Am I a candidate right now?

[MikeF]

Hi all......first post here, and essentially I'm wondering where you all were in your disability before you finally had surgery.  I'm a 57 year old squash player who began having problems in 2007. I was told then I would be a candidate for resurfacing 'someday'.  I had my hip cleaned out by arthroscopy in June 2011.  I went to my hip specialist in January to discuss resurfacing but he advised to be conservative because there was still some space in the joint and I was still somewhat active. I went on celebrex after that and I was able to ramp up the activity for a few weeks....but that stopped abruptly.
Right now I'm experiencing lower back discomfort, right groin pain constantly, discomfort getting out of a chair and tight places.  I don't think I'm bone on bone, but I limp frequently. The pain isn't awful, I wouldn't be able to sleep after playing squash however.
Am I ready.....??
Thanks much.
Mike
Rochester, NY

[kimberly52]

Hi Mike,

Funny you should ask.  I had asked the same question over and over and looked to everyone to give me that answer.  I learned that no one can make that call except you.

My hip just became progressively worse over the years and ended up in January '12 with a hip arthroscopy and found the labrum was irrepairable and there was cartlidge damage and arthritis.  Dr. Clarke said that he will give me 5 years at most before a resurface or THR is needed, my pick. 

I continued to live on ibuprophen and a few cortisone injections to delay anymore surgery.  It was moot and my activities continued to deteriorate from a very active long distance runner, hiker, and biker, to a pretty sedentary life where just walking to my office each day was a challenge.

What had resonated with me was hearing people say that when it gets to the point that it is impacting your normal activities, then it will be the right time.

I see that you live in Rochester.  Not sure if you have had a second opinion but Dr. Clarke here in Syracuse is an excellent surgeon with over 8 years experience with resurfacing.  Not sure who out your way is experienced in this area.

By the way, I was living on a nightly dose of Vicodin prior to surgery just so I could sleep. 

My best to you and please post your progress through this.

Kim

[MikeF]

Hi Kimberly.......thanks for the response. I've been reading your posts and hope you progress rapidly and get back to 'living'.
I grew up in Syracuse so I did contact Dr. Clarke last week for a chat. Our hip gunner up here is Dr. Chris Drinkwater and Dr. Clarke spoke well of him.
My situation isn't as bad as yours became but I'm wondering if I'd have better recovery if I did it soon.  I'm working out only on elliptical machines and besides being boring, I'm starting to feel some discomfort with that as well. I've had considerable deep muscle therapy and stretching for all the symptoms but you find yourself doing that stuff all the time.

Thanks again for the response....I'll keep reading posts here. Great education!

Mike

[Tin Soldier]

From the average joe hip guy, like me, I'd say you are ready.  I'd say you may have been ready awhile ago.  I believe, from a really experienced surgeon's perspective,  they'd say the same thing.  You should ask your surgeon what they think.   

I was in a similar position, able to walk and run, but had pain, mostly a nagging pain and always there, but only moderate reduction in acitvity.  I didn't like the idea of taking any meds in order to put off the inevitable and I was getting tired of having constant pain.

Good luck

 
 

[packman]

Mike - Your hip surgeon's review of your xrays vs. your pain / discomfort levels are the inputs to your decision. As a squash player, I will assume your pain thresholds were quite high like mine but then I got the bone on bone jolts fairly quickly after another ortho talked me into a cortisone shot (lasted 5 weeks but just masked the pain).
After reading here, osteo arthritis or your hip joint failure can radiate pain in a number of areas (for me it was the knee and a dull constant ache) and I read for many that it is the back. To me it definitely sounds like you are ready and I trust the backlog in the NY area is nowhere near the "north of the Border" backlog.
I was limping and not even knowing I was limping until my friends asked why was I limping, but that did not throw me over the edge. What threw me was the lack of activity, gaining weight from being inactive, the pain elements, and some mental uncertainty on "am I making the right call"
I am at week 3 1/2 from my surgery and am totally happy with the decision. The hard part is the patience to "rein" me back as I feel great on the road to a slow easy does it recovery. Returning to squash wil be a patience test for you too as that involves a lot of weight transfer which similar to running, most surgeons advise to wait fror 6 months.
Good luck in your decision.

[Kiwi]

Hi Mike

This a question a lot of us ask and my very first post here was similar. The fact you're asking, I'd say you're not far away at all. Keep in mind that if you leave it too long, resurfacing can actually no longer be an option. I think it's due to the deterioration of the bone quality.

As a fellow squash player, with a high threshold for pain, I'd give you this advice based on my experience. Don't leave it as long as I did. I waited & tolerated pain way too long. Although I was playing squash up until 3 weeks prior to my BHR, I was taking diclofenac & codeine so I could play. I would sometimes pay for days after, also impacting my sleep so was taking sleeping aids to boot. All these meds had there own side effects.

Long story short (if you want the long, refer under hip resurfacing stories), I am back playing squash now & have been since 11 months post op. I take no meds & enjoy an active pain free life. Although I did just blow my calf again on the court!

Your comment about having the op earlier Vs later so your recovery will be better, is an accurate one. The stronger & fitter you are going into the surgery better. Do strengthening exercises as much as can on you bad side prior to the op, incl core exercises. Also work on upper body as this will carry you around for first few weeks whilst on crutches.  It'll give you a good head start post op.

I think part of my delay was because I was only in my early forties. I found it hard to swallow having a hip op at this age, but I have no regrets at all. If/when my other hip needs doing, there's no way I'm going to wait as long.

Good luck & keep us posted on your decision. Make sure you get an experienced surgeon too, i.e. at least 500+ resurfacings under his belt.

Cherz
Simon

[K2]

Wow, this question is irresistible to hippies. It is like catnip.

I am a very active 58 year old male who also found out in 2007 that I would ultimately need hip replacement. I finally went ahead and had bilateral hip resurfacing in February of this year. Before having the surgery, I, like many others, had my ups and downs, took painkillers with increasing regularity in ever greater amounts all the while having philosophical discussions with myself  about why I should wait another year or five. 

The thing that finally pushed me over the edge was the restriction in my ability to participate in my life. It was sitting at home instead of going skiing.  In the end it was that simple. After 6 years of delaying the inevitable, I called and made an appointment with the best surgeon in the world and a month later had the surgery. I am now 2 months post op and my only regret is that I didn't have the surgery 2 months earlier so that my rehab would permit sports this summer.

You ask if you are a candidate right now and I think you are really asking if this is the time.  As everyone else is saying,  only you can make that decision but from the sound of where you are at now, once you do it, I bet you'll end up wondering why you waited so long.

[Woodstock Hippy]

Mike, as you can see, you get a lot of good advice here.  But only you can decide when you are ready.  My first hip doctor at Special Surgery said I wasn't ready yet because I could walk but wanted to run but by the time Dr Marwin did my surgery three months later I was in serious pain walking and when I had to go to my shoulder doc at Special Surgery the day before my hip surgeries I didn't know which was worse; walking or standing on the subway.

I say it's better to get it done sooner than later.  Why suffer waiting for it to get bad enough when you can have it done and get back to your active life.

Good luck with your decision

[hernanu]

Mike, it is completely up to you, as Woodstock advices. Only you can decide the right time.

One thing that is common, though is that after the fact, many of us wish we had done it earlier. The relief is immediate from that OA pain and the recovery is hopefully good and strong.

It is not easy, but worthwhile.

Good luck, it's good that you're asking the question; the way I see it,  you don't get extra points for suffering. I would do it sooner rather than later.

[MikeF]

I can't thank everybody enough for the thoughtful responses. I just had to know what you were all experiencing and compare. Right now, I'm only hedging because I haven't pushed myself in weeks so I haven't had any sleepless nights lately.  But when I limp on my way to get coffee here at the Med Center I feel desperate......honestly, I can't remember when this didn't hurt.

[Tin Soldier]

I think you can sort of grow used to it.  I did for a year or so, I just assumed that this was how we grow old, we walk around in pain all the time. 

There were some obvious factors that told me I was ready, many of which are posted here by lots of folks.  I think one of the keys to this question is to look at how OA is affecting you and your life, more than just today or right now, think about the last few years and the next few years.  It's not going to get better on it's own, actually it will likely get worse and sometimes rather quickly, as Kiwi pointed out.  I wasn't willing to not be able to ride the bike with the kids down to the river to swim, I wasn't willing to not be able to climb a tree, I wasn't willing to not be able to get into a picnic table, I was tired of having the nagging pain simply when I walked,...the list goes on.  I didn't want to give those up for a 5 or 10 year period until I got HR.  That would be too much life to miss.  These are the types of issues that helped me decide.

Good luck.

[Dee Dee]

Impact on daily living did it for me. I am not an athlete, but I like to garden and work in the yard.  When I started avoiding the grocery store and other shopping trips, that showed me I needed to do something.  When I actually asked for pain meds on a fairly regular basis, I knew I was ready to find a better solution.  When $-x became too painful it was time.

Hope you get a peace to make this serious, but life changing decision. 

Dee

[keepmovin]

Hi Mike,

You are exactly in the same position I am.  It's been two years since I have visited this site but it helped me tremendously when I went through my first resurfacing.  My first was pretty straight forward - bone on bone, left hip and it had to get done.  I was told my right hip would go eventually, but I was a few years out.  All was well until December of 2012 when I spent too long in NYC with family doing the holiday tour - the next day my right side was in pain.  Not only was the right hip hurting but my back, my left leg (not the hip though) and right knee.  I spent the next few months with many Dr.'s for back and hip and the long story is my right hip still has sufficient cartilage but I have a labrum tear and cysts that I'm told is not worth operating on.  I simply need a hip replacement.  I have a condition called hip dysplasia that caused me no concerns until I turned 52.  I have been to Five Dr.'s in an attempt to get to where i am today which has soured me to the medical profession.  Finally, I was given a hip injection that has given me temporary relieve but I know it will wear off soon.  I am working with a highly experienced Dr. in NYC who did my left hip, Dr. Su.  He did an excellent job and everything is perfect on my left hip.  I think he's holding off on my right hip because I'm not bone on bone yet but my quality of life has deteriorated.  Bottom line - it's not getting any better and it will never so why do we wait?  If there is nothing more you can do, as it is true for me, then get it done now and begin working on regaining quality of life.  Life is too short to spend in needless pain.  Good luck to you and hopefully, I'm right behind you!

[MikeF]

Keepmovin,
No kidding?? Thanks for the response, and yes we are in the same place.  I know I'm not bone on bone yet. At least I wasn't in January.  It's bizarre because I want this joint to get worse in a hurry. My life has changed considerably and I'm pretty restless about it.  My back, right calf, groin muscle.....all 'hot' right now.  The hip itself is all over the place-worse some days than others. I'm never walking correctly.
I'm hesitant to go back to my specialist because I don't want to be turned away again.
The stories I'm hearing about everybody's recovery is very motivating.  The recovery is pretty long, that's why I want to get going with this.
Mike

[keepmovin]

I'm not clear on the medical thought waiting till the x-rays show bone on bone to get the all clear to have the surgery.  I do feel you are your own best advocate as to when the surgery should be done.  I feel the same way about my joint - hurry up and get worse!  Unless you are given an alternative to improve your condition, you should push to get the inevitable done.  The pain just gets worse, not better.  I hope to talk my Dr. into surgery the beginning of the summer because this fall I have things I want to do and be a part of that I don't want to miss.  Mentally and physically, I would recover better now then if I had to wait. Yes, recovery can take a while but at least you know you're on the road to recovery - it's a nice feeling!

[kimberly52]

I agree with Keepmovin.  I also would suggest another opinion if your doc is telling you to wait and you have reservations about that.  I know that I have already weighed in but wanted to add a bit more.

I hear a lot of this bone on bone thing being discussed in different threads and that is one thing that my surgeon never brought up and I believe because it was sort of moot for him. 

The reason being is that when I asked him when I should have this done, his response was that it was up to me and this bone on bone criteria never entered any of our conversations.   He basically said that I would know and would let him know when it was time.  My next question to him was that I don't know how to tell whether it is the right time and how do other patients know.  He responded that some of his patients do it when there is discomfort after a day on the golf course, and other patients push it until the last moment when they are nearly in a wheel chair.

This put all of the decision with me.  Then when the hip became the elephant in the room and totally controlled mine and my husband's once active life, I scheduled.  We will be hitting the road for our retirement travels in the fall so this was done on our terms in order for a full recovery before we hit the road in October.

There are so many great surgeons out there and if this has taken control of your life and your doc wants you to wait, then possibly you may want to consider a second opnion.

Kim

[chuckm]

Mike, go get resurfaced by an experienced surgeon.

I was in the same situation as you, but younger 46- pain for several years. My local hip surgeon had me on pain meds then cortisone injection. But when I returned again that's when he said that's it...just wait until you can't take the pain anymore. I asked him if he could resurface my hip and he told me no and that I really shouldn't get my hip replaced or resurfaced.

I went to NYC to the Hospital for Special Surgery to get my left hip resurfaced this past November. It's now April and I am playing soccer again.

I can now say that a hip surgeon who recommends to endure pain longer before getting resurfaced is not providing proper care to his or her patient.

Chuckm

[chuckm]

Posting back to back here but I just found this quotation from Mr. McMinn's website:

When is the right time to stop waiting and have surgery?

Hip Resurfacing is an operation for pain, discomfort, soreness or stiffness arising from advanced arthritis of the hip, especially if the symptoms are seriously affecting your quality of life. In the absence of severe changes in your hip, other measures should be tried. However, once advanced changes develop, there is no merit in continuing to put up with it, especially if you are being forced to take anti-inflammatory medication regularly to keep the symptoms at bay.

It should also be noted that the typical patient is not in continuous pain or ache from the hip day in and day out. Most patients complain that their discomfort is related to activity. As long as they refrain themselves from
 being active, they are comfortable. Participating in simple activities, which they had enjoyed all their lives, now seem to flare up their symptoms and make them suffer later that day or the following day.

Taking long-term anti inflammatory medication or aspirin tends to damage bone quality of the femoral head (ball part of the ball and socket hip joint) making it impossible to perform a successful hip resurfacing. In addition, these medications tend to make you bleed more at operation and cause more bruising and internal bleeding after the operation, thereby hampering your recovery and rehabilitation greatly.

Chuckm

[MikeF]

Chuck,
Thanks for sharing. So, you're playing soccer six months out??  I like that story. There's a HR patient here at my health club who plays lacrosse twice a week. I'd say he's late 30's early 40's in age. He is telling me to go push my specialist to have it done now. The MD who did his HR is the same guy who would do mine. 
I'm actually going to get on a squash court Friday night. My guess is I'll be on the phone Monday morning making an appointment.

Kimberly, I'll keep Dr. Clarke in my back pocket. Thanks for your input.

Chuck while I was replying, your new (McMinn) post just popped up THANKS!!! Very appropriate.

Mike

[kimberly52]

That McMinn post nails it.  Wish I would have seen that months ago, it would have eliminated a lot of vacillation for me in making the decision.

Best of luck to you Mike and please update your status.  I am very interested to see how you pursue this and get to your pain free life.

Kim