Scary presurgery meeting

[winnergirl]

Friday I met with my surgeon, Dr. Edward Sparling in Vancouver Washington for my pre-surgery meeting.  I like him very much but I have to say that I am a little freaked out about parts of our discussion.  My surgery is Wednesday, April 30th and I am the first surgery of the day.  At this point Dr. Sparling has done 350 resurfacings, more than is indicated on this site.  He has had 4 cases where the femur broke after the resurfacing, all of them women, and 3 out of the 4 were post-menopausal women.  I want a resurfacing and I am post-menopausal.  During our discussion he said that 75% of the resurfacings he does are in men and that is because of the 4 problems he had with women. I hate it when they go through that "informed consent" list where they tell you every conceivable thing that could go wrong.  Out of all the resurfacings and total hips that Dr. Sparling has done he said he has had about 10 cases where there were nerve problems, most of them temporary.   Apparently, you can lose control of your leg if the right nerve is damaged and though it usually clears up, it can be permanent.  I am a non-insulin dependent diabetic, 75 lbs over weight and Dr. Sparling wants me to use a walker for 6 weeks and not put more than 50% of my weight on my right leg during that period.  He admitted that he is going to be extra careful because he wants me to have the best possible outcome.  I believe that unless he finds something that is overwhelmingly negative I will end up with a resurfacing rather than a total hip.  So here are my questions:
1.  Out of 350 resurfacings are four broken femurs a good or bad record?
2.  How common is nerve damage and does anyone out there know anything about it being permanent?
3.  Dr. Sparling does not preserve the capsule and when I asked about it he said that I need to trust that he knows how to do this surgery or find another doctor I do trust.  How important is that to the final outcome?
I saw several doctors before I picked Dr. Sparling and I REALLY like him.  He is absolutely dedicated to the best outcome for his patients and it is clear that he cares much more than most doctors I have met. Should I be having all the questions at this point?  I am in so much pain I can hardly walk and I can feel my hip popping in and out of the socket on every step.  I can't wait much longer.  I look forward to any feedback anyone can give me.

[Pat Walter]

Hi

I was a lot older than you when I had my surgery.  I was a 61 year old female and had no need for anything special.  I was on one crutch at 4 days and none at 4 weeks.  My surgery, however, was overseas with Dr. De Smet who has done over 3000 hip resurfacings.  He often does older women.

He has done very overweight women who he says heal well because their weight bearing is better than normal weight people.

You do, however, have to go with what your surgeon suggests.  He is going to be very conservative with you because he doesn't want any problems.

4 revisions out of 350 = 1% revision rate.  Better than the average of 4 out of 100 for most newer surgeons.

Many surgeons don't preserve the neck capsule.  Only a few do.  They think it makes a differences - others don't.

I have to say he is certainly honest.  Dr. De Smet has done over 3000 hip resurfacings and only a a couple femur neck fractures early on.  The doctors should be getting over it after the first hundred or so.

The 10 nerve problems is scary.  I have not heard about too many drop foot and nerve problems.  That is something that would scare me.  The posterior approach should help prevent nerve problems.

10 out of 350 nerve problems is 3.5% chance     That is different than I normally have heard of.

Again, at least he is honest. 

I guess you have to decide how much of a gamble that is for you.  If you really like him and feel good about him - it is up to you to take the gamble.

Personally, I wanted a really experienced surgeon since I was older and chose between De Smet, Bose and Gross.  Without insurance, I could not afford Gross. Gross has done over 1300 resurfs.

I don't know what else to say other than we each have to go with our gut feelings. If you don't like his odds, then maybe you need to look further.  I would be looking for a doctor with a thousand or more resurfs if you really have a lot of problems.  A lot of doctors don't like doing people that are overweight.  De Smet has done quite a few really overweight people.  No problem at all for him.

Let us know what you decide.  I wish you the very best of luck.  Keep in touch.

Pat

[silvercat]

Pat,

I notice that you had your hip(s) done by Dr DeSmet (3200) and had no insurance.  I am in the same boat.  I just talked to a man her in California that just had surgery with Dr DeSmet on April 20, 2010 and has just gone off his crutches as of May 20, 2010 and is very happy.  He said that it cost him and his wife a total of $22K including all travel, food, lodging etc. 

Dr Bose's (email states over 1500) office emailed me back and he was $7,300 US plus travel.   

I talked to Dr Amstutz's office in Los Angeles CA and he can not take me but Dr. Schmalzried (500) can handle my case for $24,950 plus travel which is not much since I am in San Jose Ca.

I have reason to travel back and forth between CA and Ohio so I contacted Cleveland Clinic.  I have not talked to Dr Peter Brooks (650) office yet so I don't know his fees.

What do you think so far?

My right hip is my big problem but the left is getting worse a little each month it seems and my knees are starting to bother me so I was thinking to do both (is that Bilateral BHR) with Dr Bose since i could possibly afford to do both.  I am 61, male, athletic all my life and in good shape currently. I just lost over 40 lbs so I am raring to go.  What do you think about bilateral?

Thanks for any advice. I will not hold you to anything so just let me know your opinion. 

George

Hi

I was a lot older than you when I had my surgery.  I was a 61 year old female and had no need for anything special.  I was on one crutch at 4 days and none at 4 weeks.  My surgery, however, was overseas with Dr. De Smet who has done over 3000 hip resurfacings.  He often does older women.

He has done very overweight women who he says heal well because their weight bearing is better than normal weight people.

You do, however, have to go with what your surgeon suggests.  He is going to be very conservative with you because he doesn't want any problems.

4 revisions out of 350 = 1% revision rate.  Better than the average of 4 out of 100 for most newer surgeons.

Many surgeons don't preserve the neck capsule.  Only a few do.  They think it makes a differences - others don't.

I have to say he is certainly honest.  Dr. De Smet has done over 3000 hip resurfacings and only a a couple femur neck fractures early on.  The doctors should be getting over it after the first hundred or so.

The 10 nerve problems is scary.  I have not heard about too many drop foot and nerve problems.  That is something that would scare me.  The posterior approach should help prevent nerve problems.

10 out of 350 nerve problems is 3.5% chance     That is different than I normally have heard of.

Again, at least he is honest. 

I guess you have to decide how much of a gamble that is for you.  If you really like him and feel good about him - it is up to you to take the gamble.

Personally, I wanted a really experienced surgeon since I was older and chose between De Smet, Bose and Gross.  Without insurance, I could not afford Gross. Gross has done over 1300 resurfs.

I don't know what else to say other than we each have to go with our gut feelings. If you don't like his odds, then maybe you need to look further.  I would be looking for a doctor with a thousand or more resurfs if you really have a lot of problems.  A lot of doctors don't like doing people that are overweight.  De Smet has done quite a few really overweight people.  No problem at all for him.

Let us know what you decide.  I wish you the very best of luck.  Keep in touch.

Pat

[fenceman]

George,

i would be interested to see what you are quoted by Dr. Brooks.  Mine done with insurance paying was close to 65,000.00

[Vt waddler]

I am guessing the prices you are getting are just for the surgical doc..It is the extras that kill you. Operating rm $ 16,010,DME $30,032,anest $2,530, semi private rm $3,699, therapy 3,500 (while just in the hospital for 3 days , surgery $22,692(for both) and thousands in rehab, xrays,followups(about $700 each time w/xrays) etc. It ain't cheap.

[Vt waddler]

PS: I forgot to mention the 6 days of inpatient rehab I went through on top of the previous prices (Billed to insurance, BCBS paid a cheaper amount). I am guessing, not including lost work (my entire work season) my 2 new hips cost about $100,000. and I'm happy to report, I was a very slow recoverer, but 9 months post-they are doing very well, now my back is shot, but that's another story ! <VBG>