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"You need a new hip" the Orthopedic Doctor told me like a mechanic telling me I needed new brakes on my truck.  So matter of fact.  No big deal.  Lots of people get new hips these days.

Except it is a "big deal" for me.  

I've made it 57 years without so much as a stitch, a broken bone, a single surgery.  The last day I was in the hospital was the day I was born 57 years ago.  I am very, very fortunate to have made it this far and remain healthy for the most part.  Oh, a few minor health issues now and then, but nothing major ever.  Healthy all my life.  Until now.

More below the fold...

A year ago my hip started hurting a little.  I ignored it.  Then it got a little worse and I realized something really was wrong.  Mentioned it to my doc when I went in for my annual checkup.  "Better have it checked by a sports and ortho specialist" he says.  Referral.  Appointment in 4 weeks.  The day comes.  I'm hurting and can barely get my sock on my right foot anymore.  X-ray.  It looks bad.  Lets get an MRI.  "Yep, your hip is totally shot" he says.

I'm floored.  I can't be falling apart - I'm still young.  You shouldn't need a new hip until you're in your 70's or 80's I tell myself (and others).  New limitations:  no sleeping on your right side.  But I've slept on my right side since I was a baby!  No more long walks or standing for a long time.  What?  I can't go to Mardi Gras?  Don't carry anything heavy.  Don't get down on the ground.  Don't cross you right leg over your left.  How do I get my sock on?  Ok, you can do it for that only.

I refuse to do pain meds even though it hurts all the time.  Too many horror stories.  Just started physical therapy and Dry Needling.  It helps some.  I can also do epidural steroid shots for a while doc says.

But I have a more immediate problem:  Insurance.  My small employer says they're gonna dump it at the end of this year and let us all fend for ourselves, and they're not joking.  We have a good plan - a "Cadillac" plan in fact.  It pays 90% after deductible.  The Ortho Doc says I'm young for a hip replacement, but he'll do it when I'm ready.  He wants me to wait a few years if I can bear it.  I'd like to wait too.  But what happens if I lose my insurance at the end of this year?  I can handle paying my deductible and 10% of the cost after Blue Cross gets done discounting it now. But I have no idea what insurance I will have next January.  It could be a costly financial decision to wait on the hip replacement.

I'm seriously thinking of going ahead with the hip replacement this summer while I still have insurance and know the cost.  Is it crazy to do that?

Would you get a new hip if you were in my shoes?        

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Comment Preferences

  •  Go for it . (11+ / 0-)

    If you are going to do is latter because it needs to be done ,
    get it done now and don't suffer while waiting . It makes no sense to me waiting in pain when you can get it done and get rid of the pain . Choosing a few years in pain gets you a few years of pain .
    My fathers girlfriend had a minimal invasive hip done ,
    its working well .
    A friend of my fathers had the old style invasive job done ,
    its not working well .

    "please love deeply...openly and genuinely." A. M. H.

    by indycam on Mon Jan 13, 2014 at 07:07:44 AM PST

  •  My Late Mom Had Relief From (4+ / 0-)

    a kind of steroid injection down into the joint, which was allowed a max of 3 times a year. I'm not up on the terminology; have you discussed that with yer doc? The shot is done in some kind of self-numbing way so even though they go right into the joint, it doesn't hurt.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Mon Jan 13, 2014 at 07:08:28 AM PST

    •  it's worth trying. (1+ / 0-)
      Recommended by:
      OregonWetDog

      I tried it but it wasn't sufficient for me. Usually by the time it's bone on bone, as in my case, that only provides short term relief.

      Gondwana has always been at war with Laurasia.

      by AaronInSanDiego on Mon Jan 13, 2014 at 07:54:57 AM PST

      [ Parent ]

    •  Fluoroscopically guided injection? (3+ / 0-)

      If that's what it was, it is a more effective method of getting the steroid deep into the joint. Different people experience different amounts of discomfort from it.

      For me, I feel an ache - not terrible, but distracting - for two days afterward. I assume it's because the joint capsule is already so full of crap that there's not much room for the steroids, so it has the same pain effect as additional swelling. A little ibuprofen makes it easy to ignore.

      A friend had both knees and a hip done around age 50. She had acclimated to the pain for so long that she was completely unprepared for the amount of relief she felt. She was elated.

      Go for it, while you've got the good insurance.

      You don't want to be stuck w/no choice due to financial constraints at a time when the pain is constant and unbearable.

  •  Doctors don't even suggest a hip replacement until (5+ / 0-)

    they are worthwhile. Once a replacement is needed the exact timing is a vector of several dimensions: money, motivation, age, overall health, weight and so on (motivation because your compliance with rehab is a major determinant of how good it will be). If you are concerned that getting it replaced now is risky down the road, you might want to get a second opinion for that. I do know folks your age who have had it done.

    Good luck. Pain sucks.



    Is it true? Is it kind? Is it necessary? . . . and respect the dignity of every human being.

    by Wee Mama on Mon Jan 13, 2014 at 07:10:30 AM PST

  •  What you want to do is strengthen your muscles, (9+ / 0-)

    so there's less stress on the bone. Exercise will be necessary, even if you do get the hip replaced. If aspirin helps, take that. My mother had her first hip replaced at about age 62. It lasted her until she died at 98. The second hip was replaced when she was 80. That one also lasted until she died and actually got rid of a lot of other pains (knees,etc). I'm not sure they're making them to the same quality. You might ask how long today's models are expected to last. A friend had to have the same hip done twice because the first surgery cracked the bone into which the pin was inserted and she ended up with a leg two inches shorter. Then she had knees done and last year the other hip. For some reason the bone had deteriorated in just over a year (if the x-rays were to be believed). A gentleman down the street had his hip replaced about 20 years ago. It never healed right and he had it done again. Sepsis set in and he eventually died from that. It's my guess a lot depends on how quickly a person heals.

    Pain is not necessarily an accurate signal of disease.

    The quality of medical "appliances" seems to vary quite a bit. There are now ads in the papers seeking patients whose surgeries were not a success because the appliances were bad. I suspect one of the reasons the ACA programs seeks to tax the appliances themselves is so they can begin to track which prove successful over time and which don't. Patients whose appliances fail aren't likely to know the brand when it comes to a hip or knee joint.
    Do the surgeons keep track? Ask.

    Obamacare at your fingertips: 1-800-318-2596; TTY: 1-855-889-4325

    by hannah on Mon Jan 13, 2014 at 07:18:14 AM PST

    •  Smoking has a very serious impact on healing - if (1+ / 0-)
      Recommended by:
      hannah

      anyone is looking for an additional reason/motivation to quit, they might keep that in mind.



      Is it true? Is it kind? Is it necessary? . . . and respect the dignity of every human being.

      by Wee Mama on Mon Jan 13, 2014 at 04:23:29 PM PST

      [ Parent ]

      •  Did not know that. Thanks. n/t (1+ / 0-)
        Recommended by:
        Wee Mama

        Obamacare at your fingertips: 1-800-318-2596; TTY: 1-855-889-4325

        by hannah on Tue Jan 14, 2014 at 04:50:40 AM PST

        [ Parent ]

        •  Very big impact - some surgeons will work with (0+ / 0-)

          patients to quit in advance with a pledge to stay off cigarettes for at least the initial period of healing. A couple of links, here, and here. A money quote:

          How does smoking affect my skin and wound healing?

          Smoking causes blood vessels to become smaller.  The smaller vessels have a harder time carrying oxygen, nutrients, and healing factors to the wound.  This can cause the wound healing process to take longer.

          Carbon monoxide is a poison from smoking that enters your blood cells.  This poison lowers the level of oxygen in your blood.  Oxygen is vital to your healing. It only takes 3 full days of no smoking to get rid of all the carbon monoxide in your blood.  It is vital to quit smoking for at least 3 days before your surgery so that the oxygen can build back up in your blood stream.

          The first link has numbers showing that smokers took 50% longer to heal.

          I hate the tobacco companies. They stole my mother from me.



          Is it true? Is it kind? Is it necessary? . . . and respect the dignity of every human being.

          by Wee Mama on Tue Jan 14, 2014 at 05:40:03 AM PST

          [ Parent ]

  •  More important than the immediate question (6+ / 0-)

    which seems to turn a major medical decision essentially into an economic one, perhaps, especially as you approach your seventh decade, "Do I need a new way to look at my health?"

    That you describe yourself as being "healthy for the most part," and seem quite proud of your lack of past medical intervention, while ignoring the pain of your hip degenerating to the point of needing replaced, calls for some serious self examination.

    What else have you been ignoring? (No, I don't want to know, but you might benefit from answering that question for yourself.)

    War beats down, and sows with salt, the hearts and minds of soldiers." Brecht

    by DaNang65 on Mon Jan 13, 2014 at 07:19:24 AM PST

  •  Do it, older friend just had hip #2 replaced (4+ / 0-)
    Recommended by:
    weck, newusername, FloridaSNMOM, Wee Mama

    and she is up and around in two weeks like nothing happened

    "The poor can never be made to suffer enough." Jimmy Breslin

    by merrywidow on Mon Jan 13, 2014 at 07:19:46 AM PST

  •  Don't forget about Obamacare. That will let you (5+ / 0-)

    get decent insurance, if your employer drops their insurance.

    Starting at age 65, you'll have single payer (Medicare).

  •  I probably would, but be sure you look (3+ / 0-)
    Recommended by:
    weck, AaronInSanDiego, FloridaSNMOM

    into replacement timing.  Replacement knees, and presumably hips as well, don't necessarily last forever.  I've heard of folks who have had to turn around and do it all over again 5 years later.  So be sure if there are different 'models' available to you, you check into which is likely to last the longest.

  •  Would I? Yes (7+ / 0-)

    I'm close to having a shoulder replacement done. The cortisone injections working only a few weeks then gradually becoming less effective. My specialist does 800 hips a year and has people back at work in 30 days average, some in 14 days. He says no more pain from day one. Get your life back. Get to sleep all night long again. Stop suffering. Warning though- take rehab seriously and obey physical therapy instructions to the letter! That is the only way to get the most from replacement surgeries. Otherwise the joint doesn't heal properly around the replacement.

  •  hard to answer regarding the insurance situation. (3+ / 0-)
    Recommended by:
    weck, FloridaSNMOM, Catte Nappe

    I'm 46 and had a hip replacement almost 3 years ago. The doctors did not encourage me too wait, although I tried several alternate treatments before getting it done. The restrictions you describe were mostly temporary, and the main one I still have is that I can't do much running or high impact activities, but for me that's not a problem. I'm back to doing quite a bit of walking and hiking, and working up to doing more. Fortunately, I've continued to have insurance through my employer, although the plans have gotten more burdensome to the employee in some ways. With the availability of the ACA, I'd suggest going for it.

    Gondwana has always been at war with Laurasia.

    by AaronInSanDiego on Mon Jan 13, 2014 at 07:44:22 AM PST

  •  Just my opinion - YES (3+ / 0-)
    Recommended by:
    weck, FloridaSNMOM, Wee Mama

    and what sways my opinion is all the studies and statistics that show a hip fracture has a high mortality rate. With a bad hip, you stand a greater chance of a bad fall and fracturing/breaking your hip. It is a debilitating injury.

    Just google hip fracture/broken hip/mortality. You'll find tons of info.

    KOS: "Mocking partisans focusing on elections? Even less reason to be on Daily Kos."

    by fcvaguy on Mon Jan 13, 2014 at 07:45:38 AM PST

  •  Yes, get it done, and don't wait until summer. (4+ / 0-)

    1. The pain will not stop until you fix it.

    2. Your insurance and doctor will create less stress to you if you have enough time to heal while insured.

    3. My 86 year old dad plays golf because he has had his hips and knees done. No pain = more activity.

    4. Consult with someone who does hip "restoration".  A friend had the bones resurfaced and is quite satisfied.  He may have a total replacement later, but will qualify for medicare by then.

    If love could have saved you, you would have lived forever. & http://www.dailykos.com/blog/Okiciyap

    by weck on Mon Jan 13, 2014 at 07:46:41 AM PST

  •  Do it now. The longer you (1+ / 0-)
    Recommended by:
    FloridaSNMOM

    wait, the more weight you will put on and the harder the surgery will be for you. Get it over with as it is an easy keyhole surgery these days.

    "We have cast our lot with something bigger than ourselves" - President Obama, July 30, 2010

    by Overseas on Mon Jan 13, 2014 at 07:59:43 AM PST

  •  Get it done. Now. (2+ / 0-)
    Recommended by:
    FloridaSNMOM, Wee Mama

    Why are you living with so much pain? Not necessary.

    My Mother had both her hips done. She was in a wheel chair before the surgery. Afterward, no pain. She could walk all day, sleep all night.

    One thing - you MUST be diligent in rehab. The harder you work, the better the results.

    Do it now.

    "May the forces of evil become confused on the way to your house." - George Carlin

    by Most Awesome Nana on Mon Jan 13, 2014 at 08:04:36 AM PST

  •  Do it! (2+ / 0-)
    Recommended by:
    FloridaSNMOM, Wee Mama

    The replacement has a limited life, about 20 years, but replacing the worn parts is a simple operation.  A friend has his artificial hip's worn parts replaced and was walking his dog again in a week & a half.

  •  reminder: 2nd opinion (2+ / 0-)
    Recommended by:
    FloridaSNMOM, Catte Nappe

       We are being asked to make a decision based on too little information - says the person who absolutely hates hospitals.    
        I always assume that you have already received a second independent opinion.  

  •  I would go for it.... after (1+ / 0-)
    Recommended by:
    FloridaSNMOM

    doing a lot of research into what kind of hip they want to put in, what is available, etc.  My foggy brain remembers hearing/reading some stuff about hip parts that cause problems, are not being recalled, or are in the process of being recalled, ... I may need a brain transplant...

    Having lived most of my life without insurance, I'd say do it while you can with least cost to yourself! Otherwise it's financial aid forms and/or bankruptcy.

    I've just spent months crying every day from joint pain because I was scared of, and refused to take, anti-inflammatory drug. I finally broke down, did the research and picked one. Watching for side effects, but none so far.
    Don't be like me. Don't wait until the pain gets so bad that the option of not living seems just as good as living with the pain. (And I was on pain meds) I picked an old drug that has been around for decades. I would never go with a new drug....

    Only thing more infuriating than an ignorant man is one who tries to make others ignorant for his own gain. Crashing Vor

    by emmasnacker on Mon Jan 13, 2014 at 08:44:23 AM PST

  •  I wish I could (1+ / 0-)
    Recommended by:
    FloridaSNMOM

    Instead I'm stuck with hip dysplasia for life.

    Get it done!

  •  whatever you decide, (0+ / 0-)

    I hope you'll investigate and pursue alternative and supportive therapies. Things that make a difference include: losing weight, working with a rehab specialist, working on posture issues (Egoscue, for example), finding appropriate exercise to keep limber (Tai Chi? yoga?) in addition to something aerobic for heart health.

    If you work on these things you may find improvement in the symptoms; if you do get the surgery you will still need to do these things to make a good recovery and keep your other joints from developing the same problems.

    My dad got his hip replacement in his mid-eighties. He may have been a bit on the old side for the surgery. He is very overweight. He will not exercise. (He did the required rehab pt but nothing after that). He had an unexpectedly difficult time recovering from the surgery, due perhaps to those factors. Now he is pain free but they are telling him the other hip needs to be done. I think he could avoid that if he'd work on his health a bit but he is stubborn and won't do anything.

    Where in the Constitution does it say: "...on behalf of corporate interests" ???

    by sillia on Mon Jan 13, 2014 at 09:14:15 AM PST

  •  Do it now (while you're young) (1+ / 0-)
    Recommended by:
    FloridaSNMOM

    because you will be in much better physical condition before you start and you'll bounce back from the surgery much more quickly. Also, the last thing you want to do is become housebond or reduce your physical activity because of the discomfort and end up paying the price for that in other health problems down the road. Nearly everyone I've known who's had joint replacement surgery has remarked that they would have done it sooner if they had known how much better they'd feel afterward. I also agree with those who said don't wait until summer. You want to be recovered and enjoying yourself by then, eh?

  •  Joint replacements aren't all they're cracked (2+ / 0-)
    Recommended by:
    SuWho, Catte Nappe

    up to be. Some recent studies are showing very mixed results in terms of pain and function after surgery. There are also very serious risks of adverse, and even fatal, complications in the immediate aftermath of the surgery. And to top it off, there is a growing body of evidence that metal particles thrown off by the prosthesis as it wears are causing serious long-term issues, including cancers. I would do a LOT of research before I decided on a major surgery like that.

    Also, there are a lot of cases where the hip, even though looking bad on MRI and feeling like the source of the pain, isn't actually the problem. Back issues can cause pain that appears to come from the hip, as well as muscle issues. Again, more recent studies are showing that MRI is not a good indicator of pain - something close to half of all hips that look terrible on MRI will be completely asymptomatic to the patient. That is true of knees as well, as an aside.

    One thing they can do to narrow things down is do a nerve block injection in the hip. If that stops the pain, then at least you know the pain is really coming from the hip. Often, it does not stop the pain though, and further searching will trace the problem back to a pinched nerve in the back or something along those lines.

    Docs lately are very quick to recommend joint replacements - its an easy diagnosis - but the results of all these replacement surgeries just aren't holding up to close scrutiny. It is NOT like replacing a bad part in your car - the prosthetic will never be the same as what you have and great results are FAR from guaranteed. Please, do a LOT of research, and make sure you are really properly diagnosed. See LOTS of doctors until you are utterly convinced there is NO other option.  

    That's my 2 cents, anyway, coming from someone who's struggled for the last 18 months with an alleged knee issue. I also was recommended a replacement, but while I was foolish enough to have the arthroscopic "debridement" surgery, at least I didn't let them cut my knee out. Turns out the problem was with a hamstring muscle, and despite my knee looking like crap on MRI, it works just fine now that the muscle issue was addressed. And if I hadn't had that first "minor" joint surgery, my knee would be in much better shape than it is now. Tough lesson.

    •  The numbers I've seen show that (0+ / 0-)

      hip replacements are among the most successful surgeries, over 95% success rate, with lower rates as time goes on. But there are always risks, particularly infection in the hospital, and there may be more recent research that casts doubt on the numbers I read.

      Gondwana has always been at war with Laurasia.

      by AaronInSanDiego on Mon Jan 13, 2014 at 08:04:24 PM PST

      [ Parent ]

  •  A friend of mine (1+ / 0-)
    Recommended by:
    OregonWetDog

    had a hip replacement jsut a couple years ago, and now finds she must have another one done because the first one is a defective product. Whenever you decide to have the surgery, be sure to research the device beforehand. And best wishes for great success!

  •  It would be your decision (1+ / 0-)
    Recommended by:
    grover

    but Chuck Norris had a hip replaced in 2010 or 2011.
    For a guy in his 70s with an artificial hip, his mobility seems excellent. Now, doubtless, he isn't a guy lacking physical fitness, so I'm sure that affected his outcome....

    LBJ, Van Cliburn, Ike, Wendy Davis, Lady Bird, Ann Richards, Barbara Jordan, Molly Ivins, Sully Sullenburger, Drew Brees: Texas is NO Bush League!

    by BlackSheep1 on Mon Jan 13, 2014 at 01:02:40 PM PST

  •  Yes!!!! (0+ / 0-)

    Today's hip replacements aren't those of yesteryear. So if you hear horror stories from a decade or longer ago, ask a lot of questions. They likely don't apply.

    I have several friends who have hip replacements -- all veterans.  My dog has one, as do the dogs of several of my friends.

    I don't mean to insult you by comparing you to a dog. But you would NOT believe how active, how pain-free, how restored my human friends (and my canine buddy) are with their new hips. My dog wakes every morning, stretches, heads outside and chases squirrels and his cohorts full speed. He's my fastest dog -- and the others aren't slouches by any means. We joke that they gave him a bionic hip.

    One of my friends is about 2 years post op. He is still in the military,  hikes, works around the house when he has a bit of free time, has every bit of the normal life he had when he was younger before his hip was damaged.

    It's miraculous. Rehab requires diligence. You can't just get a new hip and go. If you can build up muscle as much as possible before surgery, that's great.

    The younger you are, the higher your odds for great results. Of course, nothing is guaranteed. There is no such thing as "minor" or "routine" risk-free surgery: and this is major surgery. If you've never had surgery before, I understand that idea is scary. But we have to weigh the risks vs benefits too. There are some surgeries that I think the assurance of  benefits is questionable. There are some that I think that the benefits can be tremendous, especially if you do exactly what the surgeon dictates post-operatively.

    All I can tell you is what I would do:  if I ever needed a replacement, before the surgeon finished the sentence, I'd be scheduling the surgery.

    © grover


    So if you get hit by a bus tonight, would you be satisfied with how you spent today, your last day on earth? Live like tomorrow is never guaranteed, because it's not. -- Me.

    by grover on Mon Jan 13, 2014 at 01:41:36 PM PST

  •  Thanks for all the replies! (1+ / 0-)
    Recommended by:
    AaronInSanDiego

    I'm doing physical therapy in anticipation of having my hip replaced, even though I haven't made up my mind.  The goal of PT is strength and flexibility. Fortunately I'm not overweight - the surgeon called me a "skinny guy", and I don't smoke.

    I'm also in the early stages of gathering as much information as I can.  It seems that a newer technique is being developed that cuts recovery time substantially.  I wanted to wait a few years for it to be more perfected and to see the outcomes of a study.

    I was actually encouraged when the surgeon told me to wait as long as I could.  I thought he would encourage it since it would benefit his practice financially. Instead he said "I'll do it when you are ready".  His main reason for suggesting I wait is that he said a hip would last about 20 years and he said I would only want to do it once.  I'm still thinking of getting a second opinion though.

    •  My main goal now, after having my hip done, (0+ / 0-)

      is to lose weight, in part to help the longevity of the hip replacement. Sounds like you're a step ahead of me on that score.

      Gondwana has always been at war with Laurasia.

      by AaronInSanDiego on Mon Jan 13, 2014 at 08:06:15 PM PST

      [ Parent ]

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