You are very welcome!

Re; the prophylactic meds to prevent HO from occurring after hip replacements. These meds are not for nerve issues (ie., neurontin, gabapentin etc.,) this would be prophylactic meds specifically aimed at preventing 'heterotopic ossification'. Most commonly higher doses of NSAIDS like Celebrex or even Ibuprofen taken for several weeks before and after surgery. Sorry for the confusion.

Heterotopic Ossification: The heterotopic ossification of muscles, ligaments and tendons is a potential complication following trauma, elective surgery, neurological injury and severe burns[2]. The most common site for the formation of HO is following open-reduction internal-fixation (ORIF) for acetabular fracture, followed by the hip after total hip arthroplasty (THA)[3,4]. Following THA, the incidence of HO has been reported as being between 5 and 90%, though only 3 to 7% of patients experience clinically significant HO; that is, to an extent that the outcome of the surgery is affected and as designated a grade of III or IV as originally described by Brooker in reference to the hip joint (Table 1)[5,6]. Reported incidence is lower following primary total knee arthroplasty (TKA), and has been reported as between 3.8 and 39% for all Brooker classification grades, but as one study reported only 1% of patients were symptomatic[5]. LinkOut: http://www.josr-online.com/content/4/1/12

If you have an appointment with your PM prior to scheduling surgery then this might be a good time to discuss what protocols he/she would recommend. It may also be a great opportunity to discuss admittance prior to the operation which will likely be difficult to get approved for the hip replacement unless your ortho is completely on board with admitting you early strictly for pain management and authorizing the THA as a separate procedure. There are ways of doing this outside the insurance restrictions but some doctors don't like to do it. I would work with both your ortho and your PM doctor way before committing to surgery if possible. If your doctor understand anything about CRPS.. knowing full well that he/she will be in an area where there is a decent amount of risk to the nerves (especially the sciatic and LFCN) then he/she should listen carefully to your concerns. If they don't then no matter how reputable the institution or doctor seems I would seek another opinion with someone who will listen and act accordingly. The least they could do is ease your concerns considering your past response to surgical intervention and spread.

On a positive note - if you aren't admitted early there is a chance that you won't experience spread. I know that is hard to believe but, as you know all to well there isn't a rhyme or reason to how CRPS progresses. I do hope your surgery is a huge success and this time you have no issues with CRPS!

I feel for you also!! Thanks for your kind words. I was actually in a head on collision that precipitated the need for surgical repair to many body parts including both my hips. Then when complications occurred I had to have more repair done and then.. CRPS II I actually just had my 14th operation (10 prior to CRPS and 4 after).. and surviving CRPS/RSD.. I'm only surviving now because of my amazing PM doctors who recently implanted an Epidural Cath-a-Port (tunneled epidural with internal port) so that I can receive continuous epidural infusion to control the pain. So I am getting similar meds as you will receive with your epidural during your THA - Fentanyl & Ropivicaine which relieves my legs from the pain. It is wonderful! How have you managed over the last 20 years? Any advice on what has worked the best for you? Did I understand you correctly in that you don't have severe symptoms on your right side?

Do you mind sharing what state you are in? Just curious if you are anywhere near me