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Alberta - Evaluation Criteria for THR?

Discussion in 'Hip Replacement Pre-Op Area' started by wayner1, Apr 19, 2018.

  1. wayner1

    wayner1 new member
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    Hello, new to the BoneSmart forum (and very appreciative of what I've read so far). I've been waiting on my orthopedic assessment for 8 months and finally have my appointment next week at the Alberta Hip and Knee Clinic to determine if I'm eligible for surgery or just continued physio treatment.

    I'm curious if anyone is aware of what the evaluation criteria are in Alberta given this is all our wonderful socialized medicine approach. Is it just pain, mobility, age, lifestyle choices? My GP says "I'm too young, they won't give me a new hip because I'll wear it out too soon, etc". But he referred me and now I'm heading in to see if I have to start cashing the cheques (checks) my mouth has been writing about getting a new hip! Becomes a lot more serious when it's a real possibility and not just a future chance.

    I'm 59, been diagnosed with osteo arthritis in left hip for about 15 months but have been having pain and mobility problems for a couple of years. Once it hit the point of no return where I could barely walk up / down stairs, etc, I finally went to physio and have spent the last 18 months alternating between physio, strength training at the gym with a trainer, home exercising, etc. Dropped 35 pounds and although sad to say, other than my hip, probably in better shape now that I have been for many many years. Silver linings, right?

    I can now walk, do stairs, live a reasonably normal life but there's lots of things I know I can't do (or do with pain later) - run, ski, play on the floor with grandkids. Thankfully I can still golf but it's actually more painful now as I'm alot stronger so I hit harder and put more stress on that hip!

    If it's strictly about pain, I'm sure there are a lot more people with greater pain that I experience on a daily basis. But having spent all this time and effort getting myself into a position to have the most optimal outcome, not to mention if I didn't do all that I would be near bed ridden, is that all the process is about?

    I couldn't find any references to the evaluation process that we would go thru, so hoping someone else that has gone thru it can provide some answers?

    Thanks in advance.
     
  2. confused newb

    confused newb member

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    I don't know how the process in Alberta works specifically, but in Ontario it certainly seems to be up to the OS to determine eligibility. I met with one OS who told me to wait another 10+ years in order to have the surgery because I was 'too young'. At that point, I was already beginning to see a decline in what I was able to do. I met with another surgeon who looked at how the OA was impacting my quality of life, and he booked me for a surgery with no question.
    Age is a terrible measure of who is able to have such a life changing surgery. I was 41 when I had mine done, and over the past year it has opened up my world again.
    Go into your appointment with a good list of how this is impacting your life. Ask for opinions from your family, maybe they see things that you don't even realize is happening. Don't be afraid to bring someone with you to the appointment so they can also speak on your behalf and elaborate.
     
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  3. Dracia

    Dracia new member

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    I'm 26 and getting mine replaced in June...so I'd say you're definitely not too young! I struggle with wanting to put it off because of my age, but it's a quality of life issue. Just remember arthritis does not magically get better, only worse. I'm sure you'll be able to find someone to do it if you decide it's the best decision for yourself.
     
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  4. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Can't help on that particular hospital's criteria but I have a score chart that can give you a good guide to where you are right now. I've attached it to this post so you can print it off and complete it. The findings are for your eyes only so don't post them on here.
     

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  5. wayner1

    wayner1 new member
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    Thanks Confused Newb - great advice. I am bringing my wife with me and she can easily talk about how it takes me 2-3 minutes sometimes to get behind the wheel of the car - some days near impossible to lift the leg up and over the door sill as an example. But reading some of the stories here, makes me realize the relative severity and discomfort we face and how different it is for everyone.
    First step in the journey.
     
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  6. wayner1

    wayner1 new member
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    Thanks Josephine - I've printed it out and added a few more rows of activities not on there. I will take that with me.
     
  7. sequin98

    sequin98 senior

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    I am from Calgary, and just had my hip replaced last month. I have not heard of such criteria. I think it depends on the OS. The wait list is brutal. Good Luck!
     
  8. sharonslp

    sharonslp FORUM ADVISOR Forum Advisor

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    I kept thinking I wasn't bad enough to have surgery because I was still functioning just fine. The pain wasn't unbearable, just terribly annoying. The turning point for me was when I realized how narrowed down my life had gotten though. I love to dance, and I was sitting out most of the time. I love to walk, but my walks were short, and punctuated with a mental awareness of how pain traveled down my legs as I walked. I adore being with my grandchildren, but I couldn't even get down on the floor to play with them. I was putting off doing things I used to love to do because it was just too much effort to deal with the annoying pain. It was almost a relief when I suddenly went bone on bone, and the pain was unequivocally bad. Decision made.

    Sure hope your surgeon sees it your way. You are most definitely not too young! Now's the time to reclaim your life and live it to the fullest.
     
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  9. anny

    anny graduate

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    Intermittent, more or less bearable pain makes it harder to make that big decision.....we have the ability to put it to the back of our minds, and only think about it when it hurts. But you make many more compromises to accommodate the arthritis than you will for the new hip. New Hip will slow you down for a wee while, but gets better and better....the arthritis will continue to demand more lifestyle sacrifices, more painfully. Many surgeons seem to base doing the operation on whether you can do the things that matter to you, as well as xrays, so if you're convinced, you're a long way towards convincing them too. Good luck, I look forward to seeing you post a date!
     
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  10. wayner1

    wayner1 new member
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    After worrying for a week, turns out the process is quite simple. Show up, go across the hall for an X-Ray, then meet with an intake Dr (former surgeon). He asked about my life issues because of the hip, reviewed the X-Ray, did a few mobility tests and then said I have moderate to severe OA and there are really 2 choices. One is injections to see if that reduces pain and gains a few months or years. Or I could opt for a THR understanding there are risks and once again, it will on average, only last 10-12 years.

    I've not had any injections (cortisone or otherwise) but said if it's my choice, I'd take the surgery as I'm going to need it anyway, and waiting another year or so while trying injections and then I'd have to start the waiting game all over again to be assessed for surgery seems pointless.

    So now, on another waiting list to see the actual OS - they said a month or two for that pre-op assessment and then 3-6 months wait for the actual surgery depending on the surgeon's calendar. That would put me in the fall/winter which I was hoping to avoid because if walking is the primary exercise for awhile, walking in Calgary in winter is near impossible on good legs, let alone a cane... But I'll deal with that when it comes.

    So it turns out to be based on X-Rays first (Dr basically said if the X-Rays didn't show anything, the rest was immaterial), then pain and lifestyle issues weighing in. And he gave me the choice which I wasn't really expecting but glad for it. Just hope I made the right one! But reading comments posted, made me realize that I too was making lifestyle choices based on how I would feel during or after the activity. And I'm tired of that.

    Back on the waiting list but a decision made so time to shift the worrying from "should I" to "what did I get myself into"?
     
  11. sequin98

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    I waited a year to 'see' an OS. They kept reminding me that it is a triage. I guess I was not in enough pain?
    Go with the surgery. There is not an injection that compares. If there was, I would not be on this forum.
    Let me know what OS you decide to use. I went with Dr. MacKenzie. He also does hip resurfacing, and you may even be right for that procedure.
     
    Last edited: Apr 26, 2018
  12. sharonslp

    sharonslp FORUM ADVISOR Forum Advisor

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    • Agree Agree x 1
  13. wayner1

    wayner1 new member
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    Thanks @sharonslp, those estimates were from my GP and the intake surgeon - I guess advising me that its my choice to proceed knowing there are no guarantees on duration. I'm hoping I will be on the longer ones but just something else to worry about 10 years from now.
     
  14. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    You will have that hip for much longer than 10 years - worry not! Many surgeons are talking about the forever hip these days. Technology is on our side!
     
    • Agree Agree x 1
  15. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    You got yourself into a new hip AND a pain free life, in my opinion.
    I understand the consternation about having a big surgery and getting a bionic hip, but my life and mobility have been changed in a big way.
    Never have regretted the surgery!
    Wishing you peace about your decision.
    Big payoffs in the future!
     
  16. wayner1

    wayner1 new member
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    @Mojo333, thanks for the great support, like everyone here! Amazes me how encouraging and empathetic everyone is, graciously offering time and support to those of us trying to figure out what to do, when to do it, how to do it. Been less than a week since I decided to go ahead, now waiting for a surgeon to free up but that's just more time.

    Meanwhile, the thoughts and worries keep flooding in - how to stop thinking? :loll: Last night, literally started thinking about toilets, raised seats, etc. And how I lean to the left to "finish my business" as I'm right-handed and then realized I probably won't be able to lean left as that's where the incision will be. So now do I have to lean to the right and learn to use my left hand? Aarrgghh... Sounds dumb but I'm semi-serious. These are the non-stop thoughts coming in. And it might be as much as 6-8 more months before I'm in the OR.. I'll drive myself or my wife crazy long before!
     
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  17. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    Not strange at all. I didn't have enough time to think, and yeah, the toilet riser, walker, etc...gave me practice for future geriatric possibilities:umm:
    I had bilateral so no good lean:blush:
    I figured most of it out as I went along, and we're not near as dependant for as long as I thought.
    Worse part was super sore thighs and back sleeping which eventually eased also.
    Lots of folks with ingenious solutions to recovery issues. :friends:
     
    Last edited: Apr 30, 2018
  18. sequin98

    sequin98 senior

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    I lean to my right, the same side I have the incision on.
    It made me a lot quicker on the can, that is for sure. More scenarios will pop in your mind. But when it happens, and you are going trough it, you may ask yourself: I was worried about this because...?
     
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  19. wayner1

    wayner1 new member
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    Thanks for the feedback - wasn't sure if I would be taken seriously on the question. I'm trying not to get over-excited yet as it may be months away depending on surgeon's calendars but there's so much information available that invariably more questions arise. But I'm finding myself becoming more aware of some of the limitations I have been ignoring previously, realizing they will most likely go away in the relative near future (I hope).

    Sleeping on my back and not crossing my ankles - next 2 issues to start work on. I'm a side sleeper and preferred side is of course my left side. And for whatever reason, my OA prevents me from keeping my feet on the floor for more than a couple minutes at a time - I have to basically always sit with my legs extended - a footstool under my desk or recliner in the living room. And I always find myself crossing my ankles so trying to get in the habit of at least recognizing when I'm doing it so I can consciously try to stop or reduce frequency. I don't know any of the limitations to be imposed yet - all coming I guess.
     
  20. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    Had same experience..and continually crossed my ankles.
    Even post op...hard habit to break.
    Wasn't told I couldn't though.
     

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