Re: THR recommendations – I need a chill pill!

[Guest guest]

Dave...

Let me offer a couple of following notes. Given what I've seen,

heard, and read...I'm ready to believe that THR is a much less

demanding surgery -- for the doctor. It requires less precision. it

requires less attention to detail. It requires no training in a new

procedure. Put the extra training into the mix with the fact that

surgeons don't get good at these procedures before they've done 50 or

so, and we may be getting a little closer to the reason for the

apparently unreasoned resistence to a " new " surgical technique.

Most doctors are people, and most people will take the path of least

resistance. THR is, when you get right down to it, a pretty crude

way to fix a hip. Resurfacing is simple and elegant...in its

conception...and in its approximation of the way the joint really

works.

Until I asked him about resurfacing, I had a fair respect for the

OS/sports med doc who diagnosed my condition. I asked him whether

I'd be a candidate for resurfacing. He spent ten minutes bad-

mouthing the procedure, never once explaining why I wouldn't be a

good candidate. But he really did want to put in a Biomet THR.

Won't be talking to him again.

Getting the information about resurfing has actually been a wonderful

adventure of discovery: discovery of the consoling realization that

I'm not alone with hip problems; discovery of a whole area of

medicine that looks forward, not back. I could go on; but I've got

to go limp home...and wait for JRI to call with my insurance

information.

Alan

> Do remember in March of 1997 when the Heaven's Gate cult members

> committed suicide to hitch a ride to heaven on the Hale-Bopp

comet?

> Do you recall your thoughts at the time? Did you wonder how someone

> could put their trust in another's belief without applying a

> modicum of their own intelligence before taking such drastic

action?

> Well now you know how I feel when I read about someone deciding on

> THR over resurfacing.

>

> Okay, okay, I'm sorry - this is way too harsh a comparison.

> First, let me quickly add that I'm extremely sympathetic to

> anyone experiencing debilitating joint pain. We've all been

> there and life sucks. But many of us have discovered the freedom

of

> recapturing a very active, pain-free lifestyle through a procedure

> that is still treated like a poor stepchild by much of the medical

> community. I just don't understand why THR continues to be

> favored over resurfacing. So please forgive the Hale-Bopp

comparison

> and help me out. When this community has, what is to us,

> overwhelming first-hand evidence that resurfacing is superior, why

is

> an inferior option so frequently prescribed? THR is a viable plan

B,

> but why is it so frequently promoted as the favored option?

>

> Your thoughts are appreciated... even on what I can take to calm

down.

>

> Dave

[Guest guest]

Hi Dave.

What is the saying about taking a horse to water but you can't make

it drink? As you know, I met with several top OS who operated on

some famous people and they all dismissed resurfacing as a viable

alternative. One went as far to refer to the procedure as seemingly

romantic with no long term clinical history and lacked merit. I am

two weeks out, driving, working full time, coaching sports, working

out at the gym, and I almost forgot, no pain! I made what I believe

was an informed decision, with much advice from you and others out

there. It all seemed very intuitive to me and I made my decision

and never looked back.

In terms of the " chill pill, " I suggest taking two C+s and go for a

nice long jog and know that you are doing your best to provide great

information that my influence some out there to make good personal

decisions.

Best... C+ Dr. Amstutz 5/04/04

> Do remember in March of 1997 when the Heaven's Gate cult members

> committed suicide to hitch a ride to heaven on the Hale-Bopp

comet?

> Do you recall your thoughts at the time? Did you wonder how

someone

> could put their trust in another's belief without applying a

> modicum of their own intelligence before taking such drastic

action?

> Well now you know how I feel when I read about someone deciding on

> THR over resurfacing.

>

> Okay, okay, I'm sorry - this is way too harsh a comparison.

> First, let me quickly add that I'm extremely sympathetic to

> anyone experiencing debilitating joint pain. We've all been

> there and life sucks. But many of us have discovered the freedom

of

> recapturing a very active, pain-free lifestyle through a procedure

> that is still treated like a poor stepchild by much of the medical

> community. I just don't understand why THR continues to be

> favored over resurfacing. So please forgive the Hale-Bopp

comparison

> and help me out. When this community has, what is to us,

> overwhelming first-hand evidence that resurfacing is superior, why

is

> an inferior option so frequently prescribed? THR is a viable plan

B,

> but why is it so frequently promoted as the favored option?

>

> Your thoughts are appreciated... even on what I can take to calm

down.

>

> Dave

[Guest guest]

Alan, , and ,

Thanks for your insights. If everyone would follow your

examples, it wouldn't matter how shortsighted the medical

community was. You're all excellent contributors to this group

and set a great example by sharing the path to your decisions. You

never abdicated responsibility for your own health. You know you

don't have all the answers yet you challenged established medical

opinions when they didn't quite make sense. You didn't

blindly follow recommendations without doing your homework. You used

your intelligence. The only other way to learn about resurfacing is

through luck – from a chance referral, or finding an enlightened

doctor, or by stumbling onto this site. By blindly taking the advice

of the wrong doctor, all of us could easily find ourselves with a THR

without ever knowing we had a superior option. Scary thought.

Dave

> > Do remember in March of 1997 when the Heaven's Gate cult members

> > committed suicide to hitch a ride to heaven on the Hale-Bopp

> comet?

> > Do you recall your thoughts at the time? Did you wonder how

> someone

> > could put their trust in another's belief without applying a

> > modicum of their own intelligence before taking such drastic

> action?

> > Well now you know how I feel when I read about someone deciding

on

> > THR over resurfacing.

> >

> > Okay, okay, I'm sorry - this is way too harsh a comparison.

> > First, let me quickly add that I'm extremely sympathetic to

> > anyone experiencing debilitating joint pain. We've all been

> > there and life sucks. But many of us have discovered the freedom

> of

> > recapturing a very active, pain-free lifestyle through a

procedure

> > that is still treated like a poor stepchild by much of the

medical

> > community. I just don't understand why THR continues to be

> > favored over resurfacing. So please forgive the Hale-Bopp

> comparison

> > and help me out. When this community has, what is to us,

> > overwhelming first-hand evidence that resurfacing is superior,

why

> is

> > an inferior option so frequently prescribed? THR is a viable

plan

> B,

> > but why is it so frequently promoted as the favored option?

> >

> > Your thoughts are appreciated... even on what I can take to calm

> down.

> >

> > Dave

[Guest guest]

> Dave:

>

> Fear of the unknown, or perhaps more fear of the unfamiliar. The

> surgeons all tend to recommend the devices and procedure they are

> familiar with. I also think many of them have sufficiently large egos

> that they can't admit when they don't know about something -

> especially something within what should be their area of expertise.

Well, some of this is due to the relatively small amount of referreed

publication on this procedure that was available until recently. A

friend of mine, whose wife is an orthopedist, was recently resurfaced.

His wife was initially dead set against him having the procedure,

because the only exposure she'd had to " resurfacing " was the accounts

of the failed resurfacing prostheses of the 1980s. She was completely

unaware of modern MoM resurfacing, and she completed her residency

only 3 or 4 years ago. If you look at the volume of literature on the

subject, there are literally thousands upon thousands of journal

articles about THRs - the number of papers written on modern

resurfacing is a mere handful. By the way, after visiting JRI and

witnessing her husband's rapid recovery, my friend's wife has a very

different opinion about resurfacing than she did a few months ago.

I guess my point is that one shouldn't necessarily attribute the

attitude of the US orthopedic community to sinister motives. It

*is* relatively new, and except for a couple of articles by McMinn,

a couple of articles by DeSmet, and a few by the guys at JRI, there

really isn't all that much hard data available. Even the NICE

assessment in the UK (which ultimately led to the NHS approving

resurfacing) was critical of the number and quality of studies

available to them. Hopefully, this will change rapidly as the

procedure becomes more common.

I'm not disputing the notion that *some* of these guys mught be

greedy, pigheaded SOBs, mind you, just the idea that this is the only

explanation. ;-)

Steve (bilat C+ 4/20/04, Amstutz)