Help - Questions - Anxiety

[digidydawg]

Hey Matt, I feel your pain ........ or rather, I've felt your anxiety. I'm surprised no one has approached your dilemma from this angle but let me share my recent hip resurfacing experience with you. I'm 50 year old male. Skied hard since the age of 8. Bump skiing and off piste glade skiing are my faves and even done some heli skiing. I've also been kitesurfing for 13 years and don't think twice about going out in double overhead waves when people are shaking their heads on the beach at me. Race my Rotax Kart at 80 mph and fly a powered paraglider which is basically like sitting in a lawnchair at 2000'. No this post isn't supposed to be a tribute to me, just an indication that I don't scare easy.

To make a long story short, had my hip resurfaced 2 months ago and couldn't be happier with the way things went  ..... and the only reason I can say that is I had help from a little white pill known as Ativan. Months before my surgery I felt like I was going to have kittens and was always thinking about delaying it. It's funny what sets people off but I felt like I was out of control and would never get through it.  My business partner actually put it best when he said that he has to take pills every day and will for the rest of his life in order to keep his cholesterol down and if I had to rely on tranquilizers for a few months than so be it. It doesn't make you any less of a man, everyone has their cross to bear and this was mine.

Go see your GP, take the pill!! ............ don't worry, be happy:)
digidydawg

[Sandspinner]

Thats a great point made by whyme to prepare for November.  I started doing the PT and other general exercises 3 months before my surgery date.  Again best of luck.  Tony 

[HippyDogwood]

Thats a great point made by whyme to prepare for November.  I started doing the PT and other general exercises 3 months before my surgery date.  Again best of luck.  Tony

The irony is I started some hard workouts on a cross trainer in prepartion and thinking it would tip my hip over the edge so that i had to make a decision and so far it feels better for it. The cross trainer is not working against the FAI which gives me most flare ups and maybe it is the combination of losing some weight and adding some more muscle support that is helping, but not the outcome I was expecting.

[mmooney42]

HippyDogwood,

Are you currently scheduled for surgery?  Or have you put it off as your hip is feeling better?  Over the past several years, I've logged a lot of miles on my bike as well as in a pool.  They seem to help strengthen the hip and protect the arthritic area.  I am coming up on 10 years from my scope on my labrum.  Most people several years ago had mentioned that the hip arthoscopy wouldn't buy much time at all.  It's definitely running out on my hip now, but I have gotten 10 years out of it and I think the bile and swimming have helped... along with giving up road running.

[HippyDogwood]

HippyDogwood,

Are you currently scheduled for surgery? 

Not yet. I got the shock of my life when I got turned down for a scope 2 years and told by 3 consecutive surgeons that HR / THR was the only option "when it is time". They all gave me "up to" 2 years and here I am.

I'm an analytical kinda guy and whilst HR is statistically a good option, you cannot ignore it has issues, which unfortunately a number of members here have found. I really do need to get to the point where I don't feel that I have any options so that if things did go bad, I wouldn't regret doing something while I still felt I was coping OK.

I really thought working it harder (albeit low impact) would help it on its way, but so far it seems to be helping which is a bonus.

October would always be a good time for surgery in my schedule, so whilst these things are hard to plan, I tend to see my (HR) surgeon each August, get the x-rays updated and then form a view as to whether I am likely to get through the next 12 months.

The annoying thing is I still feel most flare ups are down to FAI and that a scope would buy time for developments such as ceramics to come through. I know most here would rather stick with "proven" metal on metal than be a guinea pig with ceramic, but I always did like sunflower seeds 

[chuckm]

Hey Hippydogwood, do you want to talk about the issues that resurfacing has? If you pick an experienced surgeon who uses a good device, I don't think there are any issues.

Chuckm

[Debcoco]

Hippydog,

I will be forever grateful to those "guinea pigs" who took the plunge to be the first to have their hips resurfaced in the US. Thirteen years ago, a coworker and her husband traveled to Duke University for him to have bilateral hip resurfacing which was deemed "experimental" at that time. It was a total success!  Fast forward to this past December.  I emailed her about my resurfacing surgery and she called right away. She told me that earlier in the day her husband had played racquetball for 4 hrs!

I'm on my 9th week and feeling pretty darn good myself:)

deb 

[HippyDogwood]

Hey Hippydogwood, do you want to talk about the issues that resurfacing has? If you pick an experienced surgeon who uses a good device, I don't think there are any issues.

Chuckm

Thanks Chuck

The issues are simply that you can get MOM ion posioning or find your body quite simply wont accept the implant and the cup loosens, no matter who the surgeon is. It's not that common, but if you follow this site regularly (I have sat here absorbing as much information as I can) the reality is there are a number of people here who have done all the right things, but unfortunately not got a great result and had a revision. Their posts have been both an education and salient reminder that this isn't a guaranteed succes story, you merely minimise risk by doing the right things, not eradicate it.

I have a great surgeon, but he recognises that certain elements are beyond his control, as no matter what testing he does or how skilled he is, a patient can still react to the introduction of a foreign body and  / or the ions - he doesn't pull any punches about the pros and cons which is great and comes at it from the perspective of holding off longer than other surgeons because although he gets as good results as virtually any surgeon in the world, he knows there are risks and this is classified as "choice surgery" - a painful hip is not life threatening. Its a pretty refreshing attitude for a guy who makes his $$$s as a specialist in this area. There is risk in any surgery for sure and in HR its pretty clear that MOM is the bugbear and at some point there will be a change of materials, albeit potentially a number of years off.

I think HR is a wonderful option for the right person (= ME  ) compared to THR. Its just that there are risks (most surgeons in the UK here have stopped offering HR here) and until I feel that I have to make a choice my position will be to hold off. I may well become one of the "wise owls" here who look back and say I wish I'd done it sooner. But that's not a problem to me as it means I will have been coping fine before. I don't want to be the guy who goes from coping (not ideal, but hey everyone has challenges in life) to a failed HR and revision in short succession, wishing I had never had the first surgery. Its not a big probability for sure, but there are members here that has happened to, so I cant close my mind to that being a possibility. Likewise, we all dread waking up to find HR was not possible and THR inserted - if you had no other options, then there's some consolation, but if you had a hip that was deemed unrepairable on Xrays but still felt like you had months / possibly years of use on "acceptable" pain terms then I'd be pretty dispaoointed about that.

Guess this is why the surgeon always says "you will know" - we all have different pain thresholds and ways of analysing these things. I can put up with a lot and want surgery when i am 100% mentally behind the decision which is not yet. I'm certainly not a worrier who cant make decisions or suffering any great anxiety here, I'm just cold, hard analytical on these things and I'm not holding the right cards for me to play yet - the mileage of others may vary, which is why this is such a wonderful and eclectic resource. It means the OP can receive a balanced response on a topic like this where he finds responses giving encouraging stories about life "the other side" and guys like me reassuring that we understand what he is going through and thats its not a black and white answer and sometimes holding off if you are not certain is OK.

Deb - a friend of mine was a guinea pig under professor Cobb 12 years ago and is doing great. He had a MOM scare this year, but is 57 and rightly forms the view that a THR would probably be nearly worn out now, so any extra years he gets from HR are a plus from this point onwards. Glad things are working out for you and my wife is volunteering me to be a guinea pig if we can find a surgeon that uses precious metals as a replacement for cobalt 

[hernanu]

Chuck, Mike,

Thanks for the advice and feedback.  I have met with Dr. Su twice.  Once 5+ years ago.  At the time, he told me to wait.  Saw him again this past November and he said I am definitely a candidate for resurfacing now.  I asked him about waiting another year, to get through another season, he said I can do it if I can take the pain, that the window wasn't closing.

My concern about waiting is getting to a point where I am in agony and am begging to get it done.  I should be seeing him this week for pre-surgical and will go over the options with him again at that time, such as cortisone, or just go forward with the procedure.

I live in Mass, on the RI line.  I went to a Doc in Boston as well several years ago, but after more research, was not comfortable with him.  I've also been to Dr. Clarke is Syracuse (My in-laws live around the corner from him and that would be good for my wife and kids during surgery).

Dr. Su is out of network for me, so I will probably have to pay lot. 

I've also thought about Dr. Marchand in RI, who trained under Dr Su.  It's close and in network which are both comforting.  I've also heard a lot of good things about him.  However, I know Dr. Su is supposed to be one of the best and I don't want to put a price on health.

I am trying to talk myself into doing it and what the benefits are, but the other half of me is trying to find every reason to try and delay until December.

Thanks for the feedback.  Much appreciated.

Matt

Hey Matt,

Just to more fully answer your question about Dr. Marchand.

One of our hippies had a bad outcome from his first HR, done in Boston. He needed a second and found Dr. Marchand.

I remembered this, so got a hold of him to ask him for some advice for you. Here's his response about Dr. Marchand, which he okayed to relay to you:

".....  Dr Marchand was a different story.  I never even think about my left hip done by him, it is unbelievable.  His manner is great, he expects you to have done your research and he welcomes any and all questions.  He is a "no bullshitter" and an all around nice guy.  As you can tell, I like him and would recommend him to anyone.  I was referred to him by someone on this site and I am forever greatful.  whoever is asking about him, go check him out.  You won't be disappointed.  Good Luck.  Rolls"

Hope this helps. I edited his response, since he was talking about his earlier (bad) HR, but if you want the name of that surgeon, just look at my signature.

[chuckm]

Hippydogwood, thanks for clearing that up. Your fear is that you might be one of those patients whose body cannot deal with the metal debris from hip resurfacing or you have hypersensitivity to the metal. You are correct that is a risk that a good surgeon can help control but not cannot completely eliminate. Just so the readers know it is a very small risk.

I like the approach you have and I think I had the similar feeling about when it was time. I simply waited until there was such a loss of function that it became obvious that even a total hip replacement would be a good choice in the event a resurfacing did not fit. But you also run the risk of allowing the arthritis to continue too long and ruin the bone stock needed for resurfacing. That was nearly the case with me.

And now that I have my resurfacing I have returned to activities I could not do with a total hip replacement - competitive soccer.

Chuckm

[moe]

Thanks Hern, when we didn't hear from Rolls anymore I knew it turned out well for him.

moe

[HippyDogwood]

I like the approach you have and I think I had the similar feeling about when it was time. I simply waited until there was such a loss of function that it became obvious that even a total hip replacement would be a good choice in the event a resurfacing did not fit. But you also run the risk of allowing the arthritis to continue too long and ruin the bone stock needed for resurfacing. That was nearly the case with me.

Chuckm

Thanks Chuck

I go to refresh my xrays and talk to the surgeon at least once a year albeit they are never a guarantee to totally reflect the deterioration. The whole piece is a calculated gamble, I'm just waiting to turn the right card over..........

[mmooney42]

Hernanu,
Thanks for the information on Dr. Marchand.  I dropped off updated xrays at his office today.  He wasn't available to see however as he was in the hospital all day I was told.  I do have an appointment with him on the 27th.  He has personally called me twice and sent me a couple text messages as well.  Seems like a great guy and I continue to learn that he is an excellent surgeon.  I only recently looked into him when I had my surgery scheduled down at HSS with Dr. Su.  Although I know Dr. Su is top notch, I'd feel much more comfortable staying close ot home for a number of reasons.  Once I called his office and told them about being a patient of Dr. Su's, I think he may have taken an interest in me, as he trained with/under him, prompting him to call.

I also spoke on the phone yesterday with one of his patients that had HR and is also a professional BMX rider and he highly recommended him as well.

Earlier I spoke with a PT in Middletown, RI that I know and she sees a lot of his patients.  She had nothing but great things to say about him and how his patients do and said she wouldn't hesitate to tell me if she had any reservations.

I am familiar with your Dr.  He was actually the first HR surgeon I saw, back in '08.  I eventually moved on as I continued to do my research, which led me down to Dr. Su and have also seen Dr. Clarke up in Syracuse as well.  Both excellent.

Thanks for passing on the information.

[moe]

Matt, the BMX riders surgery video is on the SoCo website. You may or may not want to watch it, if you know what I mean.  Moe

[cisco.leon]

Matt I did it. 2/14/14 had my left hip done Im 33 and had the same anxiety. But if you're with Dr Su.... DO IT. He said my hip was a mess. When I came to after surgery I asked: "was it bad in there as bad as it felt at times?" He said yes- no cartilage and a ton of none spurs.

2 weeks out I'm glad I did it. I'm younger than you, same anxiety, had great pain threshold. But even now as sore as I am, my joint feels already better no more sharp impingement. Can't describe how good that feels.

Best of luck. Dr Su is great.

[mmooney42]

cisco.leon,

I hope all is well.  You are just about 6 weeks post op now.  How are you feeling?  How is your recovery progressing?

I hope all is going well.

-Matt