Had right Hip surgery waiting to have left hip surgery DOS in 2 weeks medical won’t give me MEB

Ajcrr09

Registered Member
So I’m in a funny situation, I have been seen at my clinic for hip pain since April 2017. I had x-rays on base to find out I have Right hip FAI and was referred to physical therapy on base. I completed physical therapy with still pain so the base doctor referred me off base. I was seen by an off base doctor in August due to the long referral management process. The off base doctor looked at my MRI and determined I need surgery because I also have a labrum tear. I transferred to a new doctor for second opinion shortly after only to find out both hips were FAI and need surgery. I had right hip surgery on November 28,2017 and my doctor put me on 3 month con leave due to me being security forces and not having desk job options. In December after meeting with clinic for follow up I asked for MEB. My date of Seperations is feb 25th 2018 and I knew I needed my left hip done plus I haven’t healed yet with bad prognosis from my off base doctor stating this surgery is usually the bandaid before needed hip replacements.

Long story short THE PCM denied my meb and told me I don’t have enough time to determine if the surgery worked. And my only option is to extend or re-enlist. I can’t reenlist because I can do my job with two messed up hips nor can I run for PT test. My prognosis is having hip replacements in the near future how is this not deemed unfit for MEB standards now. The military is letting me separate with a left hip that hasn’t had surgery yet and I have yet to heal to determine if I can hold off longer for hip replacement. Is there anything I can do to appeal the clinic decision to not send me up for MEB. I think this is unfair and I’m only denied because my date of separate was closing in.
 

docmanslaughter

Registered Member
Hello. I am former Special Forces operator-turned medical officer with specialties in ortho and flight surgeon. I just retired 3 mos ago after 37 yrs. Most of my last 17 years were spent as BN and BDE Surgeons with FORSCOM units. I have placed soldiers into the MEB/IDES process AND have undergone an MEB myself before retiring. First, FAI (femoral acetabular impingement) and labral tear do not guarantee you will need a hip replacement, especially anytime soon. If the surgeon offered surgery to fix the FAI and repair the labrum, I would guess that the damage was not too bad. Those with severe damage are not usually offered surgery because they WILL likely require a hip preplacement in the not too distant future; and any "bandaid" surgery will likely make the condition progress more rapidly. Based upon the information you have supplied regarding your surgical dates, I would have told you the same thing as your PCM. It can take 3-12 mos to FULLY recover from the surgery (full range of motion and pain free). During that time you will also need to complete all your POSTOP physical therapy (PT). After PT and adequate healing time THEN a decision could be made regarding fitness for duty. In short (barring any other factors that were not mentioned in your question above) -As your PCM stated, you do not have enough time.
 

Ajcrr09

Registered Member
So hypothetically I get out in two weeks my hip isn’t healed and I have to get other hip fixed as a civilian. What happens? I am another vet who is lost in the system? What about the after math and the conditions I am in now. Prior to military I was 100% healthy my body did not hurt I ran 5 miles no problems and slept peacefully. Now here I am at 26 years with an 80 year old body. What does the military have to offer me now? And on top of that I am jobless with no income because I’m still in healing process with a pending surgery. From my understanding VA takes centuries. I am left between a rock and hard place.
 

Ajcrr09

Registered Member
Hello. I am former Special Forces operator-turned medical officer with specialties in ortho and flight surgeon. I just retired 3 mos ago after 37 yrs. Most of my last 17 years were spent as BN and BDE Surgeons with FORSCOM units. I have placed soldiers into the MEB/IDES process AND have undergone an MEB myself before retiring. First, FAI (femoral acetabular impingement) and labral tear do not guarantee you will need a hip replacement, especially anytime soon. If the surgeon offered surgery to fix the FAI and repair the labrum, I would guess that the damage was not too bad. Those with severe damage are not usually offered surgery because they WILL likely require a hip preplacement in the not too distant future; and any "bandaid" surgery will likely make the condition progress more rapidly. Based upon the information you have supplied regarding your surgical dates, I would have told you the same thing as your PCM. It can take 3-12 mos to FULLY recover from the surgery (full range of motion and pain free). During that time you will also need to complete all your POSTOP physical therapy (PT). After PT and adequate healing time THEN a decision could be made regarding fitness for duty. In short (barring any other factors that were not mentioned in your question above) -As your PCM stated, you do not have enough time.
hypothetically I get out in two weeks my hip isn’t healed and I have to get other hip fixed as a civilian. What happens? I am another vet who is lost in the system? What about the after math and the conditions I am in now. Prior to military I was 100% healthy my body did not hurt I ran 5 miles no problems and slept peacefully. Now here I am at 26 years with an 80 year old body. What does the military have to offer me now? And on top of that I am jobless with no income because I’m still in healing process with a pending surgery. From my understanding VA takes centuries. I am left between a rock and hard place
 

docmanslaughter

Registered Member
I want to preface any responses I give by saying that I will tell you things straight. I believe in treating people like adults and telling it like it is. Hopefully the recipient is adult enough to receive it. My philosophy is that the US military issues you a weapon to possible have to "retire" someone from this life. There is a certain amount of personal maturity and responsibility that is expected with that. That said I am a bit confused that the ramifications of having a surgery so close to your ETS date were not discussed with you in detail by a military provider, CoC, Etc. Unfortunately if you did not think to ask what would happen regarding medical care after ETS or plan for the future, as an adult, that is on you. Speak to your provider ASAP about an emergency medical extension for postoperative recovery. Just be advised that if it is authorized it may only cover the duration of recovery from your present surgery and may not include your pending surgery. In other words your next surgery may have to be delayed until you get out. If the extension is disapproved you will have to follow-up through the VA or possibly with TRICARE insurance if you are eligible. You need to make contact with your nearest VA even before you get out so that you can get into the system ASAP. Too many vets wait way too long and just prolongs the initiation of evaluation and care. Regards to your reference to being healthy and running 5 miles Etc Etc before the military- The CAM/FAI defect you have was something you were born with. It was just a matter of time until you noticed some problems. If you were a moderate distance runner on the outside, it is unlikely military service significantly increased the progression of degeneration in your hips. I would venture to say that you have actually been lucky to have discovered the problem while on AD. Otherwise you may have been seeking evaluation and treatment on your own dime. I happen to have the same problem as you in both my hips. Since I was a "door kicker" for many years, I assumed that any periodic hip pain I experienced was related to my job. I took some NSAID and drove on. It was not until 6 years ago when I began having severe discomfort while not performing any significant physical activities, that I realized that I may have a problem. Xrays and MRI showed CAM defects, arthritis, labral tears, and bone-on-bone hip degeneration. As I stated in my first email, I am not a good candidate for surgery, except for a hip replacement. I presently receive periodic viscosupplement injections with hyaluronic acid or platelet rich plasma (PRP) into both hips, and occasionally require a steroid injection (you can Google these). I have also changed my exercise regimen to low impact activities and take a daily NSAID. This provides me adequate relief and hope that it will help my hips to "out live" me (in a nice way of course), and cancel the need for any type of joint replacement in my lifetime. After your surgeries these may be options that you may consider if you are still symptomatic.
 

Ajcrr09

Registered Member
I want to preface any responses I give by saying that I will tell you things straight. I believe in treating people like adults and telling it like it is. Hopefully the recipient is adult enough to receive it. My philosophy is that the US military issues you a weapon to possible have to "retire" someone from this life. There is a certain amount of personal maturity and responsibility that is expected with that. That said I am a bit confused that the ramifications of having a surgery so close to your ETS date were not discussed with you in detail by a military provider, CoC, Etc. Unfortunately if you did not think to ask what would happen regarding medical care after ETS or plan for the future, as an adult, that is on you. Speak to your provider ASAP about an emergency medical extension for postoperative recovery. Just be advised that if it is authorized it may only cover the duration of recovery from your present surgery and may not include your pending surgery. In other words your next surgery may have to be delayed until you get out. If the extension is disapproved you will have to follow-up through the VA or possibly with TRICARE insurance if you are eligible. You need to make contact with your nearest VA even before you get out so that you can get into the system ASAP. Too many vets wait way too long and just prolongs the initiation of evaluation and care. Regards to your reference to being healthy and running 5 miles Etc Etc before the military- The CAM/FAI defect you have was something you were born with. It was just a matter of time until you noticed some problems. If you were a moderate distance runner on the outside, it is unlikely military service significantly increased the progression of degeneration in your hips. I would venture to say that you have actually been lucky to have discovered the problem while on AD. Otherwise you may have been seeking evaluation and treatment on your own dime. I happen to have the same problem as you in both my hips. Since I was a "door kicker" for many years, I assumed that any periodic hip pain I experienced was related to my job. I took some NSAID and drove on. It was not until 6 years ago when I began having severe discomfort while not performing any significant physical activities, that I realized that I may have a problem. Xrays and MRI showed CAM defects, arthritis, labral tears, and bone-on-bone hip degeneration. As I stated in my first email, I am not a good candidate for surgery, except for a hip replacement. I presently receive periodic viscosupplement injections with hyaluronic acid or platelet rich plasma (PRP) into both hips, and occasionally require a steroid injection (you can Google these). I have also changed my exercise regimen to low impact activities and take a daily NSAID. This provides me adequate relief and hope that it will help my hips to "out live" me (in a nice way of course), and cancel the need for any type of joint replacement in my lifetime. After your surgeries these may be options that you may consider if you are still symptomatic.

Sir or ma’am, first and foremost I don’t know where you got my level of maturity from the original posting. Maturity has nothing to do with asking a question in a respectful way (in which I did). Like I said after doing research this problem is very common in athletes and military special forces individuals. My job wasn’t special forces but it certainly wasn’t a desk job either. The mature thing to do here is not go back and forth with you about the job of military personnel. I knew what I signed up for when I joined and I did my job very well my entire enlistment. FYI signing up for the military doesn’t not mean I can’t seem treatment for something that is preventing me from doing my job or day to day activities. And lastly, why is it relevant where I’m stationed? Also don’t compare my hips to yours. What works for you works for you. The mature way of thinking is to know that no two people are alike.
 

chaplaincharlie

Staff Member
PEB Forum Lifetime Supporter
PEB Forum Veteran
Registered Member
Another possibility to consider is to have the surgery knowing you would be on med hold until recovered. Even if you were flagged for MEB, you still be in for many months!
 
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