When do I know its time?

mattman

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I have had 4 xrays and the docs just say your not ready yet try and go longer. They tell me you have advanced arthritis and the later you wait the better since replacement hips only last 10yrs. I have been waiting over 4 years.

I am 52 and walk 6 miles a day 5 day a week. But the pain is there. When i rotate at times to look back it is a sharp pain. Maybe I should pop some pain relievers but they just don't seem to do anything when i want to do something strenuous. I like racquetball and tennis. No can do could never run up to the net and get the drop balls. I can ride a mountain bike tho. Even push it up steep hills when i tire from climbing. Maybe fear of snakes keeps the pain away during my rides lol.

I just hate paying for insurance all these years and not getting the reaction i would expect from the doctors. I mean putting on the underwear and pants/shorts and getting in and out of cars and getting up from the couch or up from the chair at work are all daily painful experiences.

Plus my walking gate has changed. My balance isn't the same. I have been compensating for my bad hipp for over 4 years now. I actually feel like a bit of a target almost like i can no longer protect myself like I did when i was a young wrestler in highschool.

Then i get to hear stories from people who have had hip replacements and they are out there surfing and golfing and playing soccer. The first thing they say is wow i should of done this long ago. The pain in gone!!!!

Thats what i want. I want to return to normal and have the pain be gone and with some luck possibly play tennis and racquetball again.

Maybe i need to be more persistant with my doctors and tell them i am desperate and in pain very much now?

What do you think? Cause I can walk 6miles a day and moutain bike should i really wait and just deal with the pain or possible try taking pain killers or get a shot in my hip?

They won't take a MRI. Was wondering if i just have a lingering injury instead?!
 
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@mattman
Welcome to BoneSmart, glad you joined us!!

Sounds like you are ready for a THR now, the way your life has become so limited.
Suggest you seek out 2 and 3rd opinions, many of our members have THR's in their Teens, 20's and 30's
Teenage hip replacements.
There are surgeons who will suggest THR based on the quality of your life, not the number of years you have been on earth.

Hips and knees are lasting longer than 10 years, many people are out there with 20+ year old hips and knees.

Be sure to score and take the score chart with you to your next appointment, both you and your surgeon will see how limited your life has become.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries
 
H i @mattman, sorry to hear of your pain and of the disappointing communication with the surgeon.

I'll be direct and save you time. Get to another doctor. The idea that hips last only ten years is ridiculous. This guy isn't up on research or isn't going to any conferences. Not only are hips lasting longer than ten years ... but with the latest generation of materials, when surgeons have evaluated wear patterns ... (and likelihood of loosening), they are finding almost no wear after about 12 years so far. Joint replacement surgeons tend to be cautious in public predictions but the two surgeons I narrowed my choice down to were pretty confident in private that the device would last throughout my life. They couldn't guarantee that, but they are really feeling good based on the results with the newest materials.

Get to a joint replacement specialist ... and since you're fairly young as hips go, get to a surgeon who is comfortable with people who want to be highly active afterwards. I'm a few years older than you and I am three months into recovery ... and I've gone to the gym twice this week and experienced almost no pain on the elliptical and on the bike ... which is amazing given that before surgery ... just 7 or 8 minutes of exercising would bring on serious pain.

Seriously ... just my view: I wouldn't try to change this guy's mind ... I'd go to someone who treats highly active patients or just someone who does lots of hips. You want someone ideally who does about 300 hip replacements a year.

Oh .. when is it time? ... It's time when YOU say it is time and when you are ready to go through the surgery and its risks (small but real) ... in order to live a better life. I got sick of parsing out my activity and avoiding dancing and exercising ... I would walk up and down steps fine ... could walk pretty much fine ... But I wanted to be active. I finally said to myself, I'm not getting younger ... I want to have the surgery now so that I can enjoy some really active years in my 50s and 60s. So I found a top surgeon and told him I was ready.
 
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Hi,

I am new here as well, but I do encourage you to speak to the dr on your quality of life. I am 34, and had a THP last week.

At first my doctor didnt want to do it, he said because of my age I'd have to get it redone eventually.

That was it for about 6 months, until i couldn't work anymore, and was having a baby. I went back. Told Dr I wasnt changing my job, and needed replacement asap because I wanted to be active as my child grew.

I left that appt. with a surgery date. He also told me that many people wait until it gets really bad, and he wanted me to think about having major surgery when I didn't really "need to". He wanted me to think about it. I did.

One week after surgery and still in recovery, but that left joint is good to go.

Good luck to you.
 
I agree with all of the above. It's time for THR when you say it's time. Do not worry about the longevity of the implant. Technology has moved on and it's on your side. Find a more up to date surgeon who will examine your hip, not your birth certificate. Life is too short to sit on the sidelines.
 
It's your call on what to do, I waited. I had my 1 hip pinned back in 69 and had problems with both hips from the time I first started playing ball. At 30 I went to an OS and back then got the wait advice. I waited and I don't regret it. I did everything possible with my factory hips, things I wouldn't do with my man made part. Sure I had pain along the way and when I got older and the pain got worse I elected to replace it. One of the deciding factors to do the replacement was it was getting worse and my GP told me you're as healthy as you're ever going to be in the future so do it now. The replacement is good, the joint pain is gone but now have new aches and muscle pains. There is no way I'd play tennis or basketball with it. Doing anything strenuous or climbing anything you are very aware of it. It's a change of life and I'm glad I waited as my timing with work and all worked out well so I could retire post surgery.
 
Wow appreciate the quick responses. I will make this THR my priority this coming year. ANterior is the way to go correct or leave that up to the DOC that hopefully does these 300 times a year?

Minimally Invasive Anterior Total Hip Joint Replacement. The anterior approach is an approach to the front of the hip joint as opposed to a lateral (side) approach to the hip or posterior (back) approach.
 
I don't think you should base your decision on approach. Base it on the OS, their capabilities and their program.
 
@mattman, you can use the time to set up meetings with multiple surgeons to find someone excellent who you like.

So ... the approach issue ... Basically you want an excellent surgeon, period. Excellent surgeons use posterior, anterolateral and the anterior approaches. Lots of people on here went anterior ... it's not guaranteed that your recovery is faster ... If you just put the patients of excellent surgeon 1 using posterior against excellent surgeon 2 using anterolateral (which I had) and excellent surgeon 3 who used anterior ... the differences in recoveries, I suspect, would be very slight and not always in favor of anterior. Surgeons using all three major approaches cut less than they did 20 years ago ... and have much faster walking recoveries than 20 years ago with much less pain (courtesy a huge amount from innovations by the anesthesiologists).

But yes, if you want anterior, make sure it's an excellent surgeon ... and yes, 300 a year is great ... Usually hip replacement surgeons are also knee replacement surgeons ... and the top ones do about 300 of each a year. There are some hip surgeons who also do other stuff and still they're excellent. Again, make sure their hip numbers are high.

The other thing is to find someone who supports your goals, who is confident you can get to the activity level you want to get to. And most of us want someone we "like" and trust, though there are some folks who are OK with just technical excellence without feeling much of a rapport with the surgeon. I needed technical excellence (to the best of my determination) and rapport.
 
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I haven't started my own thread Matt, but your situation is a lot like mine. I got back into tennis a few years ago, was reaching Districts and Regionals with my tennis team. I liked playing singles so was going hard at it; yeah, ok, so I wasn't getting balls that I could get in my 20's, but still was playing competitive and was going to advance in my rating. My sport was soccer, but played tennis all growing up; mom had us in tennis lessons during the summer--she was a tennis player at university and probably wanted us out of her hair for parts of the summer growing up.

Anyway, I had a tough, competitive match in doubles just over a year ago. I definitely would have aches and pains playing and towards the end of a match where I could hardly pick up a tennis ball. And after a match I would get these aching, aching pains in my groin/inner thigh area. Standing, drinking a beer with the crew, I would have to excuse myself to sit down the pain was bad. Didn't think too much of it, hey, I thought, I'm in my late-50's and squeezed more years in those 50+ years. So, after that match above, something just didn't feel right, like a new kind of pain right around my hip.

Go in and get an Xray, yep, osteoarthritis with bone spur(s) in my left hip. How's your right hip? Not too bad, why? You have the same problem. :umm:Ok, well it doesn't seem as bad. So they throw me in PT for six weeks. :thud: Ok, tell me again, we are trying to build muscle around a compromised hip? I then get a steroid shot. Really? That's suppose to help? Didn't help me. All the while I can't really do anything. I mean like any sport or activity. My job requires some lifting, moving of medical equipment and other physical activity which I'm able to do, but I have no, or very little, motivation to do anything around the house; did paint daughter's old room to be our new guest room and after she came home from university. So I can clean the pool and get around, but it's just a pain in the...well, hip. Which more tellingly effects my thigh and other parts of my lower body.

I can't write that it's debilitating, but pretty challenging none the less. Shortly after my steroid shot I meet my GP for another issue. She asks how things are. I'm like, oh, not too bad, but my hip is killing me. Hmmm, should I make a referral to see a surgeon (I'm with Kaiser)? I was like, uh, I think so. So two surgeons later (the second specializing in anterior approach which one of my tennis teammates was sold on) we make a date for surgery; next month (January) where we met back in June--I figured things may be slower work-wise after the first of the year.

Over the last five/six months of meeting the surgeon, things have tended to get worse. Again, not debilitating, but certainly comprising. I seem to have developed atrophy in much of my lower body from inactivity and worry if there was an emergency where I had to run from danger, or have to run to aid someone else, I could move, but not very far or quickly. When it's bad, it's like I'm shuffling like my 86 year old dad.

There are some days at the start of the day I'm like, hey, this isn't so bad, I seem to be moving around pretty well, pain not so much, but then sure enough, that pain rears its ugly head and I'm limping and shuffling around again. Friends, family, and others see me walking around and are like, what is wrong with you??? Usually they think it's an ankle problem or something.

I'll often dream that I am running and pain free, only to wake up with a pillow between my legs realizing, nope, you will have the same problem as you get out of bed and get going today. This will be an interesting ride in the next few months. Not so much because this will be my first hip replacement, but because I will probably have to look forward to a really' (why edit it?) second one!
 
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Oh, and to get back to your original query, when is it time? Pretty much everyone who has had it done or is familiar with the procedure (like a family member, spouse, partner, friend who has had it done) has said basically, you will know when it's time.

I come into this with much trepidation, concern, wow, it's just not the right time. And there's days when I wake up (see above) and think, I can milk my current situation for a while longer. I suppose I could, but it's not a way to live. Then there's that double-edge sword; you're young (I think, hey, I am at 58), how can I be doing this now, but then cuz I am relatively young, the healing should go quicker, BUT, I suppose I could have a revision down the road. So what do you do, comprise living cuz you want to outlive your new hip? Well yeah, but then you're discounting the current living part.
 
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And there's days when I wake up (see above) and think, I can milk my current situation for a while longer. I suppose I could, but it's not a way to live.

Wayfarer's sentiment was my feeling also.....until it wasn't.

Live the life you were blessed with to the fullest, without pain. Find another surgeon who'll perform the surgery. Putting on underwear, pants...getting in and out of the car and up from a chair were all painful for me also. I can so relate! Getting out of the car and lowering my leg was the worst. I had to place my hand under my thigh and lift, then slowly lower it. You don't have to live like that. You'll be AMAZED at how it all changes post op. I seriously cried happy tears because I couldn't believe it no longer hurt to get out of the car.
Do your research and find a good surgeon. You won't regret it.
@mattman
 
Won't do an MRI? Doesn't want to offer THR? Agree with the others that it's time to find a new surgeon.

You're the same age as I was for my 1st THR. I waited about a year with significant pain (minor pain was hanging around for at least 5 years beforehand) before really doing anything , but only because I took advantage of a great opportunity to move across the country to work for my current employer. Lots of things going on to keep my mind occupied for a few months, but eventually the pain just consumed me. Lost sleep, irritation, crankiness, unending pain - there's no reason to live that way.

Research indicates these things will last a lot more than 10 years, and evidence for some shows many decades. I figure *if* I ever need to think about a replacement, medical science should be that much farther along with better options.

The "You should wait" thinking is definitely old school - and for those who can wait, awesome. But everyone's pain levels - and tolerances - are different. I couldn't take it anymore. If you can't, time to find someone who understands and values today's quality of life over the maybes of a revision many years from now.

2 questions I want to ask the "You should wait" doctors - "Why would I wait to get a shiny new hip while the rest of my body has deteriorated? What advantage is there to letting the rest of my body wear out such that it can't take advantage of all a new hip can offer the younger me?" OK, so that's 2 questions, technically covering the same idea I guess :)

Good luck!
 
Anterior is the way to go correct or leave that up to the DOC that hopefully does these 300 times a year
Leave the implant choice and the approach to the surgeon. Find someone who does 200+ hips per year. It's the skill of the surgeon that is the most important factor.
 
I'm just going to echo what everyone else here says... don't wait until you reach the point where you're debilitated! There's just no need to put yourself through that. Like you, I found my world shrinking, no longer able to do what I used to be able to do. I had a resurfacing done about a year and a half ago... and it was life changing! I'm more active now than ever. Going to the gym 3 times a week, playing hockey 3 times a week, snowboarding at least once a week, 40 lbs lighter than I was pre-surgery... it feels amazing to be able to do these things again when I couldn't even tie my shoes or ride a bike less than 2 years ago. My left hip is starting to go downhill now, a minor annoyance at this point... but I'm seeing my surgeon in the new year to look at swapping it out for an upgrade as well!
 
I had mine done in 2015. Found a surgeon I trusted and liked. When I first really considered the replacement (around 2012, maybe) I saw my surgeon and was expecting one of 2 answers: 1. "You're nowhere near ready... don't do it" or 2. "Can't believe you walked in here on that hip. Worst I've ever seen! Surgery asap!". What I got was "X-rays show the hip is bad enough but I treat the pateint, not the X-ray. Let me know when you can't cope anymore and I'll do it". He said I was on the young side but not his youngest to get a hip replacement. I wasn't quite ready then. By 2015, pain was more frequent - almost constant - and way too many changes to things like tying shoe laces. He did both anterior and lateral but chose lateral for my situation.

So far everything is great. My other hip is several years behind the where the replaced one was but it is getting worse. No hurry to do it but I don't think I'll let it get as bad.
 
I had my first LTHR anterior in 2015 at 51. I put that one-off for years, prob 10, arthritis issues started 20 yrs prior. Anyway, you sound like you're where I was at at that time (2015) pain putting on pants, underwear, putting on socks was a painful chore, not to mention clipping toenails that was a real challenge to reach them! I am very surprised your surgeon still feels your too young and hasn't done an MRI, I had quite a few throughout my process. I would highly recommend going to a high volume hip surgeon as others had recommended. My left hip is great, no pain, the fluidity and smoothness of the replacement is an amazing feeling. Surgery and recovery is by no means easy, but in the long run so worth it. My right will be replaced tomorrow and I am so ready, I waited too long only because it wasn't as bad as the left, until it was, and it deteriorated SO fast, I went from functioning fairly well to not being able to walk in Nov. and haven't been able to work a full schedule since and have been in a lot of pain daily since. Don't let it get to that point!
 
It's time.:yes:

My double hip replacement gave me my life back!
:dancy:
 
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It's time when you say it's time! It's your body, your life. It sounds like your quality of life is being impacted and you're feeling other parts of your body trying to pick up the slack. Definately find another OS. I consulted with 6 lol. They all do not share the same philosophy.
 
Clearly, the doctor you visited is clueless. He doesn't know what's going on in the wonderful wide world of hips. Sayonara, doc!!

But you haven't said what is causing your hip pain or whether you have actually tried injections. Please go to another doctor, and get a proper diagnosis first (definitely an X-ray, and possibly an MRI, depending on what the X-ray detects). Assuming it's osteoarthritis, you might have some luck with injections--especially since you're still able to walk six miles a day. For some people, injections return their hips to normal function (for awhile). Maybe this will enable you to postpone hip replacement a few years, and by then, hip replacements might be even better than they are now!! Or perhaps your specific injury requires another protocol altogether.

You asked when you know it's time...In my case, I didn't know I had dysplasia or arthritis until I was already limping badly, and the injection I tried didn't help. Despite being a younger candidate (42 years old), both surgeons I visited recommended surgery, and both said that I could expect the new hip to last 30-35 years. Things degenerated so rapidly that the decision was not difficult. Now I'm six weeks out and doing quite well.

Let us know what you find out!
 

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