Hi to all. It was a pleasure finding this forum. I've been a forum user mainly for hobbies forever (well it seems that way).
A 3-wheel rollator became my friend about 6-years ago (I don't leave home without it!).
I initially put the Rollator to use because of lumbar spinal stenosis. But the hip pain kicked-in (no pun) shortly thereafter. With my maternal grandma, father and sister having severe hip problems, I suppose genetics weren’t my friend.
For several years the spine pain was worse than the hips. But over the last year or so, that has changed. My hips are now worse.
From experience, knowing that chronic pain is pain, no matter where it's at, my hip and spine were compatible pain wise (as funny as that may sound). Alleviate the pain in one, or two areas and the pain would still exist. So, I put-off spine and hip surgery for far too long!
On a recent visit to a hip surgeon, his P/A was first-in the room. While looking at my X-rays, the P/A said my hips are "atrocious"! Of course that wasn't news to me. Film at 11:00 wasn't necessary. Both hips grind and sound like the gears in a 1964 stick-shift Plymouth, I once owned!
My last visit to the neurologist suggested that my hips should come before my spine because my hips and poor gait could be exacerbating my spine pain. Also, THR is more likely to remedy pain than spinal surgery is.
In fact, a joint replacement orthopedist actually told me a few months ago: "don't get spine surgery to relieve pain, it doesn't work"! He may be more correct than not. But I also know and believe otherwise from the evidence of friends.
At any rate, I'm 74 and am tired of being mostly house bound and in severe pain whenever I'm upright!
Unfortunately, my family's medical experiences have been bad to horrific!
For starters, in 2010, I had gallbladder removal surgery. Just after recovery, jaundice ensued. An ERCP was performed. Endoscopic retrograde cholangiopancreatography sometimes causes Pancreatitis and yup, you guessed, it did. I was told it was touch-n-go for a while. I spent two-weeks hospitalized in excruciating pain. Being drugged and out of it, with two tubes down my nose, I remember little. But my bride of over 40-years, spent 24/7 with me and was able to fill-in some of the gaps -- mainly the loopy funny ones, much to my chagrin (ha).
Three-years later, sadly, my 56-year old sister passed in her sleep 12-hours after being released from the hospital following elective THR. The educated guess is a PE (Pulmonary Embolism) or DVT (Deep Vein Thrombosis) took my dear sister's life. My bro-in-law chose not to have a postmortem performed. So, we will never know.
Similarly and in 2010, but not so devastatingly, my wife had a kidney removed when it didn't need to be...sigh!!
Prior to the complete kidney removal, a biopsy was done. Cancer with a Furman grade of 4 (the worst) was assigned by the hospital's pathology group. A 2nd. pathological opinion was obtained from a local supposed high-quality physician teaching university hospital. They too said cancer, but said it was a bit worse than the 1st. pathology dept. (go figure)! So, the kidney was removed with post haste, because of the suppsed Grade of 4!
Later, it took Mayo Clinic to get it correct -- after 4-months of anguishing worry -- no, nada Cancer & both other pathologist's concured with Mayo! But the kidney was gone and now there was worry about kidney failure, until thankfully, the one kidney sized itself to take care of its new load!
Lesson learned, 1 or 2 pathology reports aren't enough! And Murphy's Law is alive and well!! But I digress.
These experiences have made me more than a little “gun shy” as in surgical roulette shy.
However, positive experiences abound and by a large margin exceed the negative.
For example, my dad had elective and succesful THR over 40-years ago on one hip. Yeah, 280 years in dog years. My 85+ year old uncle had open heart valve repacement with spendid results. A friend recently whose mom just turned 90 advised that his mom had 1 hip and the other replaced 3-months later. 15-years later, she is doing just great! Another good friend's wife had 2-THR's several years ago and yep, she did just great. A cousin's wife had one hip done several years ago and all is well...and so it goes!!! So, fingers crossed, hopefully the same will be true for all of us going forward.
However, as I’m sure many, if not most here, don’t want to do: I don’t really want to play the surgical roulette game either. But we're here contemplating surgery, to ease pain and enhance our quality of life and in my case to stay out of a wheelchair. With an appointment this coming Friday, I have yet to schedule surgery. I remain sweating bullets as to whether I will or won't!
However, I just discovered that my surgical appointment is with a surgeon who doesn't utilize a robotic (Mako) process. That has me a bit concerned. My initial findings and technical background, suggest that if the process is more beneficial than not, then why not go with it as a choice?
Yet, the Mako tool would seem to add precision & more exacting repeatability to a task that would benefit from it. Particularly, if long term results were advantageous. With a start-up cost of around $3-million and $1-million per year thereafter, I must wonder if that's what is keeping other surgeons from jumping on-board the Mako "train". Or are they so surgically adept that it wouldn't be a prudent tool and aid? Is money the preventing factor, or is robot assistance considered a hindrance, more than a benefit? Or does the surgeon not want to learn another technique, because they’re comfortable doing what they’ve learned?
During Covid, the mantra of follow the science was everywhere. Yet, those parioting it, didn't have a clue about what science is, or the hurdles to jump in properly instituting and controlling the scientific method. Causality is one of the most difficult events to prove with a 95% level of confidence. There are few certainties and those that are present, are subject to change!
Science is a continum, not an end. Line-up 100's scientists, medical professionals et al. and many conclusions about the same subject will abound. Wanting to believe that isn't fact, won't make it one! My expert's opinon trumps your expert's opinion...I will see your bet and raise you...well you get it! 99 may be wrong and 1 correct, or vice versa. Different day, different conclusion.
It isn't prudent or beneficial to accept any one concluson, or a specific group's conclusion about science or medicine. But if you do, keep an open mind for new information; of which reading between the lines is a must or both counts -- for the old and the new information. A yea or nay without the specific data to justify either, is worth about as much as the U.S. paid Russia for Alaska, compared to its strategic and natural resource value today. ‘
Be that as it may, it seems that like the THR approach, direct anterior, or mini-posterior, results good, bad or otherwise, are primarily driven by the hand holding the scalple and their experience and expertise wielding the tools of their trade.
From a patient’s perspective, I want the most precise and adept surgery from an expert surgeon as possible! Whatever makes a good, adept, experienced high volume surgeon a better one, that would be my druthers.
A 3-wheel rollator became my friend about 6-years ago (I don't leave home without it!).
I initially put the Rollator to use because of lumbar spinal stenosis. But the hip pain kicked-in (no pun) shortly thereafter. With my maternal grandma, father and sister having severe hip problems, I suppose genetics weren’t my friend.
For several years the spine pain was worse than the hips. But over the last year or so, that has changed. My hips are now worse.
From experience, knowing that chronic pain is pain, no matter where it's at, my hip and spine were compatible pain wise (as funny as that may sound). Alleviate the pain in one, or two areas and the pain would still exist. So, I put-off spine and hip surgery for far too long!
On a recent visit to a hip surgeon, his P/A was first-in the room. While looking at my X-rays, the P/A said my hips are "atrocious"! Of course that wasn't news to me. Film at 11:00 wasn't necessary. Both hips grind and sound like the gears in a 1964 stick-shift Plymouth, I once owned!
My last visit to the neurologist suggested that my hips should come before my spine because my hips and poor gait could be exacerbating my spine pain. Also, THR is more likely to remedy pain than spinal surgery is.
In fact, a joint replacement orthopedist actually told me a few months ago: "don't get spine surgery to relieve pain, it doesn't work"! He may be more correct than not. But I also know and believe otherwise from the evidence of friends.
At any rate, I'm 74 and am tired of being mostly house bound and in severe pain whenever I'm upright!
Unfortunately, my family's medical experiences have been bad to horrific!
For starters, in 2010, I had gallbladder removal surgery. Just after recovery, jaundice ensued. An ERCP was performed. Endoscopic retrograde cholangiopancreatography sometimes causes Pancreatitis and yup, you guessed, it did. I was told it was touch-n-go for a while. I spent two-weeks hospitalized in excruciating pain. Being drugged and out of it, with two tubes down my nose, I remember little. But my bride of over 40-years, spent 24/7 with me and was able to fill-in some of the gaps -- mainly the loopy funny ones, much to my chagrin (ha).
Three-years later, sadly, my 56-year old sister passed in her sleep 12-hours after being released from the hospital following elective THR. The educated guess is a PE (Pulmonary Embolism) or DVT (Deep Vein Thrombosis) took my dear sister's life. My bro-in-law chose not to have a postmortem performed. So, we will never know.
Similarly and in 2010, but not so devastatingly, my wife had a kidney removed when it didn't need to be...sigh!!
Prior to the complete kidney removal, a biopsy was done. Cancer with a Furman grade of 4 (the worst) was assigned by the hospital's pathology group. A 2nd. pathological opinion was obtained from a local supposed high-quality physician teaching university hospital. They too said cancer, but said it was a bit worse than the 1st. pathology dept. (go figure)! So, the kidney was removed with post haste, because of the suppsed Grade of 4!
Later, it took Mayo Clinic to get it correct -- after 4-months of anguishing worry -- no, nada Cancer & both other pathologist's concured with Mayo! But the kidney was gone and now there was worry about kidney failure, until thankfully, the one kidney sized itself to take care of its new load!
Lesson learned, 1 or 2 pathology reports aren't enough! And Murphy's Law is alive and well!! But I digress.
These experiences have made me more than a little “gun shy” as in surgical roulette shy.
However, positive experiences abound and by a large margin exceed the negative.
For example, my dad had elective and succesful THR over 40-years ago on one hip. Yeah, 280 years in dog years. My 85+ year old uncle had open heart valve repacement with spendid results. A friend recently whose mom just turned 90 advised that his mom had 1 hip and the other replaced 3-months later. 15-years later, she is doing just great! Another good friend's wife had 2-THR's several years ago and yep, she did just great. A cousin's wife had one hip done several years ago and all is well...and so it goes!!! So, fingers crossed, hopefully the same will be true for all of us going forward.
However, as I’m sure many, if not most here, don’t want to do: I don’t really want to play the surgical roulette game either. But we're here contemplating surgery, to ease pain and enhance our quality of life and in my case to stay out of a wheelchair. With an appointment this coming Friday, I have yet to schedule surgery. I remain sweating bullets as to whether I will or won't!
However, I just discovered that my surgical appointment is with a surgeon who doesn't utilize a robotic (Mako) process. That has me a bit concerned. My initial findings and technical background, suggest that if the process is more beneficial than not, then why not go with it as a choice?
Yet, the Mako tool would seem to add precision & more exacting repeatability to a task that would benefit from it. Particularly, if long term results were advantageous. With a start-up cost of around $3-million and $1-million per year thereafter, I must wonder if that's what is keeping other surgeons from jumping on-board the Mako "train". Or are they so surgically adept that it wouldn't be a prudent tool and aid? Is money the preventing factor, or is robot assistance considered a hindrance, more than a benefit? Or does the surgeon not want to learn another technique, because they’re comfortable doing what they’ve learned?
During Covid, the mantra of follow the science was everywhere. Yet, those parioting it, didn't have a clue about what science is, or the hurdles to jump in properly instituting and controlling the scientific method. Causality is one of the most difficult events to prove with a 95% level of confidence. There are few certainties and those that are present, are subject to change!
Science is a continum, not an end. Line-up 100's scientists, medical professionals et al. and many conclusions about the same subject will abound. Wanting to believe that isn't fact, won't make it one! My expert's opinon trumps your expert's opinion...I will see your bet and raise you...well you get it! 99 may be wrong and 1 correct, or vice versa. Different day, different conclusion.
It isn't prudent or beneficial to accept any one concluson, or a specific group's conclusion about science or medicine. But if you do, keep an open mind for new information; of which reading between the lines is a must or both counts -- for the old and the new information. A yea or nay without the specific data to justify either, is worth about as much as the U.S. paid Russia for Alaska, compared to its strategic and natural resource value today. ‘
"There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy"
Be that as it may, it seems that like the THR approach, direct anterior, or mini-posterior, results good, bad or otherwise, are primarily driven by the hand holding the scalple and their experience and expertise wielding the tools of their trade.
From a patient’s perspective, I want the most precise and adept surgery from an expert surgeon as possible! Whatever makes a good, adept, experienced high volume surgeon a better one, that would be my druthers.
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