Wednesday, August 10, 2011

3rd Opinon from Dr. Diab

 My blog this week is a little boring so here is the short version:

Dr. Diab says I need a surgery to address the impingement.  He would do an open surgery.  He would not recommend a surgery to address the dysplasia because of how much arthritis I have and how difficult the surgery is.  I have a lot of arthritis in my hip and therefore I will probably not feel 100% better after surgery, but I will have a marked improvement.  Now I have to decide which surgeon to do the operation.

Today I met with another surgeon for a 3rd opinion about my hip.  I had to drive into the city for the appointment but it was worth the drive.  Online, there are a couple of support groups for young people with hip problems.  Dr. Diab's name kept coming up.  He works especially with children and specializes in spine and hip surgeries, especially hip dysplasia.  A quick recap:  I have 2 separate hip problems.  One is a femoral acetabular impingement (FAI), which is bone hitting bone, and the other is hip dysplasia, the hip socket is not shaped right.  Dr Diab confirmed again that I have hip dysplasia and said he could do an operation to correct the dysplasia but would recommend against this surgery. This type of surgery is too aggressive.  Dr. Diab also reiterated that I have a lot of arthritis in my hip.  Because of the years of wear and tear, and inflammation my arthritis is pretty bad. Because of this, even impingement surgery would not take all the pain away.  Also, Dr. Diab is the second surgeon to tell me that I should have never had had my first surgery to correct my labral tear since the tear was caused by my impingement.

Okay, I just want to say that I know I cant live in the past, but I am really p$ssed off that I never had insurance as a child so I could have taken care of this sooner before the arthritis set in.  I am also angry about all the "poor people" doctors that I saw, before I got insurance, that dismissed my pain and didnt refer me to a real doctor.  And finally I am angry at my first surgeon for giving me so much hope that my first surgery would correct my problem and get rid of my pain.  She just caused more pain and more arthritis. Now that I got that off my chest, I can move on.
Normal Hip
my hip, not enough space on top, not enough coverage around bottom of femur

my hip should look like, the black triangle is a shaved down femur,

Dr. Diab said he would recommend a surgery just for the impingement.  It would be an open procedure because he doesn't do arthoscopic surgeries.  He wants to be able to see everything and take out enough bone.   I felt vain but I asked him about the scar.  He said it would be about 4 to 5 inches across the top of my thigh.  The scar would be covered by reasonable underwear and swim wear he said.  I guess my underwear and swim wear isnt reasonable, haha.

I felt very comfortable with Dr. Diab.  He was patient and answered all my questions and explained my condition to me in a clear way.  I would feel comfortable having the operation with Dr. Diab even though it is an open surgery.
He is a respected surgeon, has excellent bedside manner, and is in network for my insurance.
My other options for surgeons are:
Dr. Sampson -  The best arthoscopic surgeon.  This means I would not need an open surgery.  He has great bedside manner and is one of the most sought after surgeons for FAI in my area.  However, he is not in network for my insurance.  This means I would have to pay cash for the surgery that can be upwards of $50,000.  My insurance will reimburse me 80% but 20% of $50,000 is $10,000 out of pocket.

Dr. Safran- Another respected arthoscopic surgeon in my area.  He has performed this surgery a lot and is in network for my insurance.  The downside is, is that he has horrible bedside manner (not just with me but I have read about other patients with FAI having similar experiences with Safran.)  Dr. Safran may be able to perform a perfect arthoscopic surgery, but what if something goes wrong and I need to talk to him.  Talking to him will be a pain in the butt with his bad interpersonal skills.  He doesnt really listen to me or explain things clearly and just keeps telling me to go to physical therapy.  I always feel rushed when I have an appointment with him even though I will wait 2 hours to see him.  I feel as though he dismisses how much pain I am in.

Dr. Hughes- This surgeon is younger than Safran but good friends with Safran as well.  He said he has performed this surgery many time and had done revision surgeries for patients.  He is in network and has really great bedside manner.  I didn't feel rush when I met with him.  However, he is younger than the other doctors I met with.  Maybe he doesn't have as much experience.

I will have a lot of thinking and discussing to do with my family in the next month.  I am so glad I have Gavin with me to help me through this. My biggest concern is that the surgeon does not take out enough bone with this surgery and then I will need a revision surgery.

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