Week 31 – 33

7 months post PAO surgery and 2 weeks post hip arthroscopy and screw removal

As I’ve left you in suspense for two weeks, let me start by saying, the surgery was a success!

…

Two weeks ago yesterday I woke up at 7.15am and although I wasn’t allowed to eat anything after 7am, I didn’t think three small chunks of watermelon would harm; especially as the pre-surgery instructions permitted me to drink water until 11am and let’s face it, watermelon is virtually all water! I had stayed in Clapham with Andy the night before so we didn’t have to travel far to Guy’s Hospital. Once we were showered and ready, we set off for the tube with my overnight bag and crutches in tow.

I knew my surgery wasn’t a high priority and that I would be sitting in the Surgical Admissions Lounge (SAL) for a good few hours. - Which I was. There were a few wedding magazines to keep us busy though so we browsed through them in between different cubicle visits. The first time my name was called was to provide me with my gown, stockings, paper pants and slipper socks. The second was to ensure I had followed all pre-surgery instructions, and I had my blood pressure  and blood taken, followed by signing the consent form. About an hour and a half later my name was called again by the anaesthetist. My initial impression of him was extremely friendly and caring, but now I know they were just tactics to get me to admit to my ‘breakfast’. Subsequently I was pushed to the bottom of the list and I had to wait a further three hours in the SAL. Not happy. At one point, this was all made worse during a visit to the toilet when the nurse knocked on the door and told me to get changed into my clothes again. After throwing my paper pants in the bin, I practically stormed out thinking my surgery had been cancelled for the day. It turned out they just didn’t want me to be ‘cold’ in the SAL; which in my opinion was typical room temperature. I sheepishly asked for some more pants when it was eventually time to get changed again.

Fast forward to after 4.30pm when the nurse called me for the final time. By this point my dad was in the SAL with us, so we all walked round to the double doors before saying “Goodbye”. I had been absolutely fine up until this point and then the reality kicked in. I had a few tears as I waved back to Andrew and the nurse tried to comfort me whilst guiding me around the corner. I instantly recognised the room as it was the same one I had been in for my PAO in November. Once inside and on the bed, I waited for my new ‘best mate’ anaesthetist. I had asked to be sedated before the general again and he happily obliged. If you remember back to November, my last memory before waking up in the recovery room was a young chap practically shouting “SEDATE HER” as I started to breakdown. On this occasion I actually remember having the cannula inserted and the sedative injected as the anaesthetist told me I would feel light-headed and like I’d had one too many. He wasn’t wrong.

I woke in the recovery room to one of Banksey’s minions telling me they’d found and repaired a tear in my labrum, and they successfully removed the long screws. (I barely remember this, but when he visited me on the ward the following day, I was reminded). So as I started to wake up a bit more, the first thing on my mind was FOOD! It was 7.30pm and I was starving. Knowing that visiting hours cease at 8pm, I forced my eyelids to stay open so the nurses/porters would transfer me to the ward ASAP so I could see Andy and my dad. I was happy to hear that I was returning to Sarah Ward and even happier that I had a window bay this time.

Due to my late arrival on the ward, I was given special dispensation and Andy and dad were permitted to stay until 8.45pm. I was offered a dry sandwich or a dry sandwich for dinner so I requested a couple of yoghurts and a cuppa. Both went down a treat and although I was feeling tired, I was generally ok. I’m a fidget anyway so it wasn’t long until I discovered that I could move my leg easily with minimal pain. Banksey  had previously informed me that post-op my hip would be quite swollen and there would be four incision sites so I was intrigued to see what it looked like. After lifting up my gown I found I had two dressings: one at the side of my upper thigh and one at the top of my original scar. The latter was obviously where he extracted the screws but it left me wondering why I only had one hole in the side of my thigh. The hip pain was deep in my groin so why didn’t he go in through the front of my thigh (as was explained four weeks previous). Before Andy and dad departed, a junior doctor came to tell me that everything was looking great and there was every chance that I could be discharged at around 11am the following day. She also said that I could fully weight-bear, but I had to use my crutches just in case. However, I wasn’t allowed to use the crutches until the physio came to show me how in the morning. I refrained from explaining that I’d recently been reliant on crutches for 3.5 months so I didn’t think I required a lesson, and after the boys left, I prepared myself for bed.

I was woken up for medication at 10.30pm and again at midnight for my favourite anti-DVT injection in the belly. – I do not miss injecting myself every day and luckily I only required one. Then it was back to sleep until the drama began…

My incredibly full bladder woke me up around 3am so I felt it was time to call for assistance. My buzzer was still attached to the wall behind me so I carefully stood up on one leg and pressed the ‘call’ button. After 5 mins the nurse appeared and we agreed that I should probably use a commode as my crutches were off-limits. She brought the commode but had to disappear again to fetch some loo roll. All the while I was sitting up feeling more nauseous by the second. So by the time she returned with the roll, I had filled one cardboard sick bowl for her to take away. I lifted myself onto the commode and it was a huge relief to relieve myself, but I was still feeling very sick so I began filling my second sick bowl. Then I started to feel light-headed and knew what was coming. I couldn’t speak very easily but I managed to yelp that I was about to faint. I also knew that if I could lie down I would feel ok, so I had a split second to decide whether to stay on the commode and faint with my paper pants around my ankles, or stand, turn and collapse on the bed in record-breaking time. I made the rational decision not to stand, in case I fainted immediately and seriously hurt my hip, and opted for losing my dignity instead…

It’s a good thing I’m not easily embarrassed as it turns out I left all of my dignity in Sarah Ward bay B4 that evening. I woke up surrounded by ‘the crash team’ who came to ‘revive me’. I had indeed fainted and was unconscious for a few minutes but proceeded to throw up. All. Over. Myself. The crash team were called because I was completely unresponsive (even when I woke) and my blood pressure dropped ridiculously low. One nurse wiped the sick off my face and hair and whacked an oxygen mask on (which I kept attempting to remove to spit the remaining sick out), and two other nurses helped me off the commode and into bed whilst pulling my paper pants up. From what I remember there were roughly three doctors there and about five nurses but none were aware of my history; especially what surgery I’d had. I believe my file had been removed by the junior doc in preparation for discharge in the morning so these guys were all extremely worried and I could hear a number of questions going unanswered. At this point I was capable of responding so I explained what they wanted to know and took the opportunity to voice my hypothesis on the dramatic events; Three pieces of watermelon and two yoghurts in 24-hours was evidently not enough fuel to keep the general anaesthetic side-effects at bay. Despite feeling a little better, I was hooked up to a drip, had blood taken, blood pressure and temperature taken every 5-mins, had anti-sickness injected through my cannula, and had an ECG. Whether it was just my body being an attention-seeking drama queen, or because it is just my kind of inpatient luck, my one night stay in hospital had become rather eventful. Hopefully I’ve made my point to Banksey and he won’t put me at the end of the surgery list again ;)

Surprisingly, I had a crap night’s sleep, but boy was I excited to hear the breakfast lady with her little cart. I ordered a bowl of cereal, two slices of toast and a cup of tea which had vanished before you could say periacetabular osteotomy. Three of Banksey’s minions came to see me on their rounds and we joked about my night. Soon after they left I thought of three more questions which I’d forgotten to ask. One of which was “Did Banksey actually perform my op?”, as I hadn’t actually seen him since April. Even now I don’t know whether he did but I assume so… I forgot to ask why I only had one incision and I forgot to ask where exactly my labrum was torn. I’m sure I’ll find out all at my check-up in six weeks.


They debrided the tear to remove dead
tissue. You can see the newly 'burnt'
bit which hopefully will cure my hip
pain. 

You can see the tear across the middle of
the pic. The top and bottom white bits are
bone - the top is my hip socket, bottom is
femoral head.

Once the minions left, it was sponge bath time and I couldn’t wait to wash the sick out of my hair. I managed to get half-dressed whilst still hooked up to my drip, before patiently waiting for the nurse to detach me so I could finish. It was 10am and although I felt ready to leave, I had to wait for the physiotherapist and the pharmacist. Without being rude I hurried through the physio session whilst proving I was more than capable on crutches, and unlike my huge stash of drugs last time, the pharmacist only had to talk through two sets of medication. 11.10am came and I was ready for discharge, so the porter wheeled me downstairs where my dad had the car waiting and we were off.  
 On arriving back home in Reading, my dad had resumed his carer status and began preparing some lunch. I’d been asked to make an appointment at the doctor’s surgery for a dressing change on Thursday and other than that, I was back to clock-watching for the day. We had arranged that Andy would stay with us for the week and commute to London, so it was like being back in our Kingston flat again where I would count down the hours until he walked through the door.

The following day my hip seemed fine and the only pain I could feel was superficial; where the incision sites were. The groin pain had gone and by the end of the day I was able to walk around the house without crutches and without a limp so everything should have been good. However I soon became annoyed that I’d waited 6-months to have this relatively minor operation (in comparison to PAO) and could walk around the next day with no issues. If someone could’ve predicted I’d be feeling this great, I think I’d rather have had both hips operated on and gotten the left PAO out of the way. I’m aware I’m going back on what I said last time but my mind literally does change from one week to the next. I don’t think it helps that since keyhole two weeks ago, my left hip is starting to play up almost daily. Admittedly it’s not preventing me from walking (yet). But if this is the start of my left hip finally packing in, I know I’ve got another 6-months to wait. Now in the grand scheme of things that’s not long and it would give me the opportunity to ‘live life’ until then, but when I’m face with the prospect of finding a new job, what employer would hire me knowing that I’ll be on sick leave for two months? At twenty-six, I don’t want to be job-hopping for a few months at a time to tide me over between hip operations. I’m career orientated so whatever I do next, I want to stick with it climb the corporate ladder. What will be, will be, so hopefully when the job offers come flooding in, either my potential employers will be understanding about my poorly hips, or my left hip will start behaving itself and I don’t need to worry about PAO for a few years.

Thankfully I didn’t stay disgruntled about my hip feeling fine for too long, as low and behold, my right hip became very painful by the weekend. On Thursday I stopped taking the strong meds (as it made me constipated again) and I slept fine, but by Friday night the serious groin pain had returned and it was an awful night of pain and no sleep. So first thing Saturday it was back on the strong stuff and although I did, and have managed to sleep since then, the groin pain remains. On Friday I had considered cancelling my first NHS physio session that I’d pre-booked for Monday afternoon, but after the constant pain Saturday and Sunday, I was so relieved to go to the physio. I didn’t expect them to cure the pain, but I could at least find out if this was normal.

So when Monday came it was off to the Royal Berkshire Hospital. I would summarise the session as a typical initial assessment, but the lady was no ‘Debs’. She was lovely, but she had no personal experience of PAO patients so I spent a lot of time explaining what my November surgery and subsequent rehab entailed. She did have a lot of experience with hip arthroscopy and was able to clarify that my delayed pain was very common and most likely referred due to the surgery. During the assessment there were a lot of movement tests to identify strengths and weaknesses, so by the time my session was over, my pain had actually doubled. She was impressed with my strength but explained that after hip arthroscopy I needed to take it easy and although I could do certain movements, I should take it right back to basics. My next appointment is today so we shall see what she says then.

The nurse at the surgery changed the dressings on Thursday and instructed me to change them again in five days if I felt comfortable enough doing so. I did, and this is what it looked like when I took the steri-strips off. It was here that I discovered two holes in the side of my thigh. 

New dressings reapplied and another five days later:

I think Bankesy has done great job re-stitching my scar. It's a lot smaller than it was three weeks ago!