ameet pispati, m.d., orthopedic surgeon, jaslok hospital, mumbai, india

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A Patients's Story: My India

Where to turn for advice?

My doctor told me I probably would require hip replacement and sent me to an osteopathic surgeon - I was in shock. I have known for ten years I had a bad hip but when I thought about what they were really going to do to my hip and femur bone it sickened me. Not to mention all the things I would not be doing again and the horrifying possibility of revision. Always having to be careful with everything I did and knowing with each move it was wearing away

Someone at work told me about the special on 60 minutes. I felt I had a ray of hope. I investigated the new prosthesis on the Internet. I bought Peggy's book read it and determined that was the way I wanted to go. I told the osteopathic surgeon when I went for my initial visit I wanted hip resurfacing he said my hip was too badly damaged and would not be a good candidate for the procedure. He also informed me that my femur was bent and so I would require a short shaft and my leg was about ½ inch shorter than the other and he would try to lengthen it. Feeling defeated I made and appointment for surgery. I made it four weeks out as I wanted to finish my job and recuperate over summer break.

Who should I use to replace my hip?

In the meantime I corresponded with Doctor Bose. I emailed my x-rays and he said he thought I could have the resurfacing done but he need better x-rays. All of his appointments were 8 weeks out. I preferred it to be earlier but was willing to comply if it meant having the resurfacing. I mailed my better x-rays to Doctor Bose and tried to wait patiently.

Everyday I would read the experiences of people on the Sufacehippy website (http://health.groups.yahoo.com/group/surfacehippy/ ). I also joined the THR website and comparing the two sites and the experiences of people I was so hoping to have the hip resurfacing. (http://health.groups.yahoo.com/group/Total_Joint_Replacement/)

I read on suffacehippy site the remarks from Doctor Pispati in Bombay India. I was impressed with his straight forward and informative answers to questions people had about the procedure. I looked on the Internet to read about him and his credentials.

He uses the ASR instead of the BHR so I investigated about the ASR and how it was different. The ASR is made by Johnson and Johnson and used by the Jewish hospital in California as will as other places. It is two years behind the BHR is being approved by the FDA.

I contacted Doctor Pispati to see if he could do a hip resurfacing early than Doctor Bose. I emailed him my x-rays. Just as with Doctor Bose, Doctor Pispati responded quickly. He said he had openings for the first of June and that it looked like I could have hip resurfacing done but that there was a 10% chance I would required a large Ball modular which is a THR but metal on metal and the only restriction I would have is I would not be able to jog (no love lost there). Everything else would be as if I had my real hip. I could live with that.

I emailed Doctor Bose to inform him that I was going to go to Bombay because Doctor Pispati had an earlier opening. Doctor Bose promptly responded to be sure Doctor Pispati viewed the x-rays I had sent him as his opinion was that it was not possible to resurface my hip, it was too bad. I sent the x-rays to Doctor Pispati and told him what Doctor Bose said. I asked what he thought the percentages were now that he had viewed the new x-rays and given Doctor Bose opinion. He responded with the same percentage and added that they deal with hips problems much worse than mine all the time because, like me, the East Indian people do not want to be operated on and they wait until it is difficult to fix.

So it was set. June 13th I would be in India and having a hip resurfacing with a ten percent chance of requiring a metal on metal THR that is not offered in the USA either.

Then with the waiting game comes questioning my decision wondering if it was the best. I could not talk to anyone on the suffacehippy website because no one had been to Bombay for surgery. So I investigated the hospital. My daughter works for Intel and part of her job is to correspond to people in India. She asked her colleagues for me and their reply was favorable. It is known to be one of the best private hospitals and reach centers in India. That was comforting to know that one of the best hospitals in India was backing Doctor Pispati as the head of their Osteopathic department. The makers of the BHR have distributed to him and the Johnson and Johnson Company has found him qualified to use their product.

Doctor Pispati made all the arrangements for our travel from the airport and the hotel through Leo Travels. They were very helpful and stayed with us all the way through the arrival and departure at the airport and provided transportation to the hospital and to the hotel and then back to the airport again. I felt very special while at the hospital. The staff was very pleasant and I felt like I came first in everything. There were nurses around all the time and people cleaning constantly. I know we complain that the American society is such a throw away people, well everything that still works from the 60's is still used at the Jaslok hospital. They have all the modern things they need but have not wasted useful items just because a newer one has come along. My husband was allowed to stay in the room with me. It was not a special arrangement but something they do for any patient, they may have one attendant stay with them at the same cost for the room plus the attendant's meals. I could see the tall building from my 16th floor room and could hear the noisy street outside. I felt protected from the monsoon rains and any unknown problems in India.

Now I lay me down to sleep. Nervous but confident that I would get the best prosthesis given my individual condition I was ready for surgery. When I woke up the anesthesiologist told me I had the femoral head resurfacing that I had hoped for. I was so grateful but all I could do is reach up and caress her face

Here is how the operation went, this is a quote from the Medical Report sent home with me: "A standard Birmingham posterior approach to the hip was used. External rotators were divided away from the bone to preserve vascularity of the femoral neck. The neck capsule was preserved for the same reason. The hip was dislocated. There was advanced OA in the acetabulum and an arthritic, deformed femoral head. An anterosuperolateral pocket was created, the femoral head parked into it and acetabular preparation proceeded. An acetabular cyst was decompressed and bone grafted. An ASR 60 cup was inserted in good position with excellent stability. Femoral preparation followed, with good peripheral head support and without notching. Few small cysts in the femoral head were curetted. An ASR 53 femoral head was implanted over a thin film of CMW Gentamicin cement. The reduction was absolutely stable, with an excellent rage of movement. Pulse lavage had been used through the procedure. The wound was closed in layers over 2 drains, with staples for skin. Low Molecular weight heparin (Clexane) was used postoperatively." He also lengthened my leg so I would not have a limp.

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