Dr. Robert Whitfield examines why a woman in her 30s keeps rejecting a titanium hip replacement. Mast cell activation syndrome, surgical mesh migration, chronic infections, and mold exposure may all play a role. He recommends identifying and removing everyday triggers as the first step.
I have a patient who keeps rejecting her hip replacement, the titanium. She's a young woman in her 30s. Oh my gosh. And she's rejected this hip so many times and she needs surgery again. And the surgeon's worried it's not gonna take. So this is part of the problem. We've had, you know, we've seen like mesh move across the body from like a hernia repair. The mast cells are trying to attack. But some patients have chronic infections or they're living in mold, right? It's a constant conversation about eliminating triggers. We always talk about what can we do? What are the low-hanging fruit that we can remove? 'Cause some of these things are bigger, right? So whatever you can do on a daily basis to remove the obvious triggers, right? That's what we work towards. And then we, you know, ideally I'm diagnosing them officially according to our paper that was a consensus to criteria and they have a diagnosis. So now we're gonna, and some of them don't get a diagnosis. I still treat them if they're clinically, you know, looks like they have MCAS, right? Okay, so I'm not going to exclude them, but if they have the diagnosis, maybe I have more options, let's say.
