Week 14

The big day was a success, and in more ways than one!

For the first time in over three months I took public transport, and not only that, but I managed the journey to the hospital alone. I’m aware this doesn’t sound like a big deal but I feel vulnerable when I’m using crutches, so it's reassuring to have some company. There was a significant amount of walking and standing involved too, so for me, just making it to the hospital was a huge accomplishment; especially as I had regrettably decided to take one crutch.

My appointment with Banskey was at 2.30pm and I had to have my pre-operative assessment (for the next surgery) and an X-ray before I saw him. When I arrived at the hospital at 11am, I began queuing in the waiting room for pre-op and all the hospital staff were understandably confused as to why I was having a check-up and a pre-op on the same day. I lost count of the number of times I had to explain that I’d been through one PAO surgery and required another for my other hip. Once the paperwork, MRSA swabs, blood tests and measurements were taken, I made my way to the X-ray department. I was eager to see my X-ray to check if the bone had reconnected this time…



This X-ray alone doesn't show a lot, but spot the difference below:



It may not be glaringly obvious what the difference is, but hopefully the blue circles will aid you. The area between and around the screws is more filled in on the left X-ray, compared to the slightly darker right X-ray. This signifies that my bone has successfully grown and my pelvis is officially connected again! Whoop whoop. The bottom (south-east of the blue circle) part hasn’t re-joined yet, and it may never. Either way it’s not an issue as doesn’t affect anything.

The Orthopaedic lounge was brimming when I arrived at 2.10pm. I just hoped that they weren’t all waiting for Banksey.  At every appointment, you’re handed a colour-coded form which monitors your progress: yellow for hips; purple for shoulders; and blue for ankles. I believe I have four yellows forms in my file now and the monotonousness of completing it doesn’t wear off. However, it does allow you to identify and make conversation with fellow ‘yellow form holders’ in the waiting room. On this occasion, I met a nice 23-year-old awaiting arthroscopy for a labrum injury and we had a good chin-wag until we were the last two remaining in the waiting room. My name was finally called at 4.20pm and I went through to the patient room. I’d also been messaging my Hip Twin, Natalia, all day and she gave me the pep-talk I needed to ensure I didn’t back out of telling Banksey how I felt about my non-existent NHS aftercare. When he walked in, he expressed his delight with the new X-ray and asked how I was getting on. I handed Banksey the letter from Debs and explained the constant pain and ‘popping’ I’ve experienced. I made him put his hand on the side of my hip so I could demonstrate the ‘popping’ and he confidently told me it wasn’t subluxing. The ‘popping’ was more of a ‘snapping’ motion as my IT band rubbed over the outside of the greater trochanter (see diagram below), and it was occurring due to my leg length discrepancy. He asked me to walk a few unaided steps, before I hopped onto the couch for an examination. After a few painful prods and pokes, Banksey attributed the extreme pain to inflammation around my greater trochanter; namely the bursa, and would require a steroid injection immediately. **

I believed that the ‘popping/snapping’ and the pain was unrelated but it appears that they are completely associated. I’m in a bit of a vicious circle at the moment because every time I walk (with or without crutches), my IT band snaps over the greater trochanter; aggravating the bursa and causing extreme pain. This will continue until I have surgery on my left hip and my legs are the same length again. However, I can’t get my left hip operated on until the pain stops and my right hip can support all the rehab. The temporary solution is either: walking without fully straightening my right leg; or wearing an insole in my left shoe only. Banksey did say that if the ‘snapping’ hasn’t stopped by the time the keyhole surgery (to remove the screws and fix the labrum) comes around then he can give the IT band a little snip to relieve some tension. All of which I can live with, and I’m very relieved that I don’t require any additional surgery to the two lots that I’m already facing.

** Debs and I had concluded it was probably bursitis pain, so I knew an injection was necessary but I wasn’t aware that Banksey could and would do it there and then. In hindsight, this was actually a good thing as I had limited time to work myself up. - The entire morning I was dreading having my bloods taken in the pre-op. You’d think after self-injecting for a month after surgery I’d have left behind my fear of needles, but apparently not. Banksey returned to the room armed with a big needle and a nurse to hold my hand. I predicted it would hurt, but felt the need to double-check. Banksey’s reply was: “Unfortunately yes, but you’ve been through PAO surgery so you can go through anything.” Every time I hear someone say this to me, I feel somewhat invincible, but I also feel a sense of pressure to kerb any pain-inflicted reaction. As soon as Banksey pierced my skin, it was as traumatic as anticipated and I couldn’t help blurting out a few expletives. Luckily, the fluid contained local anaesthetic too so it went numb pretty quickly.

If I hadn’t have taken deep breaths, I’m sure I would’ve fainted, so after carefully getting to my feet, I was thrilled to be able to walk with no pain at all. Banksey explained that it would be enough to get me home and then I would be in a bit of pain for three days. He’s said I’m fine to enjoy a holiday and that he’d like to check my progress in four weeks’ time. If I’m still in some pain, then I may require another injection but that’s nothing compared to PAO surgery!  :P  

Before I left, I did explain that I felt let down by the NHS aftercare and that I was disappointed his nurse hadn’t called me back the other week. He apologised on both accounts, and stated that he’s been trying to increase awareness of PAO surgery and rehab with GPs and physios but the general consensus is a reluctance to learn. I asked him what he expects others to do rehab-wise, who truly can’t afford the private aftercare, and he was sorry to say that it’s a regional lottery whether the local NHS physios know what they’re doing. The news isn’t at all comforting and I regret not investigating the NHS services prior to my surgery. Thankfully, I have found a really good physio (even if she’s pricey), and I have every faith that my right hip will recover fully now.

I can report that last week’s taping was successful for about 24-hours and then my bursa got too aggravated and inflamed. Since Thursday’s monstrous injection, I have been able to walk around indoors without crutches and limping, but I’ve had to adapt my stride length to avoid the ‘snapping’. It’s still mildly painful when I walk so I’m anticipating another injection in a few weeks. However, on a scale of 1 to 10 of pain, I’m currently at a 4.5 compared with the 10 I was at this time last week. I can’t complain and I’m over the moon with Thursday’s developments… Now I’m really looking forward to Abu Dhabi on Wednesday!!