Joint Pain

[RealtorLady60]

I had gall bladder surgery in October 2011.  Since then my hip joints, left shoulder, right jaw and wrist have started hurting really bad.  I am thinking I have a reaction to the titanium clips that were put in during surgery.  Is this a possibility?

[Rajinder Bajoria, MD]

Dear RealtorLady60,

Thanks for writing in.

I would like to reassure you that the pain in your joints is not related to your cholecystectomy or to the titanium clips that have been used.

As I believe that more information can help a physician help a patient better, I would request you to answer the following questions.

How long have you had this pain?

Which joints are affected?

How severe is the pain? Does the pain affect movement or your quality of life?

How old are you and what do you do professionally?

Do you have any swelling or redness in the joints?

Do you have any other symptoms like a rash, photosensitivity or anything else that you might deem important?

Awaiting your reply.
  
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Best Regards,
Dr. Rajinder Bajoria

[RealtorLady60]

Thank  you for being so honest and replying to my concerns.  I agree that surgery to remove the clips should be a last resort.  I am taking 800MG of Motrin a day and always take it with food.  As you expressed, I was also worried about the side effects.  I am also worried about long term pain in my joints and muscles and how that will eventually affect my body.  You had mentioned safe drugs to control the pain.  Would that be prescription drugs?  My surgeon doesn't seem like he wants to discuss my pain with me so I am having to look to other resources.  You are very knowledgable and I appreciate your help and suggestions. Looks like pain medicine is the way I will go right now.  I just need to know the right kind to take.  Thank you for all your time and help.  Linda

[Rajinder Bajoria, MD]

Dear RealtorLady60,

Thank you for writing back.

I understand your concern.

It is true that it is easy to apply clips during cholecystectomy and very difficult to remove them as removal involves open abdominal surgery in expert hands.

While Titanium clips do contain nickel and as you are sensitive to it, it might cause a few allergic symptoms. If you wish to get this removed, you can talk to your operating surgeon and discuss the problem. Perhaps he might start you on medication to suppress allergic effects.  Any allergic effects can be masked or suppressed with medicines. Removal of clips should be used as a last resort treatment.

Long term use of ibuprofen (motrin) in your age group definitely has its side effects. It has effects on the kidney (nephrotoxic drug) and stomach (gastritis). Caution is advised with its use especially at your age. Also, remember to eat something whenever you take the drug.

As you seem to be severely affected, it would be wise to discuss with your surgeon regarding this. We have other safe drugs which can control the pain. Proper treatment can be planned with the combine efforts of your surgeon, an orthopedic and pain management team.

Wish you good health.

Best Regards,
Dr. Rajinder Bajoria

[RealtorLady60]

Thank you so much for replying to my question.  I am allergic to nickel and found out that titanium clips have some nickel in them.  I started having joint pain a couple of weeks after gall bladder surgery.  It is continually getting worse and in my shoulders, wrists and right jaw.  My left hip joint has gotten better.  The pain hurts really bad at night when I am laying and try to move my arms.  I am also having trouble chewing with my jaw in pain.  I am 63 years old and a Real Estate Agent.  I never had a pain at all until after the surgery.  I have always been in good health and don't drink or smoke.  My arms hurt at work and I have to take at least 4 to 6, 200mg of Motrin a day for pain.  I don't have any swelling, redness or rashes.....Just hurt when I move.  I would like to take the clips out but have read that it is more dangerous to do that than leave them in.  I would just like some relief as I have to work.  Thank you again for any help or suggestions that you might have.  I have never had to take medicines and am sure a lot of Motrin can't be good.