First, I don’t believe you can determine how much time someone has left to live. Secondly, at what age does an individual’s right to quality time expire?

As a senior with a family history of longevity, the issue of quality time greatly concerns me.

DEAR READER: Well, you’re certainly right that I can’t determine how much time someone has left to live. My inference was that at 39, and under ideal circumstances, a person likely has 45 or more years of life left. In fact, average life expectancy in the United States is nearly 78 years. I’ve personally seen all too often that a young person with so much to look forward to has the rug pulled out from under him or her. And I’ve also seen people who don’t contribute to society, defy what we perceive to be a good lifestyle, smoke, drink too much, drive too fast, are obese, eat all the wrong foods and live to a ripe old age. It doesn’t seem fair.

In large part, quality time is what we make of every day of our lives, and hopefully, it involves good or relatively good health, not a life fraught with pain and the unhappiness of one serious medical condition after another.

Human beings should not have a predetermined age at which quality time expires. That would open a can of worms, and we would likely behave in inappropriate ways, knowing we had little time left. We would feel justified in drinking too much, getting in trouble with the law, failing to report to work or care for our loved ones, and behaving irresponsibly. Each and every one of us is different. Even within families, one individual may suffer medical consequences beyond the scope of what should ever have to be faced, while another remains relatively healthy. An exemplary lifestyle can often be snuffed out like a lit candle at an early age. We simply have no control over that. I cannot play God, nor can anyone else and determine an age at which quality is no longer important and we become mere shadows of our former selves. That’s why it is so important to make every day count. Smile at strangers. Enjoy the company of friends and family. Of greatest importance, take care of your health to fight off the unknown.

My problem now is that the only doctor who will agree to do my revision surgery (the one who did the original replacement) is not a provider with my insurance. I have consulted two other physicians, and they both tell me that I need to wait because the plastic ball part of the prosthetic is not worn enough to warrant having the surgery. At the same time, they tell me that they can’t say for sure what is going on until they open me up.

I have had every scan/test and blood test that I know of to check for low-level infections, but all came back negative. There is one other local surgeon I can consult with, but I feel he will concur with the other two doctors and tell me to hold off on surgery.

I am currently taking 500 milligrams of naproxen twice a day and extra-strength Tylenol along with Vicodin to try and combat the pain, but it is becoming a losing battle.

Do I just pack it in and have the original doctor perform the surgery for my hip and possibly go bankrupt? Or should I wait and suffer until one of the other doctors thinks it is time for surgery? I understand that revisions always come with risk and less chance of success than the previous surgery, but I can’t take much more and am ready to give the procedure a shot.

DEAR READER: A typical prosthetic hip can be expected to last 10 to 20 years. Factors such as weight and activity levels can have a bearing of success. People who play strenuous sports, perform heavy lifting or hard manual labor, or are overweight are not as likely to have as good of an outcome as those with moderate lifestyles and average weight.

You had your hip replacement 12 years ago, around age 27. This is a young age to have required hip replacement. You do not say what necessitated this surgery; however, at this point, it is not a concern.
Given your level and frequency of pain, I believe that your hip is simply wearing out and needs to be replaced. Your young age is another factor in this decision. You still have a lot of life left to live, and that should be quality time. You are likely a good candidate for the surgery.

I don’t believe that you should go bankrupt in the process of improving the quality of your life, so I suggest you either return to one of the orthopedists who accepts your insurance to discuss why they don’t think you are a candidate, given your age and pain level, or request a referral to the final local orthopedist for another opinion. You may also benefit from reviewing nonlocal physicians who accept your insurance, including those associated with a teaching hospital or a major medical center.

To provide related information, I am sending you copies of my Health Reports “Managing Chronic Pain” and “An Informed Approach to Surgery.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order per report to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title(s) or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: The pain of fibromyalgia is widespread and can be felt throughout the body. Symptoms vary from person to person and can include joint stiffness, sleep disorders, fatigue, widespread pain and a great deal more. Herein lies the problem, because every symptom can be tied in to other disorders, making it difficult to diagnose.

There is no X-ray testing or laboratory work to confirm or rule out fibromyalgia. Rather, the history a patient presents to his or her physician, coupled with a hands-on examination, will likely tell the story.

Treatment commonly begins with over-the-counter remedies such as ibuprofen, aspirin or naproxen sodium, advancing to prescription medications such as gabapentin, tricyclic antidepressants, SSRIs (selective serotonin reuptake inhibitors) and narcotics. The downside to narcotics is their addictive qualities, which appear to control one condition while replacing it with another damaging one. Physical therapy and an exercise program might be an appropriate addition to more conservative methods. Water aerobics, deep breathing exercises, massage, chiropractic manipulation, acupuncture, yoga and even counseling might teach a patient methods of successfully dealing with the constant pain. There are options. Therefore, it is important that you enlist the services of a physician well versed in the treatment of fibromyalgia. Don’t give up. The condition is an unpleasant, exhausting one but there is help.

To provide related information, I am sending you a copy of my Health Report “Fibromyalgia.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Before jumping to the conclusion of bone cancer, you should consider the more common occurrence of arthritis of the hip, a condition that leads to pain in one or both hips as the cartilage begins to wear down.

If you underwent radiation, this could have sped up the deterioration of the connective tissues. The pain could also simply be age related, but because you did not provide any history, such as age, health status, medications, etc., I can’t determine whether this is likely.

I urge you to speak to your physician, who can order an X-ray that will show whether there are any abnormalities within the hip or bone suggesting arthritis, cancer or other causes, such as osteoporosis. If anything is abnormal, further testing will be necessary to determine the cause.

I, too, have had 3 cortisone shots in my hip (no recommendation from my doctor for hip surgery) and so far they only offer temporary relief.

Inasmuch as I did not read your original article about the castor oil rubs and grape juice with pectin, I am very interested in knowing your instructions for such. I realize there is no guarantee that this treatment will help me but I would like to give it a try.

DEAR READER: Castor oil is simply rubbed onto the affected joint or joints twice a day.

To eight ounces of purple grape juice, add 1-2 tablespoons liquid pectin. This mixture can be taken up to 3 times a day until pain is decreased and then reduced to 1 glass per day as a maintenance.

Because of the high reader interest, I have recently written a health report that contains the most popular and effective home remedies.

To give you related information, I am sending you a copy of my Health Report “Dr. Gott’s Compelling Home Remedies”. Other readers who would like a copy should send a self-addressed 4 ¼” X 9 ½” letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.