Guest guest Posted June 14, 2004 Report Share Posted June 14, 2004 Pamela you really made me smile, thank you. I am so pleased for you, you are doing wonderfully. Keep up the hard work and let us know how it is going. Liney ___________________________________________________________ALL-NEW Yahoo! Messenger - sooooo many all-new ways to express yourself http://uk.messenger.yahoo.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2004 Report Share Posted June 14, 2004 Pamela you really made me smile, thank you. I am so pleased for you, you are doing wonderfully. Keep up the hard work and let us know how it is going. Liney ___________________________________________________________ALL-NEW Yahoo! Messenger - sooooo many all-new ways to express yourself http://uk.messenger.yahoo.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2004 Report Share Posted June 14, 2004 Hi Pamela, Glad to hear you are feeling so happy and doing well............. I suspect the amount of clinking/clunking etc has much to do with how poor the muscles are - well if my experience was anything to go on.......... When I first took to the pool it didn't take much before there was a lot of those sounds and I then realised that it heralded the miniscule supporting muscles getting tired.......... After it bit and with continuous exercising they grew in strength and now it is rare to hear a clink/clunk and ages since they tired enough in the pool to have it happen............ I also realised I could use the 'noises' to reorientate my brain to accepting that life had changed, that we now had good reason to expect to move the rest of the body in different ways etc.......... and it had a job to get on with in fixing up pathways long gone............. instead of worrying about how many clunks it could register............smile. Do enjoy your wedding event and getting fit again............ from my perspective there has been nothing like it after years of inertia......... with the funny side effect that my new found enthusiam has me now fitter than a heap of my peers..........smile. Edith LBHR Dr. L Walter Syd Aust 8/02 > > I am a happy hoppin' hippy. I am walking without crutches or cane! > No one can beleive my progress more than me. I am told that I look > younger and lighter (lost about 10 lbs. in the last 6-7 wks). My > face glows with aliveness and lack of pain. (I was a mess prior to > surgery.) > > Father's Day I'll be walikng down the aisle (without support) as > matron of honor for my youger sister's 25th wedding anniversary. > Today I start with my new exercycle (was suppose to start last week, > technical difficulties). > > The only thing holding me back is my own fear, years of muscle unuse, > and that " clink " which rings loud in my head (or so I think). > Sometimes being a health care professional has it's draw backs. Too > much anatomical knowledge. > > I am a pioneer! I follow the hippycratic oath! YES, I DO WHAT I > COULD NOT DO BEFORE! I STAND TALL (5' 2.75 " ) IN THE LIGHT OF NEW > TECHNOLGY. I KNOW THAT IN MY NEXT 50 YEARS I WILL DO PHYSICAL THINGS > THAT I ONLY DREAMED OF. > > Be well, be happy, be a hippy! > > Pamela > bilat C+ 5/10/04 Dr. Schmalzried Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2004 Report Share Posted June 14, 2004 Hi Pamela, Glad to hear you are feeling so happy and doing well............. I suspect the amount of clinking/clunking etc has much to do with how poor the muscles are - well if my experience was anything to go on.......... When I first took to the pool it didn't take much before there was a lot of those sounds and I then realised that it heralded the miniscule supporting muscles getting tired.......... After it bit and with continuous exercising they grew in strength and now it is rare to hear a clink/clunk and ages since they tired enough in the pool to have it happen............ I also realised I could use the 'noises' to reorientate my brain to accepting that life had changed, that we now had good reason to expect to move the rest of the body in different ways etc.......... and it had a job to get on with in fixing up pathways long gone............. instead of worrying about how many clunks it could register............smile. Do enjoy your wedding event and getting fit again............ from my perspective there has been nothing like it after years of inertia......... with the funny side effect that my new found enthusiam has me now fitter than a heap of my peers..........smile. Edith LBHR Dr. L Walter Syd Aust 8/02 > > I am a happy hoppin' hippy. I am walking without crutches or cane! > No one can beleive my progress more than me. I am told that I look > younger and lighter (lost about 10 lbs. in the last 6-7 wks). My > face glows with aliveness and lack of pain. (I was a mess prior to > surgery.) > > Father's Day I'll be walikng down the aisle (without support) as > matron of honor for my youger sister's 25th wedding anniversary. > Today I start with my new exercycle (was suppose to start last week, > technical difficulties). > > The only thing holding me back is my own fear, years of muscle unuse, > and that " clink " which rings loud in my head (or so I think). > Sometimes being a health care professional has it's draw backs. Too > much anatomical knowledge. > > I am a pioneer! I follow the hippycratic oath! YES, I DO WHAT I > COULD NOT DO BEFORE! I STAND TALL (5' 2.75 " ) IN THE LIGHT OF NEW > TECHNOLGY. I KNOW THAT IN MY NEXT 50 YEARS I WILL DO PHYSICAL THINGS > THAT I ONLY DREAMED OF. > > Be well, be happy, be a hippy! > > Pamela > bilat C+ 5/10/04 Dr. Schmalzried Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2004 Report Share Posted June 14, 2004 Pamela, I am a 50 year old woman who is trying to decide between THR and hip resurfacing. My orthopedic surgeon is dead set against resurfacing due to the potential problems years down the road with possibly cancer, kidney failure, etc. from the metal ions released. Also, he said that the resurfacing could possibly cause death of the femur. I am so torn as to which way to go - THR and eliminate the potential bad stuff, but limit myself to merely walking around the park (on even ground) feeding the ducks, Or go with the resurfacing. I have been in the martial arts for 20 years and would love to continue with it - I haven't been able to kick more than knee high for 2 years. I'm scared stiff and confused and terrified I'll make the wrong decision. How did you deal with the ion question, etc. with the resurfacing, and did you have it done in LA? I live in Ohio. Congratulations on regaining your youth. (I feel like I'm 80) Debbie > Hi Everybody, > > I am a happy hoppin' hippy. I am walking without crutches or cane! > No one can beleive my progress more than me. I am told that I look > younger and lighter (lost about 10 lbs. in the last 6-7 wks). My > face glows with aliveness and lack of pain. (I was a mess prior to > surgery.) > > Father's Day I'll be walikng down the aisle (without support) as > matron of honor for my youger sister's 25th wedding anniversary. > Today I start with my new exercycle (was suppose to start last week, > technical difficulties). > > The only thing holding me back is my own fear, years of muscle unuse, > and that " clink " which rings loud in my head (or so I think). > Sometimes being a health care professional has it's draw backs. Too > much anatomical knowledge. > > I am a pioneer! I follow the hippycratic oath! YES, I DO WHAT I > COULD NOT DO BEFORE! I STAND TALL (5' 2.75 " ) IN THE LIGHT OF NEW > TECHNOLGY. I KNOW THAT IN MY NEXT 50 YEARS I WILL DO PHYSICAL THINGS > THAT I ONLY DREAMED OF. > > Be well, be happy, be a hippy! > > Pamela > bilat C+ 5/10/04 Dr. Schmalzried Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2004 Report Share Posted June 14, 2004 Pamela, I am a 50 year old woman who is trying to decide between THR and hip resurfacing. My orthopedic surgeon is dead set against resurfacing due to the potential problems years down the road with possibly cancer, kidney failure, etc. from the metal ions released. Also, he said that the resurfacing could possibly cause death of the femur. I am so torn as to which way to go - THR and eliminate the potential bad stuff, but limit myself to merely walking around the park (on even ground) feeding the ducks, Or go with the resurfacing. I have been in the martial arts for 20 years and would love to continue with it - I haven't been able to kick more than knee high for 2 years. I'm scared stiff and confused and terrified I'll make the wrong decision. How did you deal with the ion question, etc. with the resurfacing, and did you have it done in LA? I live in Ohio. Congratulations on regaining your youth. (I feel like I'm 80) Debbie > Hi Everybody, > > I am a happy hoppin' hippy. I am walking without crutches or cane! > No one can beleive my progress more than me. I am told that I look > younger and lighter (lost about 10 lbs. in the last 6-7 wks). My > face glows with aliveness and lack of pain. (I was a mess prior to > surgery.) > > Father's Day I'll be walikng down the aisle (without support) as > matron of honor for my youger sister's 25th wedding anniversary. > Today I start with my new exercycle (was suppose to start last week, > technical difficulties). > > The only thing holding me back is my own fear, years of muscle unuse, > and that " clink " which rings loud in my head (or so I think). > Sometimes being a health care professional has it's draw backs. Too > much anatomical knowledge. > > I am a pioneer! I follow the hippycratic oath! YES, I DO WHAT I > COULD NOT DO BEFORE! I STAND TALL (5' 2.75 " ) IN THE LIGHT OF NEW > TECHNOLGY. I KNOW THAT IN MY NEXT 50 YEARS I WILL DO PHYSICAL THINGS > THAT I ONLY DREAMED OF. > > Be well, be happy, be a hippy! > > Pamela > bilat C+ 5/10/04 Dr. Schmalzried Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2004 Report Share Posted June 14, 2004 Good Evening Debbie, Yes it was a BIG decision. I was more concerned about the amount of bone removed and the stem in the femoral shaft with the THR than removing only the diseased portion of the femoral head. Regarding the metal ion issue, I feel that the body's natural filtering system will take care of it as is done with all the other toxic substances we ingest or breath without even knowing about. Example: the rise in asthma particularly in California (gas additives that we were told were safe). Also I have increased my fluid intake. I fell in love with JRI, Tower Pulmonary and Orthopeadic Hospital in LA. They are about wellness and healing!! Something quite unusual for the american health care system (sick care for profit). I saw 3 orthopods prior to seeing Dr. Schmalzried. One wouldn't discuss it, another was happy with the prothesis he knows how to use and the 3rd had great concerns but sent me to Dr. S to form my own opinion. I followed my heart with the knowledge that there are thousands who paved the way for me. Good luck with your decision. I needed all the information I could find and talked personally with others who had resurfacing. Be well and heal, Pamela bilat C+ 5/10/04 Dr. S Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2004 Report Share Posted June 14, 2004 Good Evening Debbie, Yes it was a BIG decision. I was more concerned about the amount of bone removed and the stem in the femoral shaft with the THR than removing only the diseased portion of the femoral head. Regarding the metal ion issue, I feel that the body's natural filtering system will take care of it as is done with all the other toxic substances we ingest or breath without even knowing about. Example: the rise in asthma particularly in California (gas additives that we were told were safe). Also I have increased my fluid intake. I fell in love with JRI, Tower Pulmonary and Orthopeadic Hospital in LA. They are about wellness and healing!! Something quite unusual for the american health care system (sick care for profit). I saw 3 orthopods prior to seeing Dr. Schmalzried. One wouldn't discuss it, another was happy with the prothesis he knows how to use and the 3rd had great concerns but sent me to Dr. S to form my own opinion. I followed my heart with the knowledge that there are thousands who paved the way for me. Good luck with your decision. I needed all the information I could find and talked personally with others who had resurfacing. Be well and heal, Pamela bilat C+ 5/10/04 Dr. S Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2004 Report Share Posted June 14, 2004 > Pamela, > I am a 50 year old woman who is trying to decide between THR and hip > resurfacing. My orthopedic surgeon is dead set against resurfacing > due to the potential problems years down the road with possibly > cancer, kidney failure, etc. from the metal ions released. The alloy used in resurfacing was used extensively in Metal-on-Metal total hip replacements in the 1960s and early 1970s. Long-term studies of patients with these implants have shown no increase in cancer rates (in fact, one of them showed *lower* rates for some cancers, but the difference wasn't statistically significant) versus patients who received implants using metal-on-polyethylene. There's no evidence linking them to kidney problems, either. Also, he > said that the resurfacing could possibly cause death of the femur. There's a very small risk of this happening, which gets lower with increasing surgical experience. Did he tell you about osteolysis and proximal stress shielding in THR patients, both of which can cause loosening and failure of the implant? > I am so torn as to which way to go - THR and eliminate the potential > bad stuff, THR doesn't " eliminate the potential bad stuff " . It's true that there's no risk of AVN of the femoral head with a THR, but that's because they remove it during the surgery. The risk of AVN happening seems to be less than 1% for an experienced resurfacing surgeon. Dependig on the technology used in the implant, THRs come with another whole set of " potential bad stuff " : osteolysis (for metal-on-polyethylene THRs), proximal stress shielding (which can cause loss of bone on the top of what's left of your femur and may lead to loosening and eventual failure of the implant), a possible higher risk of infection (due to the violation of the femoral canal), and a dislocation rate 20-100 times higher than resurfacing (for metal/poly and " small ball " ceramic). Risks increase with successive revisions (revisions THRs require removal of additional bone and are both more complicated and less successful than " primary " THRs). Both procedures are astoundingly safe, and some people just aren't good candidates for resurfacing, but it's disingenuous to cite unproven risks for resurfacing and neglect to mention well-known, proven risks for THR. > but limit myself to merely walking around the park (on > even ground) feeding the ducks, Or go with the resurfacing. I have > been in the martial arts for 20 years and would love to continue with > it - I haven't been able to kick more than knee high for 2 years. I've been in the martial arts for 33 years. Des Tuck, who will doubtless chime in soon, has been in the martial arts for 35 or 36 I think. If you go the Midland Medical Technology web site, you can read about : http://www.midmedtec.co.uk/case_studies.htm The case study is somewhat out of date. If I recall correctly, won the World Masters Judo Championship in his weight division in 2002, seven years after his resurfacing. He's still competing on a world-class level, nine years after he was resurfaced. When I asked a local orthopedist about continuing to do karate after a double THR, he looked at me like I was crazy and said, " Well, patients do all sorts of things we don't recommend " . > I'm scared stiff and confused and terrified I'll make the wrong > decision. Okay, ask yourself this: If you get resurfaced and it fails, what's the worst that can happen? You'll get a THR, that's what. So, the worst thing that can happen to you is what your local orthopedist wants to do to you *anyway*. In exchange for that, you get the possibility of: 1) Continuing to practice martial arts at a higher level than you would find possibile with a THR. 2) The chance that a resurfacing will outlast a THR. There's no long-term clinical data to prove this yet, but the intermediate term clinical data suggests that MoM resurfacing lasts at least as long as THR in young, active patients and laboratory test data showswear rates 20 to 100 times better for metal-on-metal technologies than for metal on polyethylene. 3) Avoiding at least one revision THR down the road. >How did you deal with the ion question, etc. Well, first off (since I have a mild renal insufficiency), I talked to my nephrologist (kidney doc). I also searched Medline for journal articles on Chromium(III) ions and cancer or Cobalt ions and cancer. I searched the EPA site and numerous materials safety sites and toxicology references for data on long-term toxicity of Chromium(III) ions and Cobalt ions and found that they're so nontoxic that EPA hasn't been able to determine a " reference dose " for them. I used the wear data on the Corin website to calculate what the average daily dose of these substances would be during the initial break-in period and found that the amount of Chromium(III) released by the implant was less than the amount you'd ingest by taking 1 Centrum vitamin tablet (well, not quite, since absorption of Chromium through the gut is not very efficient)..In other words, I did homework. The fact that I was trained as a chemist a long, long time ago helped a bit. My surgeon (Dr. Amstutz), since he was uncertain of the effect my slight renal problem might have, consulted 3 nephrologists (including the head of nephrology at the UCLA med school), a toxicologist, and a couple of European orthopedists who did a study of resurfacing in patients with severe kidney dysfunction. He found no evidence of any ill effects. Being a prudent sort, I volunteered to be a part of the ongoing metal ions study on resurfacing patients, so I'd get early warning if my metal levels were higher than usual for resurfacing patients. Finally, I asked myself that " worst case " question I asked you above. If the resurf failed, if I showed signs of toxicity, if, if, if. The answer came up the same: *if* those problems occurred, I'd have to get the resurfacing revised to a THR. So, the way I looked at it, a THR was the very *worst* thing that could happen. Why *start* with the worst alternative????? What really solidified my resolve was seeing Roche the day after his resurfacing, doing his Tarzan routine at LAOH (I was there for pre-op tests since my surgery was 4 days after his). with the > resurfacing, and did you have it done in LA? I did, and I'd recommend Dr. Amstutz enthusiastically. However, there are experienced resurfacing surgeons at several locations throughout the US and their patients seem to be just as enthusiastic about them. A number of folks here have also been quite happily resurfaced in Europe. >I live in Ohio. > Congratulations on regaining your youth. (I feel like I'm 80) We *all* know the feeling. Right now (8 weeks after a bilateral resurfacing) I feel like I'm 20, only (a little) smarter (I'm 48). Steve (bilat C+ 4/20/04, Amstutz) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2004 Report Share Posted June 15, 2004 Dear Debbie, You've come to the right place. This is such an important decision for you Debbie, and we know it's not easy. We understand all too well the pressures you face by your OS recommending a THR. It's part well meaning advice, part soliciting new business and part putting down the competition. It's the fear of an experienced surgeon competing with a relatively new procedure that has the potential to leave him with outdated skills. If resurfacing becomes the gold standard in the public's eye, it will force him to learn a new technique or go into early retirement. Resurfacing is a threat to those who make their living performing THRs. It's an example of the medical community's resistance to change and innovation. And the sad fact is this resistance to resurfacing is not based on the well being of patients, rather on the economic interests of established surgical community. What this really means Debbie is that you need to do more research. Your decision on THR vs. resurfacing greatly impacts the future activity levels of your life as you know it. Most of us surfacehippies recapture close to 100% of our former activities, and some even exceed what we could do pre-op. THRs limit you to a modest fraction of your former levels. You can't accept the advice, opinion and reasoning of one THR surgeon, no matter how well meaning it sounds, no matter how much you trust him, no matter how great his references. Debbie, you need to take ownership of your future. Please make whatever investment is necessary, take whatever steps you can to arm yourself with sufficient information to make the best decision possible. You need to at least get the opinion of an experienced resurfacing surgeon. You need to talk to other resurfacing patients and compare their results with THR patients. We're here to support and help wherever we can, but in the end, it's your call to make. Please don't abdicate your responsibility; especially don't abdicate it to a single THR surgeon. If you're looking for a roadmap on how to proceed, Steve G. in post #28300 gives us an outstanding example of one person taking ownership of his/her future health and personal well being. There's a goldmine of advice in that single post alone, with lots of great nuggets of information and rationale. Personally I was diagnosed with OA in 1979 and told I needed a THR. I knew some folks with THRs - they had very limited lifestyles including increasing problems and restrictions with each revision. I concluded I was better off dealing with pain than dealing with the lifestyle restrictions of a THR, so I waited 18 years for something better to come along. And my wait paid off. I have a relative who had a THR 3 years after my first resurfacing. He has a hard time playing golf now, never mind tennis or running, or any of the other active stuff I can do. This simply points out what a huge difference there is in the end results of each procedure. So ask us all the questions you can think of – the only stupid question here is the one that goes unasked. Enjoy the process and keep positive. Your healing has begun. Dave C+ Amstutz, 2.24.98, 3.12.04 > > Hi Everybody, > > > > I am a happy hoppin' hippy. I am walking without crutches or > cane! > > No one can beleive my progress more than me. I am told that I look > > younger and lighter (lost about 10 lbs. in the last 6-7 wks). My > > face glows with aliveness and lack of pain. (I was a mess prior to > > surgery.) > > > > Father's Day I'll be walikng down the aisle (without support) as > > matron of honor for my youger sister's 25th wedding anniversary. > > Today I start with my new exercycle (was suppose to start last > week, > > technical difficulties). > > > > The only thing holding me back is my own fear, years of muscle > unuse, > > and that " clink " which rings loud in my head (or so I think). > > Sometimes being a health care professional has it's draw backs. > Too > > much anatomical knowledge. > > > > I am a pioneer! I follow the hippycratic oath! YES, I DO WHAT I > > COULD NOT DO BEFORE! I STAND TALL (5' 2.75 " ) IN THE LIGHT OF NEW > > TECHNOLGY. I KNOW THAT IN MY NEXT 50 YEARS I WILL DO PHYSICAL > THINGS > > THAT I ONLY DREAMED OF. > > > > Be well, be happy, be a hippy! > > > > Pamela > > bilat C+ 5/10/04 Dr. Schmalzried Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2004 Report Share Posted June 15, 2004 > > > Hi Everybody, > > > > > > I am a happy hoppin' hippy. I am walking without crutches or > > cane! > > > No one can beleive my progress more than me. I am told that I > look > > > younger and lighter (lost about 10 lbs. in the last 6-7 wks). My > > > face glows with aliveness and lack of pain. (I was a mess prior > to > > > surgery.) > > > > > > Father's Day I'll be walikng down the aisle (without support) as > > > matron of honor for my youger sister's 25th wedding anniversary. > > > Today I start with my new exercycle (was suppose to start last > > week, > > > technical difficulties). > > > > > > The only thing holding me back is my own fear, years of muscle > > unuse, > > > and that " clink " which rings loud in my head (or so I think). > > > Sometimes being a health care professional has it's draw backs. > > Too > > > much anatomical knowledge. > > > > > > I am a pioneer! I follow the hippycratic oath! YES, I DO WHAT I > > > COULD NOT DO BEFORE! I STAND TALL (5' 2.75 " ) IN THE LIGHT OF NEW > > > TECHNOLGY. I KNOW THAT IN MY NEXT 50 YEARS I WILL DO PHYSICAL > > THINGS > > > THAT I ONLY DREAMED OF. > > > > > > Be well, be happy, be a hippy! > > > > > > Pamela > > > bilat C+ 5/10/04 Dr. Schmalzried Quote Link to comment Share on other sites More sharing options...
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