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Arthritis - Is Surgery Right for You?
If you suffer from severe osteoarthritis,
surgery may be in store for you.
Surgery is no small choice, and doctors
and the surgeons they work with are naturally reluctant
to operate unless you meet criteria that they consider
important.
Two of the key factors that all surgeons
probably consider are the life-expectancies of the artificial
joint and of you. Historically artificial joints last
about 15 to 20 years. New technologies may extend this,
but there's really no one offering a guarantee that
this will be so. For the new technologies, the long-term
data just isn't there yet. (That's why it's called "new.")
Doctors call the replacement of an artificial
joint gone bad a "revision." And revisions
are sometimes more difficult than the original operation.
This also forms one more cause for reluctance in treating
younger patients.
There seem to be two models that doctors
and the surgeons they work with go by.
Model #1: Age and pain intensity.
In this model, the age is a critically
important factor. If you're expected to live, on average,
to age 75 or 80, and the joint is only going to last
15 years, surgeons using this model will be reluctant
to operate until you're 65 years old.
The other parameter is pain intensity.
No matter how old you are, if you need the replacement
because the pain is just unbearable, many (most?) physicians
will agree to operate.
Model #2: Add "life style"
In this model, the factors of the first
model are still considered, but to them is added the
question of whether you're sacrificing your life right
now in order to have some kind of "ideal state"
when you're 65.
This is clearly a subjective area for
both the patient and the doctor, but in many cases,
the evidence is so overwhelmingly clear that the call
for a replacement of the joint is considered very reasonable.
And there are clear advantages to getting
the artificial joint while you are younger.
* Generally, you're better able to withstand
surgery when you're younger than when you're in your
latter years.
* Assuming the operation and recovery
go well, you'll have years of a better life that you
can look back on when you're older - even if at that
time you get sidelined because a revision isn't possible.
* Technology is improving all the time.
By the time you need a revision (assuming that the newer
materials do wear out in 15 to 20 years), the procedures
may be in place to make revisions much easier to successfully
perform.
Concluding Remarks
This article is a clarion call for arthritis
patients to be advocates on their own behalf and to
have a discussion of the effects that your arthritis
is having on your life. If you are severely restricted
in what you can do, if your family is suffering so as
to compensate for your pain, and if you can imagine
what it would be like for you to see your loved ones
in pain and know that this is what they feel about you
right now, then it may be past due for you to have this
conversation.
And if your physician and surgeon will
not take lifestyle as an important factor, seek out
a second, third and fourth doctor who will.
This is NOT a call for unnecessary or
ill-advised surgery. It is a call for a very important
discussion that you should have with your doctor.
To a pain free life...
1howto.com
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