Possible outpatient surgery option with Dr. Gross

[patrick_d]

I would really need to be saving a lot of money to not stay in the hospital for that first night.  It was nice to know that I had a staff of professionals watching over me for one night and help me that next morning.  I did have some dizzy spells when I first stood up, it took me a couple of tries over a few hours until I could walk without getting light headed.  And having 3-4 nurses around to help keep me passing out/falling out sure was nice.

Also, we had a 3½ drive home and with me in the hospital that first night, my wife could get a good nights sleep (at some in-town relatives), so she would be fresh to take us home.  The next several nights at home taking care of me were pretty tiring for her, so it was nice not to have her wiped out before we got home.

As several other folks have said in various words, Dr. Gross is a fabulous surgeon and has developed an amazing process, you will be fine either way.  But if money out of your pocket is not the issue, I would just stay in the hospital.

As for pain, Dr. Gross's patients (me included) typically do not have a ton of pain and don't need an IV pain drip.  They found they were wasting to much, so switched to just pills.

You will do great.

[Tin Soldier]

Timing is one of the biggest questions.  I think once you've gone through the surgery and recovery, you look back and wonder why you even questioned the timing piece.  That perspective probably changes, though for the very few folks that have had complicaitons. 

Hospital - On my first hip, I was glad to have the help of more than my wife in the room.  I was also a later in the day surgery and it was snowing and dark when I woke up.  I was happy to have lots of professionals checking in on me.  Getting out of bed was quite a challenge the first few times.

On my second hip, I think I could have done quite well in a hotel the first night.  I had a really early surgery and so things seemed to be rather stable for me the first night.

I'm not sure the sleep argument is really all that useful here.  Don't expect to be sleeping comfortably and getting lots of it, regardless of where you are, until several days after surgery.

Another thought, the hospital and the surgeon have a certain amount liability associated with early discharge, that's why we do all those stairs and getting in and out of fake cars,... before we go, not to mention your vitals will have to be stable and good before you can go.  I would think, regardless of an hour after surgery or 4 days after surgery, those thresholds have to met before any one will let you go.  Some will get there sooner than others.   

[bosoxgordon]

Hello again all. I had a chance to meet with Dr. Gross a couple weeks ago and get updated x-rays for my hips and I wanted to give everyone an update on the outpatient option.

Apparently they have had very good results with this program. They have only done about 20 patients so far and I am still waiting to here from a few of them to get some first hand accounts as to how it went. Dr. Gross said it is for patients with no other health issues (ie. diabetes, heart problems). He also said he feels it can be easily done as an outpatient procedure and that hospitals are just not great places to be if you are otherwise a healthy individual.

All that being said, it will really come down to money for me. With my insurance I will have to pay a percentage of the costs and the outpatient option is about half the cost of having it done in the hospital. That can translate to a pretty good amount of money depending on your insurance coverage. I guess the other thing is if you have someone that can be your caretaker for a few days after the surgery since you will not be in the hospital. Apparently they have an arrangement with a local hotel to have either a one or two room handicap suite. You will need someone there to help you for the first night and next day.

Now the tough part..........when do I pull the trigger? I am penciled in for the beginning of April but I keep going back and forth as to whether or not I'm moving too fast. Anyway, I'm not sure if I will ever have complete confidence about going through with it.

[claudia]

Hi,
I am also having to soon make the decision to have this done.  I was informed by Dr. Gross today that I would be a good candidate and I will be scheduling a consult to see him soon. 
I, too, do not like the option of staying in a hospital and think that an outpatient option would work best for me.  Hospitals breed germs and I don't want to increase my chances of getting MERASA. I will be very interested in how this all works out for you.  I live in Florida so would also have to stay in a hotel for the first few days.  No big deal...  did it in Nashville when I was scoped by Dr. Byrd.  Just make sure you get a "handicap room" because getting up and down from the commode can be a problem!
Keep us informed.

[blt01]

bosoxgordon,

I though I'd chime in with a recap of my experience with Dr Gross.  I had my left hip resurfaced by Dr Gross on 11-14-12.  Dr Gross and his staff are excellent and top notch.  He did not present a choice of devices, but I would have chosen the uncemented Biomet Recap, one reason I chose Dr Gross.  It was the absolute best hospital / surgery experience ever.  The hostpital nurses, staff and therapists were fantastic.  I cannot imagine staying in a hotel after major surgery like this, especially the Courtyard Marriot next to the Hospital.  In my opinion it was not the cleanest hotel I've stayed in and is quite dated. I would be more concerned about infection there than at the hostpital.  Although, Dr Gross seals the wound area very well and it would be difficult to get an infection post op unless it was contaminated it prior to applying the dressing. I do have good insurance and my total out of pocket was about $1500 and may have considered a cheaper option.  Post my experience, I would choose the hostpital stay.  I agree with claudia, but a scope with Dr Byrd is a totally diffent ball game than HR.  About the money, and I'm sure I speak for most people on this site, you cannot put a price tag on getting your life back and being free of the OA pain.  It is amazing how much that pain affects your outlook on life.  Priceless. 

At 40 you are not the youngest to have the procedure done. Don't wait another minute and don't second guess your decision. 

PM me if you would like more details on my experience. 

Brad

[bosoxgordon]

Thanks for the feedback everyone. I thought I'd give an update on what I know so far.

I was put in touch with a couple patients that have recently gone through the outpatient option with Dr. Gross. Both of them had glowing reviews of the entire process. They both said the transition was very easy and pain free. They both walked out of the surgical center (on crutches of course) by that afternoon. In fact one gentleman had an interesting point. His wife had each of her hips resurfaced by Dr. Gross in the hospital and he said each time she was out of the hospital by noon the next day. In light of that he didn't think there was much value in staying in the hospital anyway.

To be honest the outpatient vs. inpatient decision for me would be purely economical. I have to confirm the details with the financial/insurance people, but a preliminary evaluation of the options says I would save about $1200 out of pocket by doing the outpatient option. That may make it worth it for me to do the outpatient option. My wife and I are expecting another child at the end of August so medical expenses are going to be crazy this year. Anything I can do to keep the costs down would be good. I also have enough confidence in Dr. Gross to know that if he recommended this option for me than it would be safe.

As far as the when question, I'm scheduled for early April. I would say penciled in for now...... I'm just not sure when is the right time. Went for a short hike with the family today and actually feel ok. Other days I may suffer more. Who knows.... I almost wish it would just give out or get better (i know it won't) This tweener stuff is driving me crazy.

[hernanu]

Hey Scott... In the end it comes down to how trustworthy the doctor and hospital are. Dr. Gross is certainly trustworthy, so you go from there.

Economic issues are important. If you are confident about the situation, then that is one large influence.

As to when, many of us had 'good' days before the surgery. The vagaries of our bodies are disconcerting in that we are not just a hip, but a whole assembly of parts that might conspire one day to make us float, the other to be forced to crawl.

The thing is that it doesn't change the mechanics of the hip and what you know is happening. Once you have this and go through the recovery, the probability and the hope is that you have an endless list of good days.

[bosoxgordon]

Thanks for the feedback Hern. Some days I stress over the when question so much I just feel the need to down a few Long Island iced teas and say what the #%&$ let's just get it over with and cut me open doc!!!

[23109VC]

I had my hip resurfaced by Dr. Gross just about 2 years ago.  I was his last sugery of the day.  I joked with him that I hope he wasn't going to hurry my surgery so he could get done for the day and home for cocktails... ;)

I honestly think the idea of staying in a hotel woudl be fine.  I remember thinking that I was pretty much pain free the few days I was there.  I recall my surgery was on a Wed and I was out by Friday.  I live in CA and stayed at a hotel just across the street.  The hotel had a small kitchen in it - so my wife was able to cook nice meals.  As long as someone was checking on you and making sure you were getting your pain meds - I woudl think they coulc probably do outpatient.  the only bad part was when they yanked the catheter out....  ;)  aside from that, my hospital stay was pretty relaxing.. i was in bed most of the time..but I was able to get up and walk the halls a bit. 

Dr. Gross was wonderful.  My other hip is unfortunately probation going to crap out on me in the not too distant future...I am 100% going to get Dr. Gross to fix the othe rone.  I sure as heck won't wait as long as I did with the first one....  no need to suffer throuhg so much pain when you can fix it and get your life back!

[claudia]

I just thought I would chime in on the in-patient vs outpatient procedures...
I, too, would prefer to have the procedure performed on an outpatient basis only because of all the many issues regarding in-hospital infections however...  Some insurance companies do NOT pay for outpatient on this procedure.  It sounds odd because one would assume that outpatient is less costly to the insurance company but United Healthcare Choice Plus, does NOT pay for outpatient on this one.    :(

[packman]

I am now two weeks post-op outpatient Right HR from Dr. Gross and share some experiences as follows:'

1) Dr. Gross and his entire team are extremely diligent, organized, and precise. Make no mistake about it people this is one well oiled team that cares about your entire well-being. The experience of over 3,000 surgeries permeates thru everyone! I felt I received the absolute best care!
2) I am a 55 year old 6 ft male - how did this happen to me etc.. but hereditary/bad ice hockey/box lacrosse fall (none of that sissy field lacrosse for this guy) - who knows?
3) Surgery around 7:30 a.m. at the Harding Street surgical centre on a Thursday- out of there around 4 p.m. - Most painful part is getting into a car. Find one with a reclining seat that goes down all the way so you can inch your butt back and get leg clearance to drag it in. That was agony because it is hard to bend your leg or swing them with the nurse/caregiver's assistance - the leg just feels like a log. Very agonizing here.
4) My wife and I stayed at the handicapped suite at the Mariott. It was clean and perhaps their couches / chair are a little worn but it's a stretch to say it was dated. There is not much to eat around there - Wendy's and the Cracker Barrel are adequate takeout for salads/chicken/reuben/roast beef. The Mariott breakfast is adequate. Due to our mixup we mistakenly thought we had the handicapped suite for 2 extra days and had to move to room 118 which also has had a handicapped shower - Avoid room 118 at all costs! It is adjacent to the elevator motor and gawd people still take it up to 1 a.m.- interrupts your precious sleep
5) Post-op nurse care was solid - never did I feel "exposed" to any health risks as my wife was right there with me, and read thru the meds provided including Oxycontin for short term pain relief. I appreciated the ability to get up move around and watch some TV on thrones of pillows. Dr. Gross visited us on Friday and Saturday (after the nurse visits), and we departed for Charlotte airport on Sunday morning as I had mastered the crutches
6) No question day 2 post-op and day 3 post op (Sat and Sun in my case) are peak pain days from swelling, but there is something mentally fulfilling at getting home which in this case is suburban/rural Toronto (did you know this is now the 4th largest city in North Amercia behind Mexico City / New York . Los Angeles?). Those airport wheel chairs are just awful - hard to avoid being at 90 degrees in these for a short term ride - my mind was saying my femoral neck and another f word. The polar ice machine is a great friend.
7) So now I am mastering the cane and walking with it in my left hand about 600-1000 yards. The incision pain is nothing like the bone on bone osteo pain I experienced pre-op and I look forward to my 6 week xray, and building leg strength on an easy does it basis
Count me as an advocate of the outpatient option - It's been a great experience so far and I am so impressed with the entire team - no second guesses on my part at all!

[John C]

Thank you for your detailed story. I had my first  hip done by Dr Gross almost five years ago, and have a few questions for you when you feel up to it, since I will be having my second hip done in the future.
During the first twelve hours or so, I had a couple of pretty dizzy episodes when I got up, which were covered by the nurse or PT being right alongside. Any issues with that?
Did they have the PT folks come over to the hotel to work with you?
What about pulling the catheter out?
I seem to remember having an IV in for the first day or so, which would seem hard to travel with.
Lastly, operating rooms go to great lengths in terms of special sealed suits for the surgical staff, and sometimes cross ventilation systems, all of which are to control infection risks. Did they give you any information on the Harding Street center relating to these issues?
I appreciate you sharing your experience with this, since it is pretty new to everyone.

[packman]

Thank you for your detailed story. I had my first  hip done by Dr Gross almost five years ago, and have a few questions for you when you feel up to it, since I will be having my second hip done in the future.
During the first twelve hours or so, I had a couple of pretty dizzy episodes when I got up, which were covered by the nurse or PT being right alongside. Any issues with that?
Did they have the PT folks come over to the hotel to work with you?
What about pulling the catheter out?
I seem to remember having an IV in for the first day or so, which would seem hard to travel with.
Lastly, operating rooms go to great lengths in terms of special sealed suits for the surgical staff, and sometimes cross ventilation systems, all of which are to control infection risks. Did they give you any information on the Harding Street center relating to these issues?
I appreciate you sharing your experience with this, since it is pretty new to everyone.

Hi John
in answer to your questions
a) Did not have any dizzy spells in the first 12 hours - Day 2, 3, 4 post-op are definitely worse than day 1 re; swelling and pain. There was a slow release pain med and then the instant fast working OxyContin if it got worse. I did take a couple of Oxy's on Days 2 and 3 and they do invoke some weird dreams/sensations/dizziness
b) No physical therapy other than the nurses at the Blanding center (I erronelously said Harding above) had me walk on crutches and urinate prior to car departure. Dr. Gross provided some simple exercises for the first 6 weeks but advised walking is the best PT. MOre advanced PT post 6 weeks is the advice.
c) Catheter was inserted when I went under, and was pulled about 3 p.m. if I recall. Not too uncomfortable.
d) IV was finished between 2 and 3 p.m. prior to exit as well
e) I did not ask about the surgical centre specific infection control. I had such a strong sense during the multiple interview questions  with about 5 members of the team during pre-op that ev1 had their role and process fully prepared. I thought the risk of infections at hospitals with the numerous traffic was far greater than the Midlands Ortho centre. That said, Dr Gross and his team evaluate you for outpatient risk and qualifications, and depending on your health, pain thresholds, do not offer this option to just anyone. There are limited days and spots for this.

[kimberly52]

All I can say is WOW!  I am just one week out and so glad I was not an outpatient.  Thinking about that first night I was so thankful for the bed trapeze among other things.  I hope the hotel has one and also an electric bed which I found invaluable to assist me getting in and out of bed.

The BP tanking is real and I wonder what happens in the hotel room?  Is there an overnight nurse that first night to monitor your vitals and manage your IV line and pain?

Best of luck with your decision.

Kim

[packman]

Kimberly you missed one point - The patient does not choose the outpatient option - Dr. Gross evaluates your qualifications and medical history/condition, to see if you qualify to avoid any unnecessary risks.
In my case, I had none of the blood pressure irregularities that you mention, and I did not have any IV line after my discharge at 3:30 p.m. - only prescribed pills.  Day of surgery and first night was no issue whatsoever, and I was physically strong enough to manage crutches in and out of bed. The two days after post-op were the painful ones of swelling and no sleep, and those 2 days the nurse checked on me at 10:00 a.m. for BP, breathing etc., on both days and Dr. Gross even came to see us both days in the late morning early afternoon.
I am happy everything turned out for you and that you were happy with your choice and thx for the info you have provided.

All I can say is WOW!  I am just one week out and so glad I was not an outpatient.  Thinking about that first night I was so thankful for the bed trapeze among other things.  I hope the hotel has one and also an electric bed which I found invaluable to assist me getting in and out of bed.

The BP tanking is real and I wonder what happens in the hotel room?  Is there an overnight nurse that first night to monitor your vitals and manage your IV line and pain?

Best of luck with your decision.

Kim