Patient\'s perspective on Birmingham Hip Resurfacing. Navigates patient\'s issues in obtaining Hip Resurfacing surgery, a superior alternative to Total Hip Replacement. Addresses comparison of two types of hip surgery, choice of surgeons, insured or not insured payment alternatives, provides links to top surgeons and patient support tools.

1. Hip Resurfacing: Extend Your Youth by Fifteen Years Presented by Richard Junker Knights of Columbus, Nativity August 15, 2011 1

2. Agenda Medical options if you have a bad hip Where to get your surgery done How to pay for your hip surgery What to expect when you have hip surgery Be your own physician Questions and answers 2

3. Objectives Identify key care decisions through my own experience with hip resurfacing surgery Contrast the Birmingham Resurfacing Procedure to the classic Total Hip Replacement surgery Provide tools for navigating the health care system to get the surgery you need Provide online resources to help plan your surgery. 3

4. Comparison of Hardware: Birmingham Hip Resurfacing Total Hip Replacement 4 xx

5. Hip Resurfacing Mechanics 5

6. Total Hip Replacement Mechanics 6 x

7. Getting Started Begin to educate yourself about Hip Resurfacing vs. Total Hip Replacement (THR) http://www.hipresurfacingsite.com 2. Find out if you are a candidate for resurfacing 3. Connect with other surface hippies 4. Start researching your surgery options 7

8. Quality of Life Testimonial—Steve Beuerlein Steve Beuerlein played quarterback at the highest level, completing a career in 2003 that included a passing title, post season awards, 147 touchdowns and over 24,000 yards passing. Of course, it also included a few hits from defenders. When he retired, he thought the pain inflicted during the season would go away and he could be a normal active father and business man. Unfortunately, his hip pain worsened. 8

9. How do I know if I’m a candidate for hip resurfacing? Age under 60 ideally, mid-60s commonly Lifestyle—physically active Moderate alcohol, no drugs, no kidney impairment Bone density No diabetes Male No Avascular Necrosis (AVN), large areas of dead bone 9

11. Not many Domestic surgeons have done 100+ resurfacing surgeries

12. Reason: The FDA approved Birmingham Hip Resurfacing Procedure in the United States only in 2006. Abroad, surgery has been available since the mid-nineties.10

14. Search long and hard for a qualified surgeon in network

15. Use the Surface Hippy website’s list of qualified surgeons. Call Vicky Marlow directly at (510) 490-0245

16. Go abroad if you cannot obtain a qualified doctor through your medical plan, or if you have no insurance11

17. How to Pay for Your Surgery If you have insurance--A… Orthopedic Surgery Stateside First identify a qualified surgeon who is in the insurer’s Preferred Provider Organization (PPO) network Second, obtain an examination to determine need for surgery, and your qualification for the Hip Resurfacing Procedure Third, obtain authorization from your insurance company’s Claims Department Fourth, confirm the coverage terms of the insurance 12

18. How to Pay for Your Surgery If you have insurance--B… Orthopedic Surgery Stateside Typical coverage is a $500 annual deductible per insured, another $500 hospitalization deductible, and 20% coinsurance payment by the insured, subject to a $10,000 maximum annual amount ceiling. Example: Fees Surgeon Fee: $10,000 Assistant Surgeon Fee: $ 2,000 Hospital, Joint and Rehab Fee $40,000 Total Cost of Surgery $52,000 Patient Costs Annual Individual Deductible $500 Hospital Deductible $500 Coinsurance @20% of $10k $2,000 Total Cost to Patient $3,000 13

19. How to Pay for Your Surgery If you do not have insurance--A… Orthopedic Surgery AbroadThe following is provided to you by WorldMed Assist, Medical Tourism experts, and contains general information that may not apply to you.“We can give you access to high quality, low cost orthopedic surgery in India, Belgium, Mexico and Turkey, such as knee replacement, hip replacement, hip resurfacing, etc. We arrange all of the logistics for your surgery outside of the US and currently offer India, Belgium, Mexico and Turkey as destinations. We have partnerships with the best hospitals in these countries, including hospitals that have strategic relationships with Johns Hopkins and Harvard Medical. Medical Tourism for orthopedic surgeries is commonly done thanks to the very high levels of experience of doctors that we can provide in addition to the tremendous cost savings. Some cost examples: 14

20. How to Pay for Your Surgery If you do not have insurance--B… Orthopedic Surgery Abroad The following is provided to you by WorldMed Assist, Medical Tourism experts, and contains general information that may not apply to you… 15

21. Be Your Own Physician Question your GP and Orthopedist: Dr. Fiore Challenge your insurer Know the costs, know the technology Take good care of yourself before you need hip surgery Insist on being a dynamo into your seventies Life is pretty good to 65, then it’s patch, patch, patch 16

22. Why Wait? “ ...I was checking off my shopping list as I slowly pushed my grocery cart, slightly leaning against it, trying so hard to hide the limp that had now become so apparent. Suddenly I realized there was an item I had missed. Oh NO! It was two aisles over, an aisle that I already had walked past. I paused, leaning more against my cart, hoping to take some of the weight and pain away from my deteriorating left hip. I thought long and hard, do I really need that item? Can I do without it? Was it worth walking back TWO long painful aisles to get to that item? I decided no, it was not worth it, even though I really wanted that item, the cost of that item now equated to the amount of pain it would take to obtain it. The thought of that excruciating hip pain brought tears to my eyes, tears that I slowly and secretly wiped away... --Vicky Marlow, Founder of Surface Hippy Website I think we have all been blessed with this wonderful new procedure and we should all be very thankful and try to help as many people as we can who need this type of surgery, get it, and with a good doctor. --Karen McNulty – Dancer 17

23. Questions and AnswersVicky Marlow Vicky with Mr. Derek McMinn (Inventor of the BHR device) at AAOS 2008 18

24. Questions and Answers 19

25. Questions and Answers Dan Shulte, Hip Resurfacing 2002 Coming up on 7 years since his Hip Resurfacing, "I maintain my primary passion for surfing and cannot blame a bad session on the hip!" 20

27. Understand the Potential Risks and Complications…

28. Day of Surgery--In Surgery…

29. Recovery…

30. Regaining Your Mobility…

31. Long-term…21

32. Online Resources to Plan Your Hip ReplacementSurgery Information Central for Total Hip Replacement Research American Academy of Orthopedic Surgeons--Total Hip Replacement http://orthoinfo.aaos.org/topic.cfm?topic=A00377 Minimally Invasive Surgery THR Q & A http://www.johnshopkinshealthalerts.com/alerts/arthritis/JohnsHopkinsArthritisHealthAlert_275-1.html Your Hip Surgery http://www.zimmer.com/z/ctl/op/global/action/1/id/528/template/PC/navid/10429 Complications… http://www.hipresurfacingsite.com/Complications/Complications/menu-id-84.html WebMD…webmd.com 22