Kaiser Pulls Out of BHR

[rbt2011]

Hip
That sucks man.  Sorry to hear you had to make that decision.  Keep fighting though.  Never, ever let somebody else dictate what goes in your hip.  Thats Bull Shit.

I have a letter I sent to my HMO for a referral for resurfacing to a non-covered surgeon.  If you think it will help, let me know and I'll send it to you.
Rob

[JMS]

Even though my BHR got revised to a THR ( and it is just fine so I am kind of a defender of THRs on this website) I am glad you refused to be pressured into a last minute decision like this. None of us need to have that kind of surprise thrown at us just as we are going into surgery. Take your time, and make a decision you are good with at your leisure. You are going to live with the results of your decision for a long time.
All good wishes to you as you decide what to do.

[jjmclain]

Hip,

Make sure you ask for Andy Engh! Good Luck to you. I even called there today before I posted to make sure they took Kaiser and that is when I was told with a referral. I scheduled my surgery at my first appointment. It took me 3 weeks to get the initial appointment but then I scheduled from there. The entire office is fantastic! I went to the office in Mt. Vernon (right there at the hospital) and I think that would be your best bet. I go back on Wednesday for my one year follow-up. Take care and keep us all posted.

June

[hipnhop]

My surgeon said she just came back from the American Association of Hip and Knee Surgeons Conf in Dallas where there was a lot of concern over metal on metal devices, including THRs. As a result she feels uncomfortable doing the surgery. I went to their web site (http://www.aahks.org/meetings/meetings.asp) and found the agenda. Does any one know of these presenters? Are they HR surgeons?


SYMPOSIUM I Management Perils for Metal-on-Metal Hip
5:00-6:00 PM Arthroplasty Patients
5:00-6:00 PM MODERATOR: Adolph V. Lombardi, Jr., MD, FACS
5:00-5:06 PM Case Presentations
Audience Response
5:06-5:12 PM Understanding Mechanisms in Failure in
Metal-On-Metal Hip Arthroplasty
Joshua J. Jacobs, MD
5:12-5:18 PM A Diagnostic Algorithm for Approaching
Patients with Metal-On-Metal Hip Arthroplasty
Steven J. MacDonald, MD, FRCSC
5:18-5:24 PM Imaging Protocols: CT, MRI and Ultrasound
What Should Be Ordered and When?
Hollis G. Potter, MD
5:24-5:30 PM Synovial Fluid Biomarkers and Serum Ion Levels:
Helpful or Confusing
Thomas K. Fehring, MD
5:30-5:36 PM Clinical Presentation of Patients with
Pseudotumors in Metal-On-Metal Hip
Arthroplasty
Young-Min Kwon, MD, PhD, FRCS, FRACS
6:15-8:15 PM Posters/Exhibits Open
6:15-8:15 PM Welcome Reception
(Reception: All attendees invited)

[B.I.L.L.]

"Thrive"    ::) ::) ::) ::) ::) ::) ::) ::) ::)  Wow... just wow. The night before ??  Nice..... I think you made the right decision.

[alpsters]

I am glad to hear that you took control of your own health and opted out. I back up what everyone else has been saying, being rushed into a decision like that is just not right. I took 3 months of heavy research before I decided what I wanted. I wish you the best and sorry you have to go through prolonged discomfort. I'm rooting for ya.......best of luck.

RBHR Dr. Bose, Channai, India, July 20, 2011

[Pat Walter]

Hi

Lombardi does some resurfacing, but is more pro THRs as I understand from former info.  Jacobs makes presentations at the hip resurfacing courses.  Much of the negative MOM information is based on THRs.  Several of the video interviews I did with the top hip resurfacing surgeons explain that much of the problem is from THRs and not from resurfacing.  So that needs to be made clear.

Again, in resurfacing, when components are placed properly - there are not high metal ion problems.  You can see the stats from the National Regsitries for that information - it is not an opinion, but fact.  The BHR has a retention rate of 96%   So only a very few people have problems with BHRs and high metal ions.  Also not all problems are from high metal ions, some are just component misplacement, a few femur neck fractures, etc.  One person I know is having pain problems and it is because a less experienced surgeon placed too large of a device in her hip and she is facing a revision.  Many strange things have occured with the less experienced surgeons.

So once again, it is VERY important to know that when an experienced surgeon places a BHR, Wright C+, Cormet and even the Biomet devices - there are not high metal ions problems.  The medical and surgeons are throwing hip resurfacing in with the problems of the MOM THRs and scaring perspective patients and less experienced surgeons.  I think all of this will weed out the surgeons that don't do many resurfacings since they are often the ones having more problems.

Hip Resurfacing is an excellent solution to hip problems if you are a good candidate with good bone density - that is only determined by an experienced hip resurfacing surgeon.

Pat

[B.I.L.L.]

This place sounds like a broken record, for good reason. Less experienced surgeons getting "Scared away" from bhr's is probably a good thing ?  At least that Kaiser doc was honest and didn't try to wing it.

[Tin Soldier]

Have you ever gone to a conference and came back fired up to make some changes to how you do business?  I think a lot of us have.  Hate to make it sound so simplistic, but I do think some folks operate that way.  Although, your surgeon probably made the best choice for you and her practice.  Have you ever been a passenger in a car with a driver that doesn't look very confident? 

BTW - Kwon is in a video that we recently discussed on another thread having to do with some of the bad PR in the NYTimes. 

That synovial fluid biomarkers presentation looks pretty interesting. 

[hipnhop]

It;s amazing. She did my fist BHR under the supervision of a more exp surgeon. I refused to let her do it alone because of exactly this same argument. I think they get it now.  They should just be honest and refer all their younger patients to experienced HR surgeons (We have Mont, Engh and Thomas in our area). I really feel dis serviced.  There is no way that they should have done my first surgery and I'm glad they pulled out of my second. I am Kaiser Mid Atlantic's first HR client. However, in an off the book consultation with a notable East Coast HR legend, I was told that Kaiser has sent him some high profile clients (Media, Gov't).  I guess it is us small guys who are forced to have our lives turned topsy turvey. Just to think I was ready to let them do it because I just wanted to get it over. The worst case - Kaiser could refuse any referral on the basis of MOM hype and not even approve the referral. A that point I will be forced to endure pain, get a THR, or rob a bank.

[hipnhop]

Got denied for outside referral today. Waiting for letter to explain if it was procedural or if they are discontinuing MOM devices.
Don't use Kaiser Mid Atlantic!!!!

[hernanu]

I feel for you hip, is Dr. Engh an outside referral?

[hipnhop]

Yep, he is not part of Kaiser. I got a  call into him to see if I can get some recommendations. 

[Pat Walter]

I can't argue with you about whether your components are properly placed since I am not a doctor and can't read your x-rays.  I will say that I know of quite a few cases where the surgeon said the components were perfect - but when the top experienced surgeons like Mr. McMinn, Mr. Treacy, Dr. De Smet, Dr. Su, etc look at the x-rays, they could see the problems since they are very experienced.  I know of one case now that the surgeon claimed the components were perfect - McMinn found out why the pain and problems existed due to placing the wrong sized components.  I get hundreds of emails and know of many cases of claims that things are right from the original less experienced surgeon, only to find out from the really experienced surgeons that there were problems.  That is a fact too.

I hope you can find out what is wrong and get a solution to your problem.  No matter the reason, high metal ions are a bad situation.  I hope you find a solution soon. If you can't, I would suggest getting a free consultation from Dr. Bose of India, Dr. De Smet of Belgium, Dr. Gross of SC, Dr. Su of NY, etc.  Use the top surgeons and get information to help you out.

Pat

[cwg]

Thank you Pat I will find a solution, and yes I have two sets of  very experienced surgeons who have looked at the xrays and find perfect placement.

I will continue to post here until I find the reason and the solution. The solution being Im not sure what,  since I can't imagine another surgery.It makes me queasy just writing that.

Am having new blood work taken today 3 months since the last one, and waiting for a postponed ultrasound.

Appreciate this site and marvel at the successes

[alex3]

Kaiser is doing a BHR for me on Friday(1/27) in Denver - Dr. Gargaro.  He did have some reservations about it, but agreed to do it after other Kaiser docs though I should have the BHR.

[obxpelican]

Who are the surgeons?   

If that were me I would send my x-rays off to Dr. Su, Dr. Gross or DeSmet or another experienced surgeon.   

Most all cases are related to misaligned devices.  And I think Pat is refering to experience as in those doctors VERY experienced in finding the problem with a patient, not a doctor that has done X amount of surgeries.  The really good doctors would already know what is wrong in most cases.


Chuck

Thank you Pat I will find a solution, and yes I have two sets of  very experienced surgeons who have looked at the xrays and find perfect placement.

I will continue to post here until I find the reason and the solution. The solution being Im not sure what,  since I can't imagine another surgery.It makes me queasy just writing that.

Am having new blood work taken today 3 months since the last one, and waiting for a postponed ultrasound.

Appreciate this site and marvel at the successes