Paul Hamilton - AVN, 9/11/07, Dr. Scott Rubinstein

AVN and resurfacing...
In December of 2006 I developed a sudden and intense pain in my right hip. Since I was an avid runner and cyclist I assumed it was a pulled muscle or tendon. The pain was mostly in the groin - which sometimes radiated down into my thigh.

Paul Hamilton is the official Videographer for the Surface Hippy Info website.  His Music, Videography and creative editing work can be seen on the majority of videos on this site as well as on Paul's website. - Also to see Paul in action in a short video clip of him rehearsing with an orchestra for Holy Week, go to the bottom of this story.  Paul also recently performed at Carnegie Hall.

In January 2007 I sought treatment with a chiropractor, who eventually referred me to my current GP. After taking several xrays and MRI's my new GP informed me that it was AVN, "avascular necrosis," also referred to as "osteonecrosis" - bone death. I then had MRI's of my shoulders, and ultimately received a diagnosis of AVN in both hips and both shoulders.

By April 2007 I was in excruciating pain, after limping through the entire winter. I decided to have a surgery called a "core decompression." This procedure involved drilling a core out of the femoral head - which would hopefully allow new blood flow to the area and promote new bone growth. I had the procedure on April 30th. After 6 weeks of non weight bearing on my right hip I started to walk again - only to see the pain return in full force by the end of June. My right leg continued to atrophy... and that is when I looked to hip resurfacing as an alternative to a total hip replacement. I found the information I needed on the yahoo surfacehippy board.

Specifically, Vicky Marlow encouraged me to seek opinions from Koen De Smet in Belgium, Vijay Bose in India, and Scott Rubinstein in Chicago. Dr. Rubinstein agreed to perform the surgery, and gave me a 50/50 chance at a resurf being viable. I went in for surgery on Sept 11th, 2007. The resurf was a success, and I started the long road to recovery.

I documented my recovery with numerous videos. In each video I am showing the absolute best I could do on that particular day - it was not easy! I limited myself to swimming and walking, with minimal biking. Balance problems persisted through August of 2008, with intermittent bouts of fatigue and discomfort in my hip/waist. I attempted to try running at 6 months, just to see if it was possible. The weakness in my inner thigh indicated that I was still healing. That, along with the potential problems in my left hip, convinced me that I had to hold off on returning to running.

Now I am over one year post-op - and in the last two months the balance problems are gradually subsiding, along with a constant residual twinge of pain deep in the hip.

I have 98% range of motion back... and I stretch regularly. My recovery was rapid at first - then it leveled off after about 12 weeks, just as Dr. Rubinstein predicted.

Although I am not guaranteed a lifetime with this new hip, I am confident that I have made the right decision to get a resurfacing instead of a THR. I have saved bone, and I still have the option of a PRIMARY THR in the event the Birmingham hip ever fails. Meanwhile I am monitoring my other hip and two shoulders.

Many thanks to Vicky, Keith, and so many others who have made this valuable information available on the internet. Vicky sparked in me a sense of empowerment: to make my own decisions, based on credible information from experienced surgeons, and information from fellow patients. Dr. Rubinstein gave me back my ability to walk. I am forever grateful.

Good luck to all who seek this treatment!

Paul Hamilton
BHR, Dr. Scott Rubinstein, 9/11/07



Photo Left:  Paul and Vicky when Paul was the solo Orchestra for "Barber of Seville" in Mendocino June 2008

Post on Surface Hippy:  Patient advocates...
Wed Oct 15, 2008 1:54 pm


My main reasons for seeking a resurf were this: saving bone, buying time. I decided that if my device were to fail after, say.. two years, I would have at least bought time and conserved bone - I am now 43 years old, diagnosed with AVN in both hips and shoulders. Every day that my BHR lasts proves that my "gamble" has been worth it. If and when the BHR fails I will move on to a primary THR (which can also fail due to AVN). If the BHR lasts a lifetime, then good for me!

My first experience with an orthopedic surgeon turned out to be a "gamble" - a "core decompression": the surgery failed, potentially wiping out my chances for a resurf. The surgeon here in Chicago was not honest about his intentions until AFTER I returned to him - where he reversed his opinionHamilton that "resurfacing would be the next best option to pursue" - he suddenly suggested a THR (he does not perform resurfacing). I was extremely angry when I left his office that day. He left me with a huge core drilled out of my femur, waiting for the bone to fill in, in agonizing pain again, on crutches. He gave me a prescription for one month of Vicodin, and said "I'll see you in THREE months." Huh??

This was when I decided I to take matters into my own hands... with the encouragement of Vicky Marlow, who posts here, and another woman named Marie, who oversees the AVN International yahoo board. If they had not encouraged me to seek my own solution I would have simply followed the instructions of an overbearing, irate surgeon.

My own family and friends thought I wasting my time seeking help on the internet. I submitted emails/MRI's/xrays to Dr. Bose, Dr. De Smet, and Dr. Rubinstein. All three of them responded quickly and honestly. NEVER would I have attempted such a thing if Vicky had not encouraged me to do so (I had no idea it was possible - I thought my unsolicited email would be summarily dismissed as "spam").

At first I thought: "is this woman crazy?" No way am I going to India or Belgium to have surgery (nor do I have the resources to do so). But as I read her posts I realized that Vicky and Marie were encouraging me to open my mind to the possibility of a BETTER surgeon. That was my epiphany. I did not realize that I had so much leverage concerning my own fate. This greatly empowered me to find the very best surgeon for me (and within the constraints of my own financial/medical resources).

De Smet warned against a resurf - and advised me to have a Delta ceramic THR. Dr. Bose suggested a BHR. Dr. Rubinstein also suggested a BHR, and gave me a 50/50 chance. His experience with AVN is well established in the Chicago medical community - so my choice was with Rubinstein. His experience with hip resurfacing is proving to be very successful. In September of 2007 I was his 69th or 70th resurf, and on March 12, 2008 he personally told me he had performed well over 100. I saw him two weeks ago and he indicated he has had no failures - good for his patients, and good for him.

The great work that is done here can easily be taken "for granted." There are a lot of laypeople who selflessly spend hours of their time encouraging potential and post-op patients: the work of Keith, Pat Walters, Vicky Marlow, Alan, John K, Ron V.M., etc is an invaluable resource for the worldwide patient community.

I have personally met Vicky, and have witnessed firsthand her commitment to patients. She has not received a penny for her work, and has created a niche that has garnered the attention of many surgeons worldwide - good for her, good for them, and good for us! I have also met Dr. Edwin Su, as well as Drs. Macaullay and Zelicof. I now realize how different approaches can bring about the same results: pain free living, with natural gait and ROM.

Vicky has taken it upon herself to seek an audience with these medical professionals. It is remarkable that she has been able to achieve this, and she has freely shared the information with this board.

We went to New York over Mother's day weekend this year, to film three surgeons' interviews. Vicky flew in around 6:30 pm on Friday and hit the ground running. We both stayed up late chatting with a potential patient, who has since gone on to have a successful surgery. Vicky then used my laptop to conduct some more surfacehippy business late into the night. Saturday we started very early and conducted the interviews. I took a break, however Vicky headed across town to visit the HSS, and attend yet another conference with McCinn present. I don't know where she got the energy - I was worn out.

Please give her a break - I've seen her in action and in person: in California, in New York, and now Chicago. She is a selfless woman, who is strong, assertive, intelligent, and hopeful that ALL patients receive their fair share of excellent health care. Good for us!!

Thank you for "putting the fire under my fanny" Vicky!

Paul in Chicago
BHR, Dr. Scott Rubinstein, 9/11/07

April 2009
Paul Hamilton wrote the music for this entire mass, printed about 166 musical scores, rehearsed, video taped, edited, audio recorded and mixed.
“It's a rehearsal with our orchestra for Holy week. Spring is my favorite season, and with it comes hope. I hope you are healthy, happy and prosperous." - Paul Hamilton