Held together with Zip ties.

I am currently propped in my bed with Wonder Woman playing on the TV. My right leg is sore, painful to the bone but slowly getting there. Would you like to know how I got here? Are you okay with slightly gory post operative pictures? Yes? Read on! No? Close the window and find something else to read!
Last Tuesday I was up before the household, quick shower and final pieces packed and off I went, early enough to catch a night bus to the station. Travelled on the tube with the retail workers and work boots and tool boxes. My mohawk sans produce tucked up in a turban and a totally comfy but weird slogan for the day hoodie and I arrived early to UCLH. (University London College Hospital)

In totally British fashion there was a queue at the door as the department did not open till right on the dot of 7am. Peed in a cup and was told I was the first on the list. Which was a surprise but good. Went thought the standard medical questions and the nurse went off to get my gown and assorted gubbins. She returned with the news there was no bed for me at the moment and I would have to wait. No idea how long that would be and that generally these things resolved themselves. I hoped so, having to rearrange all the arrangements we had made would be a pain. The Anaesthetist arrived and was very pleased that I would rather a spinal over a general anaesthetic.

I sat around for a while, and Mr Gin joined me after dropping Squeaky off at childcare. I met Mr Hutt’s Fellow (possibly Registrar) and we signed forms and again I was told they generally sorted the bed issues out. While we waited in the waiting room Mr Hutt dropped in to say everything was ready to go ahead, all the bits assembled. He thought there was a bed but the surgery wouldn’t happen till the afternoon.

I was taken up around 11:30, dressed in the hospital’s finest gowns. I walked to theatre, this something if found interesting, normally there is a wheel chair or bed involved. I left Mr Gin behind, he wouldn’t be there when I got out as he had to pick up Squeaky.

The spinal went smoothly, both Anaesthetist , Mr John Dick and Chris (missed the last name) were lovely, apparently I sat very still but to be honest I didn’t feel it at all. Good work. Mr Hutt was relived that I had selected to be sedated, personally I didn’t want to be awake, nerves would make me extra chatty.

The operation was a bone graft, a piece of donor bone was to be attached to my femur with wires. The medicine/science is that the donor bone should grow into my bone and make it thicker, hopefully this will take the pressure that I can feel and spread the load. Thus hopefully lessening the pain from the stem tip that is resting against the inside of my femur.

I woke in recovery, a bit fuzzy and sore. Lovely staff, as always, recovery nursing staff tend to be the most attentive, I am assuming that recovery is a place that you have to be on your toes. I call Mr Gin, because they realised there would be no one to meet me and I really wanted to let him know I was okay. I had a lovely chat with a Filipino nurse, we talked about being a long way from home and the British weather. Then I was very proactive and threw up my nice short bread biscuit in a vomit bowl. I was feeling a bit dissociative which was to be expected but this nausea was not something I have had with a spinal. I was given a drug to help and then a swift and slightly painful bed change because my bladder was not really there so to speak and throwing up set it off. My blood pressure was low as was my heart rate, this was little bit weird, it is not a rare side effect of a spinal but the heart rate was causing concern. I needed to drink more water. Another nurse came in, a fellow who obviously spent a lot of time in the gym. We had a conversation about my gym experience as a 40 tiny woman compared to his as a hefty nurse. He felt my lower heart rate may result in being fit. (I am not sure if he was being nice, it is odd being called fit by a medical professional.)

I was taken up to the tenth floor where I was looked after by an amazing Irish nursing assistant called Kathleen, she found my home so I could call Squeaky which made me cry. She decided that a slightly nauseous, weepy, Australian mum needed that phone quickly and located it for me. She also took away the sausages and mash that landed on my table that really didn’t help and found a sandwich. Small things that helped. I rewarded her by throwing up the sandwich but in bowls, sadly still required another bed change. Another anti – nausea drug and pain killers followed. My temperature was low, not sure why, the nurses covered me up in blankets and tried to get me warmed. I was surprisingly in a single room, I was warned I would be moved onto a bay, which was fine, but I was happy to be a in a single room for the first night, feeling as spaced as I was.

A friend, H, who worked locally came over after work and sat with me for a bit. We looked at the amazing view over London but I have very little memory of the conversation because the combination of three anti-nausea meds, painkillers and wearing off sedatives really made life interesting. My blankets began undulate on their on accord, looking like that they were breathing. It wasn’t a pleasant experience but I think H thought it slightly amusing!

She left and I dozed for a bit. The downside to low blood pressure is that nursing staff want you to drink water, that in turn means that you need to pee and then that means bed pans! Ack, and getting onto those bastards is hard with a very stiff and painful leg! I hate, loathe bed pans. End of subject.
In the morning, the Surgical Fellow I met before the surgery arrived, looked at the scar, which is lower than my replacement scar, and felt that as long as the physio team agreed and I got an x-ray and that looked good I could go home that day. That was a little bit of surprise, we were expecting a bit longer and if we could get out in the early afternoon it would be all fine. My temperature was higher but blood pressure a touch low.

The Physio arrived, a lively lady named Stacey, arrived with crutches. I had morphine before she arrived in anticipation of this being tough but I was so ready to walk to the toilet it wasn’t funny. We went through a refresher of crutch using and I gently stood up. I then swore, a lot, it fucking hurt but manageable. Mr Hutt had told me that it was likely to be more painful than replacement, he wasn’t wrong. So, up I got, I was going to pee. I turned and my ears began to ring, my head felt tight and I felt really hot. I realised that I was going to faint. I told Stacey that I had to sit down, rapidly and she told me to lie down. She then harassed the bed to get my head lower than my feet. She was quite concerned and checked my blood pressure, which was low, not very low but a bit of concern and my colour was extremely pale. More goth than goth.  The Physio decided that I wasn’t going to be discharged the day with low enough blood pressure.  It took a while for my colour to return.

Stacey decided she would come back in the after lunch to see how I was going and do walking and stairs then. Annoyingly I was to stay in bed until she came back and that meant bed pans.

Mr Gin visited with snacks and I perfected some origami as we waited for the x-ray and physio. The Pharmacist dropped by and discussed drugs, including one that I had not tried before.
Dihydrocodeine, first test to see if it made me throw up and if it works.  During the day I ended up doubling it up with morphine as the pain was pretty full on. In an attempt to feel more human I changed into a nightie of my own which helped.

Stacey the Physio returned and I was fine with the crutches, although the leg was sore, I was happy to give it a go. We did not do the stairs as there was no wheelchair but I wasn’t going home anyway because the x-ray had not happened. But I did not have to use a bed pan so I did not care!
So, Mr Gin went off to pick up Squeaky and H dropped in before she went off a meeting. I was nice to have her company, we admired the view again and I wandered around a bit on my crutches. She headed off on to her meeting and I settled in for the night after saying good night to Squeaky. By 9:30 I was struggling to remain awake so I went to sleep.

The morning was an early start with the Physio turning up before the joy of the pain med cart. I walked on my crutches to the stairs, the leg was very sore but I was going to do this, I miss Squeaky and my bed. (I missed Mr Gin too, but I was seeing him.) There was two Physios and we went up and down a flight of stairs. Oh boy, it hurt, my leg is so stiff, the femur hurt a lot and the incision was tight. I did it though. I got back to my room and Stacey was a gem and located a some morphine, I was very pleased to see it. It takes a fair bit to put me in tears but there was I lying on the bed sobbing but after a while it settled.

Stacey was happy to discharge me, now it was only an x-ray and we were golden but considering they had ordered it yesterday, I was a little worried. I had a pain free nap and an entertaining time doing origami feeling floaty.

The x-ray happened and I got to see the hardware, I have five metal zip ties attaching someone else’s bone to my femur. No wonder it hurt! The x-ray technician thought I was brave, which not what I would call it.  There was a dressing change and the unveiling of the incision, it joins my replacement scar which means it that is one very long scar! The nurse said it was very neat.

The time was slipping away and Mr Gin had to go and pick up Squeaky. Thankfully the lovely R was pleased to duck out of work and wait with me while I butted my head against the wall of hospital policy about not prescribing oramorph. I was not happy with the pain management of the codeine, ibuprofen and paracetamol combo. It removed some of the pain but I wasn’t overly comfortable. The doctors suggested that I stay another night but I wanted to come home and hug Squeaky.
In the end I left with R and we had a bit of a tough time getting a cab due to being officially discharged at 5 pm. Getting discharged from hospital is unbelievably complicated and time consuming.

Home was lovely, Squeaky was lovely and it was good to see Mr Gin and eat real food. All in all it was a very different experience to Epsom and I felt it was odd that I only saw Mr Hutt once.

Two years and now the waiting is coming to a close.

Well, here we are in January. The hip replacement is officially two years old. Yes, two years! Looking back it is almost like a completely different life.
The difference is day and night, almost pain free and wonderful movement. Yes, I am still having issues with the thigh pain, recently I did have two weeks of thigh pain, some of it take my breath away pain, something I have not dealt with for what seems like a long time! There was a couple of moments of having to sit down! I think a lot of that is the strange distribution of my weight with 9 months of baby growth! I have pretty much given up trying not to waddle because normal walking can cause the thigh pain kick off.
The change in the last twelve months is the most amazing, loosing weight, gaining fitness and then excitement of pregnancy. I certainly don't regret getting the replacement, I really didn't think a pound of titanium would change my life so much.
The Pregnancy is going well, I am on maternity leave and currently biding my time waiting for the baby decide to leave or be evicted.
There has been an information exchange between Mr Hutt and the consultant team at Homerton Hospital. Mr Hutt has informed them that hip replacement is fine for a natural birth, I think something that surprised the team, which is helpful because I needed them to understand it is safe but need just a touch more care.
I have decided the option of an epidural is off the table because I want to make sure that I am not put into a position that may upset the replacement. There is a no real risk of dislocation but being able to feel the replacement will give me that reassurance that it is going stay put.  Also that my uber bendy joints are behaving themselves, feeling them is important and making sure they are holding out okay and not being pushed too far.
The pregnancy its self has been fairly uneventful, it took till about 7 months before I looked pregnant which was interesting. I am not the typical basket ball shape and carrying quite wide. This is was worrying me for a bit but my mother carried the same way. Stealth bump!  There was a bleep at about 34 weeks when we realised the baby was in breech position. Breech is not good when you are aware of Congenital Hip Dislocation and that it ups the chances. I did some googling and found the most astounding array of slightly scientific and a lot of witchcraft methods . So I did handstands in the pool and walked a long way and the baby had turned around the 36 week mark. So now we only have genetic predisposition, first pregnancy and possible girl as reasons for CDH!
I have not really enjoyed the whole pregnancy process. The hormones are hard work causing tears over stupid things ie cots, cat vomit or bus not turning up. I have have had rubbish acid reflux due to hormones and my hyperactivity and the acid in my stomach has refused to stay put, mostly when lying down. I certainly am not a glowing earth mother and am a bit over the feeling of being taken over. There s a lot pressure in my body and the wiggling presses in sort places and is disconcerting when you can watch it change the shape of your belly.
The midwives have been lovely and when I burst into tears on one this week she was very supportive. As I am over forty and the there is a distinct rise in the risks of still birth, the hospital do not like you going over 40 weeks. I did research the stats and the jumps are small but they are conclusive there is a risk. So we have had to plan the birth around this, there is no known reasons why the placenta can suddenly fail for women over 40 beyond 40 weeks. So we have a finite date but really would like to the baby leave on their own, so we are back into wives tales and witchcraft.  So there is Raspberry Leaf Tea, bouncing on the gym ball (space hopper) and walking. So far it has not worked.
All though there has been a lot of change in the past two years there has been on constant, and that is the unfailing support of Mr Gin. He has been amazing and full of excitement. I foresee a crazy co-parenting experience for the next 18 or so years.
So, Hippy birthday to my replacement and incoming birthday for January!

Everything on hold and a focus shift.

So, in my blog last time I wrote this "I am happy to support friends who embrace body positivity in all its forms, as long as they support me too."  There have been a number of instances, recently, where this has not happened and people have been actively quite depressing and negative about people trying to lose weight, for the sake of losing weight. I have taken these things a bit personally.

I have worked fucking hard over the past six months to loose weight, there have been also some muscle building goals as well and side effect of becoming fit. But the Big goal was to lose 10kg by July, by June I had lost 13 kg.  I did this through hard work and discipline, getting up early to go to the gym and counting a calories like only a woman with an addictive personality can.  It was hard going to the gym and pool and working hard, it is not an activity I enjoy. I did have Mr Gin and there personal training team to support me but that was all there was really besides a work colleague who was really lovely as she slimmed down to for her wedding. But the numbers were important, I wanted to jump up and down with every .5 kilo lost. Mr. Gin got lots of photos like below  because I felt putting them on social media was not that caring for a variety of reasons. I was gutted by a couple of instances that just made me feel fairly shit about my numbers and the reasons I was doing this. I really didn't get this when I was doing my best to support their choices by not carrying on. So I am now going to talk about numbers, I needed that support and will need it again.

I got down to 70 kg from 83 kg in December 2016.  At 153 cm that is a huge chunk of change. Both myself and Mr Gin worked hard, he really has been the sole support through it all. We had a goal, to drop weight to reduce the stress on the implant and avoid surgery. I got to the goal and I was pleased with the strength in the legs, there was a lessening in the pain but not as much as I would have liked.
I saw Mr Hutt in July, I had maintained my weight for a month and half so was stoked.  He was very pleased with my movement and the amount of muscle I had gained. My walking has improved and I just stand when getting out of a chair, no need for hands (although I am glad he does not have a low couch like we have at home.)  This is really good for the long term outcomes of the replacement.

We agreed that although the pain had decreased living with it was frustrating but possibly livable with. Leaving it over winter to see if the pain is worse seems to be the best course of action along with more muscle building and weight loss. Dropping to a BMI healthy weight range, again means less pressure on the joint and also if the NHS get carried away with BMIs for hip replacement, it does mean I am in a good shape for the left when it goes. But we have not taken surgery off the table for the implant, to push the stress along the whole thigh bone and hopefully making it less painful. And anyway he can not operate at the moment!

A surgeon not operating?  Why? Well, it is not his fault. Sort of, losing all the weight and getting fit seems had a interesting side effect.  I am pregnant! Something Mr Gin and I thought wasn't going to happen! It does mean we can't do anything with the replacement for a while.  As far Mr Hutt is concerned there is little impact on the replacement and I know it will make it less painful. As I have the replacement I have to have a chat with a consultant about what they think the good outcomes are.

I am having issues because I am hypermobile and I have Pelvic Girdle Pain and am working hard on strengthening the muscles to try and halt that getting worse. As I am older (43) there are risks that go with my age and I am aware the toil it is taking on my body in general. I am tired all the time but hopefully that will change. I am working hard at maintaining my current weight until putting weight is required, which is totally fine given my current weight is classified as obese still.

So, this blog is taking a bit of a turn for a hip replacement and pregnancy combo.

A couple of answers to questions.  We are due late January and we know the baby is human and very likely to be ginger other than that we can't change anything and won't know time they are born, we are both every excited. Oh, and no real bump yet, and of course ask first!

12 month review - Could do better

Yesterday was the 12 month anniversary of the hip replacement and I am nursing a stonker of a hangover today.

A lot and nothing has happened since I last blogged.  I went to Australia, relaxed, showed my tattoo of my implant to my mother and drove 1500 km in 10 days with surprisingly no ill effects! I also have managed to swim a full 1 km in the pool. All in all, the joint is wonderful, it sometimes grates or vibrates when I stretch which an odd sensation.

I have have very sore feet, I have developed plantar fasciitis which is makes my heels and arches very tender, I went to the GP when they got unbearable, not long before headed to Australia in November. She gave me some exercises that seemed to be okay and my sports masseur released my rock hard calves and stretched the soles of my feet. The reason for the developing of the feet is because of my pretty sudden change from no activity to wanting to walk everywhere!

There was not much improvement but I stuck with the exercises and they settled whilst in Australia only to flair again when back walking in London. I had organised some more Physio on the suggestion of Mr Hutt earlier and we were looking at my walk which is still very limp like and he had done a pretty good job on the skeletal stuff and I shouldn't be limping.  So the Physios have started building my glutes in an effort to stop me dropping into the joint. This seems to be working, very slowly. They also rejigged my exercises for my feet to accommodate my hypermobility. This seems to be helping but I still get days where the feet burn as I sit in the tube which is very uncomfortable. I am finding that I want to limit the amount of walking and that is frustrating, so I am heading back to the GP to see if I can get some steroid injections so I can continue with the exercises but not be in as much pain.

The feet have been frustrating but the fact the thigh pain has not disappeared has been very difficult. We were hoping it would go over time and it wasn’t obvious in Australia except when I tried running on the beach (soft landings there).  Coming back into the cold it became apparent that the pain was still there, some days very bad, sharp pain, when I walk. Going up stairs I can feel the implant every step. Getting up off the floor, that downward pressure is very evident.

I went for my 12 month check up with Mr Hutt, he was very pleased with my progress, the bone is growing into the replacement and overall he is very happy besides the ruddy thigh pain. We talked about what was causing it, the shape of the stem, which is a documented issue but fairly rare. The tip rests on the bone of the femur, which is causing the pain, we think.  Hutt feels it is a pressure differential between the metal and bone. Hence when there is pressure put on the joint moving there is pain flairs.

He has suggested we leave it for another six months, to see if it rights itself. If not we will have to have a CT scan and isolate if it is the whole stem or the just the tip of the stem causing the issue. If it is the whole stem the option will be replacing just the stem.  If it is the tip, it would be putting in a plate to spread the pressure and possibly some bone grafts. Of course the third option will be to leave it and live with it.

In the meantime I am going to try to lose some weight and strengthen the muscles around the hip. This may help and frankly I am ready to grasp at those straws.  I am overweight and the muscles are weak so there are improvements to be made there regardless.

Needless to say the thought of more surgery and revising the implant has made me quite upset and my mental health has taken a bit of a tumble with this newish development. I am really disappointed about it and finding it difficult not to worry big time. It will not be an easy decision if I have to make it. Thankfully Mr Gin is being wonderful and supportive as always.

So Hippy Birthday to me and hopefully this will pass.

Six months, really, yes really!

The Big Six month update.

It has been quiet on the blog because there is not all that much to report. Not much has changed but I have had the six months check up with Mr Hutt so an update feels to be in order. It is not an overly cheerful update because I am still frustrated but will try for an upbeat mode.

So, sports massage, brilliant idea, has sorted out my back. Fabulous! I have found a good masseur through work, she is close and reasonably priced. My rock hard calves have settled down which is brilliant. I suspect this is no longer a luxury but a necessary to help my body along as I try to sort this walk. Loosening muscles seems to help a fair bit and maybe it will help with the thigh pain I have having.

Thigh pain. A frustrating new thing along with a knee that is a bit sore and audible in its crunching! The thigh pain is from tip of the implant in my thigh bone, it is deep and ranges from nothing, a bit achy to quite sore. I rarely take pain killers for it but it is not something I want to live with. Mr Hutt has explained some of the issue comes from me being a dainty wee thing, well, short (153cm) and the stem being reasonably long. It tends to get sore when I put pressure on it from exercises etc. It is deep, under muscle pain. It was intermittent when I first got the hip done then disappeared and then came back in June and has not disappeared. Yet. There is hope as it all beds in that the pain will disappear and things will be peachy. The pain is such that I am bit wary of trying to run, even for a bus because I think that will be a nasty sharp pain. Mr Hutt, thinks in 12 month we will know if it is going to be an ongoing issue.

Sadly, if it does not go in that time, the only option maybe a revision and new hip. I want to avoid that. So much. So much. So at the moment lots research happening and exercising to gentle persuade the tip to bed in and the bone to become less sensitive! I just hope it is all worth it.

The knee could be muscles pulling on the knee cap which I will get my masseur to look at that and if that does not help, off to the GP! Frankly dodgy left knee is in the bad books because I would like the body to give me a break for a while.

Needless to say all the above it a bit tough to deal with and digest but recently finding someone with similar issues with the same implant and put in by the same surgeon has helped a lot.

Exercise. I hate the gym. But I am doing static biking, leg weight machine things and cross trainer. Not too much swimming lately but I am doing a fair amount of that, not quite cracked the 1 km in 30 minutes mark but hoping to soon. At some point there will be leg presses and rowing soon, if I can work out how to use the rowing machine!

The bloody walk. I have new sneakers but they are being rapidly destroyed by my twisty left foot. I am still hip hiking and a little bit of the waddle, a throw back from the old walk and also a bit with the thigh pain. Mr Hutt felt that perfection will not happen on its own and there are some terrible habits of a lifetime break. The skeletal foundation is the best we can hope for, we think the hip has settled about 1mm down which is not much but could have been the angle of the x-ray or a result of normal settling or a major collision I had with the floor 3 months ago. He is very pleased (as am I) with the movement I have. I can sit cross legged like a primary school child, this is something I have NEVER been able to do even as a child. The range of movement is very good and smooth. The muscles are building nicely but could do with some more building.  So, this means some more gym work and locating a physiotherapist to help with the walking. There is more in this than weak muscles, there are old habits and I do not really know what a proper walk feels like.  I think this is clincher, the past physio expected I would know what a normal walk would feel like. I really don’t I have never walked like a normal person, my gait has been awkward since I learned to walk on a dislocated hip as a two year old!

I am walking fair distances and with speed, I can keep up with Mr Gin pretty well and now there is no longer any forward planning for going out, I walk my local high street easily and climb two to three stories of stairs, although a bit puffy, quite well. My overall fitness and weight leave a bit to be desired but that is the story of my life and not really to do with the new hip. I could do with losing a good 30 kilograms and that might help with the overall fitness. Sadly, I find gym boring and rather like food and booze, so this is always going to be a struggle.  I have been walking more because of all things, Pokemon Go, it drives Mr Gin bonkers but gets me out and about. I am trying to catch buses that require more walking and generally not take the lazy way out. I have to try and cut down on the red wine.

Work is a stressful which makes cutting the wine down hard. We have a trip to Australia booked, I am sure that I will set some sensors off! I have also got it my mind this new hip is going to do some driving, a lot of it. I am looking forward to a holiday.

There is not much else to report besides a little six month celebration but that will get its own post!

Six Week check - Mr Hutt

So, today was my six week check up.

I trundled my way out to the far reaches of Wimbledon. Went through the now standard excitement of X-Ray (Yay for yoga pants) and then without much waiting it was off to see Mr Hutt.

Mr Hutt 

He was very pleased with the scar, even though I have had an awful outbreak of eczema around the scar. That should be solved with large amount moisturiser.

The implant is a titanium and ceramic S-ROM implant with a Pinnacle cuff. It is attached using ‘Press Fit’, which means they are both uncemented and the bone should grow to attach them firmly.  It has a long stem and the reason for some of the thigh pain I have. Hopefully this will disappear but this could stick around. It also is closer to a normal hip on its angles so I have a different range of movement. Not a huge different but it does explain why my turn in is not as awesome as it used to be. The small fracture I got in surgery was because I have round shaped femur and not elliptical like most people. The stem is shaped for normal people and was a very tight fit.

Mr Hutt was awesome and answered the three pages of questions I had. Very matter of fact. Very little sugar coating. The left hip looks good but not great and I should be aware that it could go but he said that is a while away yet.

He was impressed by the knee bruise, he felt it was referred bleeding from the operation.It was not something he had seen before. He said that knee had been twisted but not to the bruising extent.

He also said that I can ski and ice skate but to be aware that if I do take a tumble and fracture the right femur it is more likely to be a nasty fracture.  So I shall think about those. Cycling and swimming are for the win the win. This bit is for Red, Mr Hutt was slightly horrified at the thought of Skydiving and that the release of the shute could cause some issues. He did not say no but did look little bemused by the suggestion. He did say that marathons were totally off the table.

So, onto slightly more practical matters. I am able to get rid of the second crutch and when the Physios are happy with the walk, getting rid of the second crutch soon. Also, I can gently attempt to go for putting on socks and tying up laces. If my muscles allow it I should also be able to squat and to sit cross legged.  If I manage to sit cross legged, this will be something I have never done! Never!

There is very little I should not be doing. Most of the danger zone for dislocation is over, and I have to be aware of some twisting but generally it all good. I doubt Prima Ballerina is going happen but I think that there will be a new me.

So, this is a large thank you to Mr Jonathan Hutt for undertaking the job.  At six week I am more than happy with the outcome and the care both he and the EOC showed. Mr Hutt said that we really should know in 12 months how well it has gone.  Hopefully the year mark will be a show case for exciting new movement and life.