Nerves! Just a few days to go...

[ricol]

Hi everyone,
I'm set for my resurfacing surgery with Dr. Su this week. I feel confident that I've made the right decision, but I suppose I'm having some inevitable nerves as the day approaches. My thought process is below. I hope my logic appears sound, and if not, please be gentle

This has all been a shock to me, since I was diagnosed with severe hip OA at age 42 in May 2018, after 9 months of twice-weekly physical therapy for hip and gluteus pain/stiffness. The arthroscopic surgeon I saw at that time told me I was not a candidate for arthroscopy and needed a hip replacement. That was quite a shock!

So, about 3 months to the day after the diagnosis, I'm going ahead with surgery. That seems fast compared to some of the stories I've read on this site, which had caused me to wonder if I was rushing. The following is why I have decided to go ahead now: I know my functional ability with the current state of my hip is way below what I need/want for these next years of my life (e.g. I was hobbling for a week after carrying my 35lb, 3.5yo daughter on my shoulders for 15 yards; I was waking from sleep for a week after riding a stationary bike for 30 mins; running? haven't done that in almost 18 months). My ambient pain is bearable, but I am really not able to do anything except go to work and back. Driving has become painful as well. I did not see the wisdom in trying to squeeze out a few more years before having surgery with an activity level that is not really recognizable to me even compared to only 2-3 years ago - I know I won't make it to 50 or beyond without some type of procedure, so I asked myself what really is the difference between having surgery at 42 or 44 or 46? In any case, I'd still be a “young person” in the context of joint replacement. The cost of delaying surgery seemed higher than the cost of going ahead.

I've been able to access expert orthopedics care very quickly, including opinions with Dr. Su at HSS and Dr. Brooks in Cleveland, as well as Dr. Kwon at MGH in Boston. Dr. Kwon only does THR, not HRA, and was quoted in one of the negative articles by Barry Meier in the NY Times. Even Dr. Kwon, who at least from the context of the Times article, is framed as a critic of HRA, was not discouraging of a resurfacing in my case, an active male of average to above average size, (5'11", 180lbs). Dr. Kwon did say he thought I would do well with a THR as well, and that he places no restrictions on functioning for his THR patients (because he says he knows they'll do it anyway!), but rather leaves them with the guidance that the harder they are on the joint, the sooner it will wear out.

Ultimately, I decided on HRA for these reasons: 1) bone preservation, in anticipation of future revision and also for the bone-preserving aspects of maintaining the original load-bearing structure of the femur; 2) greater confidence that it will not dislocate, which I believe, psychologically speaking, will allow me to continue to "act my age," whereas with a THR I might hold off doing something spontaneous and silly with my kids - to say nothing of continuing to ski aggressively in a way that is recognizable to me. I have been reassured about the risks of metal-on-metal by virtue of having a highly experienced surgeon in Dr. Su, my size, and the long-term follow-up studies of cancer risk (e.g. Visuri et al., 2006) that found no elevated risk vs the rest of the population. In the end, I was more comfortable with the balance of risks and benefits for HRA for someone my age, than the risk and benefits of a minimally invasive THR - which does not cause release of metal ions (although it does cause the release of plastic and ceramic ions), but which leaves less bone for revisions, and involves the prospect of osteolysis by time of revision, and of course dislocation.

Anyway, there it is.

I'll be drawing good vibes from you all, and will be sure to let you know how things go! Praying for a good recovery, with as little discomfort as possible.

 

[blinky]

At your age and with a young child, with the limitations on activity you have described, the time to act is now. Some of us waited too long to pull the trigger.


Best of luck to you.

[moe]

You will be fine. Dr Su trained my surgeon and it's been 9 years of non stop activity. Road cycling, mountain biking, weight training, hiking. No issues whatsoever. I was 56 at the time of surgery, both hips, same day. Take it slow and easy during recovery and let the body heal at it's own rate for good long term results.


moe

[hernanu]

Closing in on eight years on both hips (August 24th and November).  It's probably the best thing I've done for myself outside of marrying my wife.

Dr Su. just did some work on a friend's daughter (she's about 32 ... I think). It was a very difficult case which had been carrying on since she was twenty. I suggested Dr. Su as a possibility, since she was tiny (5' 1" or so) and he would do right by her.

She is very pleased and recuperating.

You listed a whole lot of good thoughts about why you're doing this now. It's normal to be nervous, but my experience is that I was up on my feet in a few hours after the surgery, in pain from the surgery, but none of the other, identifiable and soul draining pain from the arthritis.

Now nothing is guaranteed, but the success rate with the best surgeons is very good. You will need to recover well, but I can tell you - both my recoveries went well and I hope for the best for you.

[catfriend]

Nerves are completely normal! Even though I needed and wanted the surgery I seriously thought about getting up and leaving the OR. It's terrifying, but so worth it.
You're not moving too fast at all. I was diagnosed with hip arthritis in July, had a cortisone shot in August (which was the best five weeks I'd had in years, and then it completely failed and I was even worse), sought out Dr. Pritchett and had my initial consultation on Christmas Eve followed by surgery January 19.
There is no point or benefit to waiting. Had I known that I had arthritis, and just how bad it was, I would have had my surgery sooner.

[Pat Walter]

I wish you the very best.  Just focus on your recovery and being out of pain.


Keep us posted when you can.


Pat

[Saf57]

Although it's only 3 months, I can tell from your post that you have carefully thought this through. You are making, in my opinion, the correct decision. Having some trepidation is entirely normal, you will be fine. I had my first resurfacing at age 45, and have never looked back. Best of luck to you!

[Quig]

I'll add to the chorus of encouragement... It's time and you're doing the right thing!


I had both hips done at the same time at 39 and it sounds like I'm built similarly at 6' and 185. I'm about 2.5 years post surgery and could not be happier with my hips.


None of us chose to **need** these types of surgeries especially at our younger ages but you've got to make the the best hand out of the cards you're dealt. I don't think any of us took the decision lightly and, as a general rule, we're EXTREMELY happy with the results and I'd certainly predict you will be too.


You're in great hands with Dr. Su. Good luck, and keep us posted!

[ricol]

Thank you everyone for your stories and your wishes! They've been a real help.


And Pat than you again for everything you've put in to this site. I could never have navigated this process as effectively as I feel I have.


More from post-op life!

[ArthriticHip]

Hi Ricol - I thought I would just share the cliff notes version of my recovery. You and I have fairly similar stories. I'm 45, of roughly the same height and weight. I dealt with hip pain for around 5 years leading up to my surgery. I had my left hip resurfaced with Dr Books of the Cleveland Clinic on 2/26/18, so I'm at my 6 month mark. I couldn't be happier with the recovery to date. Completely out of pain. Most of the time I don't even think about my hip because it feels like a "normal" hip. I remember the anxiety leading up to my surgery and I'm so glad to be on the other side. One thing that really helped me mentally in the early days of my recovery is that pre-op I knew that every day that went by my hip was getting worse. Post-op every day that goes by I know my hip is getting better. You've selected a world class surgeon so you're in wonderful hands.

Best of luck.

[Granton]

I was a bit older than you (51) when I got my first BHR. My thinking was pretty much the same - especially about acting your age. I did not want to constantly worry about wearing it out. With me it was tennis and still is.


My big nerves hit the night before surgery. I seriously considered getting out of my hospital bed and going home (it's not THAT bad is it?).


Glad I didn't. That was nearly nineteen years ago and it has been perfect. Get it done!