I am considering Travelling To India For BHR - Dr Bose - Can you advise please

[dsfbrit]

Hi, there

I am a 'newbie' that has been reading this web-site quite a lot since I found it a few weeks ago. Thanks to Pat for setting it up, its been the most useful site I have found so far.

I hate anything 'medical', get nervous just thinking about hyperdemic needles and would rather drag myself along on my hands and knees rather than go 'under the knife' to have my hip repaired -- or so I thought!!!!

I was diagnosed with OA in my left hip  3 years ago. Like many people on the site, I decided to ignore it as much as I could until it affected my life too much. I think I am reaching that stage now.

I am male, 56 years old and keen on playing sport - mind you going on long walks would be included in 'sport' nowadays - well it would be a major exercise anyway that would need to be 'psyched' up for - just to ignore the pain!!!!

The last 3 years have been quite strange really, because even though when I walked more than 200 yards it ached a lot, when I played squash I tended to limp around court quite a lot, but it did not really hurt much at all. Mind you, as I have played squash at a high level much of my life,  I was able to get to most parts of the court with less than 5 steps steps and a stretch, so not much running as such. I bore you with that bit of detail as now its hurting quite a lot even with just a few steps, certainly to the point where its just not fun any more!

Walking around the house and sleeping, doing chores etc... are still not that painful. Still, I feel its probably (may be) time for the op - I am such a coward!!!

I live inThailand and since being diagnosed 3 years ago, I have been quietly going to see various doctors at different hospitals in Thailand, to decide who would do the operation when it became necessary. Initially, I was seeking a THR, but about a year ago I realised I would be a good candidate for BHR. So BHR it is then.

I have found a good surgeon at Bumrungrad hospital in Bangkok. Well I say he is good, he works for a good hospital, seems like a nice bloke, and has done a lot of operations (I think). However, I have no personal recommendations about this surgeon - so who really knows. This is the detail of the hospital.

http://www.bumrungrad.com/overseas-medical-care/Hip-replacement-resurfacing/

Anyway, I read with some 'envy' the stories here of people having their operation carried out by someone with a proven track record. Certainly Dr Bose seems to be a good surgeon. I especially like the fact he will not revert easily to a THR operation if he has a problem with the BHR. I could not quite get the surgeon at Bumrungrad to say how often he has had to do do the THR instead!

It was only by accident when I googled Dr Bose in Chennai, India, that I realised that from Bangkok Airport, Chennai is just a 3 hour flight away!!!!

So this has opened up a completely new opportunity for me to have my BHR carried out by someone who is guaranteed to know what he is doing.

So I would like to ask the people in the 'know' here a few questions, to start with, as I am paying for this myself, could I please ask someone to tell me what it would cost roughly for the operation in total, assuming all goes according to plan.

I dont need exact figures, just rough figures for someone who has had an operation this year???

I know that in Thailand it will cost about 500,000 baht - about 11000 pounds - thats for the operation and the BHR Prosthesis.

I am seeing the surgeon again in Bangkok in 3 weeks time on January 11th 2011, so I feel very lucky to have found this forum in time to help me decide if I want to to change my plans to have the op in Bangkok or not.

Thanks very much for your help.

David

[Lopsided]

David,

I have to reply to you, as my situation was very similar. I live in Thailand too, and have already had my resurfacing. I went to Belgium.

Please read my post about how I chose a surgeon:
http://surfacehippy.info/hiptalk/index.php?topic=1824.0

The surgery in Belgium cost 11,000 Euros, not including the hotel/clinic and air ticket, but definitely comparable with the price of Bungrumgrad. The nurses at Bungrumrad might be better but overall you cannot beat the service in Gent. (Do not go there in the winter!)

Where in Thailand are you? David, keep in touch!

Dan

[obxpelican]

Ok, I've never been out of the country, never, but let me add my .02 cents.

No question, Dr. Bose hands down is arguably one of the best in the world for HRs, but, big but, I've read too many patients suffering with pain post-op, Dr. DeSmet on the other hand has many patients without much pain post-op.

I know what bone pain is, had my femur broken in 1981, had an older doctor with a bad pain protocol, fast forward to 2008, I had a doctor with a great pain protocol and I and many others breezed through the surgury with only slight pain on day 2 post-op.  I was never in more pain post-op than my worst day pre-op.

I would say both surgeons are VERY good, but if I had my choice I would go to the doctor who has the best pain protocol because bone pain post op can be pretty bad, believe me.

I just do not believe that anyone should suffer with what is known today about treating pain and I've read too many patients who have suffered lately.

Keep in mind my only reason for posting is the difference in pain protocols.

Chuck

[dsfbrit]

Thanks for the feedback Chuck and Dan.

Dan, I read your referenced post... very interesting. Dr Sitthiporn Orapin at Bumrungrad is the surgeon I spoke to and will see again next month on the 11th. He seems honest, but like you I am concerned that he has performed relatively few ops. Less than a hundred I think.

I will take yours and Chucks advice and go and read about Dr De-Smet...

thanks again

David

[BerkeleyGirl]

CHUCK: What is a "good pain protocol"? I've been having quite a bit of pain; I'm now Day 15 post-op. The surgery was with a spinal and a local anesthesia that wore off about 10 hours after the surgery. I had a PCA in the hospital. I took Vicodin home, but it wasn't enough; I'm now taking Percocet every 3 hours or it hurts a lot, so much that I can't attend to anything else. I have a high sensitivity to pain plus a high tolerance for pain meds, thanks for frequent migraines over the past 30 years, so I'm a tough one to treat on this front.... But I'm still wondering what you consider a good pain protocol. Thanks!

Berkeley Girl
Gilbert RBHR Dec. 10, 2010

[dsfbrit]

Thanks for that BerkeleyGirl, I will wander over there now and read Vicky's account.

I hope your pain goes away soon!!!

[obxpelican]

Hi David. Check out Vicky Marlow's Yahoo group and website on hip resurfacing. She just returned from her second BHR with Dr. Bose, and she has written an extensive account of it expressly to help other people going to India for the surgery.

CHUCK: What is a "good pain protocol"? I've been having quite a bit of pain; I'm now Day 15 post-op. The surgery was with a spinal and a local anesthesia that wore off about 10 hours after the surgery. I had a PCA in the hospital. I took Vicodin home, but it wasn't enough; I'm now taking Percocet every 3 hours or it hurts a lot, so much that I can't attend to anything else. I have a high sensitivity to pain plus a high tolerance for pain meds, thanks for frequent migraines over the past 30 years, so I'm a tough one to treat on this front.... But I'm still wondering what you consider a good pain protocol. Thanks!

Berkeley Girl
Gilbert RBHR Dec. 10, 2010

Sorry to hear that you're in bad pain.

Pain protocol is basically how the doctor treats you before, during and after the surgery.  For instance many doctors use an anesthetic that is shot in and around the operation site during the operation and before they close you up, Dr. Gross uses enough that most of us were numb in the hip area for 24-30 hours post op.  That first day is when you are going to be in agony unless the surgeon has a good pain protocol.  When you wake up with Dr. Gross he has your hip wrapped up in a pad that has very cold water pumped through it, this keeps both pain and swelling down.

10 hours post op I was still not even taking tylenol, that to me is not a good pain protocol to have bone pain within 10 hours.

I think it's a shame that anyone is in agony post op considering what is known today about good pain protocol.

Berkeley Girl, it's not the norm for most hip patients to be in a lot of pain 15 days out although all of us are different and had slightly differerent surgeries, at 15 days many of us (including me) were walking without any pain, all I had was a very slight pinching feeling at my incision.

 I would seriously consider calling your doctor to see what is up with that pain that you are having.  To be on narcotics 15 days out just does not sound good.

In the mean time I am going to be sending you out prayers and good healing thoughts!!!


Chuck

[BerkeleyGirl]

Hi. Thanks for the info. Dr. Gilbert did use the local anesthetic in the hip as well as a spinal. It didn't wear off til 12 hours or so after surgery. I think that I'm probably just over-sensitive to pain, and semi-tolerant of some pain meds, thanks to long experience of taking them, including one period when I was on a pain patch for migraines. I was told this could be a problem after a surgery, and here it is. I've heard of a term called "hyperalgesia," when a person is so tolerant of pain meds that they no longer work, and though I don't think I'm anywhere near that, I'm perhaps on the very low end of that spectrum.

Also, I don't know if there are other "migraineurs" on this site, but those who have frequent migraines have a more highly sensitive nervous system in general. Migraines aren't a circulatory disorder (the swollen blood vessels in the brain and head that cause pain are a reaction to the nervous system excitability). Anyone can get a migraine, but people who get them more often simply have a lower threshold for over-stimulation. A big migraine trigger for me, for instance, is weather changes; my headaches are WAY worse in the winter (I have a barometer to track what's going on in the sky, but my head can generally tell me in advance). What can I do about that?! I've had tests and apparently simply have a very sensitive brain! There are also benefits -- I'm a writer and artist, too -- but it can be a trial. I think that all this is part of why I'm still having pain from the hip when the operation itself went perfectly.

I've now gotten off the Percocet and am taking an occasional Vicodin, and transitioning to Aleve. I can't really help the fact that the pain is still there, but it's definitely getting better. My strength is returning very quickly (I can easily walk unaided without a limp 19 days post-op!), the pain is reducing more slowly, and maybe this is just another instance of everyone's recovery being unique.....

I appreciate everyone's insights and responses!

[obxpelican]

Ok, I am trying to get this in my head, you are walking unaided without limping, then the pain is not when you put weight on?  If you had pain when you put weight on then you would limp for sure, maybe in your case it's some soft tissue healing issues or some stitches inside cause some issues.

You certainly sound like you are doing really well with the hip, I just think all of us would like to see you real soon not having so much pain that you need a narcotic.  Have you tried ibuprophen?  Assuming you are allowed.

Here's to a painless new year for you girl.


Chuck

[dsfbrit]

Thanks to you for the feedback on this. I read the links and along with all the other information on this very useful website, I decided on Dr Bose.

I fly from Bangkok in Thailand to Chennai in India on 1st February for an operation on the 4th February.

I chose Dr Bose over some of the others because he is a well recommended specialist on this website and from where I live in Thailand the trip to Chennai is very simple indeed. Flight time from Bangkok to Chennai is just 3.5 hours direct compared to 12 hours to Belgium etc...

I know to some it may seem over cautious, but the 'tipping point' on my decision was the constant bad news regarding flight delays to /from and within Europe  due to snow, strikes and even ash clouds over the last year. Its hard enough getting 'psyched up' for the operation without having to worry about transport delays getting to and from the hospital.

Another consideration, but one I tried to ignore, is cost. An operation like this should not be decided on price, but when I realised my decision meant that the cost including flights, hotels before and after the op, and all the surgery costs were less than 10,000 US dollars, I was pleasantly surprised.

A Happy New Year to you all ....

David

[obxpelican]

As I said before, the only thing I've ever read bad about the guy is some people do complain about bone pain post op, other than that the guy is arguably one of the most gifted surgeons in the world.  LOL although everyone thinks that about their surgeon if they have a good outcome  ;-)

I guess unless you were first class and had lot's of room on the plane that might be a tough trip, mine was 10 hours in a hyandai but we could stop and stretch when we wanted.

Good luck and God's speed be with ya!


Chuck

Thanks to you for the feedback on this. I read the links and along with all the other information on this very useful website, I decided on Dr Bose.

I fly from Bangkok in Thailand to Chennai in India on 1st February for an operation on the 4th February.

I chose Dr Bose over some of the others because he is a well recommended specialist on this website and from where I live in Thailand the trip to Chennai is very simple indeed. Flight time from Bangkok to Chennai is just 3.5 hours direct compared to 12 hours to Belgium etc...

I know to some it may seem over cautious, but the 'tipping point' on my decision was the constant bad news regarding flight delays to /from and within Europe  due to snow, strikes and even ash clouds over the last year. Its hard enough getting 'psyched up' for the operation without having to worry about transport delays getting to and from the hospital.

Another consideration, but one I tried to ignore, is cost. An operation like this should not be decided on price, but when I realised my decision meant that the cost including flights, hotels before and after the op, and all the surgery costs were less than 10,000 US dollars, I was pleasantly surprised.

A Happy New Year to you all ....

David

[dsfbrit]

Hey Chuck, 10 hours in a hyandai sounds like luxury to me

As you say and from what I have read on this forum, I would agree that the differences between the recommended doctors here are at the 'margins'. They have all performed hundreds, or in some cases 1000's of HR operations and so have a proven track record.

Before I found this website I had chosen a surgeon here in Thailand. who seemed good enough, the trouble is he has only performed under 100 BHR operations.

He kept mentioning the fact that if he had problems during the operation then he would revert to the old THR replacement - he would decide himself - he would have to, as I could not be involved in the decision as I would be unconscoius. !!!! I kept asking him what percentage of operations he had felt the need to do this - he was very vague in his answer - in fact he did not answer it at all.

At least now I am a lot more confident I will wake up after the operation with a well fitted BHR.

Now the next thing I have to do is get 'psyched up' for the pre-med checks.

I have 'white coat' fear - its not the operation that scares me so much as the thought of actually entering the hospital and having nurses and doctors in 'white coats' descending on me with hypodermic needles and blood and heart monitoring machines. Do I really have to have to be connected up to a drip - the thought of a needle in my arm for just a few seconds is bad enough, but for several days ?? fills me with horror 

Come to think of it, do the blood tests have to be with needles, cannot they be urine tests or something. If they must use needles, do they have to go in the inside of the arm - cannot they put them in my leg or something?? I have had needles in my mouth for the dentist and in my the top of my back and they dont bother me - its needles in the veins in the inside of the arm that fill me with horror!!! a daft phobia I know - still I guess all phobias to people who dont have that phobia seems daft. My wife runs a mile when she comes within 10 yards of a snake... I like snakes

[obxpelican]

You'll do fine my friend, you were a very good self patient advocate, you did your homework, besides once they give you that pre-op happy juice you will allow them to do anything. 


Chuck

[dsfbrit]

Yes - you are right. As my mum used to say when I was a kid  - '... be a brave boy David and you will get a sweet!!!'.

To be honest I have stopped focusing on the needles and stuff, I will just do like I did when I was a kid and close my eyes - sorted. Dont suppose I will get a sweet though!

Also on a more serious note, people here on this forum have suggested thinking about doing all those things you currently cannot do - that for me has been terrific advice. Today I walked to the shops - a mere 200 yards -limped all the way - I have always loved walking - today though it was no pleasure at all!!!  So that will be something to focus on and look forward to - painfree...then maybe I can get back to the sport...hope so...

cheers chuck and the others who replied and thanks for the support...

dave...