Part 1
I was chatting with a former client the other day and I asked her if she could tell me the burning questions she had when she discovered her hip replacement surgery had “failed” and that she needed revision surgery. It turned out to be a masterstroke on my part, because a few days later she sent me a three page list of intriguing questions (let’s call it “The List”). Many of these questions I have answered in previous articles on this site. But not all of them. In fact, some questions startled me, as I had not considered every possible uncertainty a person may have when going through such an awful ordeal. I will answer three of these questions in this post, and I will return to The List in the coming weeks to answer more of the questions.
What Questions Should I Ask My Surgeon?
Here is usually how it works: you will undergo the hip replacement surgery, and you will see your surgeon post-operation and then for follow-up visits in the next few months following surgery. But the surgeon will quickly disappear, as he or she has more patients to see and more surgeries to perform, week after week. So you will spend more time in the recovery and rehabilitation period with other medical professionals, such as your physical therapist and perhaps your primary physician. Your physical therapist may be the first to identify that there is a problem with your recovery and therefore that there may be a problem with your hip replacement. Or it could be your primary care physician. Or it could actually be the orthopedic surgeon who performed the procedure, who may explain that the hip has failed in one of these post-op follow-up visits. (Of course, keep in mind that the artificial hip could take months or even years to “fail.”)
No matter who first identifies a possible problem with your hip replacement, your orthopedic surgeon will likely be the first person to confirm that your hip replacement surgery has failed.
When something feels wrong with your hip, schedule an appointment with your surgeon. Immediately.
It is critical in this meeting to slow down. Ask every question you need answered:
What happened?
Why did it happen?
Why do I feel this pain?
Why is my hip popping? Or making noise?
Why does my hip feel like it’s locking?
Why do you think the hip components failed?
How can hip components “fail”?
I thought metal-on-metal hip parts were supposed to last decades?
Did you know these components were failing? If so, when?
Have you had other patients with failed hip replacements?
What company made the hip components?
What do I do now?
Can I walk? Run? Swim? Play tennis? Garden?
What are my options?
Can I live with this?
Do I need another surgery? If so, why or why not?
What is involved in a revision surgery?
Can my body handle a second surgery?
If it’s not the hip components, what is caused the hip to fail?
Don’t worry that you’re wasting his time. This is precisely what he is there to handle. Do not be troubled if he acts as if he wants to leave the room. I’m sure he does. Write down every question you can think to ask the doctor before the meeting and go through your list methodically. Ask other questions that pop into your head. We are talking about your health. But you are also laying the groundwork for a successful legal action if it turns out you were the victim of someone else’s negligence.
Surgeons hate these meetings. I don’t blame them. This is a bad result for a patient, and the doctor has to explain that the result is bad. And let’s face it, total hip replacement surgery is not the same as getting your tonsils removed; it is a major, invasive, difficult surgery to go through. No one expects to go to all that trouble and then end up in worse shape. When it fails, well, it’s terrible for everyone. Of course, mostly for you, the patient.
Should I Request My Medical Records?
Yes. Here is how it works in litigation: once you choose an attorney, the attorney’s staff will have you sign medical releases for all your medical care providers, and the law firm will build a complete medical record for your case, from the surgeon’s “Operative Notes” to the physical therapist’s file to the pharmacy records. Still, it is useful to gather any documentation early. Tell the surgeon or his nurse or his staff you want their complete file to review. Occasionally, things get “lost,” and if you got the complete file early, it could save your case.
Should I Ask That the Doctor Preserve the Removed Hip Components After Revision Surgery?
Absolutely. When preparing for litigation against huge corporations like Johnson & Johnson and Depuy Orthopaedics and Zimmer, Inc., you need as much evidence to support your case as possible. Although the “product stickers” for the hip components should be in the original medical records, I have seen cases where the product stickers were not preserved (which is dumb, but it happens). Before you go into your revision surgery, make sure you ask your doctor and your nurses to preserve all removed components from your body. Sometimes these components are delivered to you in a sterile solution, sometimes in a Ziploc bag. Ask them to make sure they identify the components as belonging to you.
Remember: you doctor and your nurses and all those who work in hospitals are human beings. And human beings make mistakes. Do your homework, plan ahead, and be prepared, and you can minimize the damage if a mistake happens (such as a hospital discarding the product stickers or tossing out the actual components).
I will answer more questions from The List in future posts. You can always call me if you have specific questions of your own: 919.546.8788.