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How do you know when it's time? Putting off, vs. dealing with pain.

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Me2. Our stories are similar. I blamed hip pain on fall from horse, starting running after many years not, but initial groin pain was sudden onset. Treated as such for long time before initial diagnosis (times 3 surgeons) of bone on bone arthritis but wait as long as you can cause of 15 year life of joint. No health insurance in USA resulted in more wait. I felt I needed to exhaust all other possibilities as well as lose weight and "train" for marathon of recovery for being self employed I cannot afford to take anytime off without losing business house and all.

I trained physically with swimming and aquatic exercises. Kept up with range if motion exercises and found stretching etc exercises online.

Most important I scheduled OS consults, I lucked out and found one in first month the day after finding Bonesmart. Remember when interviewing docs not just about incision but also what he does on inside that will affect recovery time. The one I found called his anterior but what he described was more like SuperPath from front. It was most important to me to have least amount of soft tissue damage and regional anesthesia so as not to lose time to recovery from anesthesia. I finally refined my search by asking for an appointment with the most minimally invasive surgeon in practice.

Yes I would love to take off weeks to recover. But for me it was not do surgery or prepare as best I could for marathon of recovery. We wouldn't run a normal marathon without finding out about the right training. Third day post op I am amazed with my recovery. I am exceeding my own highly motivated goals and feel great for the most part. I have to force my self to not do too much and be patient and allow pampering.

I so far do not regret waiting as everything came together so perfectly to make my decision when time was right for me.

Start training for this marathon, find the right surgeon, and make the right time happen for you!


Sheryl from Pittsburgh
LTHR on 4/2/2014
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I know I am feeling better than most but I have actually been doing paperwork since evening of surgery. So if it's a desk job I think I saw indicated and/or you can do from laptop in recliner like I'm doing now while still in hospital ..,,,,,, you can find a way.


Sheryl from Pittsburgh
LTHR on 4/2/2014
Sent from my iPhone using BoneSmart®
 
Me2 said:
I know I am feeling better than most but I have actually been doing paperwork since evening of surgery. So if it's a desk job I think I saw indicated and/or you can do from laptop in recliner like I'm doing now while still in hospital ..,,,,,, you can find a way.


Sheryl from Pittsburgh
LTHR on 4/2/2014
Sent from my iPhone using BoneSmart®
Click to expand...
 
Glad you are doing well Me2. And yes, I do have a desk job, but working from home on my laptop is not something my employer allows. We must be IN the office, or use sick leave. It sucks, but it is what it is.
 
From others I see on her I think you should be ok in 5 weeks with a desk job. Just my opinion which means nothing ... Lol . Better than not living your life fully. Life is way too short for that.


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Hi Chessie- I had the anterior method at age 49 and was in pretty good shape. I am a programmer which requires some focus and concentration. I think my doc told me to plan on at least 4 weeks off. I ended up taking a little more than that because of the fatigue, because I had the benefits to do it, and because we were having a bit of a lull at work. I felt like being able to rest and focus on PT allowed me to recover faster in the end. And when I did return I was fully ready. However, if I had absolutely had to, I could have returned at 4 weeks. I would have had a hard time sitting all day, though, so if you have access to an adjustable work station, or can take fairly frequent mobility breaks (walk around a bit), it will help. I also kept ice packs at work.

This is a major surgery. Honestly, I can't imagine returning to work after only a couple days off. There is a lot of blood loss and just the fatigue of the trauma to the body would prevent that in most people. I wouldn't want to see you plan on a really short recovery and then not be able to do it.

At 2 weeks I was still on painkillers at night. Those drugs affect me into the next day, so I would not have felt ok returning to work at that time. Yes, you will see some folks are back to work after a couple weeks with anterior, but even with the typically faster recovery of anterior, I think 2 weeks is the exception rather than the rule.

I don't mean to be a downer, but I would hate to see you have unrealistic expectations. It is definitely a conversation you should have with the surgeon. Best of luck with your decision!
 
@Chessie my story is very similar, two years ago a local OS told me "its not a matter of if you get your hip replaced, its a matter of when you can't take it any more". I bike, swim, and elliptical (I ran my last 5K back in September, I had to walk a good 1/3 of it) now it hurts to swim, so I'm there. LTHR is scheduled for May 6th.
My personal choice is to travel to have a minimal technique done that is not available locally. I'm not advocating that for you, I'm saying find the surgery technique you want, then find the best surgeon you can and get yourself back to where your hip isn't making decisions for you. best of luck
 
@Chessie First off, I've been told that hip replacements last a lot longer now. I wouldn't base my decision on thinking I might have to have it done again. You can't go on in pain now in fear of what MIGHT happen years down the road.

I let mine go on way too long, and by the time I got in to see the OS I was pretty much disabled. It's a matter of quality of life. I had zero quality of life before I had the surgeries done. My pain had sort of gone along for about two years or so as not too bad, then suddenly went downhill fast to the point where I couldn't get around at all. I had to wait almost two months for an appointment with the OS I had chosen, and then it was another two and a half months wait for a surgical slot. So I was pretty much flattened and in awful pain for several months. That's a place you don't want to be in.

Hip arthritis isn't going to get any better and may get worse fast. I would certainly advise to go ahead and get it done NOW and get it over with. There will be recovery time, of course, and you can't go back to work right away; but if you let it go too long you may lose even more work time in the end if it gets so bad you can't get around. And if you try to go back to work too soon, you can have a setback that will slow down recovery and keep you out even longer.

My only regrets are that I waited so long to admit to myself that I was going to have to have the surgeries done, and that I tried to do too much too soon and had a setback. But I am SOO glad I had the surgeries done. I actually have a life now that is not bounded by pain!

Peace and love to you.
 
Agree with others I so dislike having to lift my left leg up to get it in the car but do it automatically. Have a temporary handicap placard for that reason because many times I haven't been able to open my door far enough to get in when someone parks close. Made me break down and cry a few times just feeling so helpless at those moments - stuck and not being able to fend for myself.


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Dieter said:
@Chessie my story is very similar, two years ago a local OS told me "its not a matter of if you get your hip replaced, its a matter of when you can't take it any more".
Click to expand...

That's a great way to think about it I guess. I suppose that is what I am trying to come to terms with...how long I can tolerate this pain, and not being able to do the activities I love.
 
Butterfly said:
@Chessie First off, I've been told that hip replacements last a lot longer now. I wouldn't base my decision on thinking I might have to have it done again. You can't go on in pain now in fear of what MIGHT happen years down the road.

I let mine go on way too long, and by the time I got in to see the OS I was pretty much disabled. It's a matter of quality of life. I had zero quality of life before I had the surgeries done. My pain had sort of gone along for about two years or so as not too bad, then suddenly went downhill fast to the point where I couldn't get around at all. I had to wait almost two months for an appointment with the OS I had chosen, and then it was another two and a half months wait for a surgical slot. So I was pretty much flattened and in awful pain for several months. That's a place you don't want to be in.

Hip arthritis isn't going to get any better and may get worse fast. I would certainly advise to go ahead and get it done NOW and get it over with. There will be recovery time, of course, and you can't go back to work right away; but if you let it go too long you may lose even more work time in the end if it gets so bad you can't get around. And if you try to go back to work too soon, you can have a setback that will slow down recovery and keep you out even longer.

My only regrets are that I waited so long to admit to myself that I was going to have to have the surgeries done, and that I tried to do too much too soon and had a setback. But I am SOO glad I had the surgeries done. I actually have a life now that is not bounded by pain!

Peace and love to you.
Click to expand...

Thanks Butterfly. Believe me, I have no plans to let it go on that long. But I understand what you are saying about it taking a sudden turn...I don't want that to happen so I that is why I am here learning what I can. You are correct - I DON'T want to be in that place!!

I actually just got an appointment with a surgeon, for April 25, for a consult/x-rays. He is an hour away, but he is supposed to be one of the best. I'm nervous about it...but I think this is the best route. That is 3 weeks out, so we'll see what he says.
 
For me, I had a lot of denial, acceptance, responsibility, and issues to deal with. My original diagnosis was presented with the "challenge" of putting up with it as long as you can. Well, I have very high pain tolerance coupled with self-employment, health insurance issues and medical phobias which made forever seem okay to deal with. In no small part, finding this site helped me come to terms with taking care of my hip problem. I don't regret putting off surgery for the 5-7 years. I think the time to research, lose weight, get back in shape and new techniques and perfecting of said techniques really helped the timing to be right for me. If I waited until I couldn't take it anymore, I would have waited another 5 years.
 
I didn't read all the replies, but it sounds like your world is getting smaller and your hip is bad enough that it prevents you from doing what you want to do. That, to me, says it's time. 58 is not too young--I don't understand the surgeon that wants you to wait until you are 60. Why is 60 the magic number?

You may want to consider looking into hip resurfacing, since you are a runner. Many surgeons believe that resurfacings hold up to running better than replacements.

Best of luck whatever you decide to do.

Dorothy
 
@rider1960, it was not a surgeon that stated that I should wait. It was my Primary Care Physician, during my physical last month.

She felt that the benefits of receiving the replacement later in life would be greater, as she knows that I am active and will most likely be a very active senior. So in her mind, the longer I wait, the older I would be before it would need replacing again. This is from the Mayo Clinic site:
"While the components of an artificial hip will eventually wear out, most people can expect their joint replacements to last for at least 15 years. Hip replacement is usually postponed until later in life, so the life span of the prosthesis more closely matches the remaining life span of the person. "

I have read about resurfacing, but I also read that this is a surgery that is much more complex and potentially more bone loss. I will definitely ask about it though, at my upcoming appointment. This is from an article that I read. It doesn't make it sound appealing to me.

"I recently read an article that cited a case study from France indicating that 90 percent of the patients in the study who were runners prior to hip resurfacing procedures resumed the activity afterward. A common perception in some circles is that hip resurfacing is the trendy option for younger patients and athletes. Likewise, many older or more sedentary individuals may seek out this procedure because they too want to be more youthful and sporty. I believe this study probably has more to do with patients in the survey choosing hip resurfacing because they thought that would enable them to run more successfully afterward, than the actual merits of the procedure. In reality, patients with broken link removed: https://www.holycrossleonecenter.com/hip-replacement-surgery/total-hip-replacement.html can resume the activities they enjoy just as easily as those who have had hip resurfacing.

Hip resurfacing, unlike total hip replacement surgery, is a procedure that reshapes the damaged hip ball, which then is capped with a metal prosthesis. The damaged hip socket also is fitted with a metal prosthesis. The socket used with resurfacing is a one-piece cup with its inner surface polished.

Most modern day sockets used in total hip replacements are composed of two main components: a metal socket into which bone grows and a plastic liner. This is an important distinction because if for some reason the hip fails and more surgery is necessary, the entire socket in a resurfaced hip most likely will need to be removed and replaced with a new one. If a total hip replacement fails, requiring more surgery to revise the socket, it is designed so that only the plastic liner has to be revised, not the metal shell.

Another reason why hip resurfacing has attracted younger patients is because less bone is removed from the femur with a hip resurfacing procedure than with a total hip replacement. This is important because if the resurfaced hip fails, then having more femoral bone available will make the femoral revision easier. But, unfortunately, because the all-metal socket will need to be removed, there often is more bone loss on the socket side. As a hip revision specialist I can tell you that it often is easier to deal with bone loss on the femoral side than on the socket side.

Also, the procedure to do a hip resurfacing actually is more complex and the dissection much more extensive than with total hip replacement surgery.

These reasons alone might make you rethink hip resurfacing, yet there is an additional reason why many orthopedic surgeons, including myself, have stopped performing this procedure"
 
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you didn't mention the biggest detractor to resurfacing, and the reason an OS I consulted with doesn't do resurfacing anymore, the issue of the metal on metal bearing surface of the prosthetic. some countries have gone as far as to ban MoM bearing surfaces. Maybe that is what would have followed the last line of your quoted article.
 
@Dieter, yes, there was some reference to the metal-on-metal issues as well. Also mentioned the issue of metal allergies being a significant problem, and since I have a nickel allergy, I would not want to even go there.
 
Oh, if you have a metal allergy you definitely wouldn't be a candidate. I'm the same way, so I was told I wasn't a candidate.

Just FYI stuff:

My surgeon does both hip resurfacing and replacements. He's been doing them both for around 15 years. As far as I know, he isn't cutting back on resurfacings. I think he does routine bloodwork testing to monitor the metal ion release stuff. He does a lot of revisions too--he's a hip specialist who doesn't do much else other than hip related surgeries, and does a lot of them. He says revising a resurfacing to a replacement is easier than revising an existing replacement, although he told me that doing a revision on a replacement was not usually a problem unless there were complicating factors. I asked about this specifically because I was only 51 when I had my first hip replacement, so it's likely I will need to have it revised during my lifetime. Personally, I wouldn't worry about having a revision unless an experienced hip surgeon thinks it will be a problem. I don't think I would give a primary/general/family physician's opinion much weight.

It is true that a resurfacing is a more difficult surgery and usually has a longer incision than a replacement, but it's not that much bigger--my surgeon says his resurfacing incisions tend to be an inch or 2 longer than the same patient would have if they had a replacement. He has no problem with resurfacing patients running on their resurfacing, but discourages running in the replacement patients. I did notice that when I was hospitalized, the resurfacing patients tended to have a speedier in-hospital recovery than the replacement patients. They seemed to have less difficulty walking longer distances quicker and most left the hospital a day before the replacement patients, and there were young, active people having both procedures done while I was there.
 
I'm only 31 and docs have told me to wait til my 60s!! If you're ready and need one then that's that. And general practice docs know just enough to make them dangerous when it comes to this. I'd suggest a consult with an ortho at least. :) good luck!


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