Metal Ions and Childbearing

[AndyJH]

Hello all,

My name is Andy, I'm 36 and I live in Essex, England. I have osteoarthritis in my left hip and I'm due to have surgery on 4th December. My surgeon is Dr H Banan who will performing the op at King George Hospital, Goodmayes, Essex

My dilemma is that I was originally due to have the resurfacing procedure but I have since been advised that I might be better off having a FHR. A couple of weeks ago I went in for my pre-op assessment and I actually got to meet Dr Banan (on 3 previous visits I've seen 3 different consultants who work under Dr Banan). He went through all the various options for surgery and then asked me if I had children or was planning to have them in the future. I explained that I don't have any children at present but I am planning to have them in the near future as I'm getting married next year. Dr Banan raised concerns about the metals used in resurfacing which could result in chromosome changes, meaning that these could be passed onto an unborn child - the end result being that a child could be born with a defect. Dr Banan said that it's far too early to say if there is any substance to the claim or what the risks are; however he advised me to think very carefully about having the resurfacing if I want to have kids.

So just when I thought everything was sorted it looks like I've got a big choice to make. Has anyone heard of this risk? I'd appreciate all help / advice.

Thank you in advance.
Andy



 

[Pat Walter]

Hi Andy

Welcome to Hip Talk.  I hope you did not mind, but I wanted to start your topic under a new subject so everyone will see it.

This is a small discussion group and very new, if you want much more input, I would suggest joining the Yahoo Surface Hippy Group of over 6000+ memebers.   http://groups.yahoo.com/group/surfacehippy/
  The group is having a conversation about this topic now. 

I am sorry if I embarasse you, but are you male or female?  I assume male.  In the past, most of us hippies in the large group have come to the conclusion from much reading that no one has really officially, medically, proved that the metal ions cause problems.  There are a few young women on the group that had BHRs and also later had children without problems so far.

Most of our doctor seem to think it is insignificant.  But recently, I just read an email from a lady where Mr. McMinn suggests there could be problems passed on to the baby.  I have not yet found the study he refered to.

I do think there have not been many studies yet. 

I will say that you are very, very young at 36 to be having a THR. The main reason people have hip resurfacing is to conserve the femur bone so if or when you need a revision later in life, you have a complete femur bone to do the revision with.  When you start with a THR, they have to break apart your femur to remove the long rod for a revision. Then they wire it back together.  So each revision gets more and more difficult until you end up in a wheel chair.

I am only giving you my opinion - I am not medically trained.  I think you need to think about your future health first before having a baby.  You need a good hip to remain active when you have a child.  If you are a man, could you possibly have your sperm saved or frozen so in the future you could still have children, but not worry about the ion issue.

I think you need to do a lot of thinking before making a choice here.  You are so young and could face several revisions in your life.  You don't want to be chasing your teenager around in a wheelchair.

If it were me, and I am a 61 year old female speaking, I would try to find a way to have the hip resurfacing because you should come first.  You can't be a good Daddy limping about or in a wheelchair.  Could you possibly talke to some other surgeons.

I used Dr. De Smet in Belgium since I did not have health insurance.  He will give you a free email consultation if you send him your x-rays in a .jpg format.  Actually, he and Dr. Bose are such nice men, that they might give you their opinion if you ask them what they felt about the metal ion issue and having babies.  Dr. De Smet has done over 2700 hip resurfacings and over 3000 THRs.  He is one of the best in the world and very easy to talk with via email.

Please keep in touch and let us know how things are going.  You are so young, I would take time to decide what is best for you - then what is best for your children.

Pat in Ohio
3/15/06 LBHR De Smet

[avid]

 In the past, most of us hippies in the large group have come to the conclusion from much reading that no one has really officially, medically, proved that the metal ions cause problems. 

Most of our doctor seem to think it is insignificant.

I used Dr. De Smet in Belgium since I did not have health insurance.  He will give you a free email consultation if you send him your x-rays in a .jpg format. 

Pat,

Two issues that are on my mind were raised in your response. The first is the metal ion issue. IF one would develop high levels of ions and IF they were causing problems what would be the solution? A revision to a non-metal THR?  Sorry for the double hypothetical ; but better to ask now than afterwards. 

Secondly, how does one go about converting X-rays into .jpgs so they can be sent to DeSmet and Bose. Seems like it would be pretty important that this be done correctly to avoid a long trip for naught. Thanks again!

avid

[Pat Walter]

Hi Andy

First I have to tell you that I have absolutely no medical training.  I only tell people about what I have read and where to find info.  I have 5 good articles and studies about Metal Ions on my website here  http://www.surfacehippy.info/metalioninformation.php

It is my understanding from listening to some doctors that the metal ions are at a much higher level during the break in period of the metal on metal hip whether it is a BHR or a THR.  The metal ions are lost thru your urine.  They seem to indicate that the level goes back to normal after the break in period.  I guess it is because there is not as much lubricant between the bearing surfaces right after surgery.  Eventually, you body fluids and blood make a fluid bearing surface between the cap and cup of the BHR. Again, this is only my understanding of what I read.

One hippy said that the levels of cobalt they are talking about is not as much as in a multi vitamin table that has minerals in it.  Again, that is what I heard.  I also looked on my vitamins and that seemed true.

You can take digital photos of your x-rays if you don't already have them in digital format.  I just held mine up to the window and used my digital camera.  Size them after the photo to be about 500 pixels wide or high - or smaller.  Not too much smaller.  That is how many of us made our digital x-rays.  You could hold them up to your doctors light table for x-rays and take them if you are in the office.

Dr. Bose and De Smet are very good at reading x-rays.  I kept asking if I needed to send the real ones to them and they said NO - they could see all they needed from the x-rays. May of us sent them that way.  Once you are in Belgium or India for surgery, they take many more x-rays to set the angles and size the hip etc. for surgery.

If you send your info and x-rays to Bose and De Smet, be sure to tell them your concern about the metal ions. Let them answer your question. They are the doctors.

Pat

[avid]

Pat,

Would using a computer scanner work. TIA

[Pat Walter]

I could not get a good picture from a scanner since the x-rays are not solid.  If you leave the cover up, there is not enough light.  But maybe you have a different kind of scanner than I do.

You can also hold the x-rays in front of a light or fluorescent light.  Some people have held them in front of their computer monitors, but I never could get mine bright enough for a good image.

You can hold a piece of thin white paper between the light and the x-ray to give a better picture.   I just held mine up to a window when there was no sun shining thru. You might need an extra hand since x-rays are large.

Pat

[avid]

I get it! I have a light box that I could lay them on and take digital photos. Thanks for taking the time to explain the issues.

avid

[avid]

This is a small discussion group and very new, if you want much more input, I would suggest joining the Yahoo Surface Hippy Group of over 6000+ memebers.   http://groups.yahoo.com/group/surfacehippy/
  The group is having a conversation about this topic now. 

Pat,

I think Yahoo Surface Hippy is not working. I tried making two posts and they didn't. Search gives zero results and the same five posts have been on the front page for the last four or five hours. Do you know how to contact the Moderator? Thanks

avid

p.s. I referenced your Doctor's list in one of my attempts. 

[AndyJH]

Hello Pat,

Thank you for your reply and advice. In answer to your question I am a man. My fiancee and I were talking about my options last night and she mentioned the possibility of freezing my sperm before my op, but using IVF isn't without risks either. However I don't think I can take the chance of having the resurfacing procedure and there being a risk, even if it's a small one, of any future children being affected - I don't think I'd ever be able to forgive myself.

Have you got the email addresses for the two doctors that you mentioned - I think it's a great idea to contact them and see if they are willing to give me some advice.

Thanks again.
Andy

[Pat Walter]

Hi Andy

My Doctors list has many of the experienced doctors on it  http://www.surfacehippy.info/listofdoctors.php  Here is the page should you need it in the future.

Here are Dr. Bose and De Smet's info

Dr. Koen De Smet
2700 Hip Resurfacings to date ***
ANCA-Clinic
Kalverbosstraat 31A
9070 Heusden
BELGIUM
Phone: +(1)32 9 2525903
Fax: +(1)32 9 2526457
+1 for USA & Canada:
E-mail: helpdesk@heup.be
ANCA Clinic Website


Dr. Vijay C. Bose
1000 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
Hip Resurfacing India Website

I hope that helps. They can give you good information - first hand and from very experienced doctors.

I will mention that there have been many younger men getting hip resurfacings and no one has said much about the issue for a man.  Normally the issue is with the child bearing aged women.  There are several women with BHRs that have had children on the Yahoo Group without problems - at least so far.

Pat

[Pat Walter]

About the Yahoo Surface Hippy Group

Sometimes the Yahoo Group does not work quickly.  Yahoo is HUGE and the messages sometimes lag in getting posted.

Also sometimes there has been so much fighting between people, that the group is moderated.  Meaning that the moderator has to read every post and approve it.

The Moderator has no control over how quickly the messages get posted, unless it is in moderated condition.

The search function is VERY difficult to use.  It takes hours to find information sometimes.  That is the reason I started my website.  To post much of the importanat information and have it indexed so it can be found.

That is also the reason I started this group - trying to make it easier to use and easier to find information.

Pat

[AndyJH]

Many thanks for the info Pat, it's much appreciated.

I've emailed both Doctors so fingers crossed they'll get back to me. I've also requested an appt. to meet up with my surgeon again so I can run through everything in more detail.

Will keep you posted.

Thanks again.
Andy

[Pat Walter]

Here is a list of more questions to ask  http://www.surfacehippy.info/questionsfordoctor.php

Your surgeon should be helpful and give you answers to all your questions.  If they don't, I would look for a surgeon that will work with you and answer questions.  You need to know the answers so you feel good about your surgery and the choices you have made.

Pat