised that her hip would last her the rest of her life and now she’s in terrible pain and she’ll never walk again, she is confined to a wheelchair but she won’t survive a revision surgery so it really runs the gammet from young to middle age to old and all of the ppl have their own private stories but for the most fact the sadness is that this probably Could’ve been avoided. Our evidence and my research and I’ve spoken with many many ppl shows that these manufacturers knew before they told ppl that their hips were defective. So if they would’ve taken them off the market when they heard that they were they probably would’ve only done ½ the number of the hips and would’ve received only ½ the profit but they could’ve saved a lot of ppls lives and it’s very sad… so, it is a very sad situation but you do have to take control and come up with a plan and tha’ts what we help you do at drug watch. We try to get you to the right kind of a dr. and get the right kind of test for you and then come up with a plan as to what are your options not only medically but also legally depending on the type of prosthesis you have and your location. I did want to mention too if you have symptoms of a bad hip there are normal tests that your dr. should recommend to you immediately and they would include a ct scan or an ultrasound or an mri of the tissue surrounding the implant to determine the health of them and then the blood to for the metallosis those should be done right away if you determine you have a problematic hip

M.L. ~So ppl should def. go and see their drs. If they’re having any of these complications

J.C.P. ~If they’re having, yes… or even I must say that I spoke with a man from south FL, and he was a very nice man but unfortunately he had 2 striker rejuvenate hips he was in such good shape at the time that they did one and then a month later they did the second one. So He had 2 defective hips and he knew he had the defective hips but he didn’t have any symptoms. So he didn’t know that he was going to have to have a revision until he got a letter, he did get a letter from his dr. finally saying come in and once the dr. reviewed his imaging tests and his blood tests then they determined that he would have to have these out of there. b/c even though they weren’t symptomatic at this pt. they would be in the near future b/c the blood showed a great percentage of metal

M.L. ~oh oh one moment here, I don’t mean to interrupt but let me interject b/c you brought up the fact that ppl can be asymptomatic with these hips and I think there was a recent study done on the fact that ppl with these hips on a mri you can actually see the tissue damage starting to happen

J.C.P. ~yes b4 you feel the pain

M.L. ~b4 you feel the pain, so it’s still a prob. Even If ppl you know they think well you know I’m walking around I’m fine so this is not going to be a problem for me, but it still is isn’t it

J.C.P. ~well in almost every case, even if you’re asymptomatic but you have one of these problematic hips yes, the answer is if you wait until it is painful then you’re tissue and bone have been injured a lot more and your rehab for the revision will be a lot greater. So even though nobody wants to face surgery, I know that, I’ve had surgery its no fun… nobody wants to have it again. You’re better off to have it when your tissue and your bone are healthier and you’re younger than to wait until you’re in a real bad way and then have to have it

M.L. ~until the hips actually fracture or dislocate

J.C.P. ~or fall off, yes yes

M.L. ~ so go see your dr. that’s the most impt thing, go see your dr. have these tests done just to make sure you know that if you have one of these hips you need to take it upon yourself to go see your dr.

J.C.P. ~now an interesting thing that I think every person who has had an hip implant should do is to get their operation rpt and determine the type of hip that they have, that is their first step. If they can’t interept their rpt. They can call us at drugwatch and we’ll help them interpret the rpt. Or get them to someone that can read the rpt and then they may find out that it is not one of the problematic hips and that would be good too but they do need to know b/c from experience and speaking with hundreds of ppl with these problems, I can tell you its better to know and to get into the situation and study it rather than waiting until you’re in terrible pain and your hip is hurting and you’re in the hospital to find out you have one of these hips

M.L. ~Yeah and also if you’re a caregiver for maybe a elderly parent or some loved one that could have one of these hips too it’s prob. Something you should talk to them about right

J.C.P. ~Yes interestingly enough the metallosis is insidious and many ppl are complainingof all sorts of symptoms that comes from the meatllosis b4 they are even having the tissue and the bone painful so if you’re loved one has any of the metallosis symptoms which can be 1sr of all a skin rash around the groin is one of the 1st symptoms you know go online, go to drugwatch and look and see what the symptoms of metallosis are so if you have those that’s a key that you need to get that operation rpt.

M.L. ~B/c it actually even effects your mood also right, your mental functioning and your

J.C.P. ~Yes, it does… it effects your, it can give you psychological problems and can make a person very depressed. It can also cause fatigue you know. These are things were ppl think well you know I’m just getting older. That may be true or maybe you just have too much metal in your blood from these…

M.L. ~Yeah or maybe it’s a flu, ha ha which a lot of ppl you know

J.C.P. ~you know that’s a very good pt. michelle I’ve had ppl say I had flu like symptoms. That can be caused by the metallois as well as weakening of your heart so we don’t want a lot of metal in ppls body that is a bad thing unfortunately that is a result of the defective design of metal on metal hips.

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M.L. ~Alright now you’ve spoken to hundreds of ppl like you said. Do you have any advice for anybody that is currently dealing with this besides get some help you know and call somebody that can help you

J.C.P. ~Well don’t feel like you’re alone b/c it is coming to the forefront that you’re not imagining these things if your dr. says oh hip implants always hurt, take these pain pills and go home that is not a normal result of a hip implant don’t feel that you’re overwhelmed and you can’t do anything and you’re helpless. Call drugwatch I’ll be happy to speak with you, we have a lot of patient advocates that do speak with ppl with hip problems and hip implant questions so you’re more than welcome to call. If you can’t get any help from your dr. go to a diff. dr, go to an orthopedic surgeon and take your operation rpt. From the original operation and tell them I am concerned, I received a hip implant. I want you to chk and see if there is anything the matter with it and here’s my operation rpt. That would be another proactive thing to do if you’re concerned.

M.L. ~Alright well t.y. very much for being with us today Joyce

J.C.P. ~My pleasure, t. y. for asking me

M.L. ~And I am sure that if anybody calls you, you’ll be more than wonderful in helping them out

J.C.P. ~thank you

M.L. ~Again we appreciate everything you do for these ppl

J.C.P. ~thank you michelle for having me

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