The downside of ‘unique’

Being unique is usually a good thing. Except when an experienced orthopedic surgeon examines your X-ray and admits he’s “never seen that before.”

But that wasn’t the worst news I received during my recent consultation with Dr. David Fajgenbaum.

After examining me and observing my gait he said that, because I have waited so long, the muscles in my hip joint are likely to be so atrophied that I may never walk without a limp – even after extensive physical therapy.

“If it’s as bad as you say, why am I not in more pain?”

“I don’t know.”

Then he recommended I get a bone density test because my bones appeared “thin” in the X-rays. [The results from my bone density test were normal, so maybe he’s wrong about my recovery too!]

Getting back to my X-rays, Dr. David pointed out the two views of my right hip: one of extreme arthritis and the other of a hip out of its socket. And for that reason he did something he does not routinely do – he ordered an MRI.

Although his candor surprised me (and sometimes reduced me to tears), I was ready to let Dr. David perform my hip replacement. I have met my share of arrogant orthopedic surgeons, and he is not among them. Throughout our meeting, he stressed that the decision to have the surgery – and when – is mine. “We treat patients, not X-rays,” he said. “We’ll do the surgery when you say you’re ready.”

The MRI confirmed “markedly advanced degenerative joint disease evident at the right hip with severe joint space narrowing…” among other ominous medical jargon. From the report Dr. David concluded that the discrepancy on my X-rays is likely due to my spinal fusions, which are causing my pelvis to tilt forward. As a result, I could be at a slightly higher risk of dislocation following hip replacement.

“Have you ever done a hip replacement on a scoliosis patient like me?"

“No. So I think you should get a second opinion.”

He recommended Dr. Michael Bolognesi at Duke Medical Center. Based on the volume of spinal surgery at Duke, Dr. David thinks Dr. Bolognesi is “more likely” to have encountered a patient like me. Here’s hoping.