7/20 appt w/Dr Su

[David]

Trying to formulate as mant questions as I can for my initial consult with Dr. Su.
Anyone have any suggestions as to questions I should ask based on your experiences?
Thanks...
David

[Pat Walter]

Hi

Here is a list you can print out

http://www.surfacehippy.info/questionsfordoctor.php

Pat

[David]

Thank you Pat.
I guess the next question is, as a young athlete trying to get back to what I do, is there anything different you should do with the implant/resurfacing?
Thanks.
David

[KirkM]

David -
I am less than 4 weeks out from resurfacing with Dr. Su.  I have been doing Ironman Triathlon for almost 20 years and, of course, was anxious to convey to Dr. Su my desire to return to the sport.  What a great experience it was dealing with him.

On the morning of surgery, I was put into the prep room and had all the checks and tests done.  Then Dr. Su came in and briefed me on what was to take place.  He sat and talked to me and I realized the questions he asked were not just for some basic information, he was asking about what I did in life, what I was planning to do when I recovered and what I expected out of the new hip.  He took the time to listen and didn't seem in any hurry to cut me off and get off to something else.  I know he had a bunch of surgeries that day, but I felt like I was the only one to him.

As great as that made me feel, the true significance of it didn't hit until I saw him on my one-week follow-up.  He went over the post-op x-ray and not only answered every question clearly and patiently, he explained exactly how he configured the cup and reformed the femoral head to maximize ROM and minimize the chance of impingement when running or riding in aero position on the bike.  I was completely blown away.

Not only did he LISTEN and REMEMBER what I told him in pre-op, he actually knew what the demands of the sport were.  My jaw almost hit the floor when, while explaining this all to me, he leans over the exam table onto his forearms in bike aero position to illustrate how the cup angle he used would allow for optimized motion and minimal risk of impingement.

I became a superfan from that moment on.  This guy does his homework.  He knows what type of person most likely is going to go for hip resurfacing and knows they expect a lot in terms of results.  He is not a triathlete and he certainly doesn't do most of the high-level sports and activities that many of his clients pursue.  But he is totally into what he does, and by extension, PAYS ATTENTION to the peripheral elements involved which will allow him to do his job better.

I, too, was worried about making sure I asked the right questions when I spoke to him, but, as it turned out, the more important thing is that HE knew what questions to ask ME.  And he used the answers to maximize my results.  My recovery so far is undeniable proof of that.

To me, that is what separates a good surgeon from a great one.

Kirk

[lori.36]

I would ask:  what surgery do you think would be the best surgery for me?
Will the surgery eliminate my current issues?
What device would you use on me? Why?
The 20 th will be here b4 u know it.  Best of luck and keep us updated.
Lori

[ScubaDuck]

David-

I second the comments that Kirk made.  Discussions with your surgeon on what you plan to pursue post-op is very important.  And you will find each surgeon has different protocols in returning to activities.  It seems like the important thing to remember is to return slowly to let the body heal before pushing too hard.

Best wishes.

Dan

[David]

Thank you all.
Kirk that is very comforting to hear.  Are you progressing well?
I've been in a lot of pain the last couple of weeks, all of a sudden seems to have multiplied tenfold.  Just getting a bit apprehensive as my appointment and reality approaches.
All of your input is much appreciated.
David

[KirkM]

Yes, I am doing extremely well, in fact. 

I need to qualify this by saying I was very mobile before my surgery.  I could run 5 or so miles before getting extremely sore (stopped running and switched to deep-water running with an Aquajogger about 5 months out to prevent destroying the femur and disqualifying myself from resurfacing).  I was swimming 7500 meters per week and biking a few days a week with the longish ride at about 50 miles right up until I got on the plane for NYC.  I was sore a lot, but it was quite manageable and I took NO pain meds at all, not Tylenol, not Advil, nothing.  I am very fortunate that I have an extremely high pain threshold.  It honestly didn't really bother me that much.  Dr. Su was surprised at my activity level before surgery considering how destroyed my hip was when he got in there.  Oh, I am also a freakishly fast healer.  I have healed at about 1/2 the time considered "normal" with the 4 or 5 various (non-hip related) surgeries I have had over the past 10 years.  OK, enough of the disclaimers.  You would think I was a lawyer or something.

Obviously, your level of fitness and muscle usage pre-surgery will have a very big impact on the ease and speed of your recovery.  I know it is typical for most going into this to have pain that greatly limits the ability to stay active, so it is kind of a tough situation.  But there are ways to move and keep strong without the impact pain.  Many can ride, either outside or on an indoor trainer / Lifecycle.  Also, deep water running is absolutely great.  It is extremely easy on the legs and hip but really does work to keep fitness.  Many pro triathletes use it for injury rehab and even just to get an extra run day in without the impact damage.  I have used it in the past for rehab from running injuries and it really is an amazing tool.  Just get an Aquajogger (www.aquajogger.com) and find a pool that is deep enough so your feet don't touch the bottom.  Then just mimic the running motion for an hour or so at a stretch.  Feels like you really aren't doing anything productive, but you are.

There are also all kinds of shallow-water things you can do.  Shallow water running is good, and also the tons of in-water exercises and ROM movements will help keep you fit.

I strongly recommend doing everything you can to stack the deck in your favor.  IMHO, you have done the most important one by choosing one of the best surgeons for this in the country.  Now, I urge you to get creative and find ways to stay as fit as possible before surgery within your pain limits.  You will be very thankful afterwards as, from my experience, it makes the recovery so much easier. 

** JUST MAKE SURE WHAT YOU DO FOR FITNESS IS NOT DESTRUCTIVE TO THE HIP WHICH COULD WEAR IT TOO MUCH AND DISQUALIFY YOU AS A CANDIDATE FOR RESURFACING.

This relates to the original topic of this thread about what to ask - ASK Dr. Su about your specific situation regarding how much damage is there and what you can safely do to keep you a good candidate for a BHR while also keeping active and fit.  He will undoubtedly have your x-rays and should be able to give a good general assessment of your condition.

Lastly, relax.  This is just something you have to take care of.  You will have a proven doctor, a proven device and tons of information and support available any time you want.  All things considered, that's not such a bad place to be, is it?

[David]

Hey Kirk,
Glad you are doing well and continue to do so.
I hear you regarding the high pain threshhold, I'm starting to view it as a curse of late though.
I'm still very active, excepting the running at this point.
10k masters swimming a week/15min water run 2x week.
Biking 2-3x week as tolerated up to 150m.
Started doing SUP about 6 weeks ago up to 3-4x week.
Any weight bearing is just intolerable at this point though.
I am my own worst enemy as I did St. Croix and Honu halves on literally no running and have deteriorated to the point I am now since the beginning of June.
I hadn't even thought about the fact of possible damage to prohibit chances of a BHR.
I've been seeing Dr. Moley who is the Physiatrist who works in the same office as Dr. Su at the HSS Hip Center for the past 2 years, FAI arthroscope, microfracture and labral repair prior to that.  He is the one who thought I'm a good candidate for resurfacing.  Just have to remain positive and know this is the direction I should and must be going.
On another note, has anyone had any experience with using the spice "turmeric" as an anti-inflammatory supplement?  I was prescribed "Voltaren" oral as well as gel, which helps with the inflammation, but makes my head feel light and out of it.

Best...enjoy the weekend...it's a good one in the NE...
David

[KirkM]

Obviously, you are good in the fitness area. 

Had to skip Honu for the last year because running off the bike was just too painful.  I am in for next year, though!  That one is my favorite.  70.3 Oceanside is right in my backyard, but it is too early next year for me to do safely.  Back to full distance no later than 2013.

You have had some more complications than I did, but it sounds like you have everything handled.  It also sounds like you need to get this done sooner rather than later.  I guess the main issue with pushing impact activities too much before surgery is that bone on bone can create cysts (pockets where the bone is kind of mush) in the femoral head.  If they are not too big and not in critical spots, it is OK.  I had a couple they took care of.  If there are too many or they are too big and it compromises the integrity of the femoral head below the area they shave off for the device "cap", you may not be a candidate.  Although they don't really know the true extent of cysts until they get in there (unless it is obviously destroyed), they can see them somewhat with x-rays and make an educated guess on whether there could be problems doing a resurfacing.  Again, they can't be certain until they are actually in there, so there is always a chance they will discover something that just can't be seen on an xray.

The strange thing with me was that I had a DEXA bone-density scan a couple of months before my hip surgery and it showed mild ostiopenia just about everywhere.  That is odd for an endurance athlete.  After surgery, Dr. Su said my femur and pelvis bones were rock-solid and completely contradicted the DEXA scan results.  ?

I'm no help in the turmeric area.  I just ice like crazy (wrapped fully around the upper thigh, front to back) and it works great, both prehab and rehab.  I walked almost 3.5 miles yesterday at a pretty brisk pace and just carried my cane.  I didn't need to use it and, after icing last night, my hip felt really good.  My 4-week anniversary is today and I can definitely feel myself changing from "recovery" mode to "begin strengthening and training" mode.

I am confident that your excellent fitness going in will put you on the fast track for recovery.  Not to tease you, but you are going to like it A LOT better on this side.

All the best and keep us posted.

Kirk

[ScubaDuck]

Kirk-

It sounds like you are similar in age.  You are definitely in better shape since I haven't had the time for triathlons or major training for years.  I have started back to training and it feels great except for the hip.  And that will change in a couple of weeks.  I hope that because of a decent level of fitness I will be able to bounce back quickly like you.

Dan

[KirkM]

Dan -
You will be great.  I'm 53 (but have been mentally / emotionally stunted since about 20  ).   

Just be patient in the beginning for that turn from recovery phase to building back phase.  You will probably get impatient with the recovery phase no matter how short it is.  Mine was really fast and I was still SOOOO done with it at only two weeks.  Now, at 4 weeks, I feel the turn and it is making me feel like a horse in the gate.

The true discipline starts here.  In early recovery, you really can't (and don't much feel like) doing a ton of work on it.  Now, I have the false sense that I can go out and really push.  I say FALSE sense because it truly is a false perception.  I can really hurt my future during this period so I have to be less a dumb jock and more a thinking, focused "athlete" on a rehab path.  Hate that thinking thing.  It takes so much, um, thought.  I just want to hammer like the stupid mental 20 year old that I am.  How I ended up in this 50+ year old body is a complete mystery to me.

But I digress...

And I think I just hijacked this thread.  Sorry about that David....

[David]

That's funny Kirk, I just turned 50 a few weeks ago and feel the same way.
I'd rather hang out with my 9 year old son then my so called peers...

[Lopsided]

I am forty eight. Good thing I am way off fifty.

D.

[KirkM]

Ahh, yes, the late forties.  I have fond memories of those days of youth long past....   

[Lopsided]

Kirk, I have got a question. There ain't too many Kirks in the world. In fact I have only ever met one. From what I can gather from what you have posted, you are not necessarily the Kirk that I used to know, although the picture you use is quite similar. Perhaps all Kirks look the same.

But on the off chance, did you and I meet for the first time in Korat close to twenty years ago? If you do not know where Korat is, then it is not you.

Cheers, D.

[KirkM]

No, it wasn't me.  Where is Korat?
I seem to look like a lot of people.  This type of "hey, how've you been?" thing from people I never met before happens surprisingly often.  I guess I am just one of the repeating patterns in the world's human wallpaper.

[ScubaDuck]

I turn 50 in 16 days and have my surgery 6 days after that.  My second half century starts with a new hip!  I am looking forward to it!

Dan

[KirkM]

I think you will be very happy you did it.  I sure am.

[Lopsided]

Dan, you will wish you had it done at forty.

Kirk, hey, how've you been? Sorry I have never met you, but I am glad your new hip is doing well. [ http://en.wikipedia.org/wiki/Nakhon_Ratchasima ]

D.