This is my situation:
- Male, 62, still trying to stay as active as possible - still running/limping short distances 2 or 3 times a week
- from Canada and attempting to get OHIP to pay for surgery with Dr. Brooks [Cleveland Clinic]/will probably be denied
- as an alternative, thinking of going to India to have Hip Resurfacing with Dr. Bose [within my price range]
- if I wait to long I may have to settle for Hip Replacement [also could be long wait]

Risks of going to India:
1. have to survive covid-19
2. have to get vaccinations?
3. will I need blood transfusion?
4. long flight/probably 15 to 20 hours, risk of embolism?
5. if I stay 1 month will that significantly lower risk of embolism?

Have not seen any posts of people going to India recently but everything I have read about Dr. Bose seems positive.
Any other risks I have missed? Appreciate any opinions to help alleviate my fears. I have never had major surgery.

Thanks,
Ernie

I haven't had any surgery, or any medical treatment whatsoever, in India, so I can't answer questions specifically about that. But I have been to India a few times, so hopefully I can answer a couple of others for you. First, surviving Covid. Well, Hmmm. That's going to be a risk everywhere for a while. You can go ahead right now and take the precautions that you can, or you could wait and gamble on the possibility of a vaccine early next year. No easy answer there. AS for other vaccinations, check Canada's CDC equivalent for recommendations, or even just the CDC itself. Generally speaking you want to be current on the standard recommended vaccines for everyone (polio, measles, etc.), plus you may want to consider Hep A (you may already have had this vaccine) and typhoid. You will definitely want a malaria prophylaxis. Resurfacing surgery does not typically require a blood transfusion. You will be on some sort of blood thinner for the first month after surgery. There are others on this forum who have travelled long distances, even internationally, who can allay your fears about an embolism. I expect you will be best off wearing compression socks and getting up to walk regularly on the flight home. Do remember to arrange for a wheelchair when you make your flight reservations.

Chennai is in southern India, and is hot. I was there in January (not this year, previously) and it was hot when I got off the plane at 2AM, and it was hotter during the day. There is AC there, but it's something to keep in mind. You'll want to look up the expected temperatures for the month you're planning on going. Southern Indian food is delicious.

Hope you get some Bose specific answers.

Hi Ernie, I'm in Vancouver, BC and went to Seattle for mine - Dr. Pritchett.  But couldn't you go to Dr. Emil Schemitsch in Ontario?  He seems to be our highest volume Canadian surgeon for hip resurfacing.

Best,
Grant

Catfriend, thanks for the info about vaccines, nice to know.  I've had most of those vaccines except malaria. Good to know that blood transfusion are not usually required. From what you mention Chennai may be good for me, if the Hip Resurfacing is successful I can escape some of the Canadian winter.

Grants, the problem with Dr. Emil Schemitsch is that there is a backlog of about a year to get surgery and just getting in for an appointment probably adds another few months. Also, from looking at his website, it seems like he restricts the Resurfacing to people under age 60.  I do not want to wait too long so now I am just waiting to hear the result of the OHIP request and take it from there.

Generally, I am surprised that Hip Resurfacing is not more widely accepted?  I had an assessment with a Doctor [I mentioned Resurfacing] and he just said that I would be happy with the total Hip Replacement.  To me it just seems that Hip Resurfacing should be an option for most people.  if your situation allows it why cut off the ball of the femur when you don't have to?  Some people think I am crazy to even consider Hip Resurfacing but thanks to this website I feel more confident opting for this procedure.

Really appreciate the responses,

Ernie

OHIP [Canadian Insurance] denied my request as expected. Their reason is because I declined to see Ontario Doctor [Dr. Emil Schemitsch] they will not pay. Before their decision I informed them that Dr. Emil Schemitsch only does resurfacings on people under age 60 [I am 62]. Also, by the time I have a consultation and possibly convince him to do my surgery it could be 2 years. By that time the ball of femur or ligaments could be too damaged to have Hip Resurfacing.

It is probably because of Covid-19 that there is a huge backlog of surgery. When I had my hip assessment the lady said that I am still well functioning; apparently, once you are in constant pain with limited mobility then you will be scheduled for Hip Replacement. She was not aware of Hip Resurfacing, she was interested and I informed her of this website. I also told her that Dr. Emil Schemitsch is one of the few surgeons who does Hip Resurfacings in Ontario. When I declined a consultation with Dr. Emil Schemitsch, she agreed that it could be a long wait time.

Having difficulty contacting Dr. Bose [India]:
Tried to make contact with Dr. Bose through a Medical Tourism Site but I do not think the response I received was from Dr. Bose. The response I received was something to the effect that I may be more suitable for a "Dual Motion" Hip. After this I found email address for Dr. Bose from "Doctors over 1000 Hip Resurfacings" but have not heard anything back yet.

From my experience so far I am a little apprehensive of travelling to India so I am looking at other Hip Resurfacing Surgeons. The cost may be 2 or 3 times as much but seems less risky. There are 2 surgeons that I am considering; Dr. Koen De Smet and Dr. Derek McMinn. Any opinions would be welcome.

Thanks,

Ernie

Maybe you read my post on how me and Dr Gross got my health insurer to provide coverage for an out of network doctor.  In your case you mention "When I had my hip assessment the lady said that I am still well functioning".  Who was the lady?  Someone from OHIP or an orthopedic surgeon you consulted?  If she is from OHIP that's great because she might be the decision maker for your case.

I would do as the lady has implied, get a consult with Dr. Emil Schemitsch.  Will Dr Schemitsch do a remote consult where you send him information and xrays to determine if he is willing to do a hip resurfacing on you?  If he could deny you because of age, could he give you a letter right away so OHIP knows he's not interested and you should seek service elsewhere?  If an appointment is required, get it in writing how many weeks out Dr Schemitsch is scheduling consults and surgery, I think it would have to be an unreasonable amount of time for the insurer to allow you to go out of network.

Did Dr Brooks say you are an excellent candidate for hip resurfacing and will he and the clinic accept OHIP terms?

I went 5 years too long and worried about the visual deterioration I saw with each xray, then I found this site.  I had a doctor on the list tell me I wasn't a candidate, and was very disappointed, but he was no longer actively and regularly performing resurfacing and I should have asked him for a rejection letter so I had (or Dr Gross would have) something to present to my insurer. 

The sweetest words were when Dr Gross told me I was an excellent candidate and his office would apply to my hmo insurance to cover surgery by him because I had been denied by my home network.

Hey dannythebeerman,

I found out about OHIP paying for Hip Replacement from this website and sent my x-rays to Dr. Brooks who replied that I was a good candidate. In Canada [Ontario] the procedure is as follows:

1. My doctor had to file an Out of Country Prior Approval request on my behalf [which she did]
2. Mentioned in report; if I wait to long I may have long term joint damage
3. Then I had to go for an assessment which I did and it was determined I am still well functioning
4. She was willing to send me to Dr. Schemitsch but I declined because I thought the wait would be too long [because of Covid-19]
[from my research I found that from consultation  to surgery would probably be well over a year ... she confirmed this]
5. They denied my request; I expected it but figured it was worth a try

I am in aggreement with you regarding waiting too long.  I should have done it last year and maybe could have had it completed before this Covid-19 lockdown. In the last 6 months I really notice the deterioration and hope to have the resurfacing done soon. I could appeal the OHIP decision but I just do not want to wait that long [not getting any younger].

Dr. De Smet already resonded to my request and said I am suitable candidate for Hip Resurfacing. Informed Dr. De Smet that I want to have the Hip Resurfacing and I am just waiting for his response.  My only concern now is, will I be allowed to travel to Belgium during Covid-19. Maybe I will have to start a post and see if other people have travelled to other countries for Hip Resurfacing during Covid-19.

Also, I like your handle [dannythebeerman].  Hope I can have some beer if I make it to Belgium.

Thanks for your reply.

All I can add here is that you should consider Dr. Gross in South Carolina.  He just did my 2nd hip 5 weeks ago, my first being 8 1/2 years ago.  He has a variety of payment options, and has done approximately 6,500 resurfacings.  His website has not updated that number, but I asked him before hip #2.


He and his staff are the BEST.  My recovery this time seems twice as fast as before.  You can't go wrong looking into him as an alternative.  He also does 75% if his surgeries as outpatient, saving a bunch of money on the overnight hospital stay.

I'll second imgetinold's recommendation that you at least inquire with Dr Gross' office. I know they have many patients traveling from other countries who pay out of pocket. I had mine done earlier this year at age 51, and being relatively "young and healthy", I had the procedure done outpatient at their surgery center. I stayed the night before and the night of in a regular old Marriot Residence Inn, Dr Gross checked in on me the next morning, and I felt well enough to travel several hours home (by car).

If you are a good candidate for outpatient surgery, I'm sure it would be considerably less expensive than a hospital stay. And of course, consider all the wonderful things people say about Dr Gross and his staff :)

It's good to hear that you have confirmation that you are a good candidate and are trying to work out particulars with the surgeons overseas.  I was interested in helping you save money and distance.  In a previous career I worked in insurance, not health insurance, but professional liability.  My knowledge of contracts and how work flows helped me navigate my case.

If you find you may wish to pursuit using Dr Brooks later I'll certainly try to give helpful ideas.

I'm assuming Dr Brooks' consult was included in your doctor's Out of Country Prior Approval submission to OHIP?  I should post copies of the compelling reasons that were submitted on my behalf.  My case may have been easier to approve because the fees were in line, my condition had a sense of urgency, and there wasn't a doctor in my network.

the beerman thing, I used to serve beer at the ballparks and am fond of the Canadian national anthem.

Hello BionicHip,
I have had three hip surgeries: 1) A resurfacing with Dr. Pritchett (Seattle) in 2006, age 55. 2) A total hip replacement on my other hip in 2818 because, at age 67 (and small frame female), I was no longer eligible for resurfacing. That was done by a surgeon in Tampa after we moved to Florida. 3) A revision to my resurfacing later in 2018 due to metallosis. I flew back to Seattle for the revision. Dr. Pritchett did the revision and preserved the resurfacing.

There aren't noticeable differences between my THR and my resurfaced hip, except that my THR joint is very small so I have been advised not to torque it in a way that could cause dislocation. For me, that means not using a rowing machine or heavy leg presses. I can walk, run, swim, kayak, cross country ski, etc. For me, it's fine.

When I traveled to Seattle for the revision, I stayed for 2 weeks before flying back to Florida. It was a 5 hour flight and I was totally exhausted by the time we got to Tampa. I can't imagine an international flight. India is a unique country. If you have traveled to 3rd world countries before, you might be comfortable. If not, you might want to reconsider, especially during Covid. Belgium, if possible, would feel more comfortable despite the necessary flight.

Dr. Pritchett in Seattle is one of the most experienced resurfacing surgeons (similar to Gross and DeSmet) and I am sure he has operated on many Canadians. I suggest that you send him your images to get an opinion and ask about dealing with Canadian insurance. Good luck!

By the way, I DID have a blood transfusion with my first resurfacing procedure. Unusual, but it happens. Also, many doctors don't perform resurfacing because it is technically more difficult than a THR, and most patients really are fine with the latter. Orthopedic Surgeons tend to stick with procedures they've done over and over again (which is a good thing) and few of them have been trained in resurfacing.