Re: Re: My Belgian Experience

April 5, 2004

-- I was going to write you with the same question as Harriet has

asked. And your account was fabulous. I have forwarded it to my husband

(I'm the would-be patient) for his edification. Thanks for taking the time

to post your description. Very helpful.

> ,

> Thanks for your wonderful account of your experience in Belgium. I

> only very recently stumbled on this website and am still educating

> myself about hip resurfacing. Can you tell me what is different

> about the surgical procedure,technology, etc. that is being performed

> by Dr. De Smet compared with what's available in the US. It seems

> for one that the recuperation is much, much quicker.

>

> Thanks,

> Harriet

>

> > Hi All!

> > I kept thinking I would catch up on all the back postings

> before I posted, but this is such a prolific group (a good thing!)

> that I'm still about 800 in the hole! Since I'm leaving town again

> on Tuesday to check out colleges with my son on Spring Break, I

> thought I'd better just post now...I'll be even deeper in backlogged

> postings when I return this weekend.

> > I flew into Brussels with my sister, Marilyn, on Monday, March

> 2nd, checked into the hospital in Ghent on Tuesday afternoon, and

> Dr. Koen De Smet resurfaced my right hip on Wednesday. On Friday I

> transferred to the Holiday Inn. The whole experience was great!

> Thank you, thank you Dr. De Smet for giving me my life back! Marilyn

> is a nurse, and Koen allowed her to observe the entire surgery. She

> was really impressed with the whole surgical team. They didn't

> hurry, but they worked together like a well-oiled machine, without

> any wasted motion. My surgery took only 1hr & 20 minutes. I had no

> joint pain at all after surgery, but the 24-hours of IV Acetaminophen

> (Tylenol) was not sufficient to control my incision and muscle pain

> for the first few days post-op, so I supplemented it (with the

> nurses' knowledge and approval) with my own prescription Tylenol

> with Codeine #3 from home. I had no nausea or weakness post-op, but

> my hemoglobin level was 27 (should have been about 30), and Koen

> recommended a blood transfusion. Since I was feeling so good, I

> declined, agreeing that if I started feeling nauseous or weak I'd do

> later. In addtion to the (small) risk of AIDS or hepatitis, blood

> transfusions from donor blood can cause nausea, and fever as the

> body's reaction to blood that is compatible, but still contains non-

> self proteins. I continued to feel well, and resumed the iron

> tablets I'd been taking for a couple weeks pre-op. I also used my

> own prescription and non-prescription medications for non-related

> condtiions ( hormone replacement therapy, vitamins, etc.) It seemed

> to be common practice for patients to bring and self-administer their

> normal maintenace medications while in the hospital, unlike in the

> States.

> > At the Holiday Inn the fabulous (included in the rate)

> breakfast buffet was a gathering place every morning for all the new

> surface hippies and their spouses and families. We'd share stories

> about the good doctor and his staff, information about vouchers for

> the free weekend and evening taxis into Ghent, train schedules to the

> nearby medieval city of Brugge, and as we began to get out and

> explore more, tips on sights and restaurants that were " must-do's. "

> One by one, we'd leave the table to keep our daily appointments with

> Marc, our physical therapist. We had Canadians, Americans, Russian

> immigrants now living in Seattle, and a Dutch anaestheologist among

> our group, and we had a great time together.

> > Sunday and Monday (days 4 & 5 post-op) after my daily physical

> therapy with Marc, Marilyn and I took a taxi into the old part of

> Ghent and visited several cathedrals, windowshopped the lace and

> chocolate shops, and stopped for tea or a late lunch before returning

> to the HI. I kind of over-did it those days, so we stayed in on

> Tuesday and Wednesday, exercised in the pool, and watched old movies

> and CNN on TV. By Wednesday evening when Jan came for my daily

> dressing change, it was becoming apparent that I was not tolerating

> the waterproof dressing. Skin over an inch away from the incision

> but under the dressing was weeping and breaking down. Switching to a

> plain gauze dressing (no more swimming & no showering for 24 hours)

> resulted in an immediate improvement.

> > By Thursday (post-op day 8) we were on the train to Brugge for

> a full day of sight-seeing, including a horse-drawn carriage tour.

> Brugge was so beautiful we had to return on Friday as well! Saturday

> (post-op day 10) was our last touristy day, so we finished touring

> the art in the crypt of the Cathedral of St. Baaf in Ghent, then took

> the train to Brugge again to watch a 81-year old lady make lace by

> hand in front of one of the lace shops, take the canal tour, and shop

> for chocolate, lace and watercolors. It was a long day, and I was

> tired, but not exhausted, so we ate in our room, and packed our

> treasures and dirty laundry in preparation for an early departure the

> next morning

> > Sunday morning (day 11 post-op) we hit the buffet at 6:30 and

> were loading ourselves and luggage into the taxi for the airport in

> Brussels by 7:00. My swelling was down considerably by day 11, and

> the flight was much more comfortable than I had expected. We traded

> seats with another passenger so that I could have an aisle seat.

> Every hour of so I walked the length of the economy aisle and back.

> I flew economy both ways and actually was more uncomfortable on the

> flight to Belgium than I was on the return flight after surgery! I'm

> not tall--5'4 " , so taller patients might need the first class seating

> to be comfortable, but I was fine in economy.

> > I was so tired of sitting after the taxi ride and after the

> long flight back to the East Coast that I didn't use a wheel chair in

> the airports. Walking felt really good. I probably would have been

> better off using one in Newark, however, since after the incident in

> Spain, they were x-raying every piece of luggage and the conveyer

> belt broke down. In a wheelchair I could have gone to the head of a

> 2-hour line to get through Customs and Luggage Re-Check, but who

> knew! Fortunately, we had a 4-hour lay-over before the flight to

> Minneapolis, so there was still plenty of time to make it to our

> gate. We caught one of those little motorized carts that nearly run

> people down on the concourses to get to the gate, and that was much

> faster than a wheelchair! We were met by family in Minneapolis about

> 6 PM Sunday, and went to the Mall of America (close to the airport)

> for dinner together.

> > Monday, post-op day 12, I was driving, running errands, and

> trying to catch up at home after being gone for 13 days. I stopped

> using 2 crutches about 3 weeks post-op. I still use one crutch most

> of the time, but sometimes walk short distances without it in the

> house. April 19th I'm scheduled to return to my full-time job as the

> night pharmicist in a local hospital.

> > In my experience, if you are in considerable pain before your

> surgery in Belgium, it works well to schedule your surgery for the

> day after your arrival and plan to stay a few days longer than the

> minimum recommendation. This gives you extra time for the swelling

> to go down before your long flight home. If you need the extra time

> to recover, you'll have it, and if you feel better and are walking

> better than you did before the surgery (as I did), you have a few

> days to do some sight-seeing with your new painless hip! Also, bring

> along any medications you routinely take at home (except NSAIDs such

> as Ibuprofen), especially Vicodin or Tylenol #3 for those first few

> days post-op. For the ladies, I bought several pairs of over-size

> boxer shorts to wear as underwear over my swollen hip. They worked

> very well for me. I just washed them with my TED stockings and let

> them dry in the room. Bring a couple of pairs of baggy pants,

> several fast-drying tops, and a small bottle of Woolite. One couple

> in our group sent all their clothes to the hotel laundry and ended up

> with a 150 Euro (about $200) laundry bill!

> > Good luck to all the late April Belgium surfacehippies. Say hi

> to Koen, Hugo, Marc & Jan for me!

> >

April 5, 2004

Hi Harriet!

Dr. De Smet has performed over 1200 hip resurfacings, so he has more

experience with the procedure than anyone in the States. There are 3

manufacturers of these devices. The Conserve + and the Cormet are the only

resurfacing devices available in the US. Both are classified as

Investigational by the FDA, and only the surgeons enrolled in the

multicenter clinical trials for each are allowed to use them. Somebody

correct me if I'm out of date here, but I believe that the Cormet is still

undergoing clinical studies, and the Conserve + has concluded their studies

and is awaiting FDA approval. Surgeons who conducted the Conserve + studies

are still allowed access to the devices while the FDA deliberates. The BHR

(made in Birmingham, UK) is used in England and Western Europe as a standard

of practice. This is the device I have.

The concensus on this site seems to be that they are all comparable for

most patients, so the main decision is picking a surgeon you are comfortable

with. For patients with severe dysplasias, the BHR has the option of a

dysplasia cup with screws. Dr. De Smet thought I would need this after

looking at my x-rays, but my bone was in better shape than the x-rays

indicated, so I have the standard device after all. The BHR is available

in larger sizes than either of the US devices, so this is a consideration

for large patients. One of our March surface hippies in Belgium was a

rather large man who required a larger ball and cup than is available in the

States. Dr. De Smet has accepted and successfully resurfaced difficult

patients that were rejected for the US studies He's an excellent surgeon

and a kind, caring person. There doesn't seem to be an arrogant bone is his

body!

Others can correct me if I'm out of line here, but my perception is

that the US docs are more conservative about post-op weight bearing and

exercise because these devices are still Investigational, and they are more

accustomed to the greater limitations of THR patients. My only limitations

when I left Belgium were to follow the 90 degree rule, wear my TED stockings

for six weeks, finish my 3 week course of post-op medications and continue

my exercises.

Hope this helps. Feel free to contact me directly at

lindap@... or here on the site if I can be of any further help.

Re: My Belgian Experience