Jock training for a marathon

[shell_shocked_jock]

Hello everyone. I am a 31 y/o man who was diagnosed with AVN on April 28. I had difficulty finding the right words to explain my pain and hadn't taken it seriously as I thought it was working out too hard or some other general stiffness, etc. I had been in pain for over 2 years and nothing could have prepared me to hear I would need a THR in America while not having insurance. Luckily I found a doctor at a sliding scale clinic who was young and progressive and dedicated to seeing me through this ordeal. I hadn't fully appreciated how much my lifestyle had been compromised by this limping and pain. She immediately helped me with my pain management and referred me to a big teaching University hospital that encouraged me to put off surgery as long as I could because of my young age. I felt like I had no voice and couldn't speak forcefully on my own behalf because I had no insurance. They told me to come back in 6 months and we would consider the situation then. Because this is such a small town and the University and Hospital are such a big part of the community I really got out there and started writing letters and advocating on my behalf and asking others to do the same for me. I had another appointment at the joint clinic in August where they attempted to dissuade me away from surgery and told me that I was on the "waiting list" and people could be on the waiting list for months before being called. I made friends with the lady who made appointments who gave me lots of good advice about how to effectively advocate for myself and how to present myself and the best way to move ahead quickly. I made another appointment to state my case October 27th.

Meanwhile, opiates in the form of percocet became a fentanyl patch and I was starting to worry about the long term consequences of such habit forming drugs. The pain was so bad I was unable to sleep at night and Ambien became part of my pain management cocktail. I also was seeing a physical therapist to try to strengthen my legs and body so I would be in great shape when the time for surgery came. He showed me there were a great many exercises I could do for hamstrings and gluteal muscles that were not weight bearing. I could barely walk 2 blocks but once I got to the gym I could really strengthen my body. I was seeing a psychiatrist who swapped the Ambien for elevil (an antidepressant) with the side effect of making you sleep. At my appointment in October the resident I met with went over my file and I told him I believed and my physical therapist and doctor believed we had taken the conservative route as far as we could and now it was time for surgery. I told him how hard I had worked so I would be in great shape when the time came for surgery and the sooner the better. He spoke with the attending surgeon who came in and looked at my xrays and spoke with me and agreed my xrays were "impressive" and we should not wait any longer. We made a date for December 8! I am meeting with him again the last week of November and am meeting with my doc who will give me clearance next week!

I have great faith in the surgeon who will be performing/overseeing the procedure. He thinks I am a perfect candidate for ceramic on ceramic and after speaking with him and doing my own research I agree with him. He has done more than 500 of them in the past year and that is pretty much the only material he uses. He offered to refer me to someone else if I wanted to explore Hip Resurfacing or Metal on Metal but the science behind ceramic on ceramic is compelling. As a younger person I think its my best shot at not needing a revision in the future. I am so ready to move forward and want to encourage others out there who are being told they are too young or that they should wait for any other reason to not take that as the final answer. Do a lot of research and have a good idea of what you want before you meet a surgeon so you can participate fully in the dialogue. The days of doing what the doctor says are over and we must look toward a model of collaboration. No one is going to be as mindful about your health as you are. Doctors may have the best of intentions but they are busy and have lots of competing agendas.

As scary and as frustrating as this experience has been it has inspired me to move in a different direction in my professional life. I was studying to be an Art Appraiser but had to drop out because I had no money for tuition and getting around to classes was too difficult anyway. While I haven't made any final decisions I am thinking about a future career in rehabilitation or physical therapy or something relating to getting our bodies in good shape. I know that my surgery will go better because of the work I am doing now and I want to take what I have learned and share it with others. Warm thoughts and advice and love are all welcomed so please give me a shout out! I would never have asked for this but I am trying to make the best of the situation.
Warm hugs,
Daniel

 

[Pat29627]

Its such a shame you're having all this at such a young age. I think your change in career plans is a great idea. With the aging population, joint replacement and rehab is going to be a big field. Best of luck to you! Keep us posted.

 

[JudyS]

Daniel Welcome. i am so glad you joined us. This site has helped me so very much from the first time i posted when i had my surgery date last year. I was very active and a trail runner and shocked that i needed a new hip. my docs were shocked as well. my mri showed no arthritis. My hip surgeon went in and did a hip scope to clean out the joint and did microfracture surgery to try to grow new cartilage, but also told me it might last 6 months to a year as it was severly arthritic on both weight bearing surfaces.
Anyway i was so scared, but it was the best decision, my new hip is awesome. I have a ceramic ball on a poly liner. My surgeon was originally going to use a ceramic liner as well, but read to much on the squeaking that can occur with both being ceramic. You might want to look into this or ask your surgeon if any of his 500 patients has this problem.

i have also had to learn lots about endocrinology a few years back and flew from Georgia to Ca to meet an amazing endocrinologist. now that we have moved back to socal i volunteer at his evening clinic as he helped me so darn much . he tells me with all my other medical craziness that i just have to be my own General!!

It is quite an experience. I am having back surgery on dec 11th so we can recover together.
You will love your new hip. I am so glad you are finally going to get this done. At my 3 month mark i was swimming every day and back to hiking almost every day. i was still on percoset for 4 months. Then when my back problem got more severe i started taking it for that. So i havae been taking percocet since June 2008. don't worry about addiction, just make sure your surgeon knows you have probably built up some type of tolerance and may need more than the average person.

sorry i wrote you a book!!!
welcome
judy

 

[Philrob]

Daniel,

Don't give up on the resurfacing option so easily. You are still a young man, and if you want to carry on running, you should consider resurfacing. With resurfacing, if you are unfortunate enough to have problems in future years there is always the option to revert to a THR. Being a keen marathon runner, I am 55 years old and waited far too long to have mine done, (running through years of pain) but I finally had my right hip resurfaced on June 26th 2009 and I am running again, pain free. I am not advocating that there is anything wrong with THR but please don't make your decision lightly, especially as you are a keen runner. Widen your search, and at least have a look around the web at sites such as the two surfacehippy websites to ensure you have all the facts. There are far more interesting post-resurfacing athletic success stories than mine for you to view on these sites.

Good luck with whatever decision you make.

Phil

 

[JudyS]

Daniel i was an obsessive runner. I have run a little very pain free after my hip replacement, just it is the only not allowed activity do to the wear. I forgot what you said about resurfacing. my doc said i was not a candidate to to bone density issues.
judy

 

[Jamie]

Welcome to the forum, Daniel. We're glad you're part of the BoneSmart family. You have a WHOLE BUNCH of folks here who are available to support you through this process toward your new, pain-free life. Young or old....a person DESERVES to be able to take advantage of the options medical science has available.

I'm impressed with the thoughtful research you have accomplished so far. It is obvious that you have worked hard to advocate for yourself and get things done. What an inspiration you are!!!

If you didn't actually look into resurfacing, you might want to do that. It sometimes is an option that preserves the hip joint. It's not for everyone, though, and that's a decision only you can make.

No matter which way you go, BoneSmart is here for you!

 

[shugaplum]

Hello Daniel from a 26 year professional dancer! I also faced the endless doctors telling me I was "too young"...now that I'm through the surgery and feeling 150% better I find I'm actually offended when I hear a doctor suggest this to anyone. Who can say when you have had enough pain? And who has the right to deny you a better quality of life? I think you are doing a wonderful thing and doing it the right way by having your full research done. I think Ceramic on ceramic sounds like a good choice...and if that is what your doctor (who sounds great) is comfortable with then I would not second guess it. The more confident your surgeon is then the better your surgery will go.

You will be very active once you are healed and you are smart to be in great shape going into the surgery! It will make the recovery process a lot easier. Just simply getting in and out of bed is easier. I'm 2 months post-op and I feel fantastic and am more active than I've been in the past few years. I can once again dance better than my students!

I, too, am looking to be in the physical therapy field. I start back in college next semester to take some sciences that were not required for my dance degree is hopes of applying to a physical therapy department in the next few years. I think having the kind of experience we all have makes us more empathetic and understanding to others in our situation. We also know just how much is made possible by having this surgery and creates perpetual orthopedic optimists out of us!

 

[Josephine]

Phil - if Daniel is having to fund this himself, HR could be out of his range.

 

[Josephine]

Welcome both of you to BoneSmart.

 

[shugaplum]

Daniel...you must feel bombarded by Resurfacing suggestions in this thread! This generally happens to all younger male THR people on this board when they first post. I would say that based on what you described financially and how much research you have done you should do what is most comfortable for you. I could not have a resurfacing due to the ion discharge and the fact that I'm a child bearing age female. I'm very happy with my total replacement...I did get the larger diameter prosthetic for a greater range for dancing. Yes-I will need at least one revision down the road but I made this decision knowing that. This surgery has changed my quality of life and has made it worthwhile for me to require that revision eventually. Because of our age-by the time we may need the revision the technology will be more advanced and the surgery will be even better!! Research the revision just to know all options and then still make the decision both you and your surgeon are happiest with.:thmb:

 

[ajp]

Daniel...you must feel bombarded by Resurfacing suggestions in this thread! This generally happens to all younger male THR people on this board when they first post. I would say that based on what you described financially and how much research you have done you should do what is most comfortable for you."... :thmb:

INCOMING!

Hi Daniel. So sorry, life can certainly test one's mettle. The link below contains a rather good debate between UTdave and myself a number of months ago. I could add a bit more but not much.

https://bonesmart.org/forum/hip-resurfacing-arthroplasty-ra-white-paper-t2116p6.html

It is hard for someone in medicine to dig through all the studies, reviews and opinions on these proceedures let alone a layman. The truth is that there are legitamate academic discussions debating the best proceedure, device, articulation, stem and so on. It is EXTREMELY important that you know what you want out of it and at what risk. Unfortunately there is nothing here that is "the best of all possible worlds". So, while resurfacing will let you get back to high impact sports like running. One should not do any high impact sports with the current ceramics. Resurfacing (specifically the BHR from S&N) has been out for over 12 years unchanged BUT as other's will point out has about double the initial failure rate. HOWEVER we are talking about double of a very low number. Most failures (especially the early ones) will result in conversion to a primary THR.

You need to talk to an EXPERIENCED resurfacing surgeon, they will give you an expert opinion if it is for you. With AVN, it depends on how bad, there are resurfacing surgeons that even specialize in that. Google Cory Folk, he is an athelete who has done miltiple IronMans and UltraMans in the three years since his surgery for truamatic AVN. I am one year out and was able to run four miles five times in eight days recentlly. Then had a mild pull of a hamstring which resolved, so will do four again today. Still have issues with v-ups or extended strait left lifts or things needing those moves. Can live with it.

I didn't make a "good cripple". Had been a rather rotund couch potato till started running three and a half years ago at age 46. Uncovered a damaged hip with cam impingement. Still went from running two miles a day (down from four) to barely able to walk in one football game. Talk about shock, had only found out that I even had arthritis the day before. The bone on bone x-ray with bilat cam impingement decked me. Anyway, whatever you choose, the shock will wear off when you take your first pain free steps. Welcome to the collective. alan

 

[Texas]

Hey Daniel welcome im a knee but your story really touched me i wish you th best and think you will do amazing with this surg............it is ashame about the med bills etc.......you just keep your goal in sight and you will gt there for sure.........you sound like a strong person.........keep our chin up and we will all see you thru this...these people have helped me more then you couldn't imagine............take care and post anytime..........)

 

[shell_shocked_jock]

Hello again everyone and thanks for all the warm wishes and helpful information. Why did it take me so long to find this site? I could have used all this support back in April when I first heard about AVN!

I had done a lot of research and was CONVINCED that I absolutely had to have Hip Resurfacing! I was sad to find out that there was a reason I wouldn't be a good candidate. Otherwise I would be all for it. Who wouldn't want more of their own bone?

I think the reason I wanted to post my experience was to tell people especially younger people to not be scared away from this procedure. I don't know what I would do if this had happened to me 10 or 15 years ago.

I am going to see my doctor tomorrow to be cleared for surgery. I will see the surgeon on November 24 and if all goes well I will have my surgery as planned on December 8. Are any last questions I should be asking my own doctor or the surgeon? I will keep you all updated.
Thanks all,
Daniel

 

[Josephine]

Daniel, I'm so pleased to see you back! I thought our heated debate (which you may notice I moved elsewhere!) had put you off!

Well, THR is pretty good and by no means a poor second best. And I see you're on for a ceramic on ceramic which is about the best there is for younger people since they seem to have ironed out a lot of the early issues that plagued them. Best of luck, my friend!

 

[Jamie]

Good luck, Daniel!!! We're all rootin' for you!

 

[JudyS]

Dalniel i love my new hip and really think you will too. Actually i can not tell i have a new hip, except the fact that it never hurts!!
judy