Want a hip resurfacing if possible

[dzr]

Hi Pat, Vicki and et al,  
   I am very new to this site, but I would like to thank all who are involved with it.  It has been enormously helpful to me in trying to understand what is going on with my hips.
   My situation is similar to one that I read about on here.  I have hip problems that have been hidden by back pain for along time.   About 12 years ago (1998), I bent over to pick up a piece of paper off the floor and when I stood up, I had a tremendous burning pain in my lower back.  It turned out to be a a ruptured disc at L4-5 which required surgery.  I had the surgery about 2 months later, but also had a very slow, painful recovery.  It took about 5 years to get to feeling pretty decent again.  I felt ok most of the time, but had occasional flare ups of lower back pain that lasted from a couple of days to a couple of weeks.  My back seemed to stay in this condition for a couple of years and then seemed to start going down hill again.  
   In 2006, I started noticing that after doing some hard work for a few hours, I seemed to have a good bit of pain in my lower back, hips, and knees.  I also noticed that if I took it easy for a couple of days, the pain would pretty much go away.   The next year, in 2007, this back, hip, knee pain seemed to come up alot more often and without nearly so much exertion.  As a result of this fairly constant pain, I told my doctor about my previous back surgery and told him it was starting to give me  alot of pain again.  My doctor then gave me a prescription for some pain medication.  I took the pain meds a couple of times a day and it pretty well controled the pain.  
   In 2008, the pain was getting more intense, and I seemed to have it all the time that I was standing or walking.  I then decided to see a local chiropractor who made a couple of x-rays and did a couple of treatments.  I had never been to a chiropractor, so I didn't know what to expect.  All I knew, was the treatments did not seem to help.  About this time, I aslo started walking with a cane.  
   By the time 2009 rolled around, the back, hip, and knee pain was getting really bad and meds were not helping nearly as much.  The pain occured mostly when I was standing or walking.  At its worse, the knee pain would be so bad, my knee would collapse as I was walking and would cause a fall if I didn't have a cane in my hand to help take up some of the  
load and stabalize myself.  Since it was clear I was getting worse and worse, I decided to apply for social security disability.  After  assuring me that they were going to deny me, they took a couple of x-rays and had me see their doctor.  Not suprisingly, and true to their word, the doctor's diagnosis was that he couldn't find anything wrong with me.  I even took the x-rays that the chiropractor had taken in 2008 and the social security doctor looked briefly at them.  (As it turned out, those 2008 x-rays showed that my right hip was in very bad shape-- the femur head was flattning and collapsing, which was causing the horrible hip pain.)  Since it was abundantly clear that Social security was going deny me no matter what  was wrong, I just gave up on the idea of dealing with them.
   By May of 2010, my hip and knee pain was so bad I had times when I just couldn't stand it, even with the meds.  I still walked with a cane, but my activities were really dwindling, because if I was on my feet, I was in severe pain.  That meant that I needed to sit down, alot.  Since the pain was so bad, finally, my brother insisted that I go see his chiropractor.  Being in a state of despiration, I agreed.  The first thing the chiropractor did was an initial consultation and sent me in for a MRI and x-rays of my knees.  These were put in the radiology depts. electronic file at the hospital.  When the chiropractor accessed the file to look at my MRI and knee x-rays, he also found the x-rays that social security had made of me a year earlier.
  At my second visit to the chiropractor, he showed me the results of the MRI which showed and additional ruptured disc at L5-S1.  Then he asked me how come I hadn't mentioned the x-rays that were taken a year ago.  I told him those were taken by social security and according to social security, they didn't show anything, therefore they weren't worth mentioning.  As it turns out, those x-rays showed that I had advanced arthritus covering the upper half of my right femur and early stage arthritus of the left femur head caused by avascular necrosis.  After telling this, the chiropractor went on to tell me I was a candidate for a double hip replacement and that my right hip should have been replaced years ago.  Incidentially, the x-rays of my knees showed that they were both in good shape and normal.  The intense knee pain, which felt like an ice pick stabbing in my right knee, turns out to be "referred pain" caused by my hip and is not uncommon for my situation.
   After a couple of months of intense research, I have determined that I would prefer to have a hip resurface if possible and not a THR due to the fact that I am 53 years old and want to remain active with no restrictions.  The x-rays show that my right hip is in very bad shape and probably can't be resurfaced, especially with avn.  It seems that if I don't want a THR, my only other option is to get a birmingham midhead resection which isn't available in USA.
   Also, as one might expect of a person with back and hip problems, money is a great big factor.  I can't possibly afford these hip surgeries without some serious help.  In my 2 months of research, I have also been looking for ways to get some help with these surgeries.  After talking with friends and other people with disabilities, I found that the state dept. of rehabilitation will pay for my hip surgery if it is recommended by an orthepedic doctor and the surgery is done in my home state.  That sounded great except for the fact that in my home state of MS, there aren't any well experienced doctors doing resurfacing and of course none doing bmhr.  This is a brick wall of a problem that I am unable to solve.
   Pat, Vicki, and others, if you have any suggestions, information, or other ideas that might help me with this problem, I would greatly appreciate hearing from you.  I had seen on surfacehippy where one guy with similar hip problems, involving bilaterial AVN participated in a clinical trial and had a bilateral bmhr done.  He indicates he is really happy with the results.  The clinical trial seems like a possible solution, but I don't really know how to follow up on that idea.  Once again, I'm open to any and all ideas.
  
   Thanks for taking the time to read about my case and I really do hope it will be informative and of some help to others with a condition like mine.  

DZR  
    

[Pat Walter]

Hi DZR

Welcome to Hip Talk.  I am really sorry to read your story about your hip problems and pain.  It is very diffiuclt to get a new hip when you don't have insurance or money.  I know because that is where I was in 2006.  The large hospital in Columbus would have given me a free MOM THR if that is what my doctor suggested.  We had almost no income and we just had my ex's heart bypass surgery of $104,000 paid off as chairty.  So they only option I had was the THR or put a resurfacing on my credit cards.  I was 61 and wanted a resurfacing, so I used my credit cards.  It cost about $18,000 for my ex and I including travel, hotel and medical expenses.  I could have done it for $8000 - $10,000 with Dr. Bose in India.  So that is most likely your only solution if you need to pay for it yourself.

If you have no house, savings or job, you might be a candidate thru DAST.  You can check that out, but you can't have any assets.  http://www.dastinternational.org/

I noticed you wrote your post to Vicky too.  She normally doesn't post on my Hip Talk Group much.  She monitors it, but I don't think you will get a response.  If you want to talk to her, I would post your story on the Yahoo surfacehippy Discussion Group  http://groups.yahoo.com/group/surfacehippy/
   I didn't want you to be dissapointed if she did not answer your post.

I think DAST or going to India might be your only options for a resurfacing.  Please remember that a MOM  metal on metal THR is not a bad solution.  Not my first preference, but it would have be my second.  If you can get a MOM  metal on metal large ball THR free, you might want to consider that.  You don't want to stay in pain and you need to get on with your life.  You are very young.  Most people with MOM THRs are very active and have no limitations.  The femur cap and acetabular cups are the same as resurfacing.  It might be your only choice at this point.  Please don't sit in pain and inactive if that is the case. 

Do your research and find out if you can get a resurfacing.  If not, please condsider the MOM THR alternative.  Don't let them give you a small ball old fashioned plastic/metal THR. That would definitely limit your activities.  Try to get the MOM THR. 

Please keep in touch and let us know how you are doing and what progress you have made.  Don't sit on the sidelines much longer.  I am sorry I can't help you with the trials.  YOu might want to ask Vicky about that.  I do know several surgeons were suppose to start trials with BMHR, but have not heard anything else at this point.  So I can't post anything publically about things I don't have facts about.

Pat

[dzr]

Hi Pat,
   Thanks for responding to my message.  I really do appreciate hearing back from you.  Once again, I can't express how much I appreciate this website and everyone who contributes to it.  I have tried to read as much of the informatioin as possible on this website and learn as much as I can from that information.  It has been a great help to me to try to make an informed decision on what to do and what not to do.  When I had back surgery, I did almost no research-- just went in and had the surgery.  That's probably the worst mistake I have ever made and I have spent 12 painful years paying for it, with more to come.  Before back surgery, I had a great job that paid well and a really nice savings account.  After the back surgery, I lost my job and have not had a good job since, which has caused me to go through all my savings.  I read on another blog where a woman was telling her story and she said "back problems = no money".  I thought to myself how much truth and wisdom she put in so few words.
  When I was first informed that I would need a hip replacement, I was shocked, then very depressed, and then tried to come to grips with the idea of having a total hip replacement.  At first, I thought a THR would be better than a resurf., but after reading all the  success stories from patients and doctors on this website, I have had a total change of mind.  A resurf. seems to be the way to go if at all possible.  The most important reasons to me for coming to that conclusion is 1. that the resurf seems to have a very,very, good success rate and also very important to me is that 2. a resurf allows you to keep a fallback position, or a plan B, if you will.  That means if the resurf wears out say in 15 years, the hip can be redone as a THR because the femur canal has been almost untouched.  Then if that lasted 15 years, in my case, I would be 83 years old.  That doesn't doesn't sound so bad, because I probably won't live much longer than that anyway.  On the other hand, if I do a THR right now, and it wears out in 15 years, in my case, I will be 68.  To me that doesn't sound so good.  From the research I have seen, and what doctors have told me, a THR is much, much harder to re-do because the top of the femur bone has already been used.  And from the research I have seen, there seems to be a fair chance of the femur bone fracturing or breaking below the femur implant.  If that happens, what does one do then???   That's one of the main reasons I would prefer the resurf.
   In my case, it is very possible that because of the AVN I may not have good enough bone stock on the frmur head to do a resurf. and the doctor may not be able to tell for sure until he actually see the femur head.   In that case, I would most likely wake up with a THR, which is not my preference.  With this in mind, it seems like in the ideal world, the very best thing for me to do would be to go to India to see Dr. Bose, who seems to be very experienced with AVN cases.   If he was  doing the surgery and saw that my bone was  not good enough for a resurf., he could do a bmhr instead.  If that happened, I would probably still have the option of having a THR some years down the road if and when the bmhr wore out.   Surely, this would be the preferred route for me to take.  The only drawbacks I can see are the costs of the surgery and having to go out of the country to do it.
  It is very tempting to just go ahead and take free THR right now and put and end to this pain and be able to be normal again, and able to work and make a living again, but, I just keep thinking and wondering what I will do in 15 years when the THR wears out.  I would be 68 years old and they may not be able to do a re-do, which would put me in a wheel chair for the rest of my life.  This situation so serious and the stakes are so high, I just cannot afford to make a mistake.  With all of these things in mind, it just seems like the best thing for me to do is to hold off for now, and try to scratch up the finances from somewhere, and then go to Dr. Bose for the surgery.
   Sorry to be so longwinded, but I am just trying to explain why I feel so torn about what really is the right thing to do here.  It is a really hard decison to make, but Pat, it is encouraging to see that you had a similar decision to make with your resurf. and now have it behind you, with what seems like really great results.
   Pat, I do appreciate your input here and I will stay in touch to let you all know what ultimately happens.

DZR