One year on !!!

wow, so that was quick. What a difference a year makes is all I can say. This time last year I was recovering from my LTHR and anxious/excited about how it was going to pan out. One year on, my new hip is fabulous and hasn't let me down once. I can walk for miles, swim (even breast stroke !), run (if I had the notion to), canoe, row, dance, jump, twist, crouch, bend...well you get the picture.

My consultant is delighted at my progress and thinks I'm doing so well he doesn't want to see me for another 18 months - 2 years. Woohoo !

So it's back to having a life and getting on with it....More on that soon !

Missed the 6 months post op update !!

well it's all good on the left and getting better every day - ROM is almost 100% and the leg is strong and capable. I wish I could say the same about the right which for some annoying reason won't let it be. It's not at the stage yet of needing painkillers round the clock but I feel a bit like it's a volcano bubbling away and just waiting to erupt.

Official position on it is the angles are worse than the left hip (which has always been the problem one but is now bionic.. yay !) so structurally it's bad and the socket is very shallow. The femoral head is a good shape though and my OS is of the opinion that it's a great candidate for a PAO and we have a window of opportunity before the damage sets in and takes it down the path of a THR. According to xrays in March there doesn't look to be any significant damage and of course any pain is a sign of things starting to deteriorate. Up until last summer my right hip never ever caused me ANY pain whatsoever and I guess I was lulled into thinking in the last year it had been a bit overworked and would settle down.

Clearly it doesn't feel the same way and now thinks that it has a shot at glory, and can disrupt my life now :( It started a few months ago and the best way to describe the pain is that it's noticeable on going upstairs and feels like it is at the top of the socket (right inside if that makes sense). It's a sharp pain but then goes as soon as I stop. In the last week though I've had a couple of long days sitting in the one spot, in an uncomfortable chair, and the right hip is not happy about it. The dull nasty ache deep inside the joint sets in and is only relieved by painkillers. I've also got a bit of tenderness in the trochanteric bursa (which was the indicator of the start of the downfall of my left hip) and can't lie on the right hand side for too long.

I'm still in denial/absolutely terrified of a PAO/not ready for that decision and hopeful that if I can lose a stone or two, that might make a difference (note to self, stop the chocolate biscuits then).. because another surgery requiring another 2-3 months on crutches after 3 surgeries in 2 years, and most of that time on crutches, is NOT in my plan... full stop.

but equally, I've had a glimpse of having my life back and that makes me determined not to live in pain for any longer than I need to. Arghhhhhh...

Swimming....

at last I finally feel my old self coming back. Swimming was always my thing when I was younger and even in recent years. I haven't really been able to swim much in the last 3 years because of the pain in the hip. Even more galling, it's the only thing I could beat my husband at so I was desperate to regain my former ability to win at something !
So yesterday, I bit the bullet and went to the local pool.

I got into the pool with a bit of trepidation but was delighted to find that yes, I could still swim, and even managed the breast stroke kick. OK so it was only 12 lengths but you have to start somewhere and I was a bit worried about how it might feel today so consciously didn't want to overdo it. If anything, my cardio fitness held me back rather than the hips ! I did lots of exercises too which always feel good in the water, and a bit of deep water running (OK only a minute or two but again, a start !).

So pleased to report I feel good today, the muscles aren't complaining and I'm going back tomorrow for some more !

No news is good news...

wow,I've really been a stranger - sorry followers that I've been missing. You may have guessed that this means the hip is doing great ! I passed the 3 month milestone last weekend and I am totally at the stage of forgetting 90% of the time that I even have an artificial hip - which has to be a good thing ! I decided to look back on my pre-op entries and found a list of things I hoped for post op..

Things I am looking forward to are:

*being able to walk upstairs like a normal person yep - can even run now...
*being able to walk upstairs whilst carrying something no problems - washing baskets,boxes, ladders, etc, etc
*not being stopped in my tracks by a nasty sharp spiky jab to the hip no more nasty spiky pain - yippee !
*being able to put my own socks on and tie my shoelaces (well eventually) yep - have done for weeks now..
*being able to paint my own toenails (hey a girl has to keep standards up)as above !
*being able to walk as far as I want to without worrying about how I'll get back 3 miles at the last count - unheard of !
*being able to meet a friend for coffee without having to go somewhere next to a car park
delighted to park at the furthest away spot now !!

wow, when I look back at those simple wants, I'm more than delighted at where I am 3 months post op and feel like it's just getting better and better. I also feel passionately about others who are on this journey not taking no for an answer and pushing back against that diagnosis of 'yes you need a THR but only once you're over 50....' No, not acceptable at all - there is a pain free life out there and I never imagined it would be this good. I feel amazed and grateful every day about my new hip.

Sorry - been awol....having a life !

ooops... missed a few weeks there - was off on a work trip to France which I'm pleased to report went well as it involved lots of trekking around airports and towns & cities - all of which the new hip coped brilliantly with. Even the now bad hip behaved itself. Then I had a lovely week on holiday and did lots of walking and a little cycling, and it continued to behave itself.. I love my new hip !!

I'm now 9 weeks post op (I think - just had to check the calendar which is a good sign) and it's not all about the hip - at last !! I'm at the point of more or less being able to do most things - can do upstairs now although there is a bit of residual muscle tightness down the left of my thigh - about halfway between the knee and hip.. so am working on that with my physio.. can put my socks on and tie shoelaces - not quite with total ease yet but I can do it and that's what's important !!

Inevitably now the left is fixed, my mind has turned to thinking about the right - no real symptoms - just the odd niggle if I've been sitting in a funny position. My OS has told me I'd be a great candidate for a PAO (the mother of all hip surgeries and not be taken lightly) on the hip and as it's largely symptom free he thinks if we do the PAO I might never need a THR.

I guess what I'm struggling with is I've had a great recovery from the THR (touch wood) so far and I know the PAO recovery would be much tougher and longer. Having had 2 previous ops on the left hip in the last 2 years which were difficult to rehab from I'm not in any hurry to go down that path again any time soon. I also feel like I have my life back now and I want to get on and live it and not have to rely on other people AGAIN for another x number of weeks while I'd be on crutches unable to do cook, look after the house, walk the dog etc.

Plus, thinking about having kids and although I know it would be sensible to get the PAO out the way - I'm sick of having the hips dictate what I can and can't do and just want to live. So, I've left it with my OS that I'll have a follow up at 1 year post op for the left hip and if I experience any increase in pain on the right, I've to get in touch with him. So fingers crossed it stays as it is. I think my gut feel is if I could get through having kids etc and a few more years down the line, have a THR on the right I'd be happy.

Seems extreme I know but I am a bit freaked at the thought of messing with something that doesn't hurt at the moment (athough once the pain starts it means that damage is being done and a PAO will become less successful) What I do know though is if the right starts to hurt the way the left did when it began to deteriorate a few years ago, I'll be knocking down the surgeon's door for a PAO asap. I guess I want to have my cake and eat it but is that so wrong ?!!

'Scuse the rambling !

4 weeks post op !!

It's my birthday today and I can't think of a better way to celebrate turning 36- with a brand new shiny hip !

wow, days are flying by. I marked the 4 week occasion today by going for a walk this morning with just a stick - no crutch !! Hip feels really really good and I'm managing a couple of walks every day of around 20 mins each time. Having had 2 previous ops in the last couple of years, this recovery is a walk in the park by comparison. I don't seem to have lost too much muscle strength and so I'm not limping really at all when I walk without a crutch or stick, and I suppose for the first time in a long time I actually have a hip joint which works properly - which makes a big difference !

I also drove for the first time yesterday (I have an automatic so in theory it's easy) although it wasn't the easiest to get in and out of the car so I'm not in a massive hurry to do it again. There's quite a lip to lift my leg over into the car so it just felt a bit awkward. I'm sure with a bit of practice I'll get there though !!

I've also been keen to get on an exercise bike although I have a recumbent static bike - a sit back rather than sit up bike and the angles are just not quite right to allow me to cycle without breaking the no knee above the hip rule. So I got my other half to rig up my mountain bike on a stand to try that but unfortunately as it's got a bar across I'm struggling to get onto that too ! Never mind, once the restrictions are lifted in a couple of weeks, I can get back on the bike.

Also getting a new hybrid bike for my birthday so looking forward to getting out on that - it's a step through bike so should be able to get onto that with no problems !!

Gettting better every day...

...wow the hip is feeling good. Managed my first proper walk outdoors today with only one crutch and I'm starting to get the feeling inside that I could walk around in the kitchen without any crutch/stick. I also feel like I'm ready to walk upstairs normally (even with the crutch) rather than one step at a time.

It definitely feels this weekend like it's taken a step forward - swelling less so I'm only icing once a day instead of 3/4 times - and needing less painkillers which is great. I realised this morning that when I woke up I didn't need a painkiller as the discomfort I felt was simply stiffness in the muscles rather than any soreness if that makes sense.

I'm doing physio exercises 2 or 3 times a day and they are also getting easier. The leg length issue seems to be resolving itself slowly too although it may just be I'm getting used to it.

Will be 3 weeks post op on Tuesday and can't wait for it to be 6 weeks so I can drop the restrictions. Going to see my surgeon on the 8th March for my review so hopefully he'll be pleased with progress and I can get back to doing normal things !

10 days post op...

I think actually it's 11 but who's counting ? Continuing to do well after my Left THR - wound is healing up nicely and bruising has almost all gone - pictures to follow - and I can move around on one crutch in the house now although it feels a bit strange on the left leg and I haven't braved the stairs yet with only one crutch. Am using an icepack 2 or 3 time a day to stay on top of the swelling as the whole left hip/upper thigh/butt area is still pretty swollen and swells up when I'm on my feet.. I expect it will continue to do this for a while yet.

I can shower and dress now without any help and I'm definitely starting to feel more independent and not worried about needing someone else in the house all the time. Just as well really !! I'm also planning on doing some work this week to keep the brain active and ticking over..plus I'm pretty bored of daytime TV !

I'm starting to get cabin fever now - haven't been out since getting home from hospital last Monday so I think I will twist someone's arm this week to take me out somewhere for a change of scene...

My new hip...

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

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 !