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Author Topic: The saga of a bad hip and BHR surgery w/ Dr. Palmer  (Read 7269 times)

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DakotaDocMartin

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The saga of a bad hip and BHR surgery w/ Dr. Palmer
« on: March 13, 2011, 08:42:09 PM »
About six years ago, I slipped on some ice on our concrete steps of our old house.  My feet went out from under me and I fell with all of my weight right on to the greater trochanter of the femur of my left hip.  It jammed the joint so hard I had to lay there for awhile as tears rolled down my cheeks.  That was the beginning of the end of an otherwise good hip.

If that wasn't enough... I did the same thing again later on and managed to fall on that same hip in various ways about six more times.  As time went on, my hip became very painful and I slowly lost most of the ranges of motion.  That also caused the muscles to become weakened.  I did a lot of sitting and slowly but surely stopped most activities.  No walking, lawn mowing, snow shoveling, motorcycle riding, cowboy action shooting... pretty much everything I liked to do became too painful to do.

I had let my Blue Cross/Blue Shield insurance drop some years before figuring I could just buy another policy some day.  Wrong!  Nobody would insure me because of preexisting conditions.  So, I kept putting it off and lived with the pain.

In June of 2010, I decided that I had to do something about the bad hip or I'd be dead within a couple of years at the rate I was going downhill.  For $647.00 per month, I purchased insurance through North Dakota's high risk pool known as CHAND (Comprehensive Health Association of ND).  They repeated assured me that after the first six months that all preexisting conditions that are deemed medically necessary would be paid for.

So, the end of November of 2010 I made my appointment to see Dr. David Palmer of the St. Croix Orthopaedic Clinic in Stillwater, MN (about a 5 hour drive for me from Grand Forks, ND).  He evaluated me and said that I was a very good candidate for the BHR (even though I weigh 390 pounds).  Out of the more than 650 BHR's he had done, only two failures and revisions to THR were needed.  One was a heavy person such as myself and one was a woman with osteoporosis.  We set the date for the surgery for January 3rd and I returned home excitedly anticipating the surgery.

Almost immediately, I received a letter from CHAND saying that they were not going to pay for such a surgery and their staff MD (whose job it is to deny claims) said it was because I am overweight.  A letter from Dr. Palmer and an appeal didn't do much.  I had the ND State Insurance Commissioner contact them and all they did was refer it to yet another of CHAND's staff MD's for a second opinion and they said it would be another 45+ days before they would decided anything.

So, I contacted Senator Kent Conrad and he contacted CHAND on my behalf.  It's interesting that CHAND decided they would indeed pay for the surgery that very same day. :)

So, the surgery date was again scheduled for February 9th.  We drove down to Stillwater on the 8th and I had my blood drawn again for the last of the pre-op work.  We stayed overnight in a motel.  My hip was aching so badly that I had to sit in a chair all night waiting for the sun to come up.

We reported to the Lakeview Hospital at 7:00 am as instructed and they prepped me for the surgery.  They tried to do a spinal block but couldn't get a good needle stick.  So, they opted for a general anesthetic instead.  The last I knew, they were telling me to take several deep breaths. 

The surgery lasted about 90 minutes and the next thing I knew I was waking up in a private room in the hospital.  I was very impressed with the staff and the cleanliness of the hospital.  The worst thing was the crappy hospital food.  (There must be an unwritten rule about that somewhere.)

They had me up and walking on the new hip that same day.  I had to demonstrate that I could get in and out of bed, go to the bathroom, etc. several times and by noon on the 11th they released me.  After a five hour drive we arrived home again that Friday evening.

Since then, I've improved daily.  I only used pain meds for about a week, warfarin for two weeks and I am currently on the 325 mg aspirin for a month.  Other than that... it's wonderful!

I have just a hint of bone pain surrounding the BHR.  Most of my pain involves my low back and getting used to walking upright again.

Just for the heck of it, I added up the bills I've received.  Including the pre-op work and the surgery, it came to $44,588.80.  My total out of pocket was $3000.00 + $6,470.00 for 10 months of CHAND.

I now feel like I have my life back again!  Just as soon as this nasty icy winter weather is gone I intend on getting out of the house and doing some walking.  Until then, I walk around in the house.  PT wasn't required but has been approved if I do need it. 

The only thing I would recommend is to not let it wait as long as I did.  I had one fluid filled cyst in the femoral head that was luckily just under the 1 cm maximum.  I did my homework for a couple of years and SurfaceHippy was a great tool.  I decided that the BHR was indeed the best way to go for a hip and I found an excellent surgeon who had done a lot of them.
« Last Edit: January 28, 2012, 12:53:20 AM by Pat Walter »
"Never start vast projects with half-vast ideas"
Left BHR - 02-09-2011 - Dr. David Palmer

jjmclain

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Re: The saga of a bad hip and BHR surgery
« Reply #1 on: March 13, 2011, 10:55:22 PM »
Congratulations! You are now on your way to getting your life back and becoming active and healthy again. I wish you luck and keep us posted on your progresss.

newdog

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Re: The saga of a bad hip and BHR surgery
« Reply #2 on: March 14, 2011, 12:19:02 AM »
So glad things finally worked your way! In the end that is a good story. I can't wait to hear more on your progress.
Steve, Dr. Gross bilateral, uncemented Biomet, January 10 & 12, 2011, Columbia S.C.

Tin Soldier

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Re: The saga of a bad hip and BHR surgery
« Reply #3 on: March 15, 2011, 04:20:43 AM »
Good job Dakota - I think there are lots of folks out there that just keep hobblin around for various reasons that could get their life back, but they don't, probably a lot from bad or no insurance.  Pretty sad, yet your story is inspiring and it sounds like you just buckled down, focused on it, and you got there.  You should be stoked and happy to be crusing along the road of recovery.  I'm 3 weeks post op and feeling good, some pain, not walking fast, and major swagger without a cane, but happy to be here and looking forward to having fun again.

Congrats! and keep us posted.
LBHR 2/22/11, RBHR 8/23/11 - Pritchett.

DakotaDocMartin

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Re: The saga of a bad hip and BHR surgery
« Reply #4 on: March 25, 2011, 04:35:35 PM »
This morning, I discovered that I can walk backwards unaided.  That's something I haven't done in a couple of years.  I can also walk for short distances without a walker or a can.  I waddle like a duck though. :)

But, I seem to be improving daily.  Hopefully, all of the snow and ice will go away so I can get out more.  It's been a LONG winter.

I'd say about 99% of the pain is gone as of today.  There's only a tiny bit of a sensation in the surrounding bone.  Otherwise, it's just like a "normal" hip again.  Some of the muscles are still weak from a couple of years of not being able to move much.

Bottom line: Don't put it off as long as I did if at all possible.  :o
"Never start vast projects with half-vast ideas"
Left BHR - 02-09-2011 - Dr. David Palmer

FlbrkMike

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Re: The saga of a bad hip and BHR surgery
« Reply #5 on: March 25, 2011, 05:02:55 PM »
This morning, I discovered that I can walk backwards unaided.  That's something I haven't done in a couple of years.  I can also walk for short distances without a walker or a can.  I waddle like a duck though. :)

Can you say "AFLAC!!"?   ;)

Really, though, it's great to see that you're doing so well.

Mike

Dr. Ball
56 years old
LBHR 2/11/11
RBHR 3/11/11

DakotaDocMartin

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Re: The saga of a bad hip and BHR surgery
« Reply #6 on: March 30, 2011, 03:00:00 AM »
UPDATE (03-29-2011): I just got back from a 12 hour round trip to Stillwater, MN (10 hours driving time) to see Dr. Palmer for my one week delayed (due to snow storm) 6-week checkup.

I was x-rayed and examined and told I'm doing quite well.  I still need to strengthen the hip flexors and abductors some more.  I asked when I should come see him again and Dr. Palmer told me I don't have to unless I have problems.  So... I'm off for adventure and to use the new life I was given. 

My local family physician was so impressed he wanted me to pick up some brochures and Dr. Palmer's business cards for him.  He said he's going to start sending patients to him  ;D
"Never start vast projects with half-vast ideas"
Left BHR - 02-09-2011 - Dr. David Palmer

hernanu

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Re: The saga of a bad hip and BHR surgery
« Reply #7 on: March 30, 2011, 02:03:37 PM »
Congrats, Doc! Love the attitude. Keep up with the walking and PT.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

DakotaDocMartin

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Re: The saga of a bad hip and BHR surgery
« Reply #8 on: May 14, 2011, 05:02:26 PM »
I've been going into the PT torture chamber three times per week for about a month now.   ;D

Although the Birmingham fixed my hip, I hadn't realized how weak some of my muscles had gotten.  Mainly the flexors and abductors had gotten so weak they were almost non-existent.  Not being able to move my arthritic hip very little to none in some directions made the muscles atrophy.

When I first started the PT I was put on a Nu-Step recumbent cross trainer stepper machine.  The resistance can be set on a scale of 1-10.  With it set to 2, I was able to do about 50 steps initially.  After one week, with it set to 6, I could do 1000.  Now, after about a month, I can readily do 20 minutes with it set to 7 and at a rate of 70-80 steps per minute.  Plus, we are doing all sorts of things for the rest of the hour to build the muscles.

The bottom line is I am not using a walker (my wife put it in the basement a few weeks ago) and, I'm using my cane less and less.  It won't be too long until I can walk without any support for the first time in years.  I can go for short distances now but due to the muscle weakness, I tend to have a "waddle" gate.  I was demonstrating my new-found ability to my wife a couple of days ago and it caused my youngest beagle to start howling.  ;D  He'd never seen me do that before and it apparently scared the heck out of him.

Doc

PS:  Just in case anyone is interested... here's the Before and After x-rays of my left hip:

"Never start vast projects with half-vast ideas"
Left BHR - 02-09-2011 - Dr. David Palmer

DGossack

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Re: The saga of a bad hip and BHR surgery
« Reply #9 on: May 14, 2011, 05:49:08 PM »
Thanks for the update, Doc.  Thor part about your dog howling at you just cracked me up.  And your comment about how weak the muscles had gotten reinforces my decision to have this surgery now before I get much worse.

Dan
LBHR, Dr. Pritchett, 8/1/2011
fullmetalhip.wordpress.com

DakotaDocMartin

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Re: The saga of a bad hip and BHR surgery
« Reply #10 on: May 14, 2011, 06:01:26 PM »
And your comment about how weak the muscles had gotten reinforces my decision to have this surgery now before I get much worse.

If I had it to do over again I would have had the surgery a couple of years ago.  Don't wait so long that you have to rebuild the muscles as I'm having to do.  If I had good muscle strength I'd be basically like "normal" now.  The hip feels wonderful.  With a 90 minute surgery and 1 1/2 days in the hospital, that part is a piece of cake.  The PT... now that's a different story.  ;D
"Never start vast projects with half-vast ideas"
Left BHR - 02-09-2011 - Dr. David Palmer

newdog

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Re: The saga of a bad hip and BHR surgery
« Reply #11 on: May 15, 2011, 12:21:12 AM »
Doc,
That left hip looks awful! But look at that beautiful piece of modern technology that is in there now. It sure feels better doesn't it? The "waddle" will pass soon. Great pics.
Steve, Dr. Gross bilateral, uncemented Biomet, January 10 & 12, 2011, Columbia S.C.

jakemn

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Re: The saga of a bad hip and BHR surgery
« Reply #12 on: May 24, 2011, 02:52:12 PM »
Great story, Doc. Thank you for sharing it.  I am glad you are on your way to getting your life back.

I am in Rochester, MN, and I recently visited Dr. Trousdale at the Mayo Clinic about potential hip resurfacing, and I was thinking about getting a second opinion from the St. Croix clinic where you went.  I was thinking about seeing either Dr. Palmer or Dr. Panek.  I was wondering if you considered seeing Dr. Tim Panek, or was Dr. Palmer the only choice you considered, and why you decided to see him (other than he appears to be the older, more experience, founder of this particular clinic)? 

Did you ask them about other implant devices like the Conserve Plus implant, and why they prefer the BHR implant device over other options?

Stay well !

Jake in MN
RBHR - Feb. 2012 - Dr. Rogerson - Madison, WI

DakotaDocMartin

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Re: The saga of a bad hip and BHR surgery
« Reply #13 on: May 24, 2011, 03:09:17 PM »
Jake,

Dr. Panek had only done about 100 BHR's at the time while Dr. Palmer had done 650.  There are several other doctors in the same region that have done 100 or less.  From what I've read, more is better.  It just makes good sense to go with the more experienced doctor.  I'm very confident that I made the correct decision.

The clinic and the hospital in Stillwater, MN are both first class operations.  I think you will be impressed if you go there.

I did my own research on the various hips before I contacted Dr. Palmer.  From what I've read and discovered, the BHR is the best way to go.  And, so far, everything is working out as planned.  ;D
"Never start vast projects with half-vast ideas"
Left BHR - 02-09-2011 - Dr. David Palmer

DakotaDocMartin

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More PT and continuing to get stronger
« Reply #14 on: May 24, 2011, 03:14:15 PM »
I'm still in the 3X per week PT regimen and am getting stronger by the day.  I am able to walk short distances without a cane but the muscles on the left side (surgical side) are still a little bit weak.  So, I still have the waddle gait. 

I was able to turn up the resistance on the Nu-Step to 8 and I was easily able to do 20 minutes at the rate of 65 steps per minute.  I do a lot more than the Nu-Step but I'm using it as a gauge for my progress.  It's a far cry from the original 50 steps at level 2 only about 5 weeks ago.  ;D
"Never start vast projects with half-vast ideas"
Left BHR - 02-09-2011 - Dr. David Palmer

jakemn

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Re: The saga of a bad hip and BHR surgery
« Reply #15 on: May 24, 2011, 04:00:46 PM »
Thanks for responding so quickly, Doc!  I am encouraged to hear about your experience with St. Croix, and I am leaning towards making an appointment.  I was also just looking at Dr. Rogerson's website (Madison, WI), listed below, and he has a video on there in which his personality really comes thru.. he just seems like a great guy, and he mentions he will probably be getting a BHR at some point himself!

http://www.orthoteam.com/home/hip/birmingham-hip-resurfacing/

If you are at all interested, you can read the story of my initial visit to Mayo Clinic story under this post:

http://surfacehippy.info/hiptalk/index.php?topic=2483.0

While quite professional, I found the Mayo doc to be somewhat...hmmm...."brusque" perhaps is a good description.. maybe it was my large list of questions that interfered with his very busy schedule no doubt.   Anyhow, check it out, and perhaps reply with any thoughts.  Since I live in town locally, I am biased towards going to Mayo for convenience sake, but I didn't come away from the visit with an overly warm, fuzzy feeling :)

Take care my friend!

Jake in M
RBHR - Feb. 2012 - Dr. Rogerson - Madison, WI

DakotaDocMartin

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Re: The saga of a bad hip and BHR surgery
« Reply #16 on: May 24, 2011, 06:36:35 PM »
Jake,

Well, I had a really great first impression with Dr. Palmer and his nurse Karen.  The more I got to know about Dr. Palmer the more I liked him.  One thing that really impressed me is how he spends two weeks every year doing medical missionary work in Africa.

Outside of that, Dr. Palmer was pleased to answer any questions I had for him including his failure percentage and infection percentage.  Both were infinitesimally small.

One thing that did surprise me because I had assumed the posterior approach involved severing the small external hip rotators was that Dr. Palmer doesn't.  The muscles are spread apart enough to gain access to the femoral head.  That in itself literally gave me a "leg up" in the healing process.

If I hadn't waited so long to have the surgery my muscles wouldn't have atrophied as they did.  But, the wonderful thing about the human body is that it can heal itself in such circumstances.  It just takes time.

I just came home from grocery shopping with my wife.  The first time since last year!  Another sign that I'm returning to "normal" as time goes on.  :)
"Never start vast projects with half-vast ideas"
Left BHR - 02-09-2011 - Dr. David Palmer

newdog

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Re: The saga of a bad hip and BHR surgery
« Reply #17 on: May 25, 2011, 02:52:51 AM »
I just came home from grocery shopping with my wife.  The first time since last year!  Another sign that I'm returning to "normal" as time goes on.  :)

Doc,
That put a big grin on my face!   ;D   Isn't it wonderful? (Your hip that is, not my grin. LOL)
« Last Edit: May 25, 2011, 02:58:43 AM by newdog »
Steve, Dr. Gross bilateral, uncemented Biomet, January 10 & 12, 2011, Columbia S.C.

DakotaDocMartin

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Re: The saga of a bad hip and BHR surgery
« Reply #18 on: May 25, 2011, 02:58:39 AM »
Yes, it is!  And, I just got home from seeing the new officers of my Masonic Lodge installed.  I haven't been to a meeting for most of two years.  Everyone was saying how much improved I look.  The last time they saw me I was still using a walker and a cane and could barely get from the van to the building.

I'm looking forward to having two of my grandkids visit us this summer.  I'm already planning fun stuff for us to do now that grandpa isn't such an old grandpa anymore.  :)
"Never start vast projects with half-vast ideas"
Left BHR - 02-09-2011 - Dr. David Palmer

jakemn

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Re: The saga of a bad hip and BHR surgery
« Reply #19 on: May 25, 2011, 02:28:54 PM »
That's awesome!  That's where the rubber really meets the road, IMO.  Spending more quality time with your grandkids or any of your loved ones is a big thing, and could probably add 5 to 10 years to your life just from an improved positive attitude, staying active, and having more fun in life in general.
RBHR - Feb. 2012 - Dr. Rogerson - Madison, WI

 

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