Progress on day 3 post op LTHR...

Pretty tired today as I had hydro yesterday which was great but definitely quite tiring.. which I'm thinking is to be expected but still managing on just paras and diclo (can't quite believe it myself) and diclo are down to once every 12 hours. I really thought I would be counting the minutes between painkillers but it isn't like that at all. Did some physio this morning - basically along my floor upstairs along the floor above and then downstairs back to my room on the crutches and I'm fine on the stairs (not like I haven't had the practice).

I can't explain just how positive I feel about having had this op and I think that plays an important part in my pain levels and how I'm coping with it all. Mr Witt my surgeon came in last night and is very pleased with xrays that were done yesterday and has given me some stretches to do as my operated leg is feeling longer than the non-op leg (very common and will sort itself out apparently). I got the feeling if I'd lived closer or had pushed it he might have let me go home this morning but as it is we have non-changeable train tickets for Monday to travel back from London to Scotland and although my brother lives nearby, they have 4 flights of stairs which I'm not so keen on tackling. My wonderful hubby borrowed a wheelchair this afternoon though and took me for a blast of fresh air (was a beautiful day here) round the block.

The only negatives are I have no real appetite (could be a bonus if I lose a few pounds though !) so it's a bit of chore to eat and that's not normally an issue for me. The food is very good and there's a big menu to choose from but sometimes you just want to eat what's familiar etc. I also can't bear the smell of chocolate weirdly which I'm hoping lasts !!

As nice as this hospital is, they totally aren't geared up with all the right equipment like proper toilet seat raisers with a frame etc - they brought crutches etc but no grabbers (I ended up borrowing one from the physio) or a long handled shoe horn or all those other essential bits and bobs. So I'm looking forward to getting home to have home comforts and home cooked food. Although they are good with physio too and there are always nurses to help etc, no-one has shown me how to put my socks or underwear on, or addressed those kinds of issues. If I didn't know what to expect, that could have been pretty scary. Probably a reflection of the private system which doesn't provide OT support and assumes that you will arrange it yourself.

Anyway, all good so far, no regrets and I can't stress enough that although it's scary to have to have a THR at 35, it's totally doable and not nearly as bad as I expected it to be. And boy, the feeling of stability and a solid hip everytime I take a step is great.

Dee x

I made it !!!

OK so I am bionic girl ! It's now just over 24 hours after the op and I'm feeling pretty good so far.. had a bit of a rocky night last night - only 2 hours sleep or so and quite a lot of sickness but that's to be expected. Went down at about 1.30 yesterday afternoon and into theatre about 2, then woke up in recovery about 4.30.. most of last night is bit of a blur due to lots of pressing on the PCA morphine pump - anaesthestist's advice was don't let yourself feel any pain so I took his advice ! I also had a block which lasted about 6 hours then the feeling gradually came back. I remember nothing about the spinal as they'd given me some sedation by that point - phew !

Had a yummy omelette for dinner last night as I was starving but unfortunately when the anti-emetics wore off about midnight, I lost most of it all over the bed and me with some nice projectile vomiting. I had warned the nurse I felt sick and she told me not to think about it and to take some sips of water..Erm, like that was really going to stop the morphine making me sick !! So she had the pleasure of cleaning it up 5 minutes later and although I got another injection was sick again 4 hours later when it wore off too. So I had a bit of strop when the day shift came in about not being left without it whilst I was on the morphine so fingers crossed will be better. Not been sick today but they are keeping me topped up -and I'm having less morphine too.

Saw my orthopaedic consultant Mr Witt last night and this morning and he's very pleased with how it went. Pre-op my bad leg was apparently 1cm shorter and he says it will now feel longer than the non-op leg but that it will even out over the next few months. Still got a catheter and the PCA but hoping to lose the catheter later as I had my first walk this morning !! Physio came about 11 and I was raring to get out of bed.

I'm allowed to fully weight bear with the crutches as support/balance (Mr Witt's opinion not the physio !). So I scooted over to the edge of the bed and stood up, onto the most stable feeling hip I've ever had ! It feels very heavy and stiff which is the swelling but I made it about 30 metres down the corridor and back and had to tell the physio to hurry up as he was pushing the thing with all the wires etc. Instantly can tell the dysplasia pain has gone which is amazing. He also managed to use my old open scar and I have dissolvable stitches and glue holding it all together - yes no dressings - but the glue provides a waterproof coating so I can shower no problem and get in the hydrotherapy pool.

Managed another walk this afternoon and lost the catheter which is great..although I still need help getting to the bathroom with my PCA pump on the stand. Physio has said I can do hydro tomorrow which I'm looking forward to and I'm also having an xray so looking forward to seeing that..

A good day I think all in and roll on tomorrow...

Final preparations

Been getting organised this weekend as it's the last weekend before the big op and the crutches take over for few weeks. Essentials have included getting hair cut and coloured - from past experience if you've got to be stuck at home on crutches feeling sorry for yourself, make sure you do all you can to look/feel your best first !! and hopefully a pedicure tomorrow so at least my feet look pretty as my hip certainly won't ! No coloured nail polish though as they make you take it off at the hospital.

Got to phone my surgeon's secretary tomorrow morning and find out where I am on the list ..hopefully near the top so not too much waiting about on Wed, but que sera sera..

I've been really fortunate in the last few days to read some great positive blogs about other young people's THR experiences and I'm feeling really optimistic about the pain going and getting my mobility back... FINGERS CROSSED !!

Is it wrong..

to be excited about my new elastic shoelaces ? I know I'm going to look back on this period of my life and fondly remember it someday (ha I don't think so!) but my new shoelaces arrived today and I'm thinking why didn't I know about these months ago as I've twisted myself into various contorted positions to try and put my shoes on.

lace up the shoes, tie them tight and bingo - you can slip those shoes on and off all day !! I may even keep these once I'm better as why would you bother with having to ties laces ever again....then again maybe not !

I really think I need to get out more...

This time next week...

I should hopefully be out of recovery and in possession of a shiny new ceramic hip. I have to be at the hospital for 10 am next Wednesday so I know I'm on the afternoon list for surgery - but I do have to call on Monday morning just to check - would be kind of nice if I got moved up the list and got done in the morning - saves all that waiting around never mind not being allowed to eat all day.

I'm ready I think. Foam cushions have been procured, shower seats looked out, and all manner of other boring things that shouldn't belong in the house of someone in their 30s. But hey, they are a necessary evil and I need to make sure I look after this new hip by sticking to the restrictions and behaving myself. At the moment I'm prepared for 6 weeks of restrictions (no crossing legs, no bending the knee at more than 90 degrees, no crouching, no twisting etc) but I'm aware that some people have them for longer so fingers crossed.

Other than looking forward to being able to actually walk properly, I'm also looking forward to the day when it's not all about the hip...

If there ever was any doubt...

...then I know for sure this week that THR is the right decision. The hip has been gradually getting worse since December - and funnily enough took a big step downhill when I saw my surgeon and he confirmed the op - power of the mind or what ! In the last week my pain levels have escalated to the point that it's pretty much sore all the time (from needing to take a painkiller once a day if I overdid it to pretty much needing them all day and night) and it feels like I actually have another tear or something similar in the joint. Not that it matters as in just over a week I'll have a brand spanking new hip joint and fingers crossed, the nasty dysplasia pain will be gone, gone, gone !

Things I am looking forward to are:

*being able to walk upstairs like a normal person
*being able to walk upstairs whilst carrying something
*not being stopped in my tracks by a nasty sharp spiky jab to the hip
*being able to put my own socks on and tie my shoelaces (well eventually)
*being able to paint my own toenails (hey a girl has to keep standards up)
*being able to walk as far as I want to without worrying about how I'll get back
*being able to meet a friend for coffee without having to go somewhere next to a car park

hmmm I bet you can detect I'm a bit fed up today !! Roll on next Wednesday...

How bad is bad enough for a THR ?

A question I have asked myself a lot these last few months. After my hip scope in March 2009 my orthopaedic surgeon (OS) started talking about the need for a THR within 18 months - 2 years rather than by the time I was 50. He found 2 patches of bone on bone within the joint where the cartilage has literally worn away with the abnormal presssures caused inside a hip joint with dyplasia. My hip socket on the left is too shallow and doesn't fully cover the head of the femur. Once you have this degree of damage, it cannot be undone and will only worsen and progressively deteriorate over time.

Unlike many people with hip dysplasia, I did get some benefit from the hip arthroscopy - although I was warned it could make things worse or speed up the arthritis in the joint - but I got a lot of pain relief even if I lost some flexibility and range of movement as a result (I struggle to put a sock on the affected leg, never mind paint my toe nails !).

The burning question for me though was how bad does it have to be before I should get the THR done ? My surgeon was of the opinion that it could be up to 18 months or longer and I should hold off until I really couldn't stand it any longer. I'm keen to start a family and my surgeon wanted me to have kids before having the THR but instinctively this doesn't feel like the right option. I don't know that my hip could cope with a pregnancy and I don't want to be having a baby and not be able to crawl around on the floor etc. Having spent 6 months prior to the scope in significant amounts of pain, on and off crutches and swallowing painkillers like they were smarties, I also wasn't in a hurry to go back to letting the pain increase or lose any more mobility. It seems crazy to let things worsen when in reality, the end game would be the same and what does another year or two years buy me ? I'll still be having a revision THR in 15-20 years. I feel like my life has been 'on hold' for the last few years and to be honest I'm done with having to let this hip dictate what I can and can't do. I want to have my mobility now and I'll worry about the future when I get there.

It's such a difficult call and those of you with hip problems already will fully appreciate that you adjust your life to cope with a painful hip - you walk less, you park closer to the shops - or give up shopping - you change your car to an automatic so you can drive with less pain, you give up high heels cause the pain isn't worth it, you have to think twice about going anywhere that involves standing (like concerts, queueing in the post office), I could go on....

...in my case I also work from home most of the time so my definition of what is normal in terms of mobility has definitely changed over the last few years. I think my walking is fine as I get around the house OK but reality gives me a sharp shock when I go out and try and do something normal, like walk round a supermarket or just walk at my old pace... I have been so frustrated by these limitations and just do not want to face a further decline into more pain and restrictions.

So when my right (never had any problems or caused any pain) hip started playing up this autumn I decided it was time to seek the advice of a hip specialist who treats young people with hip problems, and dysplasia specifically. No disrespect to my current OS but he doesn't specialise in dysplasia and to be honest I feel he is definitely in the camp of let's wait and see rather than let's do something proactive. So I had a consultation with a London specialist who agrees my right hip does have dysplasia and bizarrely is worse than the left (go figure !) however as my activity level is nowhere near normal, we can't really assess whether it's symptomatic yet or not.

I explained my frustrations to him about having to wait until things deteriorated further on the left hip and his opinion was that as my activity level is already compromised by the hip, we should probably get on with it. Yippee !! At last, a surgeon on the same wavelength who gets it. This man sees people like me every day and knows how disruptive, wearing and frustrating dysplasia is. So, that same day, I booked my LTHR for 27th Jan. Bring it on !

Where do I start ?

I'm sitting here with just less than 2 weeks to go before I have a total hip replacement at 35, wondering how I ended up in this situation ? I'm pretty organised in the practical sense but it's the unknown that holds the biggest fear just now. Will the operation be a success ? Will the pain really be gone afterwards ? How long will it be until I 'get my life back' ?

I won't bore you with a long history but as it's my blog and therefore my story.. here's a bit of background....

I was born with CDH, or congenital hip dysplasia for those of you outside the hip club, but it wasn't picked up until at the age of around 14 months when I began trying to walk but couldn't. This was a bit of a giveaway that something was wrong and my mum discovered that my left hip was dislocated as the left hip socket hadn't formed properly. Fast forward through months in plaster following a femoral osteotomy (basically where the femur is broken and reset to encourage the hip socket to grow around it and improve the coverage) and a plate which was in my leg until I was about 5.

Although I couldn't ever do the splits and wasn't great at running, I basically had a pretty normal childhood and had no real problems until my mid 20's. I always knew though that at some point I would need a hip replacement, possibly in my 50's. Every few years, my hip would flare up and cause problems with getting in and out of cars, or running and I would go back to an orthopaedic consultant for a check up. In my late 20's the pain in the hip increased significantly and I had an MRI arthrogram (injection into the joint which allows the soft tissues to be seen on x ray) which showed a small tear in the lining of the joint.

This eventually settled down and I was fine again until the summer of 2007 when things started to go badly wrong in the hip. After a lovely weekend in Paris and lots of walking, I was left unable to walk far and in huge amounts of pain. Explorations found that I had trochanteric bursitis and this led eventually in early 2008 to having open surgery on the left hip to have the bursa removed (after physio, cortisone injections etc all failed) and at the same time I had a tendon lengthened and the surgeon found my gluteus media muscle had torn - so he very kindly reattached it.

12 weeks later I got off the crutches and was recovering well and almost pain free. In August 2008 however I tore the cartiladge in the left hip again and almost straightaway I was unable to walk any distance, stand on the spot for any length of time without severe pain and discomfort. After xrays, ultrasounds and finally another MRI Arthrogram a tear was diagnosed and my surgeon advised that an arthroscopy (keyhole surgery into the hip) would allow him to look inside the joint, repair the tear and assess the condition of the joint.

This happened in March 2009 and he did repair the tear but unfortunately found that the condition of the joint was poor, arthritis had set in and there were two significant patches of damage to the joint. His view was that the next step was a total hip replacement (THR) and that I would probably need it done in 18 months time.

So here I am, nearly a year on from that having made the decision that my activity level is compromised enough (more on that later) and pain levels are enough to warrant getting on with the THR now and worrying about the consequences in 15 years or so (most replacements last 15-20 years these days if you're good)...

Roll on 27th January !