I looked through the section of the paper with the horoscopes in it this morning as I was heating up my oatmeal. It gives Libras five stars for March 31st. I'm not feeling it.
What I am feeling is anxious. That feeling of just having so much I should/could be doing that none of it is getting done because as soon as I look at one piece, I start thinking about another piece, and then I look at that piece. Rinse. Repeat.
I'm not nervous about the surgery (well, I'm not nervous about that right now). I'm nervous about all the logistical decisions I have to make, and all the information-gathering I have to do: What if I don't ask the exact right question of my insurance, and end up with a huge bill? What if I don't ask the exact right question of my insurance, and miss out on coverage I could have had? What if New York is less expensive than India? What if flying to and from India is awful? What if I miss my kids while I'm gone? What if I make a mistake??????
Also, my work is going through a huge systems change starting tomorrow. So I'm trying to clean up loose ends as best as I can in anticipation. So I can't even distract myself with work - I just have a bunch more 'what ifs' there.
Some days it's just really hard to be a grown up. I would not give those days five stars.
Thursday, March 31, 2011
Tuesday, March 29, 2011
You're thinking of going WHERE?!?
The top docs in the hip resurfacing community say my age and activity level are worth the effort of getting a resurfacing right on me. My shallow socket (hip dysplasia) is more of a concern than my bone density score - and the experienced doctors would be the most-skilled at getting the placement right, which is the reason for concern with dysplasia.
Besides, I believe this is really the best long-term option for my bone density - I'll be able to focus on keeping my bones strong through exercise with a hip joint that more closely resembles normal anatomy.
So I've started crunching preliminary numbers (they could use... something... paprika? salt? no...) and it's looking like I could see a top US surgeon and pay the out-of-network provider fees (assuming my insurance would cover out-of-network at all, since there are providers in-network that could do the surgery, even if they won't do the surgery) - OR I could fly to Chennai, India, be hospitalized at Apollo Specialty Hospital for 5 days, and then stay at a nearby hotel or resort for the next 8-9 days, and fly home for approximately 25-30% less than the out-of-pocket cost of any US surgeon.
That's a lot!
Listen, I would never have thought I'd be the girl who looks for "medical value travel." I am one of the last people I would expect to seriously consider this. But the more I learn about the doctors, the more I hear about others who have done this, the more I want one of these top docs.
And my gut says Chennai. So Ted and I are gathering information. I may change course, once again - acquiring information does that sometimes.
Besides, I believe this is really the best long-term option for my bone density - I'll be able to focus on keeping my bones strong through exercise with a hip joint that more closely resembles normal anatomy.
So I've started crunching preliminary numbers (they could use... something... paprika? salt? no...) and it's looking like I could see a top US surgeon and pay the out-of-network provider fees (assuming my insurance would cover out-of-network at all, since there are providers in-network that could do the surgery, even if they won't do the surgery) - OR I could fly to Chennai, India, be hospitalized at Apollo Specialty Hospital for 5 days, and then stay at a nearby hotel or resort for the next 8-9 days, and fly home for approximately 25-30% less than the out-of-pocket cost of any US surgeon.
That's a lot!
Listen, I would never have thought I'd be the girl who looks for "medical value travel." I am one of the last people I would expect to seriously consider this. But the more I learn about the doctors, the more I hear about others who have done this, the more I want one of these top docs.
And my gut says Chennai. So Ted and I are gathering information. I may change course, once again - acquiring information does that sometimes.
Saturday, March 26, 2011
I'm Your Density
Much like George McFly, my destiny is intertwined with my density. For me specifically, it's my bone density. Both surgeons have given me basically the same message: I am possibly a candidate for hip resurfacing. But I'd need to be prepared to wake up with a total hip replacement - it all depends on what they'd find when they got in there and got their hands on my femur - is it like a hardwood or a softwood? God forbid it's more like styrofoam, but Dr. Sparling says he's seen bones that porotic.
So on the drive home from Vancouver, my husband (that's Ted, for anyone who doesn't know) and I had a good talk, we Googled up a storm this morning looking at hip replacements, hip resurfacings, projected and actual outcomes and recommended activity restrictions. The longer I sat with it, the more I'd really like to try and get a resurfacing. In order to do that, I'll need to find a very skilled and experienced surgeon.
I would NOT have guessed that this is the route I'd be looking at. And frankly, even more surprising to me is that Ted is totally encouraging me to have my x-rays looked at by the top docs.
So, no plan yet. More information gathering to follow.
Wednesday, March 23, 2011
To Be Determined...
I called the surgeon up in Vancouver, and spoke with a medical assistant. My dexa score is not an automatic 'No Resurfacing' in their office, so I'm going for an appointment - and they got me in this Friday afternoon!! I'm pretty happy it's so quick, because I am having a TERRIBLE time not planning out all my options, and my head is sorta driving me crazy.
If after seeing me, my x-rays, and my dexa report, he says he'd be willing to do a resurfacing, I'm planning on signing right up. If he says no, I'm not a good candidate, ... well I don't have a plan yet.
I'm trying to stay balanced between advocating for what I want while not trying to force things. I can do either extreme fairly easily - either go balls out or just give up - so finding a reasonable middle ground may be a matter of noticing balance as the pendulum swings past.
Have I mentioned my hip is really hurting this week? It kinda is. I'm going to have to go the sensible shoe route for the next couple of days, and those who know me well know that's a sacrifice. I have pants I can't wear, because they're too long without heels; it affects my entire wardrobe! I'm only being partly facetious, I realize there are worse things. I just feel like whining.
Maybe in 48 hours there will be a plan. Maybe not. I will be ok, either way, even if I don't think so.
If after seeing me, my x-rays, and my dexa report, he says he'd be willing to do a resurfacing, I'm planning on signing right up. If he says no, I'm not a good candidate, ... well I don't have a plan yet.
I'm trying to stay balanced between advocating for what I want while not trying to force things. I can do either extreme fairly easily - either go balls out or just give up - so finding a reasonable middle ground may be a matter of noticing balance as the pendulum swings past.
Have I mentioned my hip is really hurting this week? It kinda is. I'm going to have to go the sensible shoe route for the next couple of days, and those who know me well know that's a sacrifice. I have pants I can't wear, because they're too long without heels; it affects my entire wardrobe! I'm only being partly facetious, I realize there are worse things. I just feel like whining.
Maybe in 48 hours there will be a plan. Maybe not. I will be ok, either way, even if I don't think so.
Tuesday, March 22, 2011
Visual Aid
This picture is from Patricia Walter's Suface Hippy site and I think it does a good job explaining the basic difference between a hip resurfacing and a hip replacement.
Check the difference in remaining femur between the two. Also check the size of the metal ball in the metal socket of each.
Surgeons and Hip Resurfacing
Well, I was going to make my next post about the importance of surgeon experience for this particular surgery, and now I have even more to say about it. With this post, I think I'm moving into present tense with this process, as opposed to the "hey, just so you know, I've been doing this hip thing" tense of my previous posts.
As I've mentioned, there is a very active online hip resurfacing community. These are patients who have had or are looking into this procedure, including some who have become patient advocates who run websites, discussion groups, attend conferences, and communicate directly with some of the most experienced and well-regarded surgeons. This community is made up of people who take a very active role in their own health care, educating themselves about not only the procedure but also the specific prostheses (which manufacturer's device?), surgical approaches (where and what will be cut?), etc.
Frankly I was pleased that there was a surgeon close to where I live that had done enough surgeries for me to feel comfortable that he was well past the learning curve. He said I was a candidate for resurfacing, and I was happy.
Then last Friday I got a call about the final tests I would need before my pre-op appointment. I'm having an EKG and some blood work done at my Physician Assistant's office this week, and I had a DEXA (bone density) scan done about six weeks ago. The surgeon's office had received the DEXA report, but it isn't in the format they typically see. They want me to re-do the DEXA scan at their office when I come up for the pre-op appointment in a couple of weeks, because if the T-score in the report is comparable to the T-score they typically see (and why wouldn't it be? it's a freakin' T-score), Dr. Boyd will likely not be able to perform a hip resurfacing.
In the format they typically receive, they see a T-score and a note. My T-score is -1.2, which, in their format, would usually be accompanied by the note "moderate to high risk of fracture". My report has no note. A quick Google search, gives me the following information:
So maybe my -1.2 isn't really that bad? Just a leeetle bit osteopenic? I mean, come on, "moderate to high risk of fracture?"
The irony here is that the reason my femur's bone density is in question is because the hip socket isn't deep enough (hip dysplasia) and the socket doesn't fully cover the ball of the femur. In a correctly formed hip joint, the weight-bearing of your hip causes the femur to strengthen itself by becoming more dense. (This is why weight-lifting is recommended as you age, so that your bones remain strong.) But since my joint is not quite right, the bone density is not being encouraged by the joint.
This is all my own description, and not necessarily medically accurate - I should probably mention that, huh? I'm doing my best, but please remember I have no medical degree or training.
Here's what I'm thinking - if Dr. Boyd will not do a resurfacing with the -1.2 T-score, then he's pretty conservative about choosing his resurfacing patients, which he has every right to be.... I think my next move will be to contact a surgeon in Vancouver WA and see if he would consider me. The Vancouver doctor has more resurfacing procedures under his belt, and is more highly regarded in the online resurfacing community. From what I can tell, the more a surgeon participates in ongoing conferences, etc. in the resurfacing doctors' world, the better. Boyd is not that participatory, which I sort of attributed to him being late in his career. But there are stories I've heard (some people call them 'bait and switch') of doctors saying they do resurfacing, but unless you're a super-easy case, they'll talk you into a Total Hip. Which is really just a more pessimistic view of a doctor being conservative about choosing his resurfacing patients.
One option, should Dr. Boyd not be willing to do the resurfacing, is for him to do a Total Hip Replacement using the "Stryker Rejuvenate Stem." Again from a quick Google search, this system better replicates the anatomy of a hip joint (bigger ball than old-school hip-replacements, more comparable to the size of your femur) which provides better stability, less chance of leg length discrepancy, blah blee bloo blah blah. I can't find much about this, other than press releases or info from the Stryker Orthopaedics website. Which, frankly, I put as much faith in as any commercial for any other product.
Of course, yet another option is to take $12,000 out of my 401k and fly to Chennai, India for two weeks to have one of the top surgeons in the world take on my case. I'm not kidding. I think the surgeon in Vancouver would be covered under my insurance (he's listed as a provider) but any other US surgeon that I would go to is not, and resurfacing would therefore cost in the ballpark of $40,000 for surgery and hospitalization. Surgery, hospitalization for 5 days, another 9 days at a resort in Chennai, and airfare would be only $12,000. And infection rates at Apollo Specialty Hospital are apparently better than your average US hospital. So says the well-informed hip resurfacing community, many of whom have chosen this option.
And now we arrive at the point where I whine, "I HAD EVERYTHING PLANNED! WHY ARE MY PLANS BEING DISRUPTED LESS THAN A MONTH BEFORE MY SURGERY!?" Seriously, I don't like this. Up until now it seemed like everything fell into place rather effortlessly, and frankly, I took it as a sign from the universe that I was doing the right thing. UNIVERSE, WHAT ARE YOU TRYING TO TELL ME??!!?
As I've mentioned, there is a very active online hip resurfacing community. These are patients who have had or are looking into this procedure, including some who have become patient advocates who run websites, discussion groups, attend conferences, and communicate directly with some of the most experienced and well-regarded surgeons. This community is made up of people who take a very active role in their own health care, educating themselves about not only the procedure but also the specific prostheses (which manufacturer's device?), surgical approaches (where and what will be cut?), etc.
Frankly I was pleased that there was a surgeon close to where I live that had done enough surgeries for me to feel comfortable that he was well past the learning curve. He said I was a candidate for resurfacing, and I was happy.
Then last Friday I got a call about the final tests I would need before my pre-op appointment. I'm having an EKG and some blood work done at my Physician Assistant's office this week, and I had a DEXA (bone density) scan done about six weeks ago. The surgeon's office had received the DEXA report, but it isn't in the format they typically see. They want me to re-do the DEXA scan at their office when I come up for the pre-op appointment in a couple of weeks, because if the T-score in the report is comparable to the T-score they typically see (and why wouldn't it be? it's a freakin' T-score), Dr. Boyd will likely not be able to perform a hip resurfacing.
In the format they typically receive, they see a T-score and a note. My T-score is -1.2, which, in their format, would usually be accompanied by the note "moderate to high risk of fracture". My report has no note. A quick Google search, gives me the following information:
A T-score compares your bone density to the optimal peak bone density for your gender. It is reported as number of standard deviations below the average. A T-score of greater than minus-1 is considered normal. A T-score of minus-1 to minus-2.5 is considered osteopenia, and a risk for developing osteoporosis. A T-score of less than minus-2.5 is diagnostic of osteoporosis. (http://orthopedics.about.com/cs/osteoporosis/a/bonedensitytest.htm)
So maybe my -1.2 isn't really that bad? Just a leeetle bit osteopenic? I mean, come on, "moderate to high risk of fracture?"
The irony here is that the reason my femur's bone density is in question is because the hip socket isn't deep enough (hip dysplasia) and the socket doesn't fully cover the ball of the femur. In a correctly formed hip joint, the weight-bearing of your hip causes the femur to strengthen itself by becoming more dense. (This is why weight-lifting is recommended as you age, so that your bones remain strong.) But since my joint is not quite right, the bone density is not being encouraged by the joint.
This is all my own description, and not necessarily medically accurate - I should probably mention that, huh? I'm doing my best, but please remember I have no medical degree or training.
Here's what I'm thinking - if Dr. Boyd will not do a resurfacing with the -1.2 T-score, then he's pretty conservative about choosing his resurfacing patients, which he has every right to be.... I think my next move will be to contact a surgeon in Vancouver WA and see if he would consider me. The Vancouver doctor has more resurfacing procedures under his belt, and is more highly regarded in the online resurfacing community. From what I can tell, the more a surgeon participates in ongoing conferences, etc. in the resurfacing doctors' world, the better. Boyd is not that participatory, which I sort of attributed to him being late in his career. But there are stories I've heard (some people call them 'bait and switch') of doctors saying they do resurfacing, but unless you're a super-easy case, they'll talk you into a Total Hip. Which is really just a more pessimistic view of a doctor being conservative about choosing his resurfacing patients.
One option, should Dr. Boyd not be willing to do the resurfacing, is for him to do a Total Hip Replacement using the "Stryker Rejuvenate Stem." Again from a quick Google search, this system better replicates the anatomy of a hip joint (bigger ball than old-school hip-replacements, more comparable to the size of your femur) which provides better stability, less chance of leg length discrepancy, blah blee bloo blah blah. I can't find much about this, other than press releases or info from the Stryker Orthopaedics website. Which, frankly, I put as much faith in as any commercial for any other product.
Of course, yet another option is to take $12,000 out of my 401k and fly to Chennai, India for two weeks to have one of the top surgeons in the world take on my case. I'm not kidding. I think the surgeon in Vancouver would be covered under my insurance (he's listed as a provider) but any other US surgeon that I would go to is not, and resurfacing would therefore cost in the ballpark of $40,000 for surgery and hospitalization. Surgery, hospitalization for 5 days, another 9 days at a resort in Chennai, and airfare would be only $12,000. And infection rates at Apollo Specialty Hospital are apparently better than your average US hospital. So says the well-informed hip resurfacing community, many of whom have chosen this option.
And now we arrive at the point where I whine, "I HAD EVERYTHING PLANNED! WHY ARE MY PLANS BEING DISRUPTED LESS THAN A MONTH BEFORE MY SURGERY!?" Seriously, I don't like this. Up until now it seemed like everything fell into place rather effortlessly, and frankly, I took it as a sign from the universe that I was doing the right thing. UNIVERSE, WHAT ARE YOU TRYING TO TELL ME??!!?
Tuesday, March 8, 2011
At Some Point, I Knew Something Was Wrong
I have this word document I wrote up before I saw my surgeon for the first time last summer. I tried to write down what sort of symptoms I was having and when they started and all that. I will log this information here for posterity!
I first started having/noticing hip problems when I was pregnant 13 years ago. My right hip would ‘catch’ painfully and just wouldn’t feel completely trustworthy sometimes. I attributed it to wonky pregnancy joint stuff. After I was done being pregnant, I still had symptoms so I saw a chiropractor. He did a couple of adjustments, thought it was likely some bursitis, and I seemed to improve.
I had my second pregnancy 9 years ago, and didn’t really notice the same hip problems. However, about 6 years ago I was having stiffness and pain again, so I went back to the same chiropractor I’d seen before. I had more adjustments then I’d had the first time, and wasn’t getting the results I’d gotten. I spoke with a friend who is a nurse practitioner, (and by ‘spoke with’ I mean ‘complained to over a couple of years’) and she encouraged me to have it looked at.
I had my right hip x-rayed at my general practitioner’s office about 4 years ago, and the diagnosis was “seems to have some arthritis” which the radiologist and my primary-care gal both thought was odd, given my age at the time of 37. She sent me for some physical therapy sessions, and the PT flat out told me she didn’t believe I had arthritis. I did some strengthening which I think helped my overall fitness level, but didn’t make a huge difference in the hip pain.
So after another couple of years complaining to my friend, she strongly suggested I see an actual orthopedist which I did about 17 months ago. He did more x-rays and confirmed the arthritis diagnosis, and noted that I had some dysplasia. The Dr. also asked me if I had injured myself jumping off of something as a child. I jumped out of swings as a kid, and I did jump off of my grandmother’s garage with my cousin, but we jumped on the side where the hill met the wall, and I don’t remember any injuries.
He said I should avoid high-impact activity, and that while I wasn’t a candidate then, I would likely be a candidate for a THR (Total Hip Replacement) in the future. I had heard of the resurfacing procedure and asked him about it, but he said that the studies he’d read said that the outcomes weren’t as good for women, but on the other hand, it may be that I’d be an ok candidate as I was pre-menopausal.
Since that time my right hip is almost always sore. When I stand up, I have to sort of ‘prepare’ myself to walk, and I limp some. I try to get cardio exercise on elliptical machines or in a Zumba aerobics class (Latin ballroom steps, low impact). I am achy if I get no exercise, but sometimes I am extra-achy after exercise.
Last summer I went on a trip with my best friend and my kids to Washington DC where I knew I’d be doing a lot of walking and standing in museums, etc. I carefully chose footwear, I tried to remember to sit down whenever I could. I took ibuprofen several times a day, and took pain meds a couple of nights, after having a hard time getting comfortable. Overall, I actually did better than I thought I would, pain-wise.
However, the pain has gotten worse in my day-to-day life. I take ibuprofen pretty much every day. I read other people’s stories about how they couldn’t sleep without pain meds, and I am not at that point. On the other hand, I always feel pain when I walk, my range of motion is not at all good, and I think about my hip all the time.
Last Halloween I over-did it at the gym (I thought I was taking it easy on a stationary bike, but I had the resistance too high) and I couldn't walk. I was stunned to have to sit home while everyone else went trick-or-treating.
So this is where I was when I decided I wanted to have the surgery. There was a bunch of additional surgery-related choices - mostly surgeon choice and timing - but I'll save those for another day.
I first started having/noticing hip problems when I was pregnant 13 years ago. My right hip would ‘catch’ painfully and just wouldn’t feel completely trustworthy sometimes. I attributed it to wonky pregnancy joint stuff. After I was done being pregnant, I still had symptoms so I saw a chiropractor. He did a couple of adjustments, thought it was likely some bursitis, and I seemed to improve.
I had my second pregnancy 9 years ago, and didn’t really notice the same hip problems. However, about 6 years ago I was having stiffness and pain again, so I went back to the same chiropractor I’d seen before. I had more adjustments then I’d had the first time, and wasn’t getting the results I’d gotten. I spoke with a friend who is a nurse practitioner, (and by ‘spoke with’ I mean ‘complained to over a couple of years’) and she encouraged me to have it looked at.
I had my right hip x-rayed at my general practitioner’s office about 4 years ago, and the diagnosis was “seems to have some arthritis” which the radiologist and my primary-care gal both thought was odd, given my age at the time of 37. She sent me for some physical therapy sessions, and the PT flat out told me she didn’t believe I had arthritis. I did some strengthening which I think helped my overall fitness level, but didn’t make a huge difference in the hip pain.
So after another couple of years complaining to my friend, she strongly suggested I see an actual orthopedist which I did about 17 months ago. He did more x-rays and confirmed the arthritis diagnosis, and noted that I had some dysplasia. The Dr. also asked me if I had injured myself jumping off of something as a child. I jumped out of swings as a kid, and I did jump off of my grandmother’s garage with my cousin, but we jumped on the side where the hill met the wall, and I don’t remember any injuries.
He said I should avoid high-impact activity, and that while I wasn’t a candidate then, I would likely be a candidate for a THR (Total Hip Replacement) in the future. I had heard of the resurfacing procedure and asked him about it, but he said that the studies he’d read said that the outcomes weren’t as good for women, but on the other hand, it may be that I’d be an ok candidate as I was pre-menopausal.
Since that time my right hip is almost always sore. When I stand up, I have to sort of ‘prepare’ myself to walk, and I limp some. I try to get cardio exercise on elliptical machines or in a Zumba aerobics class (Latin ballroom steps, low impact). I am achy if I get no exercise, but sometimes I am extra-achy after exercise.
Last summer I went on a trip with my best friend and my kids to Washington DC where I knew I’d be doing a lot of walking and standing in museums, etc. I carefully chose footwear, I tried to remember to sit down whenever I could. I took ibuprofen several times a day, and took pain meds a couple of nights, after having a hard time getting comfortable. Overall, I actually did better than I thought I would, pain-wise.
However, the pain has gotten worse in my day-to-day life. I take ibuprofen pretty much every day. I read other people’s stories about how they couldn’t sleep without pain meds, and I am not at that point. On the other hand, I always feel pain when I walk, my range of motion is not at all good, and I think about my hip all the time.
Last Halloween I over-did it at the gym (I thought I was taking it easy on a stationary bike, but I had the resistance too high) and I couldn't walk. I was stunned to have to sit home while everyone else went trick-or-treating.
So this is where I was when I decided I wanted to have the surgery. There was a bunch of additional surgery-related choices - mostly surgeon choice and timing - but I'll save those for another day.
Monday, March 7, 2011
So I'm Having Hip Resurfacing Surgery Soon
I'm scheduled for April 18, 2011 for Hip Resurfacing surgery with Dr. Harold Boyd in Salem, Oregon.
I've meant to start keeping a diary of sorts for some time now - to let my online peeps know what's up with me, to keep track of my progress and expectations about all of this, and just maybe inform someone else who might find this information helpful.
Wait, what are you having?
A hip resurfacing is like a hip replacement in that I'll end up with a new metal-on-metal joint, but it's different from a hip replacement in that I get to keep my femur. This procedure has been approved by the FDA for less than a decade, but there have been successful surgeons in other countries using the current technology for much longer.
The procedure is not well-known in the United States, which is another reason I wanted to post my experience online - I'd like to educate anyone I can that this option exists. There are several online communities that provide patient-to-patient information, which is how I learned about it.
Aren't you a little young for hip surgery?
Why, thank you, yes I am. I have been having worsening hip pain for over 12 years. At first I thought it was wonky pregnancy joints. But then I starting complaining about it when I hadn't been pregnant for some time. I had my first hip x-ray about five years ago and the diagnosis was "That's weird, it looks like you have some arthritis."
Two years ago, I thought well, if I have arthritis, maybe I'll go see a orthopedist who knows a thing or two about hips. There my diagnosis was confirmed, and I learned that the reason I had developed arthritis in my 30s was that my hip joint had not developed appropriately - I had mild dysplasia. Yes, if I was a German Shepherd I wouldn't have been allowed to breed. I'll wait here while you think up your own female dog joke....
The orthopedist I saw told me that I would eventually need a hip replacement, but as they only last "20 or 25 years" I should wait until I couldn't stand it any longer before I had it done. So that was really hopeful....
This procedure can help me act like a 42 year old, while I'm still 42. Rather than acting like a 65 year old, until I'm 65 and old enough for a total hip replacement.
And why aren't you having the surgery done by someone local?
It turns out that hip resurfacing is a bit more technical than a traditional hip replacement (this is not intuitive to me for some reason, but that's what the data show). The cup placement in the acetabulum (in the 'socket' of the pelvis) is very important for long-term wear of the implant.
Criteria for hip resurfacing is more limited that for total hip. For a while, they thought maybe women were not good candidates; but now they understand that as long as you have good bone size and density, you can be considered. Many women who would benefit from a new hip are post-menopausal, and therefore at higher risk for bone density issues. Younger, active people often make good candidates for hip resurfacing, since there is less risk of dislocation, better 'loading' of the hip (more like the natural joint), and fewer limitations in activity after surgery than a total hip replacement.
Anyway, there seems to be a noticeable learning curve with this procedure. Especially if you are not the 'perfect' patient, i.e., a large-boned male under age 65. So I hunted around these online communities and found Dr. Boyd, who has done over 700 of these procedures.
In case you're dying for more information, check out the following sites - they're chock full of detail.
Vicky Marlow's Hip Resurfacing Site
Patricia Walter's Surface Hippy Site
I've meant to start keeping a diary of sorts for some time now - to let my online peeps know what's up with me, to keep track of my progress and expectations about all of this, and just maybe inform someone else who might find this information helpful.
Wait, what are you having?
A hip resurfacing is like a hip replacement in that I'll end up with a new metal-on-metal joint, but it's different from a hip replacement in that I get to keep my femur. This procedure has been approved by the FDA for less than a decade, but there have been successful surgeons in other countries using the current technology for much longer.
The procedure is not well-known in the United States, which is another reason I wanted to post my experience online - I'd like to educate anyone I can that this option exists. There are several online communities that provide patient-to-patient information, which is how I learned about it.
Aren't you a little young for hip surgery?
Why, thank you, yes I am. I have been having worsening hip pain for over 12 years. At first I thought it was wonky pregnancy joints. But then I starting complaining about it when I hadn't been pregnant for some time. I had my first hip x-ray about five years ago and the diagnosis was "That's weird, it looks like you have some arthritis."
Two years ago, I thought well, if I have arthritis, maybe I'll go see a orthopedist who knows a thing or two about hips. There my diagnosis was confirmed, and I learned that the reason I had developed arthritis in my 30s was that my hip joint had not developed appropriately - I had mild dysplasia. Yes, if I was a German Shepherd I wouldn't have been allowed to breed. I'll wait here while you think up your own female dog joke....
The orthopedist I saw told me that I would eventually need a hip replacement, but as they only last "20 or 25 years" I should wait until I couldn't stand it any longer before I had it done. So that was really hopeful....
This procedure can help me act like a 42 year old, while I'm still 42. Rather than acting like a 65 year old, until I'm 65 and old enough for a total hip replacement.
And why aren't you having the surgery done by someone local?
It turns out that hip resurfacing is a bit more technical than a traditional hip replacement (this is not intuitive to me for some reason, but that's what the data show). The cup placement in the acetabulum (in the 'socket' of the pelvis) is very important for long-term wear of the implant.
Criteria for hip resurfacing is more limited that for total hip. For a while, they thought maybe women were not good candidates; but now they understand that as long as you have good bone size and density, you can be considered. Many women who would benefit from a new hip are post-menopausal, and therefore at higher risk for bone density issues. Younger, active people often make good candidates for hip resurfacing, since there is less risk of dislocation, better 'loading' of the hip (more like the natural joint), and fewer limitations in activity after surgery than a total hip replacement.
Anyway, there seems to be a noticeable learning curve with this procedure. Especially if you are not the 'perfect' patient, i.e., a large-boned male under age 65. So I hunted around these online communities and found Dr. Boyd, who has done over 700 of these procedures.
In case you're dying for more information, check out the following sites - they're chock full of detail.
Vicky Marlow's Hip Resurfacing Site
Patricia Walter's Surface Hippy Site
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