The choices....single or double? Overwhelmed.

[Toddlermom]

oh my! Forgive my 'brain dump'. Maybe it is my lingering turkey food coma? I was aware that I needed a new hip at 42......However, I didn't expect the bilateral hip dysplasia diagnosis on Tuesday. Or the revelation that I will eventually need the other hip done too! (I knew it was catching, but I really thought I had 5-10 years rather than 2). I am completely overwhelmed by the sheer logistics of this. Keeping up with the activity level of my adorable little ones is completely wiping me out. I had hoped to last until summer, but I am now considering February. Just getting real with myself! I gotta get this fixed to be healthy for these wee ones.

I had a friend who did them both at the same time. In one moment, I think that is a better plan with a 2 and 4 year old. One deductible, one longer recovery period, and sorting out childcare assistance ONCE. And the next minute.....my brain says, what are you thinking?!?!? My mother is totally against this (she had THR done 2 years ago). However, my husband supports either decision. I have been staying at home with my kiddos, but I was hoping to go back to work in a year or so. And another hip replacement looming over me doesn't get me closer to that goal.

To add to my fluster, we need to pick our Marketplace insurance insurance in the next 2 weeks, and that will determine which doctors I can use. So I need to pick a surgeon quickly. (And of course my mother has an opinion about that too!). I am so thankful for more information, so I can make progress. However, this is a bunch to absorb since Tuesday + turkey day.

Here are my questions....
1. Anyone have any dysplasia specialists in Houston Texas? I have met with Dr. Kearns and I have a recommendation from a physical therapist friend of Dr Kreuzer.
2. I don't have to make the decision about 1 or 2 yet. Where can I find information about the differences in the recovery and complications? My dysplasia is moderate with a leg length difference already....so I will be starting over and teaching my muscles how to walk normally.
3. Does anyone know what activities I will need assistance with my kids, and approximately how long? My husband works from home, but he works 3 nights a week away from the house. My mom can stay for 2 weeks. But I am thinking that I am going to need some assistance (family, friends, babysitters) to complete the nightly bedtime routine for 4-6 weeks ....or more? I understand energy drain....lasts a while.

Thank you all for reading all this fluster! And any advice in planning would be greatly appreciated-

 

[Jaycey]

Hi @Toddlermom , so sorry you are getting flustered by your diagnosis. We have all shared that feeling.

If it were me I would have BTHR - for the exact reasons you suggest. One op, one recovery. We have many members who have been through BTHR and all came out with the same resolve - why did I wait so long?

There really isn't any difference between THR and BTHR recovery. You will be mobile very quickly post op. PT will teach you how to move about on your own. Depending on your surgeon, you may have restrictions.

Hard to say how long you will need help with your little ones. Lifting post THR is restricted so you will certainly need help with that. Bending and twisting may also be on your restriction list. Every surgeon is different so be sure and discuss this with your OS.

My mother is totally against this (she had THR done 2 years ago).

Every recovery is different. If your mother had a tough time that does not mean you will. And having had both hips replaced with about 4 years between the left and the right I can confirm the procedures have changed and methods for pain control have continued to advance.

I'll tag a few of our BTHR members so you can chat with them here about your concerns. @Hip Hip Hooray! @Suzette @AndyH99 @djklaugh @Michegon

Please keep us updated!

 

[Hip Hip Hooray!]

I had both of mine done at the same time. My surgeon recommended it, for the reasons you listed. I totally trust him, and it made sense to me. I don't have children, but I do have two large dogs. I put them in a kennel for five nights, and my dad came and helped me for a few days.

I think the main thing is to get the best surgeon you can. I paid cash to have Dr. Matta do mine. He charges $6,500. per hip. My insurance covered the rest. They will reimburse me for part of the surgeon's fees. He's considered out of network because he doesn't bill insurance. It was totally worth it. He is exceptional.

There's probably more pain with a bilateral, but I didn't know the difference. I made sure to put it writing that I wanted the pain medications on schedule, and that really helped. It was very manageable. I used the call button if the nurses were late, and I made sure to ice. The first three days are the worst. I was advised to stay ahead of the pain, which was crucial. It's very hard to catch up if you miss a dose of the meds.

I feel that the healing has been easier with the bilateral surgery, because I was able to rebuild the muscles at the same time. I used a walker, and went slowly. I'm very happy with the outcome. It was such a relief to wake up in recovery and know that both hips were done. I didn't feel a thing, and was asleep the entire time.

 

[djklaugh]

@Toddlermom I agree with Jaycey and Hip Hip Hooray - go for the BTHR and get it over and done with! The first six weeks or so will be awkward depending on what restrictions your OS gives you. As Jaycey said lifting and bending and twisting will probably be on the restriction list - and those (again depending on your OS) last for about 6-8 weeks. I was quite a bit older than you and had no kids at home when I had my BTHR - and I am thrilled with the results. In addition to what you said about reasons my OS also said that I'd be less likely to have a leg length differential problem with BTHR - and I'd regain normal gait faster too. With some careful planning I think you will be fine - and able to get back to usual activities fairly quickly. If you go over to the Recovery side you'll see some threads have tags in front of them - find a green Bilateral tag and if you click on that it will give you a list of all the Bilateral threads. Feel free to read any or all of those - or any other thread that takes your interest. Recently there were a couple of threads here on the pre op side from women like your self with young children at home - check those out too Best of luck to you - you have found the best place for great information and wonderful support. Keep us informed of your decisions and progress.

 

[Hipster Girl]

@Toddlermom I had mine done close together but not at the same time. My surgeon doesn't do bilaterals. If you have the option, I would do the bilateral and get it over with in one fell swoop. Best wishes whichever way you decide!

 

[copsham]

Hi @toddlermum,
I had one hip replaced, other did not need doing but if I needed bilateral I would definately have them both done at the same time. Having read threads on Bonesmart for nearly a year I do not recall any one who wished they had not had bilateral and wished they had gone for single. I often been amazed at bilaterals and how they get going so quickly after op.
Maybe your mother found the pain was at the limit of her tolerance and would not wish double the amount of pain on you. But from other threads, with careful pain management, the pain seems to be controllable for the most part. I wish you well.

 

[dandy_candi]

Hi @Toddlermom I am getting ready to book for BTHR but I will have mine the min 6 weeks apart that my surgeon prefers.
My PT advised against two at the same time but I wish he hadn't because I would like to get them over with at the same time. He explained for my situation (rheumatoid) that it gives you one (relatively) good leg to stand on and this can make recovery quicker as your not slowed down by having more mobility issues as having both done at the same time can cause.
I do not have children so I can't comment on that aspect but I guess healing time can be impacted by which method used- anterior or posterior.
I honestly looked up my surgeon because he did anterior and I knew the recovery rate was quicker and there were no hip precautions post recovery.

With your mothers advice I would thank her for it and tell her you would like to research the different methods and make a decision yourself. Everyone is different and being younger than your mom when your having yours done will mean likely a completely different experience.

I, like you, was so overwhelmed with all the information that was being thrust upon me, it took me a while but I gave myself the time on my own (late at night while Hubby was asleep) and researched as much as I could cwhich helped me come to my decision.


Candice. Rheumatoid Arthritis. Diagn.1999 at 12 yo. Live in Victoria, Australia. Planning to book BTHR July/Aug 2016.

 

[Hip Hip Hooray!]

Hi @Toddlermom, I've been thinking your thread. You've gotten some excellent responses. @copsham's advice really resonated with me. Everybody responds so differently to this surgery. The one thing I learned was that the pain is manageable, but it's important to expect it and to prepare. The medications they have now are incredible. They numb and go directly to the area. (Well, for me they did.) When I watched some of the videos on the Anterior approach, (which I had,) it seemed like people were pain free, and walking immediately. The thing is, they had spinals, so they were numb. To me it's misleading to tell people they won't have any pain. I really relied on my yoga breathing in the recovery room. It's was pretty intense in there, but my vitals were really strong, and the breathing worked. Then once I got to my room and had an iv, whatever they gave me worked like a miracle. The ice was very comforting, too. I found it helped me to lay perfectly still and just rest quietly. I didn't want to jump up and start walking. They let me wait, since I had a bilateral.

My parents were negative about me having the surgery. My mom said, "I don't think you have any idea of what a hip replacement entails, or how much it costs." She died a few months before I had it done. I was distracted by the worry over her illness, and then my hips really deteriorated rapidly. My dad made comments like, "You could die on the operating table." "It's not going to make your hips any better." (His mom had both of her hips replaced back in the fifties. She had a very difficult experience, including a dislocation.) The surgery has really come a long way since then.

When my dad came to visit me in the hospital, he was happy to see me sitting on the edge of the bed, feeling good. (I had him wait till the third day to come.) He said that his mother had been writhing in pain when he went to see her in the hospital. I think he was traumatized by that, and fearful that I would be suffering. He drove me home and was an incredible help the first few days. I was able to be fully weight bearing right away, and used my walker comfortably.

I think you will do well. There are some exceptional surgeons available, and they've made such advances with the Hanno table, etc. The information on this site is invaluable.

 

[Hip Hip Hooray!]

Oh, I also remembered one other thing. I asked a former ballet teacher of mine about the pain after the surgery. She had her hip replaced at the same place I went, but by a different surgeon. He is also excellent. She got behind the pain, and it was very upsetting. She started to panic. (She said the nurse went to lunch and forgot to give her the dosage.) She started pooping, throwing up, and crying. That really scared me. She said, "It is so painful. I can't believe you're having both of them done together." I went home and cried hysterically. But, it was a good lesson, because I made sure that they would administer the pain killers to me on time. They assured me that I could press the call button and have a nurse come help me. I put in writing that even if I was sleeping, or out of it, I still wanted the medications.

My pain was very low in the hospital and at home, and I questioned if I should take the meds. But, the one time I skipped a dose my pain spiked. So, I learned that lesson the hard way. The nurses will wake you up to take your vitals, but they're just doing their job. I planned on that, and it didn't bother me.

Oh, also, you can take it easy with the PT. That's what I did. I didn't walk very far at first, and I just did the minimum reps of the exercises. I also found it helpful to have strong legs, abs, and arms before the surgery. Because of that, I was I was able to get in and out of bed easily.

 

[Josephine]

There's probably more pain with a bilateral, but I didn't know the difference.

Actually not as it happens. In some strange way, the body only registers a certain amount of pain whether there's one op or two and we generally only need to give the standard doses of pain killers regardless.

I am getting ready to book for BTHR but I will have mine the min 6 weeks apart that my surgeon prefers.

Then strictly speaking, that's not a bilateral, it's a sequential unilateral. Bilateral means both done at the same sitting.

 

[dandy_candi]

Then strictly speaking, that's not a bilateral, it's a sequential unilateral. Bilateral means both done at the same sitting.

Thanks for clarifying @Josephine hard to keep track of all the language surrounding surgery and medical procedures!


Candice. Rheumatoid Arthritis. Diagn.1999 at 12 yo. Live in Victoria, Australia. Planning to book BTHR July/Aug 2016.

 

[Jaycey]

I honestly looked up my surgeon because he did anterior and I knew the recovery rate was quicker and there were no hip precautions post recovery.

Anterior is not necessarily a faster recovery. And these days many surgeons are not imposing any restrictions after posterior or lateral. In the end, the result is the same no matter what approach is used. The key is to find an excellent and very experienced surgeon that you trust.

 

[Toddlermom]

Well, one of the two doctors doesn't do bilateral surgeries....so it might be decided FOR me! Sigh. And it's the doctor who was highly recommended through a physical therapist as the 'guy who would do my hip replacement if I needed one'. His next available surgery isn't until April unless there is a cancellation.

Additional question:
1. Are there certain joints or approaches that are better for the structural challenges of dysplasia? I have small bones and shallow/malformed joints.

 

[Jaycey]

Are there certain joints or approaches that are better for the structural challenges of dysplasia? I have small bones and shallow/malformed joints.

This is something your surgeon will determine based on their assessment of you and any x-rays/scans. They will also base the size of your implants on your own medical situation. Please don't worry about this - that's the surgeon's day job. The most important factor is the surgeon's experience and your trust in their expertise.

 

[determined21]

After I had my first surgery I knew that it would be not long at all until I had to second surgery and I spent many nights laying awake wishing I had gotten them both done at the same time. One thought always comes to my mind is several of the best and highly recommended surgeons in our area will not do a bilateral.

 

[Hip Hip Hooray!]

It's interesting, because my surgeon, Joel Matta, is one of the top surgeons, and he has trained many of the best, as well. When they don't know what to do, they helicopter patients to Dr. Matta. He is an expert on the pelvis. The PT told me that he doesn't usually do bilaterals. He immediately suggested doing both hips together after seeing my xray, though.

I think you have to be a good candidate. There are many factors. He also said that as long as there wasn't too much blood loss with the first hip, he would go ahead and do the second.

 

[determined21]

Research shows the surgeons surgery volume and success go hand in hand in this business.so if I was considering bilateral surgery I would want to know how many successful bilateral surgeries the surgeon has performed in the past.

 

[Hip Hip Hooray!]

So true...and that could mean traveling. I spent a lot of time reading reviews of surgeons and researching their opinions. It has a lot to do with the patient, as well. It's a partnership. I knew immediately that I wanted Dr. Matta.