I have known for over a year that my left hip was failing, and that the pain I was experiencing would only get more persistent and more intense. Nevertheless, I have been engaged in cardio training for almost 3 years, and in intense training for two of those three years. I have diabetic neuropathy (numbness) in both feet and part of both lower legs, which makes running, or even walking outdoors, problematic, so my exercise is confined to a gym, where I use machines that offer a way to keep my balance. My type 2 diabetes was diagnosed six years ago, and after two weeks of monitoring my glucose I began a low-glycemic diet that has reduced my glucose and A1c to NORMAL levels, and maintained it WITHOUT ANY DIABETES MEDICATION.
I started exercising August 1, 2008, with a treadmill (15 minutes at 3.0 mph, with a 10 minute rest afterward) and as my endurance increased I had to lower some medications - 10 mg Quinapril instead of 20, 25 mg Metoprolol instead of 50, and 10 mg of Lasix instead of 20. I went faster and longer, and some pounds and inches came off. I switched from Lasix to THCZ, and stopped the Metoprolol completely, which let me really increase speed and distance, and add some incline as well. Now I was losing at least a pound every week, and the training staff insisted that I add some strength training and various elliptical machines, to create a more balanced training regimen. And by the way, for better pain relief I went from 1 Celebrex daily to 2.
I developed a meniscus tear in my left knee sometime in April 09, and had to give up the treadmill. Fortunately, I now had other machines that offered me just as strenuous a workout without the impact, and I easily moved my workouts to them. I reached my goal of 160 pounds (75 pounds less than 235) the day before Thanksgiving '10. I cut one workout a week from my routine, and have stayed below 165 ever since. When I have approached 165, I add extra workout days until I return to 160.
But now my left hip hurts almost all the time, and my left knee pops, clicks, and frequently is quite painful. I tried to make a new appointment with my Ortho-Doc, but his group would not accept my IBM-Aetna open PPO insurance and I had to find a new Doc here in Memphis. I searched, and finally located Dr. Peter Lindy. He took an AP Xray, looked at the record from my old Doc, and told me I needed a new hip. He could treat my knee, but warned me that the now 1/2-inch shorter leg would likely cause further injury. We have, in fact, set THR surgery for July 12, but I am having second thoughts about it.
I pause here to include an entry from the THR talk
I have submitted my request for an evaluation of whether I might be a candidate for BHR instead of THR. I sent the necessary Xrays, forms, and personal information to Dr Rogerson's office, and hope to hear from him very soon, because my local Ortho-Doc has me scheduled for THR on Tuesday, July 12.
BHR might be a better choice for my particular case because I am quite active physically, but only in the gym. In fact, here is a list of potential DIS-qualifiers, and my reasons why I believe they do NOT apply in my case.
1. At 71 1/2 I am more than 11 years older than the target age range for BHR, and would need to fall under the "activity level" exception to advanced age.
2. I have been diagnosed with type 2 diabetes, but have controlled both Glucose and A1c to NORMAL levels, using NO medication other than intense exercise and a low-glycemic diet. However, I do suffer from diabetic neuropathy (numbness) in both feet and lower legs.
3. I have suffered from depression at times in the past, but the exercise that accounted for losing 75 pounds in 16 months (and keeping it off for 18 more months) has also been a very effective treatment for that problem.
4. And this might be the decider - I have looked at my own Xrays, a task for which I have no qualifications whatsoever, but even I can see that I have no cartilage at all in my left hip; my pelvis is lower on the left side; my left femur "ball" appears more or less intact, but is clearly much higher than the right side. To me, this indicates that the upper part of the acetabulum socket has been very severely damaged. This might not matter, but it could indicate that the bone is too weak for proper mounting of the new (large) shell.
I could ask my PCP to schedule a DEXA scan to determine bone quality. He has checked everything else he thought relevant and cleared me for surgery.