Let the spica journey begin

It has been two weeks since Squeaky had his open reduction at the Royal London Hospital.
It has been a roller coaster of a ride. 

We arrived at the hospital at 7.30 am with surprisingly chilled baby, even though he had missed breakfast.

We had met all the team. Dr Louis, the anesthetist, was amazing, calming and reassuring as Squeaky had a bit of a sniffle and said the operation could go ahead. Then Ms Biljsma and her team, we established the leg that required operating on and she seemed relaxed and happy. I said I was very keen on avoiding a femoral osteotomy. I know this was something that may have to be done but still wanted to avoid.
We were told we were first surgery and there wouldn't be long to wait. I took squeaky to theatre but we were sent back to the ward as there was no bed for when he came out of surgery.
In the end we didn't go to theatre till 11.30 am. Squeaky was very good and even napped although thirsty and hungry.

Surgery last 2.5 hours. I went to recovery, Squeaky was hooked up to a morphine drip and sporting a purple spica cast. It went down almost to his ankle on the left to just above his knee on the right. He was very upset but a mum cuddle soon sorted that out. He had a sleep in me as we waited for the ward nurse to come and get him.  Dr Louis popped in and said it went well. Then Ms Biljsma came in, she was very pleased, she said the hip went in better than she thought it would and that there was no need for a femoral osteotomy! I think a huge weight lifted at that point.

Sarah, the ward nurse arrived soon after and we were go to head to the ward. We collected Mr Gin on the way an and headed up with Squeaky in a huge bed and a morphine pump.

We got up on the ward and there was a visit from the pain management team and all the observations as well as Squeaky wanting to have cuddles. And with those cuddles as much as napping as possible.

We gave him food as soon as were allowed as he was starving. With food in his tummy he seemed more settled.

We played pass the baby and try to chill till after his dinner. Squeaky was really out of sorts and very much suffering with being doped up.  Mr Gin headed home to feed the cats and get some rest. I prepared for a night on an extendable couch.

Buckaroo on a dopey baby

It started okay, Clark settled and drifted off to sleep up kept waking. This continued with a lot of screaming and only sleeping on me. In the end it was decided to give him more morphine and some diazepam for muscle cramps. The spinal had worn off and he was very uncomfortable. He managed to pull out his morphine cannula which was a bloody mess but showed why they put two cannulas in babies, just in case they do that! It was a tough night being on a ward made it tougher.

The following day was a morning full of visitors, the pain management team, who where going to cut down his morphine with an eye for taking him off it. The OT fitted him into his buggy and gave me lots of information and was impressed with our organisation. A surprise visit from Dr Louis! The surgical team came in and agreed to make the hole around his bits bigger so we didn't have to fight to get the nappy in. The plaster technician was going to come and do this. Then for Squeaky, the best bit, Mr Gin arrived.

More cuddles, reading and playing happened. I went out for lunch and a bit of break while Squeaky slept and had lunch.

We waited for the plaster tech and got the morphine out. We then took Squeaky joy riding in his buggy! It became clear we were not going to see the tech so we had dinner and Mr Gin headed home.

I was a bit more prepared for the lack of sleep. We had some diazepam again but that hyped him up and he played peek a boo with himself for forty minutes! I managed to get him to sleep a little buy propping him up on his tummy. It was broken sleep after that and in the end I dozed on the couch with him wedge in but on me.

Mr Gin arrived early to rescue me and Squeaky played in the play room. We had a visit from the orthopedic team who chased up the plaster tech, Derek. Who some of you may remember for removing his other cast and fitting his palvik harness.

Once that was done it was a sign off from the pain team and the nurses and we could go home. I left the hospital about Lunch time and Mr Gin got Squeaky home for dinner.

A very long few days. More on the adventures with a small boy in a big cast soon.

Slightly off topic but thank the stars for the NHS.

It is a week since I was up early after feeding Squeaky and had stopped to watch seals play in the surf that our holiday house overlooked.  It was idyllic.

My parents, over from Australia, pottered around the house as we readied ourselves to head to the coral beaches on the Isle of Skye, making the most of the glorious weather on our last full day on the island.

The road was single lane with some passing points to the beaches, a good 25 minutes from the nearest village, Dunveagan and a double lane road. The views were stunning and Squeaky was happy in his car seat with my mum on one side and me on the other.  We arrived in the carpark and parked our big hire 4x4 and unloaded ourselves. We decided the gravel was too much for the stroller, so we would pop Squeaky in the sling, same as we had the previous days before. I was wearing the sling as I was worried about Mr Gin’s back. Off we went.

The path was smooth and gravelly and smelled of sheep. Squeaky was happily watching the world from my chest and I chatted to him and my mum as we went along, the gravel changed into larger rounded stones and I slowed so my mum could keep up. I lost my footing.

I screamed and watched in slow motion as the ground came up to meet us, and my baby’s face went from smile to scared to screaming as his head hit the ground. I fell to the left trying to protect him and my hip replacement. His little head bounced on the rocks and all I could do was hold him as he screamed.  Mr Gin got me to get up as I lost the plot because all I could see was Squeaky’s head hitting the rock and all I could say was he hit his head through my tears.

As Mr Gin pulled Squeaky out of the sling I could see a huge bump along the side of Squeaky’s head. Mr Gin pulled his hood over his head and we went back to the car, Squeaky crying all the way. Between us we got him in his car seat, my dad got us out of the car park and we drove out. Squeaky was screaming and I was doing my best to get him to settle. We had no phone signal and knew Portree had a small hospital but it was almost an hour by car over the island. I called 112 and got through; I wanted to call ahead to the hospital to let them know we were coming. They couldn’t do that so they put me through the ambulance. We could tell them what road we were on but the dispatcher wanted us to pull over. We parked in Dunveagan Castle carpark and Mr Gin took over the call as I didn’t know what was better to wait for an ambulance. We waited 25 minutes for an ambulance, with Squeaky screaming and crying, the ambulance had to come from Portree.

The ambulance arrived, Squeaky had not settled, as he was so little and had a huge bump they took us to Broadford, the only hospital on the island with a Doctor on duty. It was an hour away. Mr Gin followed in the car as Graham drove the ambulance and Richard, a very kindly man, assessed the pair of us. He asked if Squeaky would be ready for a feed and suggested to do that. He stopped screaming. Graham avoided potholes as I sat on the gurney looking at the huge swelling on his head.  He stopped feeding and drifted off to sleep. I was worried but Richard said it was fine, he periodically checked that Squeaky would grip his finger and checked for signal so he could call the hospital. We were going to Dr MacKinnon Memorial Hospital as they had a rural practitioner on duty, Dr Alistair Innes, who Richard said was the best person on the island to look at Squeaky. He finally got signal to call the hospital and alerted them we were coming in.

We arrived and checked in a considerably perkier Squeaky and I was starting to feel, along with the huge guilt, that maybe we were over reacting.

We waited and a fellow in scrubs came by and told us were next, we had the stroller of Squeaky and he seemed chilled. A nurse showed Mr Gin, Squeaky and me into their one and only emergency room with a lone bed. She took lots of details and then examined Squeaky’s head. The huge swelling had gone down and Squeaky cried as she prodded the spot. She was not happy with his response and called in Dr Innes to look too. He was not overly happy and sent us off for an x-ray as there is no other scanning equipment on the island.

What followed was heart breaking as Squeaky cried as we had to hold him in position.  This was awful but needful to get the x-rays.

We were called in by Dr Innes to look at the x-rays. This showed a fractured skull. He felt that Squeaky needed a CT scan to rule out bleeding, even though Squeaky was pretty perky and smiley regardless of his ordeal. We knew Inverness was the nearest big hospital, 150 miles away. Dr Innes was not happy to send him there because if there was bleeding he wanted a specialised paediatric team to be there on site. This meant Glasgow, Edinburgh or Aberdeen.  We were scheduled to leave from Edinburgh in two days’ time.  At this moment I was very teary and he stopped the tears by saying, I will call the hospitals, find out who has space and which one the helicopter can take you to.

Helicopter? Yes. Skye only has 4 ambulances running at one time and to take one out for a 10 hour round trip is not feasible and there was no way he was going to allow us to drive him across. We were to wait in one of the 24 beds the hospital had to find out which hospital we were to be flown to.

I was to fly as I was feeding Squeaky; they needed to know how much I weighed. Mr Gin would drive to the holiday house and with my parents pack it all up, and drive to the hospital we were going to. A minimum five hour drive. Squeaky charmed the nursing staff and I waited to be told where we were going to. The isolation of our holiday location really set in.

Dr Innes came back; it was Glasgow, the Royal Children’s hospital part of the Princess Elizabeth hospital. The Helicopter would be in there in an hour. I messaged Mr Gin, ate something and tried not to cry as my little boy played with his doll oblivious to how this day was going. Dr Innes arranged that we would not have to put IV drips into Squeaky and we would not be met with a crash team as he felt that scaring the both of us more would not be needful.

The ambulance crew from Broadford, Ian and John arrived to pick us up and drove us to the airfield. There I watched the helicopter land through the window as I held a sleeping Squeaky in my arms, he sleeps in vehicles well.

The engine stopped and I was introduced to the helicopter crew, Squeaky handed over to Jack and I was buckled in. At this point Squeaky was on a pillow and buckled to me. I had a headset, Squeaky had one but I think it pressed on his head too much. We took off and Squeaky looked scared and then launched into crying. He would not settle, I cried a bit too, it was a noisy, moving environment. I did what I thought was best. I feed him.
 Breastfeeding in a medivac helicopter and four point harness. Scotland flying below me, beautiful mountains and lochs. Squeaky cried every time he came off, in the end he fed for about 40 minutes after that he was so full he fell asleep.  The views were lovely but in the end I was focused on the tiny man in my arms and struggling with feeling guilty that it was my fall that got him here.

Glasgow came into view and I was told that we were landing on the roof of the hospital. Eck!

We landed an experience that is scary and gut wrenching but smooth due to the very good pilot. We waited for the fireman to get us (an onsite guy, it was health and safety), he put us in a wheelchair and rolled us down the crazy ramps to the lifts that took us into the children’s accident and emergency department. I bid farewell to these men who bought us here, feeling a little guilty that I missed half the information due to my stress and their accents.

We were then handed over to Dr Nic, she was lovely and reassuring and checked Squeaky head to toe, getting all his history. She checked his head and said Dr Innes had been very good to pick up there was more than just a bump on the head. She noted that Squeaky was very alert and happy but they would do a CT scan. It was 8pm on a Sunday by this stage.  They were not sure if they would call in the radiographer on call in or wait till the morning. She wanted the consultant on duty to look at him to see which way to go. The consultant, Ms Cameron, felt he should be looked at this evening and called the radiographer in. She then offered to look after Squeaky while I went to the loo. He threw up on her!

The CT scan happened close to 10pm, with Laura (?) who was wonderful, poor Squeaky was not happy being strapped in and she calmed him with a dose of sugar syrup. It was funny watching his eyes light up. I wore a lead apron and held his hand as he was scanned.

Down in the E&A department we waited for the scan to be processed and the report from the radiographer.  We were going to be kept in overnight. I had no signal and only knew Mr Gin had left Skye and was driving across to us and thought he would be there at 1am.

The scan came back that he had a fracture on the right side of his head.  The 3D image showed this clearly but there was no evidence of bleeding! This was good news. We were to be taken up to a ward to spend the night. By this stage it was 11pm and Squeaky was exhausted but not wanting to sleep in the bright and noisy A&E department.


We were walked up to the ward through the staff corridors. I found out the hospital was only a couple years old. It was bright and modern but by this stage both of us were exhausted. We were handed over to the ward staff, and were shown a private room with a cot in it. Also a pull down single bed for me and an ensuite! They found me a sandwich and drink and told me it would be two hour observations as it was a head injury.  I changed Squeaky, fed him and settled him, all sleepy and full and held his hand as he slept when the painkillers took effect.

I had signal and Mr Gin was in Glasgow, in a hotel and coming to the hospital. He arrived after midnight with a bag of clothing for us and my wash bag. I had left Skye in the clothing I was standing up in and change bag for the day. The hospital had already given us some nappies.
Mr Gin left after cuddles and I settled in for the night. In the morning I was tired as Squeaky woke a lot due to wanting to feed for both food and comfort. I didn’t want to give him his normal formula and as a result was a little tired as I didn’t sleep well. I kept seeing his little face before he hit the ground.  Rachel the night nurse was lovely and managed to not wake him too much and didn’t mind when I cried.

I was up for ward rounds and found out they were fairly happy there was not brain injury but hospital protocol was that he would be kept for 48 hours and as he under one with head fracture child protection team would be involved. This made sense but did put our travel plans in jeopardy.
The paediatrician came in later to go over the incident and look at other tests. He was to have an eye test to see if there was any eye damage and possibly an MRI to rule out small bleeds and x-rays to check for any other fractures.

Mum and Dad arrived, with Mr Gin who had lunch for me as I failed at breakfast. Squeaky was very happy and chirpy but grumpy when moved the wrong way. I asked for pain killers for him.
Mr Gin and spoke with the medical team, they were happy with Squeaky’s eyes and our story. They didn’t want to do any more investigations but he had to stay in another night just to be on the safe side.

I had a walk while Mr Gin looked after the lad, then they went off to relax at the hotel. Poor Squeaky was tired and out of sorts, very clingy, very understandable. We played in his cot, on my bed, playing with his toys and some provided by the hospital.  Lots of silly songs and cuddles.

Funny pupils for the eye exam.

He wouldn’t settle for a nap and by the time Mr Gin returned with my dinner I was a little frazzled and Squeaky not wanting to be put down. A doctor arrived to tell us that things were being put in place for a quick getaway in the morning if the night went well.

Between the two of us we got him to sleep in his cot and I hugged Mr Gin a lot before trying to sleep.  Rachel was back and didn’t wake Squeaky when he slept for 6 hours straight.
In the morning I packed up, not sure if we were leaving.

Morning rounds confirmed they were happy for him to leave, child protection where happy that his injuries were accidental and the medical team felt the fracture would heal quickly with no intervention.

It was the quickest discharge I have experienced. They were wonderful. By 9.30am we were out and waiting for Mr Gin to pick us up.

Not the end of a family holiday anyone would want but I do have say this. The care we received was world class. Everyone was caring a reassuring as things escalated. The NHS is amazing, they looked after my beautiful boy so well and made sure he was not too broken. All this because we pay taxes for this service. It is astounding. Also, isolated communities need better services, a CT scanner for the population of Skye and close islands would save a lot of helicopter flights. The Glasgow Royal Children's Hospital and Dr MacKinnon Memorial Hospital, a huge hospital and small hospital are amazing.

I have a lot of guilt with the whole thing, we had agreed early on that Mr Gin would wear sling because my hips meant I fell but I had not fallen for ages and I had worn the sling around a lot, safely. Needless I will not be using the sling again and not holidaying in isolated places for quite some time.

The most important thing, besides a rapidly fading bruise, Squeaky is okay and still amazing.

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!

South West London Elective Orthopaedic Centre

I’m home and have been so for about 24 hours or so, and I’ve had time to digest my experience at the South West London Elective Orthopaedic Centre (SWLEOC).

They are a Centre of Excellence, within the NHS (National Health Service) and the majority of procedures are knee and hip replacements. There are a number of these centres dotted across the UK and different one specialise in different things.

A number different hospitals feed into the centre, including St Georges and Kings.  It is outside of London but still within the M25. For us it was over two hours on public transport. And almost on the opposite side of London.  The surgeons there are the top of their field and the nursing staff, physiotherapists and other staff are specially trained in the care of joint replacement patients.

The dedication and expertise of all the staff was very apparent, and the regime was intense. The nursing staff worked 13 hour shifts. There was a consultant on duty 24 hours, something that is quite rare. There was physio and radiography seven days a week, on the weekend a smaller staffing of the physio and x-ray.  The ratio is very good and the wards had no more than 3 beds in them, and it appeared that they tried to place people having surgery on similar days together.  The expert nursing staff meant you were in safe hands all the time and they even had prescribing nurses if drugs needed changing or new things needed treating. The goal of coming out independent was very obvious, with all staff being encouraging and gently pushing you to strive but, if you look like a rabbit in headlights they were comforting. The respect and care for the patients was just amazing.

The facilities are world class, five dedicated theatres, a dedicated radiography suite, a day ward and two longer stay wards. It is a separate centre, attached to the Epsom General hospital but very separate. The reason for the separation is to limit patient contact with infection. Infection is the bane of joint replacements. A bad infection can result in a dreaded revision. The SWELEC has some of the lowest infection rates for joint replacements in the word and they do about 5000 procedures a year. Just amazing.

They also will collect you and take you home, hour and half drive home was done by Bill. Which was gratefully received, I could not have done it on public transport.

Even though there was a lot of older patients there were some younger ones and even though it was commented I was young, I could just say I was born with congenital dislocated hips, there were questions of procedures and outcomes that were intelligent and well versed. This led me to believe, I was not that far off the norm. Once the explanation of my age was there, they procedure with me as the same as the oldies.
So, fabulous surgeon world class facility and a top of the line individually selected hip replacement. Pre-planned and measured. Sent home with crutches, exercises and a lot of drugs.  The cost of this procedure?

A large dent in my sick leave.

Nothing, in terms of money. A rough estimate would be about £10,000 maybe more.

I am beyond thankful I was in the UK and the NHS is available to all, including this immigrant. I certainly have not paid £10,000 into the NHS with my contributions.  Thank you for the amazing NHS, a huge organisation that runs 24 hours, seven days week, and I will be campaigning to stop it being privatised because without it, I would have been crippled, in debt or both.  Social healthcare for the win.