Need decision making help!

[shipnc]

I am hoping that those of you who faced the need for a hip replacement can help me in making the difficult decisions necessary.  Specifically, I am a 65 year old active male, competitive tennis player and desire to once again play tournament tennis.  After much research and reading the many positive stories on this site, I decided to go the resurfacing route, only to be frustrated by the lack of doctors in the local area who would do it for an "older" patient.  Some that would, like Dr. Gross, declined to accept medicare for their fees.  Additionally, I was assured by those doctors I did see who wanted to do a THR that my mobility and post operation ability to play singles tennis would be just as good with their traditional methods.  Finally, I was able to find a local dr. who did enough resurfacings to meet my criteria, and who was also well regarded by other doctors.  Unfortunately, his popularity meant an almost 2 month delay even getting in to see him, and  I now find out that I will not be able to have the surgery until May!  I also am somewhat concerned that his popularity will make it difficult to have the type of personal relationship that I would like to have with someone who is carving in me. So after all this rambling, I guess this is what I am seeking:  a little input from those of you "who have been there" on my decision making process.  Will resurfacing be that much more likely to return me to my previous mobility that it is worth the prolonged wait and my concern over the doctor's accessibility?  Thanks for helping me think this out.

[Pat Walter]

Hello

Unfortunately, many US surgeons don't accept Medicare for hip resurfacing.  There are some that I know of like Dr. Mont of MD and Dr. Ure of CA.  There may be others but I don't have a list.  Many US surgeons just don't like giving older people resurfacings.  That is why I went to Dr. De Smet of Belgium when I was 61 in 2006.  I wanted a hip resurfacing so I could stay active as possible and keep all of my femure bone.

If you can't find a surgeon in the US that will do your resurfacing, just make sure that you at least get a MOM THR so you can play tennis and stay active.  Don't let them give you an old fashioned small ball metal/plastic THR.  They can dislocate easily and most people have a lot of restrictions with them.

A lot depends on what you want.  If you want a resurfacing, then wait until you can find an experinced surgeon that will give it to you.  If you don't mind having a large part of your femur bone sawed off, then go with a very experinced surgeon that will give you a MOM THR.  Most surgeons won't normally suggest an older person returns to serious singles tennis.  That is a very strenous sport.  Doubles is much more preferred by most surgeons. Those are questions you need to ask your surgeon.  There is no reason to go thru major surgery and then play very stressful sports and destroy your new hip.  Hip surgery is very major and takes time to recover.  I would not want to face a revision surgery and I am only 4 years post op.  I prefer to use my new resurfacing to keep me very active, but not do marathons and singles tennis.  I want to keep my hip as long as possible.  I feel it is a gift to be out of pain and active again and feel being a little conservative at 65 years old is wise on my part.  Again, that is up to you on how much you want to stress your new hip.

The most experineced surgeons that I know are very friendly and care about all their patients.  The overseas surgeons like Dr. De Smet will answer any email you send to him and answer any question any time.  That is the way the overseas surgeons are.  No doctor probably does more resurfacing than he does having done way over 3000+ resurfacings.  The doctors experince does not mean he is not friendly and helpful to his patients.  All the surgeons only do a certain amount of surgeries per week and save time for office calls and time off.  Some of the top surgeons will give you their private cell phone number if you have any problems post op.  Most are very concerned about their patients and will spend as much time with you during an office call to answer all your questions.

Again, it is up to you about how you feel on what is best for you - hip resurfacing or THR.  Even at my age of 65, I would want a resurfacing for my other hip if it ever needed to be done.  I would settle for a MOM THR if I could not have a resurfacing.  I would never settle for an old fashioned small ball plastic/metal THR until I was 95 years old.

Good Luck.

Pat

[Jim1957]

I went to see Dr Helmy in Merritt Island FL who is very popular for this area.  I had to wait weeks to see him.  It was worth the wait.  He takes all the time in the world that you need during your office visit.  My first appt was scheduled for 3:30 PM so I arrived at 3 PM.  I didn't see him til about 6:30 but he stayed with my wife and me until after 7.  The couple of appts I've had since have always resulted in a long wait, but he takes all the time in the world.  Sometimes you can see a doctor who gives you your 10-15 minutes and then is trying to get out the door as you're still asking questions.  I would never go back to a doc like that.  

I recommend you wait to see the guy and then see if he takes the time with you.  Dr Helmy has made me pain free for the first time in years.  It was worth waiting to see him and worth the long waiting room stays.  I get a lot of reading done when I go to see him.

[shipnc]

Thanks for the thoughtful inputs.....and thanks for this site and discussion group!

[PHBookman]

I watned to comment on your wanting a doctor who will spend time with you and build a relationship. I am 9 weeks post surgery and doing very well. I had a doctor who spent almost no time with me, saw only once in the hospital, and spent about 5 minutes in the 6 week post check up. That bothered be at first because of what I saw of his poor bedside manner. Now to be clear, I would have prefered to have a doctor who takes plenty of time with me and had better bedside manners. However, he is an outstanding surgeon with a great record. Ultimately what I wanted was a positive result and that is what I have gotten. Pick to best surgeon you can but I would put experience and track record ahead of his personality. My doctor was the best one within a couple hundred miles that did the resurfacing or I probalby would have considered someone else. Good luck