Does OHIP cover BMHR done in England?

[VG]

I live in Toronto, Canada. Our Ontario Health Insurance Plan (OHIP) covers THP (and BHR?) surgery done in Ontario. But no surgeon does BMHR in Canada - at least no info I found. But there is very good clinic McMinn in Birmingham where I would like to have the surgery on my hip (AVN). The cost is over $20K - is biting.

Why not? Basically Canada is a part of UK and Queen is head of State in Canada. It should count, isn't it?

Is anyone conserned with the same questions? Could anybody give some suggestions or info on the matter?

Thank you,
Vlad.

[Pat Walter]

Hi

You might like to know Dr. Bose of India has been doing a lot of BMHRs.  He is one of the best hip rsurfacing surgeons in the world.  I know a lot of patients that went to him.  I considered him, but opted for Belgium since it was closer.  The complete medical cost, hotel and flight for surgery with him is $9000 to $10,000   depending on where you stay.  Most people stay at a 5 star hotel.  The Apollo hospital has a new wing that he uses.  So I wanted you to know there is another option if you have a credit card or a bit of money.

I know of a surgeon in Germany too, but it is probably as expensive as McMinn.  They are going to be doing field tests here too, but haven't started yet.  THat would also be too expensive.

Dr. Vijay C. Bose
1400 Hip Resurfacings to date ***
BHR Regional centre - India
Apollo Speciality Hospital, 320, Mount Road, Chennai - 600035. INDIA
E-Mail: bose5vijay@hotmail.com
Telephone: 0091-44-(0) 98400 - 32251
http://www.hipresurfacingindia.com/

Why do you think you need a BMHR?  Dr. Bose specializes in AVN cases since there are a great deal of them in INdia. He has an excellent record with AVN.  YOu can email him and send him your x-rays in a digital format as a .jpg and he will give you a free email consultation to let you know what he thinks. He is very nice.

Pat

[VG]

Thank you, Pat, for quick response. Dr.Bose is on scope (thankfully to your list of surgeons) of my consideration too. But it is too far from Toronto - I worry how to transport myself after the surgery. Flight takes many-many hours, seats - with very limited space, e.t....

Regards,
Vlad.

[Pat Walter]

Hi

I know it is a long way, but many people from the US from California to NY have flown there.  Some were able to fly first class since the surgery is so much less money than in the US and still not spend too much.  I flew home 8 1/2 hours 10 days post op from Belgium. Others I know flew home from India and did not seem to complain much.  You need to get up and walk around the plane every hour.  Unfortunatly, it is never easy - but many of us have gone before you.

Good Luck in finding a solution.

Pat

[VG]

Pat, one more question please. How many days I would have to stay there after operation (with Dr. Bose) ? Can I book flights both ways in Toronto or I have to go for operation and then, after operation, buy flight back from there? I mean there could be some complications making me stay there longer?

REgards,
Vlad. 

[Pat Walter]

Hi Vlad

You would have to ask Dr. Bose what he recommends.  I don't know the length of stay.  They do make sure you are well enough to travel before they let you leave.  For De Smet it is a minimum of 9 days for one hip.  Longer for 2 hips.  So you need to email him and ask questions.  His office would help you set everything up.

Everyone I know buys a 2 way plane ticket.  I just booked thru the airlines.  You need to tell them you will need wheelchair assistance in airports and that you are having hip surgery.  The airports are very large and diffiuclt to walk with a bad hip and after surgery.  You are able to walk well with crutches for normal walking - but the airports are very diffiuclt since you are also in a hurry many times.

I don't know many people that don't follow the original plan for their hip surgeries.  The doctors are very expeirnced and know what to expect.  The infection rates in the overseas hospitals is very low so I don't know of anyone off hand that had to stay over for that.  I know quite a few that had problems in the US.

You stay in the hospital for a certain amount of days and then transfer to a 5 star hotel in India.  I have been told it is beautiful and on the ocean.  You can see photos of people from some of the stories.

Few people use the medical travel companies since the doctors office will give you all the info you need.  Normally all you need to do is make a plane reservation.

Pat

[VG]

Pat,

From you experience, do I really need an accompany when go for a surgery to Dr.Bose? Just afraid my close ones will not be able to go with me at that time.

Regards,
Vlad.

[VG]

Hi Pat,

New questions appear more quickly then I thought. This one I do not know to what topic to post.

Stem cells therapy for AVN hip. Does anyone tried it before going for the operation? If it did not help, is it still possible to go for BHR?

Regards,
Vlad.

[Pat Walter]

Hi
I don't know about stem cells.  I know they are working on growing new cartilage, but it is way off and not done very quickly.  It took our country 10 years to join the rest of the world in hip resurfaicng, so I can imagine it will take that long with stem cells if they ever actually get it to work.  It does work in horses, so maybe some day humans will benefit too.  Not heard of anyone have much sucess.  None in the Us that I know of - but I don't know everyhting.

You can go to India or Beligum by yourself.  Many people have.  I kow of women that went to Dr. Bose by themselves. Usually you make friends with others that are there and can get their helpers to give you a hand.  Also the medical staff will know you need more help.  I mostly needed help to put my shoes and socks on since it was really cold in Beligum in March.  You could probably wear flip flops in India.

Good Luck.

Pat

[Pat Walter]

Ask Vicky Marlow and some of the others on the Yahoo Surface Hippy Group about Dr. Bose.  She went to him by herself.

Pat

[Jed]

There are surgeons in Ontario who do hip resurfacing. There is a centre in Hamilton which does a lot. (see http://www.activejoints.com/canada.html )I live in Nova Scotia and went to Montreal to get mine done by Dr. Antoniou. He uses the ASR not Birmingham but he and his team are really good. I think the surgeon is probably more important than the device - he's done over 700 with the ASR and is a researcher so he keeps track of complications etc. His admin team also takes care of all the paper work which is a huge relief for someone out of province.
Good luck

[markkenter]

Hi Pat,

New questions appear more quickly then I thought. This one I do not know to what topic to post.

Stem cells therapy for AVN hip. Does anyone tried it before going for the operation? If it did not help, is it still possible to go for BHR?

Regards,
Vlad.

I can help with this as I have done some good reserach in this area  and am currently partaking in such a procedure by a well known Dr and BioChemistry  board chairman in the Ortho/Biomedical Engineering profession

Autologous SCT (Stem Cell transplant)  Protocol is used primarily for STAGE I-STAGE II AVN Patient. There are mainly 4 Steinberg stages (some claim 5) as I am sure some of you AVN Patients know. The reason why only stage I or II is considered  is because stem cells take many many months to start filling in the holes in the bone resulting from bone resorption (Osteclastic activity).  6-24 months is the timeline. If you are  stage III then you in all probability will not  have that much time before Joint collapse. In other words, by STAGE III, The disease IS advancing faster than stem cell growth can  repair. Results have been poor with such later stages

The procedure, known as a BMAC, (Bone Marrow Aspirate Concentrate) is simple and is used during  a CD (Core decompression)  The Dr  withdraws Bone marow from the Iliac Crest,  Spins it down for a more concentrated form (because stem cells exist in small numbers throughout the body and a small number will be in the initial draw), then injects the marrow approx 30 minutes later into the Femural head during the decompression process

I believe The hope is that the stem cells can "grow under any remaining nourishment"  and initiate  Osteogenesis  on top of the necrotic areas while also (I believe) re-establishing a new vascular system (which is really the main problem here)

The procedure is scientifically supported  by the works  of Dr Hernigou and Dr Gandji. Their   results, based on a 24 month timeline period from the day of implantation,  were  published in the IJO (Indian Journal of Orthopaedics), I believe in 2006 or '07.

There is very strict protocol that must be adhered to based on the works of the 2 Dr's above. Please note, this is not the same protocol where the stem cells are withdrawn from the patient, havested for a week's growth for higher stem cell numbers,  and then reimplanted back into the patient's body a week to  10 days later ( A certain Dr on the west coast does this)   That procedure is not FDA approved. I know that Contamination is one of the FDA's concerns with that procedure

I am 3 months and 3 weeks out from my BMAC. I had it done in Late aug and there was another AVN patient in my room who had it done 2 hours prior to me. He was at stage II. Nothing is expected for  6 months is what I am told.  Unfortunately, I have detected a slight  deterioration in the past month. Nothing significant but it is noticeable (More pressure in the pubic bone area when I sit).

In 1 year an MRI is done to detect any  new vascularization and any favorable bone marrow  changes. A 2cnd  MRI is done a year later. I will evaluate the MRI 9 months from now. If there is evidence  of new bone growth or vascularization, then I will wait another year regardless of how I feel.

If there is no evidence  of revascularization or bone growth and I continue to decline even a little bit, then  i may begin making plans to  have Dr Bose do a BMHR.  He normally prefers AVN to reach its end stage where he then does a  BHR (see his AVN Protocol on his site). However, for early stage AVN Patients who cant tolerate the pain, he does offer a mid resection option. I will choose the BMHR, not because I am impatient, but because  I simply will not choose to experience the pain that will accompany later stages in order just to get a BHR. That will put me out of work and  I cant afford that. Plus, it will mean more QOL (Quality of Life) loss (probably 2-3 years) and we all have only a certain amount of time to spend on this planet. At 47,  I wont chose to experience the next AVN stage to fill some of that remaining time on earth.

With the nature of AVN's Inevitable Joint Collapsed outcome and nothing else medically available to reverse AVN,  I am sure Dr Bose can understand my  reasoning

I hope my feedback has helped

AVN (or other) Patients  may email me with any questions or links to scientific sources