Should I travel from San Diego to have hip resurfacing

[harold]

Hello

I am in San Diego and I have met with Dr. Ball at UCSD. I am consulting with Dr. Amstutz in a few weeks.  I have Blue Cross Blue Shield PPO.  I have several qestions:

1.  Should I speak with Doctores in another State

2.  I spoke to Dr. Amstutz's office and they said he was not a Blue Cross Provider.  I guess this means I may not be able to afford his services.   Should I look out of the country and will my insurance cover it.

Thank you for your help

Harold

[Pat Walter]

Welcome to Hip Talk Harold.

You have quite a few good surgeons in CA. I am going to post the list at the end of this reply for you.

Some are pretty experienced:
Dr. Ball - 250+
Dr. Ure 300+
Dr. Vail  180+

Sometimes you can do appeals with your insurance company and win. It has taken quite a bit of effort on some peoples part to do so, but they have won.  Here is what some people have done to win

http://www.surfacehippy.info/insuranceappealinfo.php

Dr. Amstutz and Dr. Schmalzried are very good hip resurfacing surgeons.  It might be worth trying to work with your insurance company. 

Some insurance companies will cover surgery with Dr. De Smet in Belgium. You will see some letters on the page above.  You can't do much better than De Smet with over 2400 hip resurfacings.  My total cost for my hubby and I to Belgium in 2006 was $16,000    Total cost to Dr. Bose in India, who is equally good, is $10,000 to 12,000. 

I would see who your insurance company will approve first.  Maybe meet with them to see how your gut feeling is.  Meanwhile, you can fight to try to use Amstutz or Schmalried.  Your last resort is to go overseas.  I  would still choose De Smet even if I had insurance since I liked his great amount of experience.  Bose patients feel the same.

It sounds like you are just begining your search for a doctor. It may take some time. Hip resurfacing is the way to go if you want to remain as active as possible.  You are heading in the right direction.

Let us know if we can supply any other info for you.

Here is the list of CA doctors:


Harlan Amstutz , MD
Joint Replacement Institute at St. Vincent Medical Center
2200 West Third Street, Suite 120
Los Angeles, CA 90057
213-484-7600 phone
213-484-7566 fax
jri@laoh.ucla.edu
http://www.jri-oh.com/

Scott Ball, MD -Trained with Amstutz 2006
UCSD Department of Orthopaedic Surgery
200 West Arbor Drive
San Diego, CA 92103
(858) 657-8200
Hillcrest
(619) 534-6312
UCSD Dr. Ball Website

Peter W. Callander M.D. - BHR Trained McMinn 2006
California Pacific Orthopaedics & Sports Medicine
3838 California Street Suite # 715
San Francisco, CA 94118
Phone (415) 668-8010
Fax (415) 752-2560
Email  pcallander@cposm.com

Dr. Robert J. Gilbert, M.D. - BHR Trained 2006
California Pacific Orthopaedics & Sports Medicine
3838 California St., Suite 715
San Francisco, Cal. 94118
http://www.cposm.com

Dr. Raphael Klug
The Permanente Medical Group
1600 Eureka Road
Roseville, CA 95661
(916) 784-5051
Website for Dr. Klug

Thomas Schmalzried, MD
Joint Replacement Institute at St. Vincent Medical Center
2200 West Third Street, Suite 120
Los Angeles, CA 90057
213-484-7600 phone
213-484-7566 fax
jri@laoh.ucla.edu
http://www.jri-oh.com/

Dr Keith Ure
Doctors Park
635 Lassen Lane Suite 100
Mt Shasta, CA 96067
530-926-521
Doctors Park Website

Dr. Thomas Parker Vail
UCSF Department of Orthopaedic Surgery
500 Parnassus Ave.
MUW 320 San Francisco, CA 94143
Phone: (415) 476.1166
Fax: (415) 476.1340
E-mail: calcagno@orthosurg.ucsf.edu
UCSF Website


Pat

[harold]

Thank You.

[Bonnie]

Hi Harold,
Happened to see your post that you are in San Diego looking for a surgeon.
I also live in San Diego and having been researching surgeons.
So far I have looked into Dr. Ball UCSD, Dr. Vail, Dr. Ure, and Dr. Klug who is with Kaiser which is the HMO I have now but am changing over to Blue Cross PPO.
I am definately going to Dr. Gross in South Carolina. I feel other than going out of country he is one of
the best. It is not really that much of a big deal than going all the way up North. He does out of state surgeries on Wednesdays and you can fly home Saturday. You will want to fly in by late Monday, have pre-op Tues. So 6 days total.
He is a covered by Blue Cross PPO. You might want to research him.

http://www.grossortho.com/index.htm

Bonnie

[Pat Walter]

Hi Bonnie

Welcome to Hip Talk. Thanks for the post.

You have choosen a great doctor in Dr. Gross.  You will be in good hands.

Please keep us updated on your surgery with Dr. Gross. Also if you would like to write a story I will be happy to post it on the Hip Stories Page http://www.surfacehippy.info/hipstories.php  for new people to read. Reading other people's stories is very helpful when you are trying to decide what to do.

Good Luck!

Pat in Ohio
3/15/06 LBHR De Smet

[Bonnie]

Thanks Pat,
It has been a rollercoaster rider as I know it usually is for all of us.
First I was told I had AVN in 2003 and only a THR was the way, so I finally went to China 5 times for alternative treatment to buy time until something better came up and since then have been told no-you don't have AVN just
bone on bone OA and that is what the cysts are from ....... So, I have stopped going to China (TG) and just in June of this year when I felt I was
doomed for a THR I found out about the resurfacing. After sending xrays and info to Dr. DeSmet,Dr.Bose and Dr. Rubenstein; they all said I was a good candidate for resurfacing.
Well, I have Kaiser right now and my current OS in the southern region will only do a THR for me (though in May of last year he started doing resurfacings). I have learned in my 52 years to go for or buy the best, to not try to go the cheaper or easier way, or settle because I most always will regret it.
But without realizing it I was still trying to do that by going to Dr. Klug with Kaiser. He gets rave reviews and is recommended highly by surgeons and also, by I think it's 5 or 6 (men) on surface hippy, who are all crazy about him and have had great results. (though he has not done more than approximately 60 or so and does the anterior approach. And I went through
the biggest beauracratic bs to go to the northern Kaiser region just to get Dr. Klug and have it covered by Kaiser.

BUT when I spoke to him, though I did love him as a person, he spent a lot of time talking to me and is a great, compassionate, person - the downfall is, he has doubts on women post menepausal getting resurfacing because of bone quality. He said he would do all he could to do a resurfacing but that feeling of playing russian roullette with my hip stayed with me long after our conversation. Right then I knew I was settling for a financial trade off that would be easier for my husband and I after our expensive China experience rather than going with my gut on what I new was the better choice.
I remembered what I'd learned the hard way so many times - go for the best in everything whenever you can the first time, you may not get a second chance.

It was a toss up between Dr. De Smet and Dr. Gross. And though, going to
China by myself 5 times I knew I could handle it - I am just totally burned out traveling out of country for medical care, just exhausted - so I decided Dr. Gross who is such an expert also and with all that I've researched I feel very confident I will get every chance there is for a hip resurfacing with him.

The great thing is my insurance will cover him, the challenging thing is it doesn't kick in until Jan 1. But I'm going to spend this time waiting to get
strong and prepared to make post-up easy as possible.

Thanks for listening - I think I just vented all my pent up anxiety in your lap  - sorry

Bonnie

[Pat Walter]

Hi Bonnie

I can understand your frustration.  I went to 4 orthopedics costing me $200 each out of my pocket to be told hip resurfacing was old fashioned and no good. I did not have health insurance and was not able to get it at 61. 

If you were not so burned out with travel, Dr. Bose in India is equally experienced and known as one of the best in the world.  You can go to Dr. Bose for $10,000 to $12,000   Many people just love him and he writes articles for me to share on the website.  I did not go to India because I don't like to fly and 8 1/2 hours to Belgium was enough for me.

I am sorry your treaments did not work.  Dr. Bose specializes in AVN.

If you insurance will cover Dr. Gross - that is great.  You don't have too long to wait. I know it is difficult to exercise with a bad hip, but if you can, try to build up your upper body strength.  That is where I had problems.  Overseas, they use elbow crutches which are much easier to use than the old fashioned under the arm crutches.  But you still need good upper body strength to get around and move yourself around in bed after surgery.  My shoulders and arms got very sore since I was so weak.

Use the time to get prepared physically and mentally. Once you have made the decision where to go and when - you can then concentrate on how your life is going to be after surgery when you have healed.

Many of the newer surgeons doing hip resurfacing are very conservative because they are very inexperienced.  You can't buy experience and with hip resurfacing a doctor needs experience to do a really good job.  It is almost as much an art as a learned skill.

You can read Dr. Bose explanation of a dislocation http://www.surfacehippy.info/dislocationofbhr.php  that I just posted. He explains that if a doctor only does 80% of the job in trying to get the Native angles, inclination , offsets and all anatomical parameters right - you hip will only be 80% good.  20% chance of dislocation or problems. 

So many new people don't understand the importance of a surgeons experience. They feel if their doctor is a great THR surgeon - he is a great hip resurfacing surgeon.  Dr. De Smet explained that the THR surgery has been around so long that they have invented much instrumentation to assist the surgeon in placing the hip device.  Hip resurfacing is still new and the instrumentation is still limited.  So the hip resurfacing depends on the SKILL of the surgeon.

There are great arguments on the Yahoo Discussion Group that us older hippies only push people to use the old experieinced doctors. There is good reason for that - they do have the experience and in this case it is very important to your post op recovery and overall outcome of your surgery.

Feel free to vent any time. That is part of having painful hips.  Not only does your body hurt - your emotions hurt too. It is frustration having pain and having to fight with the system to find a doctor to get rid of the pain.

I wish you luck and please keep in touch. Think about writing a story about your hip resurfacing after you get your surgery.  Keep a diary - people love to read about other peoples experiences. It helps them make up their minds.

Pat in Ohio
3/15/06 LBHR De Smet

[harold]

Hello

I am in San Diego and I have met with Dr. Ball at UCSD. I am consulting with Dr. Amstutz in a few weeks.  I have Blue Cross Blue Shield PPO.  I have several qestions:

1.  Should I speak with Doctores in another State

2.  I spoke to Dr. Amstutz's office and they said he was not a Blue Cross Provider.  I guess this means I may not be able to afford his services.   Should I look out of the country and will my insurance cover it.

Thank you for your help

Harold

Hello everyone since this post in August I have interviewed and researched several surgeons and decided to have my surgery in South Carolina with Dr. Gross.  I am scheduled for surgery next wednesday the 23 of January. I want to thank everyone on this board, because I feel I have made the most reasoned decision based on my research and your input. I will let everyone know about my progress. Harold

[Pat Walter]

Hi Harold

Dr. Gross is an excellent choice. There are many happy Gross Surface Hippies.

Are you getting a cemented or cementless hip device?  Just curious.  Dr. Gross is one of the few doctors doing the cementless hip resurfacing.

I want to wish you the very best on Wednesday.  You are in good hands.

Please let us know how you are doing when you return.  When you return - be sure to start your own new story on the HIP STORIES section.  You deserve to have your own new topic started.

Good Luck - you will be on the other side soon with a new hip.

Pat

[harold]

Hello Everyone

I had my surgery last Wednesday  in  South Carolina with Dr.  Thomas Gross.  So far everything has gone well.   Dr. Gross is a good Doctor and he has surrounded himself with a great team. Nancy Smith and Lee Weeb are fantastic.  Dr. Gross has people flying from all over the US for the surgery  You never feel neglected or your Questions unanswered.  I am with Blue Cross Blue Shield CA.  I did not have to hassle with any insurance matters. (Taken care of by the Dr. Gross' staff)The Providence Hospital NE is a orthopedic surgical hospital (Professional and small) The staff was very warm and helpful. I had my surgery on Wednesday never felt any pain during the surgery but I do remember two hammer shocks , but is was more like being on a boat which had a rolling wave go under it.

I went under as I was being wheeled to surgery and woke up to my wifes smile and kiss. I used a cold water ice pack recirculating system which has limited the swelling .   I have a cyst in my femoral head so I am on a 7week protocol of crutches 10 percent weight bearing. I have had very little bleeding at the site of the wound.(Wound Care prepackaged for home use )I have had only slight twinges of pain.(I now use one vicodine at night, tylennol during the day) The physical therapy exercises are going well.

So far I am very happy with my decision of going out of state for my operation.

[Pat Walter]

Hi Harold

Congratulations on your new hip.  You are an offical Gross Surface Hippy!   Glad everything seemed to go well for you.  It usually does for Dr. Gross patieints.

I think you will be happy to have used Dr. Gross and it is great your insurance will pay for the operation.

I hope all continues to go well for you.

Good Luck and keep in touch.

Pat

[harold]

Pat

Thank you very much for putting up this site.  It has been life changing. I would not have been able to find the quality and extent of information I found here anywhere. Just prior to going in for my operation.  I was in so much pain I could not stand long enough to hang a small picture. Now I sleep all the way through the night, something I have not done for years, because of pain. 


Oh yes I have caps without cement. I will be on crutches for 7 week.  We went cementless because of the cyst on my femoral head.
Thank you again.

Harold