DEAR DR. DONOHUE: My husband is 53. He enjoys skiing, hiking, golf and other outdoor activities. He has painful hip arthritis and needs a new hip. We have heard many pros and cons about hip resurfacing versus total hip replacement. He wants to avoid a second surgery for as long as possible, but he still wants to be active. What do you have to say? — K.Z.

I say your husband sounds like a good candidate for hip resurfacing. He is relatively young. He’s active, and he wants to stay active. Hip resurfacing permits him to resume most, if not all, of his outdoor activities. He should consider it.

Let me give you a guided tour of the hip so we are on the same page. The thigh bone – the large upper leg bone – is the femur. At its top, it takes a 40 degree inward turn toward the pelvic bone. At its end, the hip bone has a ball that fits into a socket on the pelvic bone to make the hip joint. Arthritis roughens the surfaces of the ball and socket and eats away at their cushioning cartilage cover. Movement of the leg becomes painful at the hip, and the joint stiffens. Resurfacing consists in smoothing the surfaces of the ball and socket. Bone isn’t removed as it is in replacement. The doctor puts a metallic cap over the resurfaced hip ball and places a metallic cup in the pelvic socket. The person now has two smooth joint surfaces.

In hip replacement, the surgeon removes the entire ball of the femur, replaces it with a metal ball and puts a metal or ceramic cup in the pelvic socket. A resurfaced joint can take more stress than an artificial joint. Your husband will have few, if any, restrictions on his activities. A resurfaced joint has a fairly long life. If, in the future, the hip begins to hurt again, doctors can still perform a hip replacement.

DEAR DR. DONOHUE: This past year, I had bacterial pneumonia and was put on an antibiotic for six days. I felt good. But then it came back worse than what it had been, and I was put on another antibiotic for almost two weeks. I finally began to feel great. I was told I wasn’t on the first antibiotic long enough. People tell me that once you have had pneumonia, it becomes a recurring disease. Is this so? What can I do to prevent that? I did get the pneumonia shot. I keep myself in good health. – C.B.

Adequately treated pneumonia doesn’t recur. Sometimes, pneumonia damages the lungs and they become more susceptible to another infection, but the same pneumonia isn’t likely to come back. A second pneumonia is a distinct second infection, and it happens only if the lungs have been permanently damaged. Usually they are not. You have taken a giant step in prevention of pneumonia by getting the pneumonia vaccine. It’s not truly a pneumonia vaccine. It’s a vaccine against one kind of pneumonia – pneumococcal (NEW-moe-KOK-ul) pneumonia, the most common kind of bacterial pneumonia and one that is especially hazardous to older people. You should also get a yearly flu shot. Pneumonia can follow on the heels of flu.

DEAR DR. DONOHUE: I am about to turn 50, and I will be having a colonoscopy. I saw that the bowel cleansers used in preparation for a colonoscopy can cause kidney failure. I am afraid to have the procedure done. Please comment. – G.H.

Sodium phosphate laxatives, often used to clean out the colon, cause kidney failure and electrolyte disturbances only very, very rarely and usually in people who have had prior kidney illness. These colon preparations should be not be used in people with kidney conditions, and they should be used with caution in people taking diuretics (water pills) or the two blood pressure medicines called ACE-inhibitors and ARBs. Tell your doctor you have reservations. You can use other bowel cleansers. The polyethylene glycol laxatives are examples. Two names are GoLYTELY and HalfLytely.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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