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Old 06-18-2016, 06:12 AM
 
Location: N of citrus, S of decent corn
34,581 posts, read 42,741,316 times
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It is very interesting that a 90 year old would undergo major surgery. I suppose, if she was fully functioning mentally and insisted on it, she shouldn't be denied, but really this sounds crazy to me. Perhaps the surgery contributed to her mental decline, or perhaps it would have happened anyway. Now, it is what it is, so if she was my friend I would just keep her engaged and hope that she bounces back.
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Old 06-18-2016, 07:09 AM
 
Location: Texas
3,697 posts, read 2,841,454 times
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Originally Posted by gentlearts View Post
It is very interesting that a 90 year old would undergo major surgery. I suppose, if she was fully functioning mentally and insisted on it, she shouldn't be denied, but really this sounds crazy to me. Perhaps the surgery contributed to her mental decline, or perhaps it would have happened anyway. Now, it is what it is, so if she was my friend I would just keep her engaged and hope that she bounces back.
I'm wondering if the surgery was en elective hip replacement, or if it was for fracture repair, as Bluedevilz mentioned. A replacement at that age seems very unusual, but perhaps there are underlying issues the OP is not aware of. Conversely, repairing a fractured hip is considered palliative care, and is usually has to be done in most situations, regardless of age and mental status.

And hip fractures are serious business. They have a pretty high 12 month mortality rate in patients older than 65, especially patients above 80. I'm sure Bluedevilz knows for sure, perhaps he can chime in.

Last edited by Texas Ag 93; 06-18-2016 at 07:27 AM..
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Old 06-18-2016, 08:06 AM
 
Location: N of citrus, S of decent corn
34,581 posts, read 42,741,316 times
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Originally Posted by Texas Ag 93 View Post
I'm wondering if the surgery was en elective hip replacement, or if it was for fracture repair, as Bluedevilz mentioned. A replacement at that age seems very unusual, but perhaps there are underlying issues the OP is not aware of. Conversely, repairing a fractured hip is considered palliative care, and is usually has to be done in most situations, regardless of age and mental status.

And hip fractures are serious business. They have a pretty high 12 month mortality rate in patients older than 65, especially patients above 80. I'm sure Bluedevilz knows for sure, perhaps he can chime in.
Good point. To me the OP sounded as though she had one, and then another, electively, but what you suggest makes sense.
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Old 06-18-2016, 09:32 AM
 
Location: Texas
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Originally Posted by gentlearts View Post
Good point. To me the OP sounded as though she had one, and then another, electively, but what you suggest makes sense.
I think I misspoke a bit with my earlier comment where I said "repairing a fractured hip is considered palliative care". I guess true palliative care would be no operative intervention at all, but I think the general consensus is that surgery still has a better outcome for survival. Maybe the tide is starting to turn on that though?
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Old 06-18-2016, 10:12 AM
 
4,627 posts, read 10,504,468 times
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Originally Posted by Texas Ag 93 View Post
I think I misspoke a bit with my earlier comment where I said "repairing a fractured hip is considered palliative care". I guess true palliative care would be no operative intervention at all, but I think the general consensus is that surgery still has a better outcome for survival. Maybe the tide is starting to turn on that though?
My initial thought when I read the OP was same as yours, probable hip fracture treatment....still treatment of choice, surgery whether open reduction internal fixation, hemiarthroplasty or total hip arthroplasty even in a 90 year old.
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Old 06-18-2016, 10:31 AM
 
18,853 posts, read 6,160,004 times
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Anytime you let a surgeon "cut" your body you are taking a major chance and thru my experience with my sloppy, messy or whatever I might think of what I deal with, it was a real crapshoot. I was expecting SO MUCH better, SO MUCH.

All those percentages??????

That old Motto, DO NO HARM needs to be removed.
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Old 06-18-2016, 11:59 AM
 
4,627 posts, read 10,504,468 times
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Originally Posted by jaminhealth View Post
Anytime you let a surgeon "cut" your body you are taking a major chance and thru my experience with my sloppy, messy or whatever I might think of what I deal with, it was a real crapshoot. I was expecting SO MUCH better, SO MUCH.

All those percentages??????

That old Motto, DO NO HARM needs to be removed.
What about those percentages?

No answer to them I see since they don't jibe with nonsense you are trying to sell folks....

A "crapshoot" by definition is a risk, uncertain endeavor with unpredictable results....

The myriad of studies showing efficacy and success rate for total hip arthroplasty makes it anything but a crapshoot...

As for "first, do no harm" once again, a complete lack of understanding on your part...

Is “first, do no harm” even possible?

"The idea that doctors should, as a starting point, not harm their patients is an appealing one. But doesn’t that set the bar rather low? Of course no physician should set out to do something that will only be accompanied by predictable and preventable harm. We don’t need an ancient ancestor, however well-respected, or an oath to convince us of that!

But if physicians took “first, do no harm” literally, no one would have surgery, even if it was lifesaving. We might stop ordering mammograms, because they could lead to a biopsy for a non-cancerous lump. In fact, we might not even request blood tests — the pain, bruising, or bleeding required to draw blood are clearly avoidable harms.

But doctors do recommend these things within the bounds of ethical practice because the modern interpretation of “first, do no harm” is closer to this: doctors should help their patients as much as they can by recommending tests or treatments for which the potential benefits outweigh the risks of harm. Even so, in reality, the principle of “first, do no harm” may be less helpful — and less practical — than you might think."
First, do no harm - Harvard Health Blog - Harvard Health Publications
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Old 06-18-2016, 12:01 PM
 
Location: Texas
3,697 posts, read 2,841,454 times
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Quote:
Originally Posted by jaminhealth View Post
Anytime you let a surgeon "cut" your body you are taking a major chance and thru my experience with my sloppy, messy or whatever I might think of what I deal with, it was a real crapshoot. I was expecting SO MUCH better, SO MUCH.

All those percentages??????

That old Motto, DO NO HARM needs to be removed.
I know you had a bad outcome with your hip replacement, and that's very unfortunate, and sadly, you are not the only person who's had that experience. And, of course, for every individual such as yourself, there are dozens and dozens of people who've had replacements who are now living lives pain free for the first time in years (or their pain is significantly reduced) and able to enjoy activities in their life they had long ago given up on.

However, with regards to operative treatment for a hip fracture, to do nothing arguably is doing harm because of the often excruciatingly painful nature of the injury if left untreated. In an elderly person with cognitive impairment, they don't know what's wrong; they just know they're in pain. To do nothing is potentially allowing them to suffer immensely.
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Old 06-18-2016, 12:28 PM
 
18,853 posts, read 6,160,004 times
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Originally Posted by Texas Ag 93 View Post
I know you had a bad outcome with your hip replacement, and that's very unfortunate, and sadly, you are not the only person who's had that experience. And, of course, for every individual such as yourself, there are dozens and dozens of people who've had replacements who are now living lives pain free for the first time in years (or their pain is significantly reduced) and able to enjoy activities in their life they had long ago given up on.

However, with regards to operative treatment for a hip fracture, to do nothing arguably is doing harm because of the often excruciatingly painful nature of the injury if left untreated. In an elderly person with cognitive impairment, they don't know what's wrong; they just know they're in pain. To do nothing is potentially allowing them to suffer immensely.
I'm not looking for sympathy and I KNOW I'm not the only one with problems from replacements, I say this all the time and then there are some who say how so many are so great. I haven't met the great ones.

I mentioned my neighbor who fell the other night and broke her shoulder, she was struggling from the hip replacement and now this, her decline I fear. She's been so strong and tries so hard BUT....stuff happens and she can't try to live with a broken shoulder, so there will be surgery..she's 89 and has no family here to help her.

People end up so Off Balance from these replacements, I'm one. I have to be SO careful when I start to walk or I'll go down.

It's hard to be happy and light when one deals with a surgery mess. And there are mega surgery messes on the reports.
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Old 06-18-2016, 03:04 PM
gg
 
Location: Pittsburgh
16,952 posts, read 17,190,175 times
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Originally Posted by jaminhealth View Post
I've spent too much time on replacement forums and hearing from so many who had the opposite of what the 82 yr old had with both hips done and all the skiing and dancing, some miracle for sure!!!???
Will the happy people seek out a forum to find out why they feel bad? I personally know people that had replacements and they are very happy. On the internet? No so much, but people that are happy aren't searching for answers.
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