Not feeling ready for surgery at all

[mountaingoat]

My surgery date is now 2 months out. I'm set for bilateral but the trouble is I really don't feel ready emotionally at all. The main reason is that I had bilateral Synvisc injections in both hips at the end of September and incredibly they have worked fantastically for the last two months. I went from being able to barely walk 1 mile without pain in September to being able to hike multiple times per week and even carry my 17lb baby on my back hiking. I am also biking and working out at the gym and will likely get a few ski days in very soon. I truly cannot believe how much this has helped. I really wasn't expecting a lot from the injections but I needed something to get me through the 4 months of wait time and now I wonder whether I could get even longer.

The thing is, its really , really hard to sign up for major surgery when you're not in pain. Sure, my bad hip bothers me a bit here and there but it isn't debilitating at the moment. I've been able to do stuff I wasn't able to do all summer.

I wanted to re-schedule the surgery to March assuming the injections would have run out by then but unfortunately my husband is going to be rafting the Grand Canyon for three weeks in March so its either late January or early April. If I wait until April, I really won't be fully recovered for the summer.

Has anyone had Synvisc injections that lasted longer than a few months? I feel very strange going into surgery without significant pain - especially at my young age (36).

Thanks,
Amy

[Dannywayoflife]

Amy I'm pleased that the synvisc worked well. I asked to have that done but couldn't find a surgeon any where in the uk that did it!
How bad is the oa? What has your dr said about it? Who is your surgeon?
I too questioned weather I should wait longer before my surgeory as I wasn't in that much pain, but my rom sucked and I was diagnosed as grade 4 oa a year prior. So I figured that it had taken my life for long enough and I wanted it back.
I would talk to your surgeon and see what they say. But bear in mind some people have had very few symptoms and have then left it too long and hr was taken off the table.
Danny

[lori.36]

Amy,

I would keep your upcoming surgery date, until it gets closer.  If I was doing what you are able to do, then I would wait, but if the pain is preventing you from enjoying your life then go in.  I know this is hard, because you are going to be flying there, but I would wait until 3 weeks out to make my decision.
I am thrilled that you are having such good results with the Synvisc Injections!  I was gonna try that but I think my OA was way to bad. 
Are you going to Mexico soon?  Did you have your shoulder surgery?
Lori

[mountaingoat]

Hi Lori,
 Thanks - yes, the results have been unbelievable. I almost can't remember how much I was whining in August and September about my hip. I was having trouble walking from my car to my office just two months ago and on Thanksgiving I hiked 2.5 hours roundtrip with baby in the backcarrier up a steep trail and back. I wonder how much damage I am doing though?

Part of what kills me is giving up another ski season for surgery even though I know I will be back next year regardless of whether I do the surgery in Jan or April. I missed 2009 and 2010 recovering from my hip scopes and in 2011 I was pregnant so basically the Colorado winter that I love has eluded me for 4 years.

I did have the shoulder surgery and it was much much easier than I had thought - my shoulder feels great. I had heard such terrible things about shoulder surgery but I did not have a major repair so that was a big part of it. I had the biceps tendon re-attached but overall it was a very easy recovery after the first week. The other shoulder hurts more than my operated one at this point

We leave for Mexico in less than 3 weeks. I can't wait! I was so afraid that I would be hobbling around and barely able to go to the beach but given how well my hips are doing I should be able to walk on the beach and do everything I'd like.

Will you be skiing this winter Lori? I hope your new hip is still feeling great!

[Woodstock Hippy]

I talked to a doctor about Synvisc/Orthovisc injections for my hip.  He had been injecting knees with great success and he thought that he would have success with my hip.  It all looked good until I said that I wanted to extend the health of the hip.  He said that it wouldn't and that it only masks the symptoms.  I passed on it

If it's working for you stay with it.  If you are not ready for surgery put it off or cancel it completely.  The doctors will be there when you need them.  None of these guys are hurting for business and they understand when someone isn't ready.


 Don't rush anything.  Take your time and be sure of what your doing when you do it.

[mountaingoat]

Well, I do worry that I am doing more damage by just masking the symptoms...however, my OA is not as bad as many people on this board and I'm not bone on bone that I know of so I don't think I'm risking making it too much worse.

I am definitely contemplating canceling the surgery till spring but not certain. I know that Dr. Gross will understand especially given my age. My husband thinks I should just go through with it because we know that the injections are only a stop gap measure and soon enough I will be limping around again. I worry about that as well but I am just enjoying being so active for the time-being and don't want to give it up to recover! 

[einreb]

I'm 40, a bit older than you... but felt I was way too young and completely understand your interest in delaying surgery.  In may of 2010 I scheduled an August 2010 surgery with Dr Gross.  About a month later i started taking celebrex and had great (relatively speaking) relief.  In July of 2010 I went on a trip to Durango , biked hard for 4 days, felt strong and canceled the surgery.  Right about the time that i would have had the surgery, the Celebrex stopped helping.  A few months later, I rescheduled for Feb of 2011.

Lee was very understanding that I wanted to put it off.  It pained me a bit knowing that I would have hit the 6 month no restrictions point on the day I eventually had my surgery if I had stuck with the original date.

Good luck, its not an easy decision...

[Tin Soldier]

I hear you on the limited-pain deal.  I had really bad ROM, but if I wasn't very active I really didn't have much pain.  At least I didn't think I did.  I look back now and realize I was always in some amount of pain, I just didn't think it was that big of a deal.  I had a cortizone shot and the pain went away for a few weeks, I played soccer and it sort of worked, but it was obvious the ROM sucked.  It was very limiting.  The decision to go forth now or later is a tough one and I understand where you are coming from.  Although, I suspect you will be in a similar, or worse condition in a year.

I researched for about one year before pulling the trigger on surgery.  I knew I would be doing it within a couple years and I knew I would not wait for more than a couple years.  I finally had enough confidence and also had enough discomfort and limited physical activity that I decided it needed to be done.   I thought about cancelling a lot, but I just kept telling myself that I did the research, I'm not getting any better, I want my life back,... and stuck with it.  You may not be ready yet, but by going through the process of planning surgery, you may gain the confidence to fully commit the second time.  Good Luck.

[mountaingoat]

Yeah, I totally hear you on delaying it and then the relief wearing off. I know that it will eventually wear off - its just a question of when. Normally, the difference between late January and first week of April wouldn't be a big deal at all but when you've been through 3 surgeries in the last 2 years and have spent a good portion of those years recovering you can understand the desire to push it back even 3 months.

I have always had surgeries in the winter months or fall and I don't think I'd be very happy about being on crutches when the weather starts to get nice and I want to be playing outside. I'm going to have to give up something though. Its hard when you live in such a great place as Colorado because you are always missing out! 

I am considering having another child in two years if all goes well with the resurfacing. I'll want to wait at least 18 months before getting pregnant in order for the metal levels to reach the "run-in" period. So, I don't have an indefinite amount of time.

Yes, this is a very difficult decision. I am wondering how much notice I need to give Dr. G's office if I do decide to cancel - I really don't want to burn any bridges there.

[cwg]

Okay, so here I go again, but I would not have the surgery until you have zero doubt about it.
You need to be 1000% sure (In my opinion).
 Frankly I think it should be really bad before going forward with the surgery.

Hip surgery is quite huge. You better be "emotionally" certain that you need it. I went in to my BHR with  some doubt and am very very sorry I had it done.

From every great experience I have heard or read about, it has to be pretty bad beforehand.. and then the results are staggering.

Listen to your pain, as well as that little inner voice. You will know what to do

Good luck!

[mslendzion]

I understand your hesitations. It is a major surgery and you wonder how bad does it need to be before you make such a decision. I spoke with a surgeon who recommended waiting as long as possible to avoid having it wear out.

I also had a steroid shot in my hip, it helped some but it did not stop the shooting pain.  I made the appointment for the surgery as the pain gets worse every day. Sitting and sleeping hurt. I miss walking my dogs and shopping. I won't shop unless the store has a shopping cart. I limp really bad and use a cane at home.

They say you'll know when your ready. I knew as will you. It is also a lifestyle decision if the pain stops you from living you need to decide your path. For me the pain went from tolerable to unbearable pretty quickly. Not many options. Best of luck to you.

[Jimt]

I was also told you could potentially wait to long once you are bone on bone.  I guess you can damage good bone which may keep you from being a candidate for hip resurfacing.

I go in Friday for surgery.  I know I can take the pain if I wait but I also know the reduction in activity will get my whole body.  Gain weight = increase risk in diabetes and then there is the bone damaging factor.

It is time....

[manyworries]

WOWOWOW!!!  You are a brave girl to think about a bi-lat when you are not feeling all that much pain?!!  I'm going to look into the Synvisc Injection you mentioned as I would be thrilled to have pain relief with such a simple procedure.  I am bone-on-bone, but my quality of bone prohibits me from a BHR, just don't wait TOO long!! (I'm 55.) 

I'll be interested to read your history to see what you have been through. I would most definitely take into account your upcoming pregnancy.  The BHR can't wait until after baby??  Dr's office's are always having to move their schedules around, don't worry about burning bridges... seriously !!

[mountaingoat]

Thanks everyone for your kind responses - as always, there is such great support on this board. I really don't know what to do. My worse hip bothers me enough on a daily basis that I know that whether I do it in January or April I need to have it done and won't make it another year. My other ("good") hip could probably be stretched out another year or even more but again, I'm not sure I want to go through this all again in a year or even two years.

[Boomer]

The first surgeon I saw told me I needed new hips, either resurfacing or replacement. I asked how much time I had, how long I could wait. He said, "You're in pain on a daily basis, your activities are limited by your OA, why would you want to wait?".

The second surgeon I saw told me to wait until the pain was unbearable and he would do the resurfacing.

No wonder it is a difficult decision mountaingoat. There is no right answer.

I took the advice of the second surgeon and have suffered needlessly for it. OA only gets worse, it never gets better. I am now only one day away from surgery and in awful pain because I waited. I accomplished nothing by waiting.

Good luck to you. The advice given on this website is priceless. I would still be waiting and suffering without the counsel of so many Hippies who encouraged me to move forward beyond my fear.

Boomer

[cwg]

Hey Boomer- It became clear it was your hips and nothing else. Lucky lucky man. You did not wait too long. You got it right.

[Dan L]

I approached the decision this way, for what it is worth.  The day before surgery was the last day my left hip was going to continue to get worse (overall); the day of surgery and since it has continued to improve every day, now 8 weeks out.  The injections which do help for a while, with the risk of infection etc were only delaying tactics, and the decision to get better had one long term path: resurfacing.

Hope it helps,

Dan

[Woodstock Hippy]

Don't be in such a hurry to go bilateral.  If you can get two years out of the good hip, do it.  Although my xrays were different on each hip, my pain was consistant in both. 

I had a relatively easy time with bilateral surgery but I'm different than most people; I have a strong upper body from 40 years as a heavy construction carpenter and 15 years of swimming and I have a very hard head and an optimistic personality.  This post from Boomer says it all;

''That's because you are crazy Woodstock. You've been actting crazy since your very first post. Stay crazy please. You make me laugh and make me look forward to getting my new hip. I hope I have someone in the hospital like you to do PT with.

Congratulations on the progress you are making.

Boomer''

Read my post in the Bilateral section about what you should know and make your you know what you are doing before you jump right in with both hips!

[hernanu]

I wouldn't worry about burning bridges, just talk to them about your concerns. As noted, others have cancelled surgeries with them and later scheduled them. I'm a believer in HR, having had two done, but I was both mentally and physically ready, so there was no hesitation in my part.

You need to feel right about this, and don't tie yourself to doing both at the same time if you're not up for it. You could do one, then the second when that feels like you need it. Either way, there should be no other influence either way. Your decision based on your feelings, needs and your intellect.

The HRs have been such a boon to me, it is something I think will really help you, but only when you are ready for it, you will have recuperation for a bit afterwards. Good luck, we back you either way.

[mountaingoat]

All great points all around. This is a really great site with very wise people.

If my left (better) hip weren't symptomatic I wouldn't even think about bilateral. But as I've mentioned previously, prior to these Synvisc injections I was having enough pain in that hip that it would limit my activities once the other hip was resurfaced and recovered. I also hear that for many their other hip went downhill quite quickly following resurfacing on the bad hip.

I know that I can get through anything. I am super tough and in great shape despite my hips. Even through the worst of my hip pain I was still able to routinely do 3k climbs on my road bike. When I had same-day bilateral hip scopes in 2009 I was nordic skiing 7 weeks post-op and cycling before that - I have been an athelete for so long that even through the worst of my hip problems I am still fit and strong enough to recover quickly. I don't have any illusions that it will be easy though.

One of you said something poignant that stuck with me along the lines of "my hip is never going to get better from here on out". This is true and is why I ultimately want this out of my life. I have been sidelined off and on since 2008 with hip issues and I'd like to look back at my 30s and have some memories that didn't involve being injured.

Another part of this is that for the last three years my life has been an up and down story of my hips. I have re-scheduled so many trips and vacations because of it that I just want to be able to have some consistency and be able to rely on my body. I know it does not make a difference whether I do it in April or January in that regard but I am definitely doing it this year for sure because I refuse to keep putting my life on hold when my hips get bad again.