Need Some Enlightenment

[oldrunner]

I am a very very active 74 yr old with medicare Ins.
Based on my research I should try to go with:
a) Traditional posterior entry: longer recovery/lowest nerve damage risk
b) S-ROM prosthesis: more expensive/easier to get best fit & with fewer short/long term revision/dislocation problems(after wound healing).
c) Met on Met: long life even with gym, golf, etc.

Problem: Hospitals/physicians are insurance driven to lower cost prostheses.
First Surgeon without even asking my activity level said: "my way or hiway".

Self Pay route hard to navigate.

Suggestions/advice/experience?

 

[westexas]

OLDRUNNER,
HI, I AM 50 AND HAD MY HIP REPLACED ON FEBRUARY 26TH. I HAD POSTERIOR ALSO...YOU HAVE SOME GOOD QUESTIONS AND JOSEPHINE IS OUR RESIDENT EXPERT. SHE WILL SEE YOUR THREAD AND WILL BE ABLE TO HELP YOU MORE THAN MANY OF US COULD. YOU JUST HANG IN THERE. WE WILL BE THINKING OF YOU. patty

 

[oldrunner]

Hi Patti,
Thanks for the reply. I left TX (East) in for CA 1960. My X-Rays show no cartilage but unless I walk more than a mile w/o stopping little problem. However know it will get bad one day.

My subject concerning Medicare is one that no one wants to talk about, especially with Universal Healthcare so central to forthcoming election. But everyone should know that if Gov runs it it will be another Dept. of Mtr Vehicles.

R U Doing well?
Rich

 

[JudyS]

Hi Rich,
I am in Ca and had a right hip replacement last friday. I an in So Ca where are you.?
I am now 51 and decided on ceramic ball, x-linked poly acetabulum. My OS helped with the decision. I had posterior which is what he preferred. Also very active. Hiked on the Mt Baldy trail the day before surgery and had gone to the gym and really pushed it the last month. Glad I did that. I got that advice from this forum.
My love has been mountain trail running. Although my OS wanted me to promise I would not run after the implant, I was planning on begging for only up mountain trail running.
Unfortunately after surgery he told me my bones were so weak, the femur was either fractured or started fracturing , anyway he had to do some wiring. He asked me to reallly really wait for his OK to resume hiking. At that moment I saw running again go out the window. But also very glad I had this surgery as I more than likely would have done some more serious damage if I just kept up the lifestyle with the aid of vicodin!!!
I hope you have a good surgeon who will discuss all of your concerns with you.
Even with the great one I have, this forum each and every day before and after has helped so much. I am going to tell my doc next week that he should recommend it to patients. I have only called twice since surgery and would have had many calls to his office if this was not available.

I feeel like I have friends all over. One especially I hope to meet some day (yes Patty that is you)
Welcome
Judy in So Cal

 

[westexas]

Hey Rich,
You said that right about our insurance. Thank God, I have good insurance. It is a very expensive operation and no matter what, you want the BEST for your hip.
I was lucky. I live about 5 hours from Dallas and ended up going to UTSouthwestern. My surgeon was Pres. of the American Academy of Ortho Surgeons in 2005. He is 60 and had a wonderful bedside manner. You keep researching these doctors because we want to see you back out there doing what you want to do without the PAIN because that just tends to get worse over time.
And yes, there are some great people on this forum. I started after my hip replacement and wish I had known so many things before hand. That is what has helped Judy. And yes, I am doing very well at almost 4 months. I have been going to Pool/Gym therapy four days a week. That is the key afterwards, REHAB for the Hip....But, unfortunately, I also have the other arthritic hip to deal with. I go back to Dallas for a checkup in July and we will discuss the other hip then. Talk to you soon...Patty

 

[JudyS]

oldrunner,
I reread your questions.
Are you using medicare or self pay. I know medicare would be a nightmare if you have a brain and have researched what you want . I have a very active trail maintenance friend who told me go for it now, on medicare you will have very limited choices.
As for the 1st surgeon, I hope you have ditched him!!

As far as self pay I have read here of folks going overseas or living overseas who get a much better deal and more care than us in the US, but have no real opinion on that. Well, except this past week in the hospital, many of my nurses with a foreign accent I thought I may as well be in a different country!!!!
As far as metal/metal my surgeon told me the issue with it is the metal ions and the unknown health effects. The ceramic/ceramic may squeak.
Talk to you again
Judy

 

[Josephine]

Rich - welcome to the forum. Did you read my thread in this forum How to choose a surgeon and a prosthesis ? It has some points to make about surgeon vs prosthesis so I won't go into it here. I'll wait the see if you have any more questions or debate points. All are welcomed!

 

[Stanj]

OldRunner
If the medical system in the US ran as well as the DVM after going to single payer we would all be better off, but as it is, the US lags far behind the rest of the developed world in medical care for anyone other than super rich. Personal attention is almost unheard of. The cost and personal attention were the two reasons I had mine done 2 weeks ago in another country and all was better than I could have hoped for. Total costs of less than $6,000 was an added bonus. It would have been over $60,000 in the US. My old HMO would not even consider doing it and I most likely would have been unhappy with their care if they did cover it.
My advise is to rattle some cages and shop for a surgeon if you want to stick with Medicare, someone out there will be interested in you getting what is optimum for your situation. Be a little flexible however, any surgeon will know 1000 times more than you about what type of joint would be best for your particular combinations of conditions.
In my case I wanted the best that would be an optimum compromise between long life, range of movement, reliability considering my age(59), activity level, and medical status...which I assumed was pretty good since the only time I have been in a hospital was at 19 for an appendectomy. I have a diagnostic rule for any type of repair or assistance(medical or otherwise..repair of a car or stereo etc), the more time spent asking appropriate questions beforehand, by you and your doctor, the fewer surprises and more appropriate the decisions. My experience with Kaiser told me that they were not interested in my situation enough to aks any questions or spend more than 5 minutes with me. My doctor here, by the time we did the operation, knew more about me than my mother or girlfriend, and I firmly believe that was a major contributing factor in a pain and problem free surgery and after care. He knew all about my lifestyle, my eating, working and socializing patterns because there was no time pressure in appointment times. Overall, the entire experience was like a relaxing vacation, with no surprises except how smooth it all went and how great the hosptial staff was. After 2 weeks since surgery I've already gone back to work and resumed a social life....went dancing last night. After the surgery my only expense has been $2.10 for an iron suppliment that I was advisd to get due to the blood loss during surgery.
Good luck

 

[oldrunner]

Hi Judy,
Thanks for the reply. I am in S CA also. Sorry you R needing this kind of surgery at such a young age. As revisions (replacing worn out prostheses) are more risky that primary surgeries I would plan to baby my implant. Saw a 25 yr old motocross rider with accident injury that could not wait to get back to competition! Needs to do some research.

Good luck and take care. As an ex marathoner I can say there is life off the trail.

 

[oldrunner]

Rich - welcome to the forum. Did you read my thread in this forum How to choose a surgeon and a prosthesis ? It has some points to make about surgeon vs prosthesis so I won't go into it here. I'll wait the see if you have any more questions or debate points. All are welcomed!

Dear Josephine
My experience is that most physicians say they take medicare because most patients needing this type surgery are older and on medicare. However, I believe most hospitals contract for the cheaper devices and force DR"s to use those devices (One surgeon even says that on his web site). The reason: Medicare pays such a low fees to Surgeons and hospitals. If we get the Universal Healthcare that Washington wants good Dr's will flee to better paying specialties as many already have. No free lunches!

 

[JudyS]

Oldrunner,
Did you make any progress on finding a Dr.? I don't know where you are in So Cal but if you want the name of my surgeon, he is in Pasadena. He is very calm and will sit and listen and answer questions and give info, very easy to talk to.
Do you still run?
I have done a few marathons and my first was actually an ultra marathon. I will now just hit the trails at a different pace (hiking). I will finally go to swimming too as all my docs have suggested over the years.
Good Luck with all of this
Judy

 

[westexas]

HEY OLDRUNNER,

I, TOO AM HOPING YOU ARE HAVING SOME LUCK. AS I SAID, OUR INSURANCE IS NOT GOOD FOR A LOT OF PEOPLE IN THE USA. KEEP US POSTED. WE ARE PULLING FOR YOU. patty

 

[Stanj]

Dear Josephine
My experience is that most physicians say they take medicare because most patients needing this type surgery are older and on medicare. However, I believe most hospitals contract for the cheaper devices and force DR"s to use those devices (One surgeon even says that on his web site). The reason: Medicare pays such a low fees to Surgeons and hospitals. If we get the Universal Health care that Washington wants good Dr's will flee to better paying specialties as many already have. No free lunches!

I think that is a myth. A recent national survey of doctors billing issues with insurance companies and the government ranked Medicare as the best for paying what was billed at over 98% while insurance companies ranked much lower, one United, only paid on average 65%of the billed amount. It the entire country could get on Medicare, with its 1.5% administrative costs we would all have much lower health care costs. That is one government program that really works and has very low admin costs compared to any for-profit sector insurance company. When a CEO of a HMO gets $1,000,000,000 in salary/bonuses, you know that comes out of someones pocket upfront before the customers get anything in services.
After seeing health care in Europe and Scandinavia first hand for some time, There is no way that any insurance controlled company can claim they offer more for the money, it is criminal how much Americans pay and how little they get in services and medications compared to anywhere else that has a civilized notion that having good health is in the public's interest.

The only ones defending the US system are those who have not seen or experienced other systems. The health care professionals are getting squeezed as much as the customer in this system. Doctors in France or Germany earn more than US doctors(in real dollars and in comparison to cost of living) working in HMOs yet the end cost to the customer(not considered patients by the industry) pay so much more. Why is this system so inefficient? It is not, it does exactly what it was intended to do: generate obscene profits for investors.

People are complaining of gas prices but US prices are just coming up to the average prices in developed countries but when people have to pay 4-10 times as much for medical care than anywhere else in the world, or 4-50 times more for medications something there is silence.