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!! 

Week 13


It’s been eleven days since I saw Debs and up until four days ago, I hadn’t been able to replicate the crutch-less walking. I couldn’t believe that it took an entire week for the intense hip pain to subside enough for me to take more than ten consecutive steps without limping. Despite the walking pain, I religiously completed all of my physio exercises two-three times a day and I’m pleased to say there was progress.

In the last four days, I’ve managed to walk around the flat without using crutches but most of the time, I’m either limping or I’m in a lot of discomfort. I still have to grit my teeth and concentrate really hard to walk properly, or, as I discovered on Friday, I just need enough wine in me! Who would have thought aye?

After the turning point four days ago, not only did walking improve slightly, but so did the apple and pears; if anything, I find walking up and down stairs easier so I’m happy about that. I’m also off all medication again as I’m really not a ‘pill fan,’ and I like to gauge my pain and progress on a day-to-day, level playing field. It occurred to me the other day that my current position is not too dissimilar to before I went under the knife. Obviously, I’m a lot less mobile now, but the common denominator is that I still can’t walk easily.

These past eleven days gave me adequate time to truly analyse the ups and downs of my hip, so I was half looking forward to passing this info onto Debs today. I say “half,” as I concluded that something is still wrong with my hip. I’ve just returned home from physio and my suspicions have turned out to be correct. The good news is that I didn’t have to convince Debs that there is an issue; she came to the exact same conclusion herself after some assessments. The bad news is that the pain is hindering my rehab and it needs investigating. Debs believes it could be either bursitis or a tendon issue, and that it’s completely separate to the ‘popping’/subluxation. She has requested that Banksey examines both matters on Thursday and reports back so she can tailor the rehab accordingly.

In a way, I’m glad the NHS failed to provide me aftercare, as I have the utmost faith in Debs and see logic in everything she says. This is very complicated but I’m going to try and explain her opinion and thoughts:

In the last two and a half weeks, Debs has prescribed me exercises to improve my strength and motor patterns, which in turn should decrease the pain. Sometimes, especially after surgery, certain muscles don’t function optimally, so rehab is all about retraining and reprogramming muscle stimulation. Due to a lifetime of sport, I’ve always been relatively strong and therefore had a good base prior to surgery; however, my glutes have never functioned efficiently because of the dysplasia, so I’ve been attempting to re-educate my stupid bottom muscles during these past thirteen weeks. The body tends to adapt the movement when you’re in pain though, and therefore the correct muscles don’t function. So in my case, it’s literally been a right battle to get my arse in gear.

After assessing my movement patterns today, Debs concluded that there’s been a big improvement in my gluteal strength, and they finally engage when I walk. It is because of this progress that she has eliminated underactive glutes as a contributor of the pain. Apparently, it’s common for PAO patients to experience pain during the transition from crutches to walking, but this is the first time that Debs hasn’t seen the pain dissipate after successfully rehabbing the glutes.

Although it’s not ideal that something else appears wrong with my hip, I haven’t been upset with the bad news for once. Possibly because I’ve cried enough tears recently; or because I was a little preoccupied staring at Sir David Attenborough in the physio waiting room; or, most likely, it’s due to the preparation and anticipation of bad news. Everyone knows their own body, and just like I knew there was something initially wrong with my hip last year, I had strong reason to believe that something else was up. I didn’t have to persuade someone there was an issue this time around and I’m so grateful for that. Hopefully, the next stages will be relatively hassle-free and Banksey will locate and rectify the issue quickly. I’ve been through the most painful hip-related procedure there is, so even if I require more treatment to get this right hip fixed, it will be a doddle in comparison.

At the end of the physio session, Debs wanted to do one last experiment so I could supply Banksey with more information on Thursday. She carefully taped a big triangle on my hip/bum to see if it alleviates some of the pain and told me to monitor it for 48-hours. Taping is a common physio technique that is designed to facilitate the healing process while providing support and stability to muscles and joints. It’s frequently used with professional athletes or footballers and typically bright blue in colour so if you haven’t seen it already, keep an eye out. Mine isn’t quite as lairy, but it seems to be doing the job so far. So much so, that I managed to walk back to the waiting room unaided before realising I’d forgotten my crutch. That made me chuckle. Debs did say if I think it's helping then she'll tape me up every week. I think I might wait until after Abu Dhabi though...


So, the big day is fast approaching, and I have a lot to get off my chest with Banksey. Let’s hope he takes me seriously. In the meantime, I need to get things washed and packed for our holiday next week, and we need to continue packing for the big move. We’ve received confirmation that we have to vacate our beloved flat so for the first time in almost eight years, I’m moving back home. The vast amount of belongings that have accumulated during this time is crazy, so I’m biding my time with the World’s biggest declutter-thon.

The Bio-oil is working it's magic as the scar is looking a little better i think:
 

Week 12


What do Barbra Streisand, Donna Summer and Ozzy Osbourne have in common with Johnson’s baby shampoo? “No more tears” I hear you say. And that’s exactly what my stance has been this week.

My hip has been extremely painful and the snail-paced progression is highly frustrating, but, progress is progress, so I shouldn’t complain. In order to complete my daily exercises, I’ve had to consume a medicinal concoction, and even then it was tough. Hands down, the hardest and most painful homework exercise was crutch-less walking. As instructed, I attempted a few steps every day and each time I hoped that that the pain would slowly subside. Unfortunately, that wasn’t the case. It didn’t get any easier, and the pain was so intense that despite consciously trying to avoid limping, all my body could manage was a limp. It wasn’t a total fail though, as all this practice enabled me to successfully master one-crutch walking. When I demonstrated this to Debs on Thursday, she was over the moon and agreed that I’m officially down to one crutch whenever I go out. Then, when she asked me to walk to her without crutches, I somehow managed it with not a limp in sight. It was still pretty painful and worsened with every step, but for the first time in three months, I managed an actual walk on land. From the back I bet it looked quite convincing, but as I walked to Debs, my constant wincing was very evident. Even so, she was ecstatic and complemented my progress. I explained that this was actually a first as it had been previously impossible. Sod’s Law, since Thursday I haven’t managed to replicate it, but I’m hoping that’s just because my body’s recovering from all the walking that Debs had me doing. Overall she was very impressed, so has set me a new bunch of homework exercises including mini squats and step-ups. My next challenge is to walk into my next session without crutches, and walk up and down a flight of stairs without limping or hip hitching. I have eleven days before my next physio appointment and at this rate, I think my nine-month old nephew has more chance of accomplishing the milestone. He’s not far off taking his first steps so I’d say we’re near enough neck and neck at present.

Debs is still worried about my hip ‘popping’ and is voicing her concerns to Banksey so he can investigate when I see him on the 7th March. I mentioned that I thought the PAO would correct the ‘popping’ out and Debs was of the same impression and reiterated that she hadn’t seen it with previous patients. She explained that if Banksey believes it is short-term (until the left hip was corrected and my legs were the same length again) then we will have to make the best of a less-than-ideal situation. Debs and I are of the same opinion: that the ‘popping’ is hindering a full rehab. However, she’s confident that we can work around it, and strengthen my hip sufficiently so it's ready for the next surgery in May.

My hip twin didn’t have trouble learning to walk again and thought I should contact Banksey because of my pain level. So I called the hospital but unfortunately he is away until the 7th and there’s no one who can help me in the meantime so that was incredibly helpful. The NHS receives a lot of stick for negligence, and despite the terrible incidences I endured while staying at Guy’s, I’ve been the first to reassure people that the good experiences outweighed the bad. While the inpatient care may get my seal of approval, the aftercare is absolute bullsh*t and I would recommend everyone to go private. *Smiley face*

I’m very motivated and determined to complete my exercises and know that I will continue to progress, but I’m not yet convinced that I’ll be off the sticks when I see Banksey again. He’s expecting to see no crutches so I can just imagine his shock if I’m still reliant on even one of them. -In which case I'm sure he’ll be forced to postpone the next surgery too.


The good news is I have something other than more surgery to look forward to – a holiday! Whether I can walk or not, Andy and I have booked a little trip to see his cousin in Abu Dhabi in three weeks’ time. I’ve told myself that I need a holiday before, but after spending the entire winter confined to the same bricks and mortar, I now know the true feeling of needing a holiday and I can’t wait!

Week 11


Let me start by clearing up my physio situation. I’ve had no PAO-specific physio since my final hydrotherapy session with Deborah, two weeks after surgery. I did have two soft tissue/massage physio sessions (mainly to relieve my chronic back pain), and I’ve been completing the same exercises that were initially prescribed in the pool and on land this entire time. Along the way, I have added exercises of my own and that’s where the ‘self-physio’ came in. Especially after what’s come to light this week, I’m absolutely disgusted that the NHS can’t provide a physiotherapist post-discharge who can help PAO patients.

This week I have experienced my ultimate low since surgery. It’s the first time that I’ve cried like a baby since October when I had my pre-op jitters. Obviously I’ve cried since the op, but this week, I’ve blubbed! Let me explain…

Last week I paid for my final hydrotherapy self-help session, as I felt that I’d achieved all that I could in the water. While in the waiting room, I managed to catch Debs for a quick chat and she asked about my land-based physiotherapy. I explained the NHS/Tolworth physiotherapy fiasco and that I felt very let down and lost. We mutually decided that I should make an appointment with her to check my progress. Except for the physios at Guy’s Hospital, Debs is the only physio around here to have any, let alone extensive, experience with PAO patients, so I felt it was time to bite the financial bullet and pay for a session.

I had my session with Debs and spent much of the session fighting back tears. Every time Debs noticed my eyes fill up, she would remind me of the positive progress I’ve made: my rotational movement; my hip flexion; and my overall strength. However, all I could think about were the negatives.

Like any initial physio session, it began with a general assessment. Debs requested that I walk to her with one crutch, without crutches and had me stand on my right leg. I thought she was bonkers, but very reluctantly, did as she asked. It was the first time that I fully weight-beared in eleven weeks, and when I attempted to walk without crutches and stand on my right leg, it was absolute agony in the side of my hip. She then had me doing lots of standing, sitting, lying exercises which highlighted a number of things: mainly, that I’m nowhere near where I should be. Debs reassured me that my shortcomings were through no fault of my own and that I’ve been doing the correct exercises, but at this point down the line, she is concerned as to why the pain is so intense (when fully weight-bearing) and why I’m not capable of taking a few steps without crutches.

There were certain things Debs asked me to do which caused an uncomfortable ‘popping’ of my hip joint. Now, this has been happening all of my life, and I was under the impression that the ‘popping’ out, or the subluxation of the hip joint, was caused due to my dysplasia, and therefore it wouldn’t occur after reconstructive surgery. However, it’s amplified the ‘popping’ and I’ve been aware of this since day three post-surgery when the physios got me onto my feet for the first time. I’ve gone through worrying periods, to finally convincing myself it was fine and that it was only occurring due to my leg length discrepancy. Debs could hear and see the ‘popping’, which happens mostly when ‘walking’, and agreed with my earlier thoughts: it was not normal and she was very worried. Although it doesn’t exactly hurt when it ‘pops’, the intense pain I feel while attempting to fully weight-bear, occurs in that exact location. Her concern is that something could be wrong with the hip joint itself which is preventing my progression. If I’m in the same position next week, she will voice her concerns to Banksey. In the meantime, she’s given me more exercises to complete daily, alongside my previous ones and the bike, and she’s advised that I revert back to two crutches for the most part, whilst taking a few short crutch-less steps a day to monitor the pain.

There was me thinking I could possibly get away with one physio session but unfortunately, I’m going to have to fork out for quite a few if I’m ever going to walk again. Debs also predicted that I’m in no position to get my left hip operated on in April. It’s not what I wanted to hear but I know she’s right. Luckily, I spoke with the hospital this week and my surgery has been moved back to May anyway (with the date to be confirmed soon) so that at least gives me ten weeks to try and fix this crappy hip.

I feel this ‘popping’ at least eighty times a day so I know it won’t vanish on its own, so Deborah’s concern does scare me a little – hence some of the tears. Although, via little self-conducted experiments, I’ve figured out that if I elevate my left leg (so my hips are level) and perform the recommended exercises, it alleviates the ‘popping’. This reaffirms that the leg length discrepancy is a contributing factor. However, I can’t avoid the ‘popping’ while walking; whether it’s with or without crutches.

Whether the hip ‘popping’ is due to an anatomical issue or just short-term until the leg length discrepancy is rectified, I believe it is preventing an efficient rehab, which may explain the lack of progression in terms of walking, and the excruciating pain associated with full weight-bearing and crutch-less walking. I feel like it’s a lose lose situation because if something is anatomically incorrect then that could lead to yet more surgery, whereas, if it’s the leg length, then my right hip will not fully recover until my left hip is operated on and my left leg is longer, by which point I’ve got two buggered hips. – Hence some more tears.

Debs recommended that I resume pain relief to cope with the new exercises and walking, and despite returning to high doses of paracetamol and ibuprofen, I’m in daily unbearable pain. The pain is on par with what I experienced in the first two weeks after surgery: granted I’m not on the strong stuff, but still, 11-weeks post op and I did not expect this level of pain. So what if my range of movement is great, this absolutely sucks and I’m on the brink of giving up and becoming a professional couch potato.

This week, I’ve cried a small river, which is nothing compared to the ocean I cried while dreading surgery, but if when I see Debs next week and there’s still no progression, I forecast further flooding. Had I received some PAO-expert help sooner, this almost certainly would’ve been identified and prevented a lot of negative emotions and feelings.

While tempted at the thought of being a sedentary spud for life, I haven’t given up just yet; I will happily pop some more morphine if that’s what it takes to do these exercises though. My check-up with Banksey has been moved back to the 7th March, which is a little frustrating but it does give me an extra week. However, if I still can’t walk by then, I know I’m up sh*t creek and that’s when I’ll throw in the towel.

                                                                                     ...

Conveniently for me, I thoroughly enjoyed drowning my sorrows in pancakes on Shrove Tuesday, and my darling Valentine brought a smile back to my face on Thursday with these:

I may have crap hips, but I'm still a lucky girl.


P.S. Apologies for any ‘pooping’ that occurred in the writing of this post. Please let me know if I’ve misspelt any ‘popping’s.

Week 10 Post Surgery


You may have gathered from my previous post that last week was quite a struggle as the ever-growing odds seemed to be stacked against us. It was probably my second real low point (behind Christmas Eve) since the journey began on the 26th November last year and I found it hard to snap out of it. The freedom that I desperately wanted and succeeded in having on returning from Newcastle wasn’t at all what I’d envisioned. For the first time in 11 weeks (including my week in hospital) I found myself alone for 10 hours of the day and honestly, it was pretty depressing. I got into this vicious circle of watching TV to ‘cure’ boredom, which in turn made me more bored so I couldn’t motivate myself to do anything except watch more cruddy TV. – I’m dreading the electricity bill!

Between ad breaks from the likes of Teen Mom, Geordie Shore, America’s Next Top Model, Keeping up with the Kardashians, The Real Housewives of Beverly Hills/O.C., and my new favourite, Catfish, I tried desperately to figure out what I could do with my significant amount of spare time. Roughly 20 hours of television later I settled on two potential options: learn a language or write a book. While one may seem more realistic, the other is actually more plausible. My 2012 New Year’s Resolution was to learn German and like most NYRs, it was long forgotten by February. Foreign languages are definitely something that my brain can’t get its head around but as I scraped a pass in GSCE German, I reckoned the head start could be my best shot. Although, I’ve heard Spanish is considered an ‘easy’ language to learn, and I know plenty of friends who can speak fluently (hip twin), so could be a frontrunner with German. I've briefly looked into online courses/becoming acquainted with Rosetta Stone but with my previous less-than-impressive language experiences, the book definitely seems more plausible. Writing this blog has been really fun, but there is a fatal floor to my grand plan: I don’t read. The first book I read was Harry Potter and the Philosopher’s Stone about 10 years ago. The second and last book I read was My Sister’s Keeper about 7 years ago so I’m not entirely confident that I’m ‘qualified’ to write a book. I’ve bought a few books and tried to read them but if it doesn’t interest me in the first few pages, it soon ends up gathering dust. I generally enjoy reading and would like to read more, but I’m impatient and just want to fast-forward to the ending. – Not too dissimilar to my life at the moment: I would love to click my fingers, skip through my next operation and see how everything pans out, but c’est la vie.

When Saturday finally arrived, it brought with it a parcel in the post. An old Uni friend working in publishing had offered to send me a free copy of a new book. Not only is it embarrassing to admit you don’t read, but I thought this incredibly generous offer was just the thing to stop me turning on the TV, and instead, turn me into an actual reader. When I opened the package there was a lovely little note and a surprise... The Author had visited and signed a copy to me (well, to my hip).

I felt instantly overwhelmed and it was just the act of kindness I needed to snap out of my near manic-depressive state. It was so sweet and thoughtful that I couldn’t not, read the entire book; especially as it was published by Penguin! (http://www.penguin.co.uk/). So, after incorporating it into my daily routine, I’m pleased to announce that I’ve almost finished reading my third book. It’s actually really good and I force myself to put the book down after a few chapters each morning to prolong my new routine. I think next week I might read the book I received for Christmas :)  Whether it was the book or the act of kindness, my whole mood has definitely perked up since Saturday so thank you Andrea and John Green!

After careful consideration we have decided what to do concerning our living arrangement debacle. Despite not having a surgery date yet, it’s more than likely due to happen in April so the plan, as it stands, is to move back to Reading at the end of March. That way it’s easier for the Papa Smurf to take care of me second time around and we can save a few pennies. I am a firm believer in “Everything happening for a reason” and as we live in a lovely flat in prime location next to Richmond Park, the reason must be to save money. Our tenancy not being renewed has to be seen as a blessing in disguise so that we can squirrel away some money and rebuild our savings. Plus, I will have fewer qualms about the extortionate prescription costs.
The other good news this week is that I’m no longer in daily pain again. My suspicions regarding the cold weather must’ve been correct. The 3-week, 50% weight-bearing period since seeing Banksey has now lapsed which means I’m now up to 80% weight-bearing. As I have taken on the role of self-physio, I took it upon myself to use only one crutch while moving around the flat. Albeit a little wonky and awkward, so far so good. I’ve also got behind the wheel and it’s completely painless. *Freedom at last!!* On the few car trips that I’ve made, I still take both crutches as it’s generally easier and quicker to walk with two. Not to mention that stairs would be a nightmare with one. I’ve included some basic rotational movements into my exercise regime to the point where I can comfortably sit cross-legged now. And lastly, I’ve been using the Bio-oil again. At the start of this week there was a painful inflamed lump next to my scar which resembled that of another infection (above pic). Luckily it has gone down by itself (below pic) and the Bio-oil can start to work its magic.
Hopefully my pelvis has reconnected now or is very close to joining up. My next check-up is in 3 weeks so I won’t know for sure until I have the X-rays then. I’m also having my pre-operative assessment on the 1st March which is exactly 6 months after my first pre-op assessment. It’s kind of strange how fast, yet slow that time has gone by. I was recounting my hospital experience to someone this week and couldn’t believe that it was 2 ½ months ago. I think it’s still too early to conclusively say that “I’m glad I had the surgery.” Not that I had much of choice in the situation, but the aim was to improve quality of life. 2 ½ months post-surgery and my quality of life is still currently worse although I know my hip needs more time to regain strength. I doubt that I’ll know until the end of the year whether it was absolutely the right decision but I’m remaining positive, and unlike my usual book-reading approach, I’ll have to be patient. In the mean time, do I learn a language or write a book...

My two gorgeous boys last weekend

Week 8 & 9


The last couple of weeks have been a little eventful – hence the lack of blog post. The NHS have gone way down in my estimations, we’ve received a section 21 notice from our estate agents, and it looks likely that I’ll be on statutory sick pay for 6 months. In other news I am no longer taking medication, I can officially look after myself now, and I had a mini holiday up North.

Surely after having major surgery you’d be a physiotherapy priority right? Apparently not. I was discharged 9 weeks ago and after a few tedious conversations with certain NHS folk, it looks likely that I will ‘physio’ myself from here on out. You may recall that I requested to be referred straight to hydrotherapy following hospital and after three sessions, Deborah attempted to refer me for NHS physio. I say attempted as when she contacted Kingston hospital (which I live next to), they claimed to only accept GP referrals. - Very strange considering Deborah knows more about my recovery than any GP. Nevertheless, appointment made, referral requested and was told it could be up to 6-weeks. A few weeks later I missed a call from Tolworth hospital and listened to the voicemail requesting a call back. Instead, I called my surgery to explain the doctor had made a mistake and could they re-refer me to the correct hospital. Unfortunately the receptionist couldn’t comply and insisted I make another GP appointment to arrange this. I did as she wanted and wasted a doctor’s precious time in doing so. The GP seemed to understand and agreed to contact Kingston. A few weeks passed and I received another call from Tolworth, only this time, I regrettably answered it.  I can honestly say the woman at the other end was the most obnoxious, uncouth and condescending person I’ve ever spoken with. Somehow I remained calm and polite throughout so her demeanour was in no way justified. In the midst of her rudeness she explained that Kingston hospital physiotherapy department don’t accept orthopaedic outpatients and that Tolworth hospital (which is 3 miles down the road) is my only option. This lady (who I believe was the head physio) then told me I needed the correct referral from my surgeon as my GP isn’t aware of my progress. I tried to agree with her on the GP front but she seemed to have an inability to listen and presumed I was at fault. I explained that my surgeon isn’t fully aware either and if anyone would know it would be Deborah but that was shot down too. This physio kept referring to ‘my hip replacement’ so I asked if she knew what surgery I’d had and if she had seen any PAO patients herself. I’m not exaggerating when I say she couldn’t pronounce periacetabular osteotomy and confessed Tolworth hospital see maybe one PAO patient a year. I believe at one point her words were: “I don’t mean to sound condescending but as if I’m going to take your word for what you’ve been doing.” If she’s not willing to find out what I’ve been doing from Deborah or myself, and isn’t too familiar with PAO patients, then I would be foolish to put my recovery in her hands. I decided then that there is no way I will even contemplate having physio there and will continue it alone. All the treatment I’ve had post discharge I’ve paid for privately and I’m not made of money so it will soon stop. In earlier blog posts I discussed budgeting money for treatment but that included the anticipation of NHS physio so I see no alternative to flying solo with my recovery. At this moment I feel helpless and rather let down by the NHS as they’ve performed this surgery without ensuring the aftercare is sufficient and attainable. My main concern however is for other PAO patients who have experienced similar NHS downfalls and don’t have any rehabilitation knowledge. Mine is limited, but let’s hope it’s enough to make a fully recovery.

The NHS rollercoaster of fun is nothing compared to our living arrangement upheaval. Our landlord obviously likes a game of “hide and no seek” as our estate agents find it impossible to contact him. Due to an ongoing damp issue within the flat, it has now been deemed ‘unfit to live in’ and so a section 21 equates to our tenancy not being renewed come the end of March. Definitely an inconvenience but on the very small plus side, I should be able to assist in the move as I’ll be off crutches. The big question is do we move elsewhere with only one income, or move into separate family homes to save money until I’m earning again. Andy needs to be near London for work, and I will require daily assistance again after my next op. It’s a tough call. Suggestions on a postcard please.

Then there’s my lack of income; until I’m 100% fit and healthy it is nigh on impossible to fulfil my previously active job role. Unfortunately there appears to be no desk-based work available and so it looks likely that I’ll be off work until June 2013 at the earliest. That is if I’m still sane by then. I have returned to knitting (still only scarves) but feel I need a new hobby to keep my occupied until June.

I knew this double hip surgery would be my toughest experience but I’m not even half way through and life is still throwing a lot of curve balls in my/our direction. We’ll just have to see how much longer I can withstand them and discover if everything really does happen for a reason.
 
In other news:
It could be bone-growing pains or the cold weather, or a combination of the two, but this last week has been more painful than usual. I stopped taking the morphine soon after seeing Banksey and thankfully my sleeping patterns returned to normal. During the day I weaned myself off all medication too and it was fine for the first week. Despite feeling more aches and pains recently, I’ve still refrained from taking medication as I want to truly gauge it on a daily basis. It is hard to know whether new or different pains are normal or not and I guess there’s always a worry that it’s something more serious. The worst part is trying to convey the level of pain you’re in. - Especially when you’re a ‘hypochondriac’ or you’ve been fine for a few weeks. There is such a thing as regression so it’s helpful for those around you to be understanding and patient. Before jumping to conclusions, it's not my 'self-physio-ing' that caused it either as I haven't tried anything different yet. 
I’ve also just returned from a long weekend in Newcastle to see family and the five-hour journey there and back didn’t bother my hip at all. It's just the 'walking' that hurts my hip and I feel it first thing in the morning which I never used to. My aunty taught me a thing or two about knitting which was great, except she really highlighted how efficient and advanced she is, compared to a little novice knitter like myself. On returning from the North East I have been left to my own devices and my dad has returned to Reading. So far so good and the only downside is not having any company throughout the day. 

I couldn’t leave you without a picture update either…
 
The infection has gone now but it left behind a big hole which I noticed before hydro two weeks ago. Luckily the hydro clinic gave me plenty of waterproof dressings to wear daily until it stopped weeping. It looks a lot nicer now as the skin has almost healed completely, so it’ll be back to the Bio-Oil next week in an attempt to reduce all scarring. I’m not holding my breath mind.

Week 7



The long awaited six and a half week check-up with Banksey was fast approaching and I couldn’t wait to hear something along of the lines of “you can wean yourself off the crutches now.” But this wasn’t the case. The X-rays showed that my pelvis is yet to reconnect; the hip socket reconstruction was so severe that the bone still has an inch to grow until contact is made.





If you look closely you can see the cuts above (where the screws are) and to the right of the femoral head (ball part of joint), which freed the socket from the pelvis. This enabled the socket to be rotated anticlockwise so the socket covers the femoral head. My left hip dysplasia isn’t as bad as the right was but you can still see that the femoral head is partially uncovered and the socket slopes upwards instead of flattening out.

Unfortunately, as adult hip dysplasia and PAOs are relatively new, many doctors and consultants misdiagnose the hip pain even when a dysplastic X-ray is staring them in the face. If you’ve had ongoing hip pain which hurts to walk through at times, heard your hip(s) click and clunk during day-to-day activities, or experienced your hip giving way whilst walking, you may have dysplasia. Request an X-ray and ask to see it. Watch out for sloping, shallow hip sockets and mention dysplasia if need be. I suffered pain for a year before I sought help and then only had to wait three months for the correct diagnosis/bombshell news. Luckily the first consultant I met (Dr Ward at Kingston hospital) knew exactly what he was looking for on the X-ray and referred me to Banksey for surgery. I’ve read and heard a variety of stories about women seeing many consultants and waiting years for accurate news let alone surgery. My hip twin for instance was passed around the houses and suffered for five years until a Doc finally identified the issue and referred her to Banksey. Diagnosing dysplasia isn’t the only tricky bit but finding an experienced surgeon who alleviates the problem and doesn’t make it worse is the next task. Banksey specialised in orthopaedics for 5-6 years, then specialised in PAO for another 5-6 years so he really is the crème de la crème of performing PAO’s in Britain. For more information about dysplasia visit his website: http://www.bankes.com/hipsurgery_2011/hip-dysplasia-and-PAO.html

The downside to the disjointed finding is that I am to remain on crutches for another six weeks. 50% weight bearing for three and then 80% for three to encourage blood circulation and stimulate bone growth. So close but yet so far from the complete independence I desperately want and thought was imminent. Thankfully my dad has agreed to stay with us for the next couple of weeks to continue helping me out. On the plus side, Banksey did reassure me that the screws haven’t bent, the infection is on it’s way out and it’s normal to still be taking morphine at night. He also explained that I can attempt some hip rotational movements and can lie on my right side now. – It’s been tried and tested and I’m pleased to report no pain or problems this time round.

Before surgery I knew that certain bodily changes would occur such as: my leg muscles getting smaller (atrophying), arms getting toned and bigger (hypertrophying) due to the use of crutches, and possibly weight gain with Christmas on the horizon and an inability to exercise. My predictions were accurate on all accounts… My hockey thighs are no more; I could be mistaken for a boxer with my upper body; and my weight temporarily fluctuated. However I wasn’t aware that I would be 2cm taller, have a bigger hip and tonnes more back pain. As my right hip socket has been rotated it has pushed my femur (leg) down and out. The leg length discrepancy is pretty obvious to me when I stand or walk as my hips are noticeably wonky and I have to stand with my feet a foot apart to level my hips out. It shouldn’t cause too many problems (other than affect my back) and I’ll have to put up with it until my left hip is corrected. My slightly bigger right hip is visible on the X-ray if you look at where the greater trochanter (the knobbly bit to the left of the femoral head) is in vertical comparison to the iliac crest (upper rounded part of my pelvis), and then compare it to my left hip (right of the X-ray). The increased back pain is largely down to crutches so regular physio treatments will have to do until I’m off the sticks. So ladies, if you want to be that little bit taller, I’d recommend double PAO ;)

Aside from seeing Banksey, I was really looking forward to my check-up so I could see my hip twin Natalia again. We're still in regular contact so were aware of each other’s check-up date and time. It was so good to see her and Tom and we had a good catch-up in the hospital. She’s progressing really well and is ready to slowly come off the crutches. Natalia also had a visible stitch poking out of her wound but unlike me, decided to leave it. Banksey removed it at the check-up and I immediately regretted cutting mine. The infection has caused my wound to be very red and dry but whilst showering, I still notice a slight opening and what looks like either a stitch or a scab at the top of my wound. I wished I had mentioned this to Banksey and had him investigate but I missed my opportunity. During my shower the following day, I was virtually 100% sure that it was the stitch I could see and decided it was time. Andy sterilised the tweezers and watched as I pinched the white thing. It was a massive relief when this came out…

I’m a little envious of Natalia’s wound as it looks very clean and tidy still. My tiny line of a scar is very much long gone as you can see in the picture. With the stitch finally out, my skin can close up and hopefully heal properly. I wondered whether this partially caused the infection, but who knows. At least I’ve completed the course of vile antibiotics and nipped the infection in the bud.

In six weeks I have another check-up with Banksey to discover if the bone has grown and my pelvis is reconnected again, and he’s put me on the three-month waiting list for my left hip. This is later than initially thought and unfortunately can’t happen sooner as I’m not able to fully weight bear yet and I need one functional leg to rehab the other. I only have six weeks on crutches, then six weeks off crutches to increase my right-sided strength in preparation for the next surgery, and now that I’ve been given the green light to up the reps and sets of my hip, leg and abdominal exercises, I’ll be ready for it!

Lastly, I have had a few enquiries about how I’m keeping busy with my abundance of spare time as I haven’t really talked about it in a while. I’m afraid to say that 2013 hasn’t seen any knitting thus far after my failed attempt at a hat turned me into an angry knitter again. I plan to recommence this week however. I’ve been sucked into watching more day time television but no more Jeremy Kyle don’t worry. Sorting my tax return and temporary benefit money is quite time-consuming, and I’m working my way through a couple of boxsets; The O.C. and Homeland. Two months off work is not fun at all, and knowing that I'll be doing it all again in April means I need to think of more things to keep busy. Suggestions are welcome. TTFN