bilateral dysplasia, shortened and mismatched femoral necks

[bernsber]

Dev,

Double congrats!

I myself have a five and a half month old daughter. Those little girls knock you out man!

Right now I'm waiting to book a bilateral BHR. We've mostly narrowed it down to Dr. Bose, because I happen to be a very interesting case.

I have bilateral dysplasia, shortened and mismatched femoral necks(the left is a little shorter than the right due to a slipped epiphysis at age twelve), small femoral heads, cysts, and coxa vara to boot!

And I'm only 31.

Any other surface hippies out there hear of a case like mine that went well?

The reason I've chosen Dr Bose is I hear he is the master at getting things even, and will be able to do the best at making sure I end up with a BHR, and not a THR. I'm so far from wanting a THR, it's like from here to Mars.

My Mom, being a health professional, is very wary about me going out of the US for this. I still have a few questions myself, but have emailed them to Dr Bose.

The next battle is insurance. My insurance will only pay for an "emergency procedure" if I'm out of country. If I switch my plan I'll be able to go to India, but I can't switch until Jan 1st. I would really like to have this surgery this fall, and get back to strength before the snow flies.

And before my little girl gets walking.

Any thoughts?

Thanks!

[Pat Walter]

Hi

I gave your message it's own topic.  It is good to talk about special problems and the doctors that can help.

I forwarded your message to Vicky Marlow. She has been to Dr. Bose and knows a great deal about his special cases. She should be able to get back to your in a few days since she is busy right now with a test.

I believe Dr. Bose is one of the best in the world and is a wonderful choice.  If you can't get your insurance to agree to India, you might try Dr. De Smet of Belgium.  He has done over 3000 hip resurfacings and also does very difficult cases.  Many people have had their insurance pay for Dr. De Smet.  I went to him because I was an older woman at 61 with a loss of bone density and cysts.  He will do difficult cases sucessfully.

Have you thought about Dr. Gross of SC or Dr. Su of NY.  They are several of the very best in the US.  Gross has done over 1300 and Su over 500.  They will do difficult cases too.

It might be worth the wait to get your insurance company to pay, if possible.

Good Luck.

Pat

[bernsber]

Thanks Pat!

I realized this morning that I had accidently hijacked the subject on the other thread. I logged on to change my post to a new thread, but you beat me to it.

Vicky is the one who helped me find Dr Bose.  She emailed my xrays to Drs Bose, Su and Desmet. All three replied, and Vicky and I agreed that Dr Bose was my best option. Desmet seemed to suggest that it would be very difficult to get the biomechanics right with a BHR, so he suggested that I may need a THR to do that.

I'm not going to pursue Dr Gross at the moment, because his implant of choice is not BHR.

As far as insurance, I'm with United Healthcare. For my particular plan, overseas work is only covered if I have an emergency while I'm travelling through a foreign country. I (briefly) thought about find a way for the Operating Doctor overseas to word my operation as an "emergency." Then I thought twice and realized that I could get in big trouble for insurance fraud. Plus, my conscience won't let me lie.

If I switch to an Health Savings Account, come January, then they will pay 60% of overseas work. We still haven't looked through all of the HSA paperwork to figure out if this is the best option for us. Right now I'm waiting on an email from Dr Bose to find out a few particulars.

Thanks again Pat!:)

[Pat Walter]

Hi

I wish you the best of luck.  Sorry I can't help more other than repeating Dr. Bose is one of the best in the world.

I just try to keep things organized so the group is easy to use.  People are interested in talking about hip resurfacing, not organizing.  I take that job on.  No problem.

Glad to have you hear and hope everything works out OK for you.

Pat

[bernsber]

Here is a link to a Myspace picture of my pelvis Xray(the pic is to bi to post here), and Dr Bose's response to my inquiry for diagnosis.

Thanks for sending the xrays of Benjamin.
This is a challenging condition. He has gross coxa vara . In addition he has acetabular dysplasia. The combination of this makes resurfacing very unlikely. However I would give it a try in view of his age if he was my patient especially on the right side . The cup side is also complex because of gross dysplasia.
He may require a dysplasia cup
The plan for him would be to do a BHR cup ( either standard or dysplasia). Then assess the femoral side. There is also femoro –acetabular mismatch. If possible to restore function with a resurfacing , I would go ahead. If not he needs a stem with a modular BHR head on the femoral side. There is no point in doing a resurfacing if it would not restore normal biomechanics of the hip.
I should thank you for all that you do…

With best regards
Vijay bose
chennai

http://viewmorepics.myspace.com/index.cfm?fuseaction=viewImage&friendID=39792669&albumID=1874220&imageID=34402429

[Pat Walter]

Hi

You might also want to send Dr. De SMet of Belgium an email and copy of your x-ray.  He does very difficult cases. Tell him you want a second opinon.  The doctors understand you are looking for solutions to difficult problems.

Normally both De Smet and Bose are very good about giving people their opinions about problems and solutions.

You might even want to add Dr. Gross, McMinn and/or Dr. Su to the opinions.  Tell them you are searching for the best solution and not all the doctors are in agreement at this point.

The one thing that is nice about Dr Bose is that he is now doing the BMHR, if that should be a possible solution.  I am not medically trained, so I would not know.

The more info you have - the better decision you can make.

Pat

[bernsber]

When Vicky sent Dr Bose my Xrays, she also sent them to Drs. Desmet and Su. I've got a reply from both of them already. Dr Bose sounds the most optimistic. I have sent him another email personally to get more info, will post when I get it.

I also sent another email to Dr. Su today. Being that I'm needing bilat, and Insurance is out at the moment for Dr. Bose, I want more info on Dr Su perspective. In the end I'm going to choose the best Doctor, no matter the money. Risking a bad operation is not worth saving 15 thousand.

Also, Dr Desmet gave me the least favorable review, out of all three.

[Pat Walter]

I am glad you are getting as much input as possible.  You will be able to feel better about your final decision when you make it -  knowing you left no stone unturned.  The difficult cases are not easy to deal.

I wish you the best of luck.  Let me know if I can help with any other info.

Pat

[graza]

Hello

Just read your posts and after seeing your x ray was very interested to know what course of action you have decided on ?

I have undergone a right BMHR with dysplasia cup9 days ago with Mr Mc Minn, my condition was very similar to yours, i had dysplasia, with shortened femoral neck and also thickening, together with femoral cysts and a discrepancy in leg lengths of approx 1cm.

If you have not yet undergone surgery and have any questions , please let me know.

I hope which ever course of action you take works out well for you.

Graza

[Pat Walter]

Hi Graza

Welcome to Hip Talk.

I am glad to hear you are doing well with your BHMR.

I wonder if you would consider posting a little more of your story under the Hip Stories section since you have a BMHR? Maybe you could title it a BMHR with Mr. McMinn so people would see it.

I have a handful of stories about people with BMHRs on the main website and would love to add yours after you recovered further.  It is a good option for some people and not many people know about it.  http://www.surfacehippy.info/hipstories.php#Mr._McMinn_Hip_Stories_

If people want to learn more about the BMHR, here are a handful of videos with Mr. McMinn explaining all about the hip device  http://www.surfacehippy.info/doctorinterviews/mcminnbmhrvideos.php

I hope you will keep in touch with us and let us know how your recovery is going.

I wish you the best of luck.

Pat