38-year Old with a Dilemma

[AdRoc]

Hello,

I'm new to this forum, so I'm hoping to get some good information from the folks here that have already gone through their BHR.

A bit about me.  I'm a 38-year old male, in pretty good shape, but have OA in both hips (left much worse than right).  I've been a pretty active guy in my life (soccer, ice hockey, cycling, triathlons, skiing, etc.), but I'm at the point where I really have to consider a BHR if I want to continue to be active the way I would like to be active.  I'm 'riding on the rims' as one surgeon told me. 

I don't have constant pain, but I have large spurs, and little joint space left in the weight bearing regions that give me pain when I get to certain points.  Consequently, I have to refrain from impact activities (like running, which sucks because I was training for a marathon before the pain became too much).  I can do other activities, like swimming, but I'm really not ready to give up an active lifestyle, and I'd really like to be pain free.  Right now, my mobility is so severely limited in my hips to the point where I cannot squat down to pick things up.  I have to either kneel or bend at the waist (which is horrible on my back).

Here's my dilemma:
- I'm 38, and if I do this now and it doesn't last me 20+ years, I would go to a THR before I'm 60 (limiting my activities further).  If I end up living into my 80's and 90's, by doing the BHR now, am I putting myself on the path to living the latter part of my life in a wheelchair because I will not be able to have the hips replaced again after THR?
- I have a 15-month old son that I would like to be very active with, so a BHR sounds like the right thing to do.  I worry about the burden it puts on my wife to take care of him and me during my recovery (not to mention the concerns in the first bullet).  Should I gut it out with the pain and lack of hip mobility a few more years until he's a bit older and 'easier' to take care of and then go for the BHR when I'm in a time window that makes more sense as far as it lasting until I have to go THR?

Those are my 2 main concerns.  Obviously this is a big life decision for me and my family.  I know no one can make this decision for me, but I'm hoping there are some on this forum that are or were around my age when they had their BHR.  If you're in here, I would very much appreciate it if you could share your experiences with me and what went into your decision making process.

Best,

AdRoc

[Baby Barista]

If you're AdRoc, then I'm MCA... and we're rhyming over the same beats. Or, more accurately, your story nearly mirrors mine... but I'm one year younger.

Despite all my apprehension in the months before surgery... nearly 4 months after, I have no regrets. Read all my posts here, maybe they'll be of some help.

http://surfacehippy.info/hiptalk/profile/?area=showposts;u=3992

"Vitallium monkey, that funky monkey.."

[Dannywayoflife]

I was 10 years your jr when I had my bhr installed. I went through all the emotions that you speak of and then some. The best piece of advice I can give is go and see the best surgeon you can possible see and see what they say. If these devices are correctly placed then they will never wear out. I'd say if it'd effecting your everyday life then your ready. As I say consult the best surgeon you can find and see what they say.
Danny

[rbt2011]

AdRoc,

My story is essentially the same as Barista and yours.  I had my BHR 5 months ago just after turning 37 years old.  I waited it out at long as possible, too long actually as I ended up screwing up my back a bit from over compensating. I also have very small children, live an active life, and was extremely concerned about the longevity of the device.  Bottom line is that you have a bad hip and the BHR is a way to fix it.  It sucks, I know, but focus on what you will be gaining, not on what you THINK you may have lost. 

While I still struggle with regaining strength, ROM, and am not yet pain free, I am a LOT better than I was the day before surgery. 

Best advice I can give you is the same advice that was given to me:
1 Pick the most experienced surgeon you can and make sure you feel comfortable with him or her.  If you have read it once, you have seen it 1000 times, experience is what matters.  Experience, Experience, experience.
2 Once you make your decision, Trust the surgeon and trust the process.   
3 Don't rush yourself.  It sounds cheesy but it is true, You will know when it's time. 

Good luck man. 

[einreb]

I had mine done at 40.  Its a huge leap of faith and one that took me years to come to terms with and several trips to a shrink.  Its an interesting mental process.

14 months post op, I am still amazed on a daily basis how wonderful it is to not be in pain.  I'm now riding about 150 miles a week and getting strong on the bike.

Best of luck in your decision process.  You will find a lot of support here, but in the end its your decision to make.

-Bernie

[lori.36]

Hi, I was 37 when I got my BHR done.  I have two  children, both were under 5 at time of surgery.  I asked my MIL to. Ome for my surgery and recovery to help my husband with the kids.  This made an easier recovery for me.  She stayed for 2 weeks and I was okay with her leaving.  On the days that I was alone with the kids I had an14 year old help me out.  She would pick up my 18 month old and put her in the. Car seat.  Fix lunch and play with the kids.   It all worked out.  I would say do it before your wife wants a second. Child, so you can be healed when she. Comes into the world. 
What surgeons are you looking at?  There are a lot of us 30 year olds that got r done in the last year so you should see a lot of post.  Best of luck.

[obxpelican]

Personally I believe that over 80% of the people receiving hip resurfacings will be able to retain them for a long time, possibly taking them to our graves, even those who are in their 30's. 

Once your body accepts the implant there are few things that will cause you to need a revision, especially if it's a metal on metal implant.  I'll be more confident in mine once I hit the 5 year mark.  I think if you hit 5 years you are good to go for a long time, it seems if you are going to lose your implant many of them are lost < 5 years.


Chuck

[Dannywayoflife]

Funny you should say that chuck I've read somewhere that a well known surgeon thinks that once you reach 4 years then the chances of the device lasting a life time drastically increase.

[morph]

Hi AdRoc,

I am 38, male, always been sporty with 20 month daughter and twins on the way. 3 years ago I was given some great advice to wait until the point of misery before considering surgery. So I did, and now ironically I may have left it too late for a BHR. I am scheduled for surgery on June 7th and been given a 90% chance for a BHR.

I have gone through the same fears as you, especially about ending up in a wheel chair later in life. I knew myself I needed to get this sorted and the fact that I wanted to help my wife and play with our children. But there was always a niggling doubt at the back of my mind even with all the pain. What helped me was noticing the change of mood in the room when the surgeon saw my X-ray, it all went a bit serious, he told me that it was a bad hip and something needed doing. From that point it was easy for me and alleviated any fears, I just wish I had acted sooner.

If you feel it is time and life is not much fun and you want to live your life for the now, get yourself a top notch surgeon who you just have a good feeling about and be guided by their experienced advice and if need be get a second opinion.

Also there are some great people on here with helpful advice who have been through the wars, had the same decisions you are faced with and come out the other side better people. That is what I am hoping for. I wish you all the best

Neil.

[maxx6789]

- I'm 38, and if I do this now and it doesn't last me 20+ years, I would go to a THR before I'm 60 (limiting my activities further).  If I end up living into my 80's and 90's, by doing the BHR now, am I putting myself on the path to living the latter part of my life in a wheelchair because I will not be able to have the hips replaced again after THR?

As other people said, only you can decide when it's the right time for you. However, you can have a THR revised (into a larger THR) so I am not sure the "wheelchair" issue is significant. In my opinion, you can't base your decision today on something that may (or may not) happen in 40 years.

If you currently can perform all the activities you mentioned (soccer, ice hockey, cycling, triathlons, skiing), you probably are "a while" away from needing this surgery.

Good luck with your hips and your decision!!

[Pat Walter]

Hi Adrock

Welcome to Hip Talk.  You are young, but there have been teenagers needing hip resurfacing.  It is really better to get on with life and know you can play with your son instead of sitting on the sidelines and being in pain.

When hip resurfacing is done by an experienced surgeon, there are few problems.  The better surgeons have 98 to 99% retention rates.  The overall rate for many surgeons is 94% from the National registries.  If you use the top surgeons, far less chance of any problems.

The reason a hip replacement needs revised is often becuase the bone growth around the device has loosened.  When the components are loose, then there is a lot of pain.  Even THRs have about the same revision rate as a hip resurfacing.  Please understand that THRs can be revised once or twice if needed.  You need to use the very best surgeons to get the best outcomes.  Each time it is revised, they use a wider and longer stem into the femur bone.  So there is a good possibility if you have a resurfacing and ever need a THR, that will be an ok revision.  Then that THR can also be revised if it is well placed by an excellent surgeon.  You should not think about being in a wheelchair in your mature years.

Also you should live in the now.  Get that hip fixed so you can play with your son and keep up. Don't let him remember you in pain and on the sidelines.  There is no reason you should not have a long, active life with a hip resurfacing and need by, several THRs.  Lets hope the hip resurfacing will last your lifetime.  I have people's stories that have had them 17 years now.  No reason they should fail any more than a THR.

Good Luck.

Pat

[Dan L]

Adroc,

You are spot on, only you can make this big call.

The only advice I can offer, having both of mine done in my 50th year, is that I suffered for at least 2-3 years before I realized I could get *(and needed) this done, and had I moved earlier, I would have been ahead of where I am now.

There is alot of research on this site, a recent one by Dr Gross of SC, that shows 93+% with the implants still in place along an 11 year followup cycle, as well as some from the BHR pioneers in the UK (McMinn and Treacy) that show relatively fantastic outcomes over long periods of time.  I work with a large guy who had a THR 17 years ago, and although not a HR, he says he is still fine and will probably never get his revised.  All in all these devices can last many years, but as my surgeon told me, you have to take care of them by losing and keeping weight off, and by following all the post operative restrictions.

I plan on keeping mine for the rest of my days, and I am doing what I was told to assure I can do that.  All accidents and other unexpected things aside, I'm pretty confident these will last me 20+ years based on what I have read, and paradoxically, on how I feel now 7 months after the first one and 10 weeks after the second. 

Hope it helps and best regards with this tough decision.

BTW the people on this site are incredible, they will help and share as if you were family.

Dan

[Baby Barista]

Off subject... but seems a little inappropriate now to say I was the MCA to your AdRoc. Oops.

[lori.36]

So sad abo MCA, he was a legend!  Saw him in Detroit 1993!

[obxpelican]

Adrock,

You see, nobody wants to say that a well implanted hip resurfacing can last you a lifetime for sure. I would be willing to bet in another 3 or 4 years or so if the data keeps trending the way it is many doctors are going to tell you that your implants will go to the grave with you.

It's too early for anybody to say this for sure IMHO...... I say the best advice was given by President Lincoln, he said that "The hen is the wisest of all the animal creation because she never cackles until after the egg has been laid."

Wait a few years to see if our surgeons cackle, I bet they do though.


Chuck

[hipnhop]

C'mon man. By the time you go through your BHR, then a THR, then a revision to the THR, there will be some new funky, hydrolic, kryptonite  resurfacing devices on the market. You will be able to adjust your height through your Iphone 17, set speed levels by vocie commands and jump ability - well put it like this" "White men will now be able to jump!"  In fact it will let you bring sexy back at 80. What u worried about?

Seriously, kids grow too fast. Don't miss out on the fun stuff. I am looking forward to my first 5k race with my 1y year old son at my 6 month mark.

Hip

[jb46]

Find the best Dr. for you and do it asap. I'm 12 days post op with Dr. Gross in S.C. and have no pain, except incision area, walking totally without crutches or cane, and I'm now less than 6 months from being able to run again.
Recovery isn't so overwhelming that everything else stops, and if the pain is effecting what you can/can't do, you've already waited too long.
You'll find one common realization from everyone on this site...I wish I had done it sooner. And if you say how young you are, you'll get multiple replies from folks who had it done well before your age. Good luck with your decision and process, but start looking cause the best docs are booked 3 to 4 months out....jb

[akat01]

    Im a 40 year old w 2 young daughters 5 and 6. I had been injured at work 13 mos ago and opted first to have arthroscopic surgery to try and repair damage.At the time I was told I should opt for a resurfacing but that in turn it would end my career as a fireman.The labral repair didnt work and now a year later Im heading for resurfacing.Tommorrow actually.Ive always loved sports.Played hockey,softball,basketball,soccer, and skiied most of my life.In the end I was willing to give them all up and deal with pain if I didnt have to go through with this surgery.Then this winter my kids started asking me about going up to the mountains and then this spring my 6 year old wanted to join soccer and asked if I'd coach.Thats what ultimately changed my mind.Ive lived a good life and experienced alot, and I want to be able to share the same things with my kids.I dont know how it will turn out but I figured it was worth a shot.If you do enough reading on this site it should give you the confidence to go forward.

[imgetinold]

Ditto what everyone has been saying.  I, like most others, had the same fears and apprehension.

One thing I didn't hear specifically stated is that your OA is only going to get worse.....not better.  I, like you, had periods where I felt fine (with some ROM issues).  I ran 4 miles on Monday before my Wednesday surgery.  Talk about considering postponing!  But, I had just as many weeks where I couldn't walk/sit/stand/sleep without pain.  Now, four months out.....no pain.  Constantly improving strength, fitness.  Really great.

Good luck with your decision.

[AdRoc]

Wow!  What a wonderful response.

Thank you all so much for the advice an encouragement. 

I've made my decision to go forward with BHR.  I still need to find the right surgeon.  I've met with Dr. Hartford and Dr. Callander so far.  I really liked Dr. Callendar.  I still want to meet with Dr. Vail (UCSF), Dr. Ure (Shasta), and see what Dr. Gross has to say before I choose.  From that list, I'm sure I'll find the right guy.

Anyone out there have any preferences?

Thanks again!