Question about my upcoming plans for hip resurfacing

[Keith]

I am very happy to have found this very informative website. I have finally decided it is time to have a hip resurfacing operation to my aching hip as the pain that I have experienced for the past two years has become very bad during the last few weeks making it painful to walk any distance.  I will appreciate any and all info anyone can give me regarding the decisions I am in the process of making regarding having this procedure.

As for my backround, I am 66 years old and in top athletic condition.  Although I had to give up running and tennis this past years due to hip joint pain, I am still able to train several hours everyday on an eliptical machine, lift weights, and play 2 man beach volleyball (although now very painful). My orthopedic doctor says my bones are very strong but hip joint has not much space left in it. I would like to continue being very active in my sports for all my life so it appears that hip resurfacing would be my best option to do this-(am I correct in this assumption ?)

I am still in the beginning process of reading all the info available on this forum and the Yahoo forum but have to make plans soon.  I would appreciate any opinions of members of this forum might have that will help me.  I want to go to the best Doctor available regardless of where they are located.  Would members agree that Dr. De Smet in Belgium would perhaps be the best choice based on success and experience?  Although Medicare is my primary insurance which would not cover this since outside the US I also have supplemental insurance with Blue Cross/Blue Shield which I have not yet checked if they will cover this procedure outside the US--I would appreciate it if anyone who has info or experience on this insurance carrier ?? I live in California and could go to Dr. Amstutz but if Dr. De Smet is even slightly better due to his vast experience , I would prefer to travel to Belgium even if it cost me more since success of this operation means everything to me.

A few last questions to anyone that has had hip resurfacing--After a year or two have passed, is your hip back to normal that you would not even know that you had hip surgery other than seeing the scar?  If there are reminders that your hip has had surgery, would it be in the for of pain or numbness or what ?  If the surgery is successful, after a year would you be able to do everything that you had done when you had a perfectly normal good hip or would there still be some slight restrictions? 

Many thanks in advance for any help or advice you can give me...

[Pat Walter]

Hi Keith

I am a little biased since I had Dr. De Smet do my hip resurfacing March 2006.  I did not have insurance and could not afford surgery in the US. I could have gotten a free or almost free THR, but I did not want that.  I choose Dr. De Smet because of all the reading I had done on the Yahoo surface hippy discussion group.  I felt he was one of the best in the world. I was 61, female and had a loss of bone density.  I wanted the most experienced surgeon to make sure everything would be OK.  If I had insurance, I would still have choosen De Smet.  Others have choosen Dr. Bose in India who is also one of the best.  Some people have had their insurance cover their surgery with De Smet.  You normally have to pay up front, then are reimbursed later.

Since you are also a little bit older, I would choose a very experienced surgeon.  Many people still like Dr. Amstutz even though he is getting a little older also.  They still swear by him. 

I personally think people have quicker recoveries with the overseas doctors because they are not as conservative as the US doctors.  They have done hundreds or even several thousands like De Smet and know what to expect.  They also don't have to worry about being sued like the US doctors.

I can't say enough for De Smet.  But others will swear by their docs too.  I was with 8 others in Belgium and we all had very easy and fast recoveries.  I was the slowest since I was the oldest.  I was on one crutch at 4 days and none at 4 weeks.  None of us had any great swelling or bruising which many people using the newer surgeons seem to have.  I personally think it is the great surgical technique of the doctor.  Dr. Bose patients also have similar recoveries.  Some of the people with the US docs have had that kind of recovery, but it is not as common.

People can argue day and night on the Yahoo group about who is the best - but I think most would put De Smet, Bose, Gross along with Amstutz and Mr. McMinn at the top.  Of course, that is just opinion. But just experience goes a long ways and De Smet has over 2700 hip resurfacings to date.

I don't think about my hip any more.  I really didn't even 1 year out.  My incision itched for a long time and still itches sometimes.  I had some clunking because my muscles were lose and still have it occasionaly when I sit and move a certain way.  It does not hurt, just is noticable at times.  I did not take any heavy pain meds after I left the hospital.  I just took Advil for sore muscles.  Your muscles are sore along with the incision, but does not normally cause any great pain. It is uncomfortable and feels strange - but not pain like before the surgery.

I think you should get an email consultation from De Smet, Bose and Gross.  Maybe anyone else you think would be good and then make up your mind.  You will get a feeling for who you want to go to.  I wanted De Smet from the time I started to read about the surface hippies that used him, but that was before the FDA approval. so there were a lot fewer docs to choose from.

Hip Resurfacing is definitely the best option for returning to the sports you love  http://www.surfacehippy.info/athletes.php  Check out the athletes.

You might be lucky as I hope I am and never need a revision for the rest of your life.  However, if you do, at least with a hip resurfacing you have a whole femur bone left for the docs to give you a thr.  I always think that is the best reason to start with a hip resurfacing. 

Again, I have no pain or numbness in my hip.  The only thing that reminds me is the scar from the incision which for ladies in Belgium is all stitches.  No staples. You will have waterproof bandages and do water PT a couple days after surgery.  The Belgium experience is wonderful and the De Smet team is just great.  If you do some reading on the Yahoo group there are several people just recently in Belgium.  You can read how well they are doing and how they have no pain.

I hope that helps some.  Let me know if I can help with any more info.

Pat in Ohio
3/15/06 LBHR De Smet

[Vicky]

Hi Keith,

Absolutely your hip returns to being a normal hip just like before your pain started.  The only time I get reminded that I had hip surgery is when I go through security at the airport.  :-)

I personally believe two of the top surgeons in the world are Dr. Bose and Dr. DeSmet.  If you look at the super athletes that have returned to REALLY full activities,

like Cory Foulk - BHR surgery with Dr. Bose 12/21/05 and ran a marathon 3 months post op, entered 5 Ironman triathlons since and came in 11th in the Ultraman Canada last month, all less than two years post op

And Dru Dixon - bliateral BHR resurfacing with Dr. DeSmet who came in 289th in 11:45, at a recent Ironman competition in Kentucky against 1600 other contestants, that means he finished in the top 18% overall, any age, amateur or pro.

Amazing!  Astounding even! 

I am not sure if it has anything to do with the device but if you notice, like I recently have been noticing, it seems the real athletes all have BHR devices.  If you look on Pat's website under athletes, all but one had BHR's, only one had an ASR device.  Dr. Amstutz uses the C+ device and Dr. Gross uses the Biomet.  But the more I learn and the more I hear about the different docs precautions post surgery, I am beginning to believe that it also could be device related?  I understand the newer docs being more cautious but the more experienced docs telling their patients no marathon running ever are the ones using different devices.

I have been telling any athlete that contacts me that they should look into going to Dr. Bose, he not only uses the BHR device, he also preserves the neck capsule which allows the patient to have no restrictions at all after surgery.  Many of his patients are back in the gym at 5 - 6 days post op.  With either DeSmet or Bose, you can not go wrong.  They are two of the top in the world.  Both have had patients go to them and had insurance cover it.

Vicky

[Keith]

Thank you Pat and Vicky for your quick replies. It appears from what I am looking for and what both of you have said, my best choices are Dr Bose and Dr De Smet.  I will have to do some reading on their techniques but I am assuming that they both are using the same BHR device and performing the operation in basically the same way.  Would I be correct in that assumption??  If there are any differences between their devices and techniques, please let me know.  I am planning on contacting both of them but would guess this is going to be a tough decision to make choosing which one.  Are there any other factors to consider in making my choice ?  Superficially speaking, it would seem that Belgium would be a the more logical choice of a country to go to for cleanliness and top facilities rather than India however it appears that this may not necessarily be correct in this case--does anyone have any thoughts on this question?

Once again, thanks in advance for all your help and kindness.

    Keith

[Pat Walter]

Hi Keith

I choose De Smet because at 61, I personally did not want to do the long flight to India.  I also thought I would rather do the European experience rather than the Indian experience since I have never traveled before.

I would have no problem going to Dr. Bose in India.  The Apollo hospital is first rate with a very low infection rate.  Once you get from the airport to your hotel and then hospital, you are well taken care of in first class rooms.  There is a new addition, I believe, to the Apollo hospital.

The infection rate in Belgium is also low. I will tell you that to my eye, the hospital looked about one generation older than the hospitals here in the US.  I felt like I was going back into a time warp of a hospital of maybe the 60's. The care, however, was first rate.  The food is definitely not like in the US in the hospital. However, you are not very hungry for the 2 1/2 days in the hospital.  You can always have someone bring you something or hop on down to the coffee shop and have a beer and a snack!  Smoking and beer are allowed in the hospital. Europe is quite different than the US.  By the way, the 450 Belgium Beers are absolutely wonderful - unfortunately we did not get to taste them all.

I just felt more comfortable going to Belgium.  The common language in Belgium is English since eveyrone speaks Dutch, German or French - they all know some English. Ghent is a wonderful, beautiful European town and everyone is very freindly to Americans. Not so much in Brussels, but Ghent is fantastic.

The Belgium experience will probably be about $18,000+ if you take a spouse or friend.  The Indian experience is about $12,000 depending on where you stay and how you fly.

I think it is really a personal choice of how you feel about the doctors after talking with them via email or even phone if you wish and how you feel about traveling in Europe or India.  I guess you have a lot of Muslims in Belgium and a third world country in India.  Some people have talked about the terrible conditions they saw in India on their way from the airport to Dr. Bose.   It is really a personal thing of where to go.

Checking into the Belgium hospital is interesting - you sign only 2 times.  One on the admission paper and once for the credit card. A couple minutes and you are on your way to your room.  Quite different than the US experience in hospitals.

I don't think you could possible go wrong with either doctor.  They actually know each other and visit sometimes.

[Vicky]

I honestly would have thought the same thing about cleanliness, etc.  My Mom agreed with you to the point that we argued a lot about it.  She did NOT want me going to India.  I would go back in a heartbeat if I ever needed my other hip done.  They have built a new Platinum Ward that is really very plush.  To see pictures of it click on this link.

http://hipresurfacingindia.com/New_Hip_Surgery_Facility.php

First when you book with Dr. Bose the Apollo hospital gets you in touch with the International patient coordinator.  All you have to do is book your flight, they handle everything else for you.  When you arrive they pick you up at the airport and take you to your hotel which you will spend the night at, then the next day which would be the day before surgery, they pick you up from your hotel and take you to the hospital to check you in.  You are placed in a very large private hospital room which has a plasma screen TV on the wall, wireless laptop in the room along with refrigerator and microwave, all inside your own private hospital room. Very clean, immaculate even.  You have surgery the next day and stay in the hospital for one week post op.  Dr. Bose comes by every day to check on you and you have nurses at your call anytime you need anything.  You order food off of a menu and they provide a nutritionist to discuss what you will be eating daily.  Then after the week, the driver takes you to a luxurious beach resort where you will stay for a few more days before flying home.  I stayed at the Fishermans Cove a five star beach resort, the staff is set up to handle a lot of patients from Apollo.  They run to the elevator just to press the button for you.  The service and care there were outstanding at both the hospital and the hotel. 

You really can not go wrong with choosing either doctor.  The differences between the two would be incision length, Dr. Bose uses a much smaller incision and you stay in the hospital with Dr. Bose where with DeSmet you go to their plush rehab facility for pool therapy.    Other then that, they are both extremely talented surgeons, both use the BHR device.  I was on a tight budget and choosing Dr. Bose saved me around $6k over going to DeSmet.  I figured if they are both just as talented, the extra long flight was worth saving $6k.  Feel free to email me if you like and I can provide you with a cost spreadsheet so you can factor in exact costs for both surgeons.  My email address is vickymm@comcast.net

Vicky

[Keith]

 Thanks to the information from both of you, I am moving right along in my decision making process. As a point of information to fellow members, I just contacted my insurance company Blue Cross/Blue Shield of Illinois and discovered to my pleasant surprise that they will cover 80% of my cost of having it done internationally with no restrictions other than my 250 deductible. They will actually cover 100% of the cost over the initial $3000. which makes it even better.
It sounds like I could not go wrong with either Doctor and now that I find the cost is going to be covered wherever I go and the fact is that I can fly anywhere in the world for free, it is not making my decision any easier since everything from the information I have is about equal. I may have to wind up flipping a coin ! 
Hopefully some slight bit of info I get after contacting the Doctors as to scheduling or something will help tip the scale a little bit.
Vicky, since you are into triathlete, I should mention that I am currently writing this from my home in Kona, Hawaii where the big Ironman Triathlon will be held in about two weeks.  If you ever decide to do the Hawaii Ironman, just let me know at capt747@verizon.net and I will be happy to cheer you on!  I used to do some of the smaller triathlons but think it is time to give them up as I think my last 40 years of high impact running on pavement is what helped get me into this position with my hip. I think I will just stick to the swimming and biking part in the future and stay with my sports that have lower impact.
Thanks again and I will probably have more questions as I get farther into the process.