Wondering when to have surgery?

[rayareno]

I first earned about Hip Resurfacing about a month ago. While attempting to discover a different way to treat my right hip. I'm not completely sold on having a THR at my age. I'm presently 53 years old in good physical condition except for my right hip. I've been told by two local Orthopaedic Surgeons that I have a problem with Cartilage loss in my right hip. I've also been told that I will eventually need to have a THR. Neither one of these two physicians has any experience with Hip Resurfacing. I've managed to find a surgeon in my immediate area that does hip resurfacing. His name is Dr. Colin Poole. The second physician that I saw mentioned his name during a consultation. I had an appointment with this doctors office on Thursday Dec. 6, 2007. My reason for seeking help is because I am down to bone on bone. At times it can be rather painful at other times the pain isn't very noticeable. I've been experiencing some increasing pain recently. I'm not presently taking any medication to control the pain. I don't seem to find it necessary. Perhaps, I have a high pain tolerance. I've read some of stories that people have posted on this site that have made what I'm experiencing seem small. I've been experiencing some issues with my right hip for the past two years. I really started noticing the pain after playing softball. I was involved in three softball teams last year. This year I didn't play at all. After playing in a game it was difficult to walk to my vehicle afterwards. Especially on nights when it was chilly outside. This is when I could really notice the pain in my hip. I've always been extremely active. It was difficult to sit on the sidelines this past year. I question whether or not my medical condition warrants the operation. I don't want to wait until the age of 56, because my insurance company may longer pay cover this procedure. So, I'm kind in a dilemma. Should I have a Hip Resurfacing procedure done soon or am I better off postponing it? I've read about some wonderful results that some people have experienced. I'm wondering what sort of results I might be able to achieve. Any comments would be greatly appreciated.
 
Ray

[Ronnie]

Hi Ray
             I can't give much on the pros and cons yet i just had bhr 6 days ago. I can tell you i am 49 played soft ball and when running i latter felt like i had a hernia. 2 years latter here i am. I'f i had a desk job and was not active but i am a elevator mech and support 2 children i need a good hip so i will up date u when i can
                     not a easy choice

[Pat Walter]

Hi Ray

Welcome to Hip Talk.  I have a couple suggestions. 

1. Make sure when you want to find out if you are a candidate for hip resurfacing that you are talking to an experienced hip resurfacing surgeon.  Not one that dabbles in it now and then.  There is a steep learning curve and most doctors need 100+ to really become expereinced. When they are not experienced, they will often push you towards THRs or change at the time  of surgery to a THR since the Hip Resurfacing is a much more difficult surgery. So my word is be cautious about the suggestions of surgeons unless they are pro hip resurfacing and experienced.

2. You can get free email consultations from some of the best hip resurfacing surgeons in the world if you send them your x-rays in digital  .jpg formate - Dr. De Smet of Belgium, Dr. Bose of India, Dr. Gross of SC and Dr. Rubinstein of IL to name a few.  They are free and will give you an honest evaluation of what is wrong and if the time is right to have a hip resurfacing.  There is a window of oppourtunity with hip resurfacing and only a doctor can determine that.  Some people hurt really badly and are not yet in need of a hip, while others don't hurt much and are almost beyond getting a hip resurfacing.  Only an experienced surgeon that does both hip resurfacing and THR will give you a good honest evaluation.  You can see my list to find some experienced doctors near you- not always in your own town or state - but within normal travel distance.http://www.surfacehippy.info/listofdoctors.php

Brian Rader is a recent bi-lat patient of Dr. Poole  http://surfacehippy.info/hippyblogs/?p=27  He was very happy with him.

You will have to rely on the doctors to determine if your hip is ready for replacement. They can tell by looking at the x-rays.  Don't wait too long, and end up with a THR. That's the only problem with waiting too long if your hip is already deteriorated.

I should have had mine done at about 50, but did not want a THR. I did wait 10 years and all I could do was sit in a chair, not walk and not sleep at night. No meds could stop the pain.  I learned about hip resurfacing and then had mine done at 61.  You life will come to a stand still if you need a hip and put it off. You are only cheating yourself if you want to stay active and live a normal life.

Good Luck and keep in touch.

Pat

[gpmurfdog]

Hi Ray, I am a 55 year old male and had my left hip resurfaced Nov 19,2007. I was in the same delima
as you are.I had to stop dancing and going to the gym.When I would take awalk of 3/4 mile I had to stop a few times due to pain.The resurfacing is a much better surgury but you need a Dr. with at least
40-50 resurface jobs under his belt. You can check the list on this site.Now at 22 days post op I can
walk 45 minutes with 1 crutch with no joint pain,just muscle soarness.I think the quality of life Iam getting back made it worth it.Also your bad hip can put strain on your other hip and spine.
                                                        Paul 

[rayareno]

Hello Paul,

The doctor that I saw recently has done 80+ hip resurfacing procedures. I've communicated with one of his recent hip resurfacing patients. The gentleman I've been speaking with had his hip resurfacing procedure done on 10/09/2007. He had a bi-lateral hip resurfacing procedure. The first bi-lateral that this surgeon had ever done. This doctor is the only one in my area that does this type of procedure at this time. That doesn't mean that I can't travel to some place else to have the operation preformed. It would be nice to be able to do this operation done close to home. What I don't want to do is wait to long to where I've got no other choice. I really don't want to do a THR. What type of dancing do you do? I presently do West Coast Swing, East Coast Swing, Country Swing, and a few other dance steps.

I rode my bike quite a bit this past spring and summer. This is something that I'm able to do without much difficulty. I'm able to walk on my treadmill, but I can't run on it the way I use to be able to do. I've had to cut my speed in half.

I've not had any issues with other parts of my body. The only aches and pains that I have are in my hip.

I hope that you have a great deal of success with the recovery process.     

thanks for the advise.
Ray

[rayareno]

I've done some research on hip resurfacing. It seems that the pros outweigh the cons at least in my opinion. Have you thought about getting back into playing softball or are you finished playing? I played on a senior men's league, a regular men's league, and a co-ed league. I live in the Boise, Idaho. Where are you from? How many hip resurfacing procedures had your surgeon performed? I can certainly understand your reason for electing to have this procedure. I don't have any children presently living at home. How long have you been out of the hospital? Your right it isn't an easy choice to make!

I hope your recovery goes smoothly. Hopefully you won't need to use the crutches for very long.   

[rayareno]

Hello Pat,

Dr. Poole has done 80+ hip resurfacing procedures. I feel completely comfortable that this physician won't push me into doing a THR.
I believe that this doctor is a pro hip resurfacing individual. If, I didn't think that he was. I would be looking into finding another surgeon.

I'm not sure that sending a digital image of my hip to someone that I don't intend to ever using is right. These doctors have better things
to do with there time then to review x-rays images of people who may never be their patients. I wouldn't feel right about accepting their opinions and occupying their time.     

I've written to Brian Rader. I've also spoken to him on the telephone. He's known Dr. Poole for close to 5 years. He has a great deal of trust
and respect for this doctor. Brian felt that Dr. Poole is very capable. Enought to allow this doctor to do a bi-lateral procedure on him. Brian
was Dr. Poole's first bi-lateral patient. 

thanks for writing,

Ray

[Pat Walter]

Hi Ray

I am sure Dr. Poole would be a very good choice.

I do want you to know that Dr. De Smet, Bose, Gross, etc are very use to having many people contact them.  Many of us did not know who we wanted to use or if we were candidates, so we contacted at least 3 doctors.  They understand people are trying to decided two things:

1. Am I a candidate for hip resurfacing

2.  What doctor do I want to use

I also went to 4 local orths withing 2 1/2 hours of my home and they cost me over $200 each. I did not have insurance and had to pay that money out of my pocket to listen to them trash hip resurfacing.  Not one of the 4 had a clue about modern hip resurfacing.

Some people have surgeons that are not sure if they can have hip resurfacings or not or a difficult case. They too often consult with more than one of the really great doctors.  The doctors know that and MOST GRACIOUSLY give their time to people.  Sometimes they even talk to each other about a difficult case.

So yes, I would not want people just pestering the great doctors, but if you are not sure about your situation or who you want to do your surgery, please don't feel you are bothering them.  They are quite different than most US doctors.  Also what about all the US doctors we all go to and don't use??? Are we wasting their time since we know we probably won't use them? 

This hip surgery stuff is VERY major and people need to take it very seriously. They need to do their homework and get all the input the they can.  When some of it is free and given happily in the name of hip resurfacing, they should be happy.   The big 3 as we call them, De Smet, Bose and Gross know that we tell people to contact them all the time.  We are not paid to do this, but we know they are among the best in the world.

There are over 6000+ people on the Yahoo Surface Hippy Group and we always tell people the same thing. Write to the doctors.  I would imagine that they have done many hundreds of extra patients because of the suggestions presented on the Yahoo group and my website.

Dr. Gross, De Smet and Bose are very giving and caring doctors. They give their services free to one patient a year thru our DAST INTERNATIONAL non-profit organization. http://www.dastinternational.org/  I am a board member and webmaster for that new group.  So we know the doctors quite well and they know we suggest people use them.

I hope that helps explain why I tell people to send your x-rays to the doctors if you need a consultation and good information.  Sometimes people just need a second opinion.  It would be nice to tell them that up front, but they will still help people that write to them.  We people that support the Yahoo group often personally write to the doctors to get answers for questions from patients or people looking for information.

A large part of the information on my website is directly from doctors that I have contact with.

So if you want more input, don't be shy.

Pat Webmaster/Owner of Surface Hippy

[rayareno]

Hello Pat,

Dr. Poole may be the candidate that I eventually decide to use. Maybe, by the time I get around to having the operation.
He'll have the 100 hip resurfacing procedures.

In order for me to send copies of my x-rays to the doctors you've mentioned. I'll have to go to Dr. Poole's office and retrieve
my x-rays. I left them at his office when I was there last week.

I've read several different opinions regarding hip resurfacing. Most of it had been positive. I have read a few messages from
doctors who do not condoned this procedure. It doesn't seem like the medical establishment is totally in favor of this procedure
at this time. They certainly seem to have various opinions regarding the topic.   

When your talking about something like hip resurfacing. Yes, it is a very serious matter and should not be taken lightly.
Researching and invest aging the topic is in your own best interest. Take time to know something about the procedure your
contemplating having done. Don't take one person's opinion as gospel. 

thanks,
Pat 

[Pat Walter]

Hi
You are right in that a very large part of the orthopedic community does not know about or suggest hip resurfacing.  Strange how far behind our country seems to be in newer technologies. 

Hip resurfacing has been done since 1998 all over Europe, Canada and Australia, yet not considered in the US except for the few doctors performing the FDA trials.  this is an interesting page  http://www.surfacehippy.info/vmbhrhistoryinfo.phpwith current stats.  Only 7000 have been done in the US while over 90,000+ done world wide.

Hip resurfacing is a much more difficult surgery than a THR and many doctors don't want to do the training.  Also many that have learned will only do the easy cases.  So that is one reason there are not too many surgeons performing hip resurfacing.  I don't believe personally that it means it is not a good surgery - just a fact that it hasn't been accepted here until last year and we just had surgeons learn the procedure.

New things always take time to become that accepted standard.  In other countries it is not a question of do you want a THR or hip resurfacing - younger, good candidates are just given hip resurfacing.

So I don't think the medical establishment in the US is actually the best judge of whether hip resurfacing is a good or bad procedure at this point. As long as people realize that, then they can choose to find a experienced hip resurfacing surgeon if they think it is a good option for them.  Everyone thought once the FDA approved the BHR all the doctors would be doing it - not so.  So all of us surface hippies still fight to get what we want and try to spread the word to other people that don't know about it.

That's why I do the website.  I hate it when people write to me personally and say - I just had a THR and now learned about hip resurfacing. If only I had known, I would have had a hip resurfacing.  It is sad doctors won't share new information with their patients.  But it is still happening time and time again from the posts made on the Yahoo Surface Hippy Group.  This Hip Talk is a very small group right now, but the Yahoo Group has over 6000 people and the posts are very interesting and informative.

Good Luck.

Pat

[gpmurfdog]

Hi Ray,
I do West Coast and East Coast Swing ,Also CHA-CHA,Disco. I think the Bi-Lateral or Buttocks Approach
is the only way to go to save on muscle cutting but I would be a bit concerned with a DR. who did not
use this approach many, many times before.Also a small thing I really enjoyed was the skin glue that
was used instead of staples.Nothing to take out latter.Now on Day 24 I am starting to walk a little
with no crutch.
                                                            Paul

[rayareno]

Hello Paul,

Were only two years a part in age. We are both to young for THR. How did you find out about Hip Resurfacing? How much material did
you happen to read about HR before you decided on this procedure? Did any Medical Professionals recommend THR? Did any of them recommend HR? How many Medical Professionals did you happen to speak with?

Yes, I'm in agreement with you about the doctor's HR experience. The doctor that I spoke with is on the Surface Hippy Doctor List. It appears that he's performed 80+ HR procedures to date. I'm comfortable with the amount of experience he presently has. I've read and
heard some good things about this surgeon. 

It sounds like your on your way to a full recovery. Were you hoping to be further along in the recovery process? Hopefully things will
continue to improve for you. Are you taking any pain medications for your soreness? How is PT going for you? Are you looking forward
to being able to dance once again? I'm glad that your quality of life is improving. I've not had any problems with other parts of my body.
At least not at this juncture.

I hope that things continue to get better for you.             

Ray

[james]

Just to echo what Pat said, I held off on surgery because I didn't want THR and didn't know there were any alternatives. Until I really started looking and found the overseas option so actually the internet is what saved me.

I don't know much about it but my impression is the u.s. is still in the dark ages on this. Also my impression that people are still getting a THR in the U.S. who should be getting a resurface. Which doesn't seem right.

I wouldn't have considered a surgeon with less than several hundred resurfacings. 

[gpmurfdog]

Hi Ray ,I am very happy with the pace of recovery. Yesterday when I went to a couple of stores I left
my crutch in the truck and limped around.My wife has danced her whole life and I just started 4 years ago but we both can't wait to dance again.I still take 2  5MG of Oxycodone to sleep at night.I went
to my first Dr. in Jan 2007 and was told I needed a total hip replac.He did not even mention resurfacing
I got a book called Hip Replace. OR Hip Resurf. by Peggy Gabriel and went to "you tube Dr. Scott Ball
explains hip resurfacing".and went to "edheads.org and saw a cartoon of the surgury.Bottom Line
they do not cut off your femur bone and put a mettle rod down your leg. Replacement is a great procedure if your joint is to bad for resurfacing.
                                                                       Paul  

[rayareno]

Hi Paul,

I'm glad that your happy with your rate of recovery. I hope that the rest of the recovery process goes extremely well for you.
I didn't really start dancing until a couple of years ago. This is when I started getting a little more serious about it. I've never
had much difficulty sleeping at night. I can still lay on the side that's giving me issues without suffering to much pain. I couldn't
sleep all night on that side. I'll have to check out Dr. Scott Ball's explanation of hip resurfacing. I have seen the animation that
you mentioned. I found it to be informative. My reason for looking into hip resurfacing was because of bone conservation. I'm
fairly certain that some time don't the road I'll need a second operation. Who knows what medical advances will be coming
down the road in the future. Some day there may be something that will replace hip resurfacing.

It certainly will be nice when your able to dance once again.

Ray

[rayareno]

Thanks for replying to my posting.

I don't want to do a THR either. That's why I'm out here exploring my options. I don't want to make a rash decision that might not be in my best interest. I feel the same way about the U.S. being behind in this procedure. It seems that the FDA is slow in allowing approval of this procedure. I mean they've been doing hip resurfacing overseas for quite a while. Why haven't we accepted Hip Resurfacing as a viable option to THR? I can understand the FDA wanting to protect the citizens of the U.S. Sometimes it seems that the approval process is to lengthy. In my opinion. I do understand about selecting a surgeon with prior experience performing this operation. I'm fully behind this way of thinking. The problem with this way of thinking is that the surgeon's who would like to make a difference in someone's life are being penalized. Which is unfortunate. The doctor I've been seeing has 80+ hip resurfacing procedures.

Ray