Is It Time?

[Jonathan]

Hello I am a newcomer to this site and have spent a fair amount of time looking though many of your posts and found them inspiring. 
I am trying to figure out what to do.I will try to be brief: 4 Years ago my OS told me I have OA in my left hip. I am a 45, 6'4, 235 lbs and have spent most of my life in unremarkable shape. Approximately 8 years ago i decided to do something about it and was very succesful especially my cardio fitness. Everything was fine until I suddenly had an odd left groin and buttock pain...any way you all know the drill months of this and that test, medications, back injections. The OS had a look at my hip xray and decided there was notable wear but not too bad, an MRI found a small acetabular labral tear but that specialist said it did not warrant surgery. The Xrays didnt get noticeably worse over two years and last year the OS commented "Your symtoms present themselves atypically" What I really wanted him to say was its time for a BHR. He seems to have reservations about my symptoms and Xray but he admits is a "blunt tool"
I only get temporary relief by stretching the left leg or after a good nights sleep.
I am out of shape and cant find any exercise that doesnt hurt like hell a few hours later, I cannot sit in a chair especially a hard one for more than 20 minutes wihout the same buttock groin pain. I have been on Anti inflammatory medicines on and off for 4 years and now full time. I have level 3-5 pain all the time and Only a few times have I ever had to stop in mid stride from that stabbing pain (thank goodness) otherwise i dont limp at all unless I have really over done or sat too long. I have to stand mostly at my desk, I can no longer sleep on my left side. I know my condition is not nearly as bad as some of the other contributors to this site but my discomfort is constant and limits my ability to get healthy.
I would be interested to hear if anyone else is or was with the same symtoms and whether or not there is any wisdom to getting worse before i push for a BHR. By the way I looked at the clips of the BHR on Youtube, I can see its not a decision to take lightly. Also we are fortuante to have Roanan Treacy who i gather was a pioneer of BHR visit our country (Bermuda) twice a year to perform the BHR but in typical english health care fashion they dont seem to encourage group discussion like this.

thanks

Jonathan

[Pat Walter]

Hi Jonathan

Welcome to Hip Talk. 

It sounds like you are pretty limited now with hip pain.  Anyone that can't sit at their desk to work definitely has a problem.

Are you able to travel to the US or else where for surgery?  I don't know about your health system.  I did not have insurance in the US and went to Dr. De Smet in Belgium to get my hip resurfacing.  Cost $18,000  and I put it on my credit cards.  It was well worth the investment to get my life back.

Some of the overseas doctors and the more expeirnced US surgeons will give you a free consultation via email if you send them your x-rays in a digital format as  .jpg    I took photos of my x-rays with a digital camera.

Anyone that has pain all the time on a 3-5 level definitely has a problem.

I would encourage you to find an experienced hip resurfacing surgeon and get their opinion.  Mr. Traecy is an excellent and very experienced surgeon.  I know people from the US that traveled to the UK to have their surgeries with him.

45 years old is quite young to be in such pain and having so many problems.  I would encourage you to get a hip resurfacing so you can get back into life without pain meds.

Pat

[obxpelican]

Jonathan,


Only YOU can be your best patient advocate for yourself.... listen to what Pat says get other opinions.  Don't spend your life in pain, I waited much too long, I was bone on bone end stage and my surgeon's ass't told me she did not know I was able to walk in the condition I was in.... I was too stubborn to realize how bad I was. 

Things that you want to consider, if your hip starts getting bad quickly do you have a job that will allow you to be flexible and if you got real bad do you have a job that will allow you to work from at home.  It sounds like you are already having trouble now.

Take some time and read the stories on this site, it's amazing how many people you will read about where the surgery changed their lives back to being active again.  I missed too many trips to the amusement park, too many times fishing and golfing and too much time with my daughter doing fun things.

I wish you lots of luck.


Chuck

[Jonathan]

Thank you Pat and Chuck,
I am very fortunate to have good insurance. Our local hospital in Bermuda is...ok Great Surgical suites and of course Mr Treacy comes twice a year, however i am not so confidant with the ward care in the hospital or post op physio. I am certainly prepared to travel to England or Boston to get the best solution.

Chuck you raised a good point if I wasnt an executive in my own company I might have serious employment challanges...thought provoking and as I am learning more and more this life is no dress rehersal.

I guess my problem is the Local OS doubt on a BHR solution for me (he is Treacy's partner here) and my own doubt as a result. I will see the local OS next week first time in 9 months, I will ask him for a more detailed descritpion of the pathology as he sees it. I have learned a lot on this site and now have many questions for him.

Jonathan

[Pat Walter]

Hi Johathan

Since you might be able to travel if necessary, I would suggest sending an email with your x-rays digitally attached to some of the best doctors in the world.  I have them listed on my Doctors List and most will talk to you via email or even phone after they have seen your x-rays.

The most experienced US surgeons are:  Dr. Gross of SC,  Dr. Mont of MD, Dr. Su of NY and a few others if you look at my list.

Dr. Bose of India is one of the best in the world and Dr. De Smet of Belgium has done over 3000 resurfacings.

All of these doctors will answer your emails and give you their opinions.  It is really good to get a lot of input when you have advanced problems in your hips.

Check out my list for the doctors addresses and emails  http://www.surfacehippy.info/listofdoctors.php

Stay in touch.  I hope you can find a good solution for your hip pain.

Pat

[John C]

I have no medical background, other than my own adventures. It sounds as though the confusion for you centers around the amount of pain, which does not align with the x-ray evidence. You might ask your doctor about having a pain killer injected into the hip. If the pain goes away, you know that your hip is the problem; if not, you know that you need to look elsewhere. It would be a fairly easy way to feel more comfortable with your next step. Remember that I have no medical background, but I have heard of this approach helping others whose symptoms are "atypical". Best of luck.

John

[graza]

Hi ya Johnathan,

I am a 37 year old freelance personal trainer and fitness junky! I put up with pain for too long because i was scared of the unknown. (The op, the rehab, time out of work, having to rely on people) and ya know what all of those things are serious factors to take into consideration. But i am 5 weeks post op after having a mid head resection and am now walking over a mile, still with a stick but with absolutely no pain. If i had the chance i would've had this operation years ago. It is tough at first but day by day you feel yourself getting stronger. 2 weeks and i loose the stick.

I can't get across how important it is to shed some weight and try and get fit and strong before the op it really will aid your recovery. I had severe dysplasia of the hip, had lost 1cm in height due to the ball sitting so high in the joint, the femoral head and acetablia was complete bone on bone and the constant pain was horrible. Yet i still managed to hit the gym 5 times a week, cycle 60Km and surf. It hurt like crazy but my aim was not only to prove this thing wasn't going to stop me doing the things i love but to improve the density of the bone and increase the strength of not only the muscles but the surrounding connective tissue as much as possible so that the stem would have a firmer foundation and therefore improve my chances of success. I would greatly advise you to get an GOOD personal trainer, who understands your condition and who isn't just going to beast you.

Mr. Treacy has worked with Mr. Mcminn and i have read a lot of very positive things about him. You said you would fly to England. I had mine done in Birmingham with Mr McMinn and can't praise the team enough, they were brilliant.
Put a search in here for Mcminn or Pat might be able to provide you with some useful links.

Cheers and good luck
Graza

[Jonathan]

Pat, John, Graza,
Thanks very much indeed for the helpful suggestions, my list of questions for the OS next week is getting longer , I am taking my wife with me as well so she can add her comments as to living with a grumpy man in pain and take notes.
John I belive the hip injection was tried and If I recall the most profound effect was it made me limp. I recall it felt odd even though there wasnt pain and I had not limped before or since unless i have over done it. Maybe worth another try.

Graza, your comments on pre op fitness struck a cord, I have thought about gritting my teeth and just getting back into the fitenss program, which is hard enough once you fall out of sync and even harder when you know it leads to more discomfort, but I am concerned as to my Cardio and overall fitensss and realise now it must be done and will no doubt improve post op recovery.

Thanks again for all your helpful input,
I will of course keep you posted

J

[blmjumper]

With a pending operation on Dec. 1...I've started really turning up the jets and getting back in shape over the last few months. Riding to work and PT during the day. However, my hip is starting to feel better and with that, I'm getting cold feet. I'm starting to think, "hey, it doesn't feel that bad. I can still run some, ride and maybe ski this season." So maybe I should put this off some more.

I don't know....just have lots of reservations of substituting metal parts for parts of me that don't dislocate, contribute metal ions, etc., etc., etc......

The bad days are bad, but there are fewer of them than earlier this year. I know the OA is getting worse and I'm full on bone on bone, but I'm also tough as nails and can take a LOT of pain. Coming from the life as a smokejumper, I still have that mentality that pain is the weakness leaking out.

Silly isn't it.

Thanks for letting me vent a bit. Just trying to come to grips with things.

[blmjumper]

Sorry...didn't mean to hijack the thread.

The exercise part just got me thinking.

As for pre-op fitness...when I did my original damage to my femur.  I was in absurdly good shape...6+hrs a day/6 days a week swimming, running, hiking, lifting and living at 10,000 ft. in Colorado.

Having so much muscle mass was entertaining for the surgeon, but good for me. I didn't lose too much strength during the recovery and had very strong bones from a life of impact. I'm taking this logic into the potential resurfacing this December. I guess it can't hurt (too much).

 

[TomBuell]

Hi Jonathan - Welcome to the site. I'm not a doctor, but I'd say the answer to your question is YES!
- Tom

[Pat Walter]

Hi Jonathan

It never hurts to be in the best physical shape possible before surgery.  It definitely helps to have your upper body strong since you will be on crutches and moving your body around with one rather unusable leg for awhile.  I was able to lift my operated leg up off the floor unto the bed a few days after surgery.  Ususally most people can't do that without some help.  We are all different in our recoveries.

The stronger your muscles, the easier it is for your body to componsate for a less than cooperative operated leg.

Besides, it gives you a goal to work for and something to do pre-op.  It never hurts to be in top physical shape.

Some doctors and patients say it helps them to recover faster.  I have never seen any studies on that yet.

Good Luck.

Pat