Surgery scheduled for tomorrow at 7:30 am - just got a call from Surgeon saying she is uncomfortable with data on Metal on Metal and is canceling surgery unless I want THR. No other Kaiser doctors are trained in this area, plus Kaiser Mid Atlantic is frowning on metal on metal. If I wait, it will take months for out-of-network approval and even then it is not guaranteed.
Have a few hours to make a decision. Any advice?
HipnHop
Pull out. Take some time to explore your options. You didn't want THR, and it won't suit your lifestyle. You don't want to rush into this, or be forced into getting a THR. There are plenty of people who have traveled long distances to find a surgeon who will do their resurfacing.
IMHO --- I would back out of the THR, that surgery is a dime a dozen with a lot of doctors having the ability to do it so it's not as if you could not find a doctor.
Chuck
Hi hipnhop,
Ask your physician to confer with Dr. Pritchett in Seattle. They can talk by phone. He was not comfortable doing metal on metal on me so he did metal BHR femoral component with Metal with Polyethelyne liner acetabular cup. He can explain reasoning to your physician and then you can determine if this is an option you'd like to have your doc pursue with Kaiser. He never suggested a THR as an alternative to metal on metal HR.
http://www.pritchettorthopedics.com/ Here's a link to his website with contact info. You may not get a resolution today but I'd follow up on this rather than settling for a THR. You can always reschedule the surgery.
Hope things get figured out for you in a way that allows you to make a choice that is in your best interest.
Luanna
Hate this, but I would pull out, hip. You've already seen what an HR can do for you, even if you decide later for a THR, it would give you time. You don't want to rush into this. Sucks though...
Quote from: Boomer on November 07, 2011, 11:26:53 AM
Pull out. Take some time to explore your options. You didn't want THR, and it won't suit your lifestyle. You don't want to rush into this, or be forced into getting a THR. There are plenty of people who have traveled long distances to find a surgeon who will do their resurfacing.
^^^^^^^THIS^^^^^^^
Quote from: chris finn on November 07, 2011, 12:30:59 PM
Quote from: Boomer on November 07, 2011, 11:26:53 AM
Pull out. Take some time to explore your options. You didn't want THR, and it won't suit your lifestyle. You don't want to rush into this, or be forced into getting a THR. There are plenty of people who have traveled long distances to find a surgeon who will do their resurfacing.
^^^^^^^THIS^^^^^^^
Unequivocally +1 on this!
Take a breather...if after you think about it and make some other calls to other surgeons, then and only then should you consider a THR. I would NEVER let any surgeon no matter how great tell me at the last minute that you are cancelled unless you want a THR. Feels like an ultimatum, not from an advocate in your corner. Just my dos centabos. Curt
So sorry to read this. I know you are ready to go. Take your time and make a decision that is best for you in the long run!
Contact Dr. Raphael Klug in Roseville, CA.
He accepts Kaiser and is a reputable hip resurfacing surgeon.
I cancelled a THR surgery along with many others I know. Do you realize the most large ball THRs are also MOM, so you might get a THR that has a lot of restrictions. Dr. Klug of Kaiser still does resurfacing in CA. I would look around before I let them change their mind at the last minute. Sounds like "bait and switch" Cancel and then think about getting more opinons and also deciding on what your really want. If I did not have a resurfacing, I would want a MOM THR. So there is still the same metal which very few people have problems with. It is the surgeons having problems with MOM because they are not placing components properly. Understand that they can place THR components incorrectly too and that can cause high metal ions.
It is all coming down to using the top experienced surgeons for either resurfacing or THRs. I would not let them pressure you in making a decision at the last minute. That is unfair and reflects poorly on the hospital, doctor and insurance company. I would not want to work with a surgeon that was so easily influenced by outside sources.
It is your choice, but when it is your hip and your health at risk - you need to make really good decisions that have taken time to research. I would never make a last minute decision about my hips - I only have 2 and I want them working properly.
Pat
Hip
http://www.andersonclinic.com/
The Anderson Clinic in Virginia takes Kaiser if you have a referral. Dr. Andy Engh, who is also listed on this website under doctors, did my surgery one year ago this week. They are excellent!
June
June, you are awesome. Hip, I'd check that out.
Engh was on my very short list, since I live in Virginia. June's info is one of the many reasons that this site and others are so invaluable to people with hip issues. Glad I found it too. Curt
Pull out. But you didn't need me to say that. I wouldn't rush the decision, it's not worth it. Good Luck.
I drove 16 hours to South Carolina to have my resurfacing 2 weeks ago. Dr. Gross said I can return to all my pre-op activities, including barefoot waterskiing, as long as I approach things gradually. I'm not sure I want to take those risks any more, especially with a newly resurfaced hip, but the point is- I can. Will you be able to participate in all of your prior activities with a THR?
Hippys thanks!!! Surgery canceled. You're right - no one should be rushed into making this last minute decision. I was about to go with it because I can't afford to lose more business with another future surgery. I guess it's better to lose money than my femoral head.
Although the pain is pretty bad, I'm going to go back on Voltaren.
June, I am going to call Dr. Engh's office tomorrow - thanks.
Let the insurance battle begin again!!!
Thanks guys and gals!!!
Again, sorry about you having to deal with it. It'll pay off in the end.
Hipnhop, so glad you refused to be rushed into making such a crucial decision! I sincerely hope you'll be able to make your decision based on what is best for you without a lot of insurance hassles. Good luck and keep us posted!
I am also glad you decided to hold off on surgery. It sounds like you rescheduled business for your surgery and then they switched the procedure up on you. I would let them know how this is affecting you.
I am sending good vibes your way so that you may find a way for your insurance to cover a HR specialist.
Best wishes.
Dan
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
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.
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
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)
"Thrive" ::) ::) ::) ::) ::) ::) ::) ::) ::) Wow... just wow. The night before ?? Nice..... I think you made the right decision.
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
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
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.
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.
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.
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!!!!
I feel for you hip, is Dr. Engh an outside referral?
Yep, he is not part of Kaiser. I got a call into him to see if I can get some recommendations.
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
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
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.
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
Quote from: cwg on November 16, 2011, 01:30:54 PM
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