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.

Packing list for Hospital.

This is not really about what is happening to me now but more advice on what to take to hospital. Of course, your mileage may vary, the EOC does things differently to other hospitals and I am bit younger than most hip replacement patients.

When I was packing for the hospital, the EOC had provided a pretty good list I have added some bits to the list with additional notes:

• Walking Aids (Be prepared not to be using your old one when you leave.)
• Slippers and/or trainers. Nothing open backed BUT slip on with a good grip on slippy floors is the best. I had a pair of slippers and pair of sketchers that are slip on, Additionally your feet are likely to swell the size of small melons, so have some shoes are a little too big or stretchy unless you want leave in socks! 
• Nightwear – loose is good but also if you intend to wear a night gown, long enough to go over your knees when sitting. I am not the most modest woman but frankly flashing the people opposite you is a little carefree.  If you are going to get a catheter, consider a nightshirt of very loose, short pyjama bottoms. Also, I took a light dressing gown, it was handy at various points.
• Loose day clothing – stuff that will stretch over your swollen leg, I swear by yoga pants, minimal waistband and enough stretch to accommodate a leg at least twice is normal size and looking like it belongs to elephant. Also the high waist of yoga pants are a little easy to deal with when having to deal with limited mobility. 
• Big knickers! Not grandma knickers but something without tight elastic around the leg and with a reasonable amount of fabric across your butt and not to narrow at the side. I wore girl boxers, that have no elastic in the leg and covered most of the incision site, this minimised the amount of rubbing and were easy to get on!
•  I took enough clothes for five days and that was a little much but better than having to ask Mr Gin find a black t-shirt in a drawer of black t-shirts.
• Personal Towels (not white) – I could have got away with not taking a towel but for me it was nice to have one of my own. Also if you like big fluffy towels, this is something hospitals don’t have! Also take a flannel, scrubber or such like. Orthopaedic surgeons love a permeant maker and mine liked a bit of ball point pen. When you finally get to have shower you are going to want scrub that graffiti off.
• Toiletries – If you don’t normally use soap, you will need a bit because of the graffiti loving surgeon. (I don’t use much soap due to it making me itch if I use too much and didn't pack it.) If you are female and have not been through the menopause route be aware that major surgery upsets lots of things and my hormone cycle was upset. I was caught unprepared and I cursed my body at that point.
• Helping Hand, long arm grabber, reacher. I did not have one of these. Get one before you go in if you don’t have one and if you want to be able to put on your own underwear you are going to need this. Amazon provided mine. (Some councils and hospitals will also provide them.)
• ALL YOUR DRUGS! In their boxes! No doesette boxes. Also any other aides – splints, braces!
• Glasses, hearing aids, contact lens and dentures. I wouldn't bother with contact lens, mainly as putting them in when taking opiates is bloody difficult.
• Fruit juice, ready to eat prunes, apricots. Now I did not really understand this but opiates are evil for giving you the worst constipation. If you have some food you know helps get things moving take it with you. I also got bored of drinking all the water, and had Mr Gin bring in some diet lemonade for me. If you thingy about your tea and coffee, I suggest you take in a small supply too. E, 80 hip lady had a china mug and her own tea and that made her very happy.
• Coat and keys for the house. Self explanatory, especially if the hospital take you home.
• A  Cushion. I have carried around a chair pad a fair bit because being a little higher is easier and if you have to get in a car being high is a blessing!
• No valuables including jewellery. Don’t wear anything into theatre but if you, like me feel naked without your rings take some non-important ones with you.

Added to the list by me!

• Something to do with visitors – if you are having visitors, a game, we had dominoes is something that is helpful so you are not discussing bodily fluids all the time.
• Sleep mask and ear plugs – sharing a ward with strangers is entertaining up until they snore like the stream train from Whitby to Pickering without the wonderful views. Additionally hospitals are not the quiet places and sometimes getting the lights turned off is not a battle you want to take on.
• Something to do. I took a book, as did the other ladies on the ward but we all struggled to concentrate. So, I spent a lot of time on my phone, I got extra data because I knew that Wi-Fi in the hospital was pricey. I also had a small deck of cards and I played Patience because that is all I could concentrate on. I also had my laptop and played games (Minecraft of course). If you have a tablet that would be a good thing, but of course keep an eye on the expensive technology. I also had pencils and a colouring book.

Being cautious.

Today was a bit of a bust.

As I mentioned yesterday I slipped a bit heading into my WI meeting, and as the crutch went in a direction that I didn't I tried putting the foot of my operated leg through a flag stone. Twice.
It was pretty sore by the time I got home and yesterday the bone felt tender. A very different pain to anything that I have had besides when the joint was sore, pre-op style. Morphine help sleeping but last night it was very ouchy.

This morning I called the OEC and they felt that it should be looked at and there was a suggestion to head to St Georges A&E department but to be honest the cab fare would have been very expensive and tube would have been difficult. I figured if I went to my local hospital, Whipps Cross, if it looked bad I could go to St Georges.

Off to X-ray

So, off I went. I bought a sandwich and drink with me, knowing it was going to be a long wait.
All in all it was not too bad. The A&E is tucked away but it is a new building and the staff on point.
A number of x-rays were ordered (and everyone being surprised with my wonderful yoga pants with no metal bits) and then the nurse practitioner and the consultant had a look at the films. They felt there was no evidence of movement of the implant and there was no evidence of breakage or cracking of the bone. They have sent the images to St Georges to have a look at on Monday, just in case. The consultant was good, and said that he understood why I was being so cautious, so that is good.

So about four to five hours in A&E and me being very cautious, it seems it is okay and the pain is just from jarring the bugger.

Tonight I am going to romantic movie with Mr Gin. Deadpool.

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.