Time to get philosophical (kind of) on the type of new hip joint I actually received. Way back in this blog I spoke quite loudly and boldly on why I wanted a metal on metal hip. My doc stated his preference was a metal-poly hip. For a number of weeks and days prior to my surgery I was not certain just which device I was to receive as I had no opportunity to clearly and succinctly tell him my preference. We went through some telephone tag, and in the end we never did end up speaking until just before my actual surgery.
Part of my angst was based on a temporal issue, and perhaps my simple thinking - don't they need time to make the correct sized pieces? If they need more time to make a metal-metal replacement then my surgery will be delayed. Perhaps I can switch with someone who is going to have theirs after mine? Such were the pre-surgery thoughts looking at a worst case scenario. To be sure, one might assume this scenario to be the case. Well, in actual fact, as to the different sized pieces, the only piece that was to change if it were metal-metal is the cap that is impregnated/smashed/placed (your call) into the pelvis.The titanium piece that is inserted into the femur with the ball attached has already been made or prepared. The ball has to fit into the cap correctly, so I would assume that just like an auto garage has multiple tires on hand, so too does the orthopedic hip surgeon have multiple sizes of caps. No?
The key question that drove this angst was the type of replacement device I was going to receive. Separate from the details above, philosophically and physiologically speaking I really began to consider my stated desire for two pieces of metal inserted in a key joint in my body - did I really want that? What about the metal ion issues that my own surgeon had actually researched and published on? Also, I am now 50, and if the life span of these things are 13-17 years, then I will have to get another one anyway. And at my age, how much more pounding or impact sports can my body take? Do I really love lacrosse that much? Perhaps the answer to this question is based on my ego in that I am able to outrun (or I could) a lot the players my age or a bit younger. Do I really want to keep playing basketball until I am 65 or so? Well, actually I do. I think the highest we jump is 6 inches off the ground. Its low impact basketball at best. So, I might be able to hang in there until 60-something with whichever hip I get, especially if I have to get a new one. In the end, its funny how final answers to questions come to us in times like these.....
...After Wednesday night hockey, at the pub of course, and about two weeks prior to my surgery, a lengthy discussion on body wounds and reparations ensued with a friend who has had his share of repairs. He began talking about the troubles he has had with his jaw joint replacement (imagine that!). He told me about his troubles; case in point, his need to have it re-done, and finally ending up with a metal-poly type jaw joint. After going through the gruesome details and experiences, he then asked me a timely question, "do you really want a metal on metal joint?" Then he took a sip of beer and smiled in a side-ways kind of way that he does (now I know why). Perhaps I knew before we talked, but thinking about what he said, and the question he asked nailed home my answer - a metal poly is just fine thank you.
One other thing - try rubbing two pieces of metal together. Throw a bit of lube goop in there and there you have the kind of environment that would be my hip joint if I were to have this metal-metal thing. Would the joint not heat up with friction from hockey or whatever? Yes, naturally occurring body fluids would be passing through the joint. What happens in this case to the surrounding tissue? And what about cold weather high up on Whistler when I am skiing? Will it not get cold, and thus radiate through my hip area and thigh? The last consideration is the amount of pressure that the femur would have to withstand from the impact of running when the cap is not able to absorb the pressure that a poly cap can. Worst case scenario is a weakening of the attachment area where the ball piece is inserted into the femur. Enough said.
Since the surgery I have been receiving mixed signals about can and can't do's - a medical practitioner states, "once you are strong enough you can start running again, though not in a marathon right away." What? I thought I could not run? I know I can cycle, golf, ski, swim, walk, hike, play hockey etc etc.... Who knows. maybe I can get back into rowing. There seem to be enough clubs around Vancouver for me to join.
Importantly, I am at peace with this decision. There's no second guessing, concern or wavering. I am fine with this. While not using the future as an excuse to abuse the new joint, I will no doubt be through this process of replacement, recovery and rehabilitation again. This new hip is a "change" not an "alteration" of my lifestyle. I can live with that.
-fin-