I should probably start…..

….at the beginning. However, I’ve had some exciting new changes today, 7th January 2013. This morning at 7.15am GMT, I arrived at a local hospital in Manchester, scheduled for a Total Hip Replacement Total Hip Replacement. To say I was scared was very much understated. Mixed emotions and a feeling of surrealism as I’m led by a porter to my room. Mum and my long suffering other half are by my side yet I feel as though I’m not really here. So the beginning-Almost 22 years ago, I walked into my bedroom as an eleven year old girl and injured myself falling down and a poster that has become unstuck and landed on my floor. I recall trying to reach inside the wardrobe for my something. The rest is much a blur-screams, can’t weightbear, hobbling using the vacuum cleaner as a crutch to the top of the stairs. I’ve no idea how long it had taken to get me from my bedroom floor to the A and E department on Tameside, but it feels now like it took forever.

We arrived, mum asked for a chair as I couldn’t walk, I could not put weight on my left leg at all, the pain excruciating. My memory is somewhat clouded from that day, although I distinctly remember the emergency Doctor prodding my thigh and telling us to go home and put an icepack onto it as I’d pulled a muscle or had groin strain. So, an 11 year old girl, non-weightbearing, left foot turned out, in excruciating pain in my thigh. Go Home. So we did.

Ice, heat, exercise, no exercise, several trips backwards and forwards to our local GP. Nothing-no support. Everyone thought I was just a ‘mard’ kid, moaning and using my pain to excuse myself from anything I didn’t quite fancy doing. Family friends brought heat lamps, ice packs, crutches. No one could understand why it still hurt and why I was restricted. Fast forward almost 12 months-if i recall correctly it was maybe February 1992-the GP finally referred us back to the Orthopaedic Department at Tameside General. Xrays, tests, manipulation, asking me to stand, sit, lie down, turn. None of which was done on my original visit almost twelve months previously.

The diagnosis was clear. Slipped Upper Femoral Epiphysisor SUFE or SCFE, the ‘C’ in the USA being Capital. The first revelation was that surgery should have commenced within 15 minutes of presentation at A and E the first time around-FAIL. The fracture I had walked on for almost 12 months was irreparable. Salter-Harris growth plate fractures involve a fracture through the growth plate. Imagine taking a custard cream and seperating the top and bottom halves. That was the result. The head of the femur had slipped off the neck of the femur and growth plate. Ouch.

Treatment of this type of fracture usually consists of immobilization for a period of time, 4-6 weeks and surgery to pin the affected bone back into place. This had not happened. They had failed at primary treatment. I wasn’t even asked to stand up. As so much time had elapsed from the original fall, my femoral head had fused in the slipped position, imagine the ball joint falling off almost and fusion occurring before it can quite get the chance to topple off. The diagnosis ended in me visiting many different surgeons.

Referrals to Manchester Booth Hall, Nottingham Queens, Manchester Royal Infirmary. I saw doctors across the UK as far as Southampton. All were in agreement-something should have been done IN THE FIRST PLACE.

It became more and more apparent the original Doctor in A and e had made decisions that led to me not being operated on. Hip resurfacing wasn’t possible due to the remodeling and osteocytes that had occurred. Avascular Necrosis -death of the bone had occurred, flattening the head of the femur and deforming the entire bone.

My only option was Hip Replacement in my early teens. Almost 22 years on, a referral to Spire Manchester consultant on 8th November 2012 was the beginning. The real beginning started then and I look forward to a new lease of life without pain and restriction.

Physio and Personal Training

The physioherapy I had during my early recovery and the year following a total hip replacement for the 21 year old slipped upper femoral epiphysis, remains the saviour of my mobility.

Alongside balancing exercises were body weight strengthening exercises and some use of machines which you can see in earlier blogs. Key to my hip surviving, is most definitely keeping the muscles around it strong, particularly after we woke them up as they’d completely atrophied pre-op.

In September 2019, I embarked on some weekly group sessions with a local Personal Trainer. It was great! I learned so much in the 2 months I attended, being busy at work stalled my sessions in late October. My body is still somewhat wonky, and it was injuring my knee twice during those sessions that made me decide not to continue, and to use some of the exercises I had learned at home instead, avoiding the ones I know cause my knee issues. I can’t recommend finding a PT highly enough! It gave me the kickstart I needed as my gym is still closed and I haven’t found another local one to join with the same benefits to the kids as the previous one. Fingers crossed after COVID-19, our newly refurbished gym will reopen!

Six years on…

17th April 2019

I am Queen of Procrastination, so here I am avoiding some necessary admin for work. It has taken a little while to get around writing an update this year, for which no apologies are made.

I now have a successful business up and running now in it’s 6th year, a second supplementary business which runs alongside the first, and also a new partnership which has been birthed in October 2018, and is growing in small chunks. I only have thanks to my THR for the mobility to succeed in this adventure. The riddance of SUFE has brought me much joy over the years, and much mobility. The riddance of the 24 hour pain I was enduring, has given me a completely new lease of life.
The businesses run in such a way that I need to be available at a moments notice, I cannot call in sick (unless I am absolutely sick and utilise a back up), but the relationships built with clients mean they want you by their side, not somebody else if it can be helped. This would simply just not have been possible pre hip replacement, not only because any time off sick as a self employed business means no pay, but the inconvenience I would have been, would have made me hugely unreliable in my role.

On reflection, I honestly do not know how I got through each day as the haze of those days drifts further away with each passing moment with my new hip.

The restrictions which I had in the years previous, from age 11 to 32 were impacting on my life far more than I, or anyone around me wished to believe. Considered by some to be unable, disabled, lacking mobility and ability. No participation in sports which I had enjoyed as a child. No walking long distances, which only got shorter with each week I had SUFE. No running after children in the park.

As my surgeon said a couple of years ago, nobody would know now unless told, that I had a ceramic hip in place of my own necrotic one, but it was extremely obvious prior to this with 2.5″ missing off the length of my femur.

I am still terrible at getting my backside to the gym, but do go when I feel my muscles getting weak. Muscle atrophy happens pretty quickly when the muscle memory from years gone by was mostly in a state of ‘dead’.
Slowly, I am getting better at looking after myself rather than everyone else – a thing I think comes with age rather than hip replacements.

Still, the rest of 2019 is a positive one, with a strong hip (says the Chiropractor!), I should stop worrying about the risk of dislocation now, and continue to use my *still new to me* mobility to my advantage.
Being hypermobile probably contributed to a knackered hip in the first place, and now does me a favour in ensuring a good range of movement, as long as I keep my muscles strong. I REALLY WOULD like to get fitter and get back to doing some kind of low impact sporting activity, so that is my goal for the rest of 2019. Let’s see where it takes me.

Five years on

I am sure I won’t be alone in sharing post hip replacement worries. Every hip replacement group on Facebook and forums hold the same questions.

When will it fail?

How long have I got before more surgery?

Will it JUST dislocate after five years?

Will I panic, panic the kids, panic the husband?

Will an ambulance come IMMEDIATELY?

Go to the gym….Go NOW.

Keeping these muscles strong is hard work. I am a particular fan of being in the gym but I know for me it is necessary. Keeping muscles strong around the hip is an important part of self care. And I really feel it when I am slacking.

My foot begins to turn over to balance and support me when standing to compensate the weakness in my pelvis, and I know at that point I have been ignoring the gym. Off I go again for a few sessions then make a lame excuse why I can’t get there.

One of my oldest friends gets married in May. She was one of my bridesmaids and I can’t wait to see her happy on her big day. Dress shopping is not my idea of fun, but is necessary.

One thing which amazes me after years of having uneven leg lengths is trying a dress on. My pelvis being level is such a bizarre concept to me, I now just expect the asymmetrical cling to of the fabric to my hips. And shocked I am when it doesn’t.

I still carry more fat and muscle on my right side. The left was so atrophied before hip replacement and grew less in length and muscle density than my right. I find my different sized feet normal where the personal shopper just thought I needed a smaller size shoe. “No, I need the size eight to fit the other foot”.

So I have promised myself again (AGAIN), to look after this hip. I really don’t fancy having a revision. Ten years is a good stretch for a youthful hip replacement and it makes me nervous being at the half way point.

Hip replacement and exercise

Everybody knows how importantit is to exercise. Throughout our lives it is reinforced by health experts, doctors, cardiologists, on billboards, advertising everywhere that a minimum of X minutes a day or X days a week is optimum for our health.

When I had my hip replacement, I had been gradually less and less active over the previous 21 years. I was an active child, riding a bike, gymnastics, netball. Then in my final year of primary chool, SUFE hit. Gradually thorughout my teenage years my pain got worse. My mobility was instantly shot as my hip moulded into an unrecognisable mushroom. Gradually throughout my 20’s I started to put weight on due to my lack of mobility. It was painful and eventually I was unable to walk more than a few steps without exasperating, debilitating pain on top of the constamt jolts, shocks and ongoing pain that existed permanently.

My hip replacment was a revelation to  me. Thirteen month of physiotherapy from the amazing hospital I had my surgery. I eventually got to the gym for the first time in my life. I enjoyed it! Gradually see the numbers on the weights build as my strength and mobility increased for the first time in over 20 years.

What I did not realise (consciously at least), was that not doing all that exercise, 3 or 4 times a week on the weight machines, my muscles would waste again. Lack of exercise causes some muscle pain. The hip replacement can weaken. And that is where I have been, slowly losing my tone again after 2.5 years of hard work to get it right.

Hip replacement rehabilitation is not a short term thing. It is ongoing, thorughout the life of my hip replacement. Now, on the eve of my 4th hip replacement anniversary (sad I know!), I have finally realised this is for life. The gym is a necessity for me to ensure I do the exercise needed to keep my hip strong.

 

Start as you mean to go on…..

Confession:I have not been to the gym for a year. A full 12 months. And before that I ignored it for 6 months.

After my hip replacement, it took me a while to get into the gym. Once in there, you could not get me out again. I spent my mornings in there several times a week. Swimming with the kid, in the gym and sauna with friends. In the gym on the weights. My hip felt great, I lost some weight. Then I did what other people do. I stopped.

I had all of the excuses. I have not got time for the gym, the gym is too far away to justify travelling on a week day, I will go tonight, tomorrow I will go for the early session, I got up late so I can’t go, my hip hurts, I will go later…….

So after much procrastination, weight gain, soreness in my hip due to lack of exercise, I have joined the local gym. I aim to go at least three times a week. The hardest thing is getting in the car! Updates will follow…………

 

The BOSS Study

The BOSS Study is a piece of research I stumbled across in October 2016. I am excited to see this nationwide surveillance to review rare diseases in orthopaedics, such as SUFE (Slipped Upper Femoral Epiphysis).

The British Orthopaedic Surgery Surveillance (BOSS) Study is based on other successful reporting systems in obstetrics (UKOSS) and Paediatric Surgery (BAPS-CASS.) This is interesting to me both in a personal and professional level with akeen interest in maternity and obstetrics in my profession.

I contacted one of the team and asked if I could be updated along the way and I eagerly await their findings. I am particularly interested in diagnosis and treatment in the early presentation of children at GPs and Accident & Emergency Departments. Early diagnosis and swift treatment is key to preventing lifelong disability and greatly reducing the incidence of further more complicated surgery. Many children go on to continue their sports and leisure activities quickly. Some, in situations like my own, don’t end with life changing, debilitating conditions related to SUFE when misdiagnosis occurs.

I hope recognition and research will help support doctors and radiologists to discover these issues first time and that newer, enhanced technologies put better solutions out there for SUFE patients. Here is the website to check it out Http://boss.surgery/

18 months-Total Hip Replacement are great!

So, I thought I would celebrate 18 months being pain free with a Gallery of some of the photographs that have been taken over the months (more to come when I get chance to upload them. Some of them are post surgery scar pictures so maybe not for the squeamish, but I did not have a rough time of it really with bruising, it was more the swelling and post operative pain that got me down.

Anyway, you need to click HERE to see them 🙂

Yesterday, 4 days after my 18 month anniversary, I ran, RAN across the drive to beat my middle child to the car….I did not been think about it which was the greatest thing! I am still going to the gym (after a 8 month break because I got lazy!) and swimming is helping a LOT. Walking is also fun now and not a necessity to get me to the car and back, I can actually walk a couple of miles without feeling any pain. Build it up slowly 🙂

For anybody thinking about having a hip replacement, especially hip replacement in a young person, JUST DO IT! You will not regret it, absolutely not. Find a decent surgeon who is willing to take you on, do not take no for an answer and just go with it! Good Luck!!

Physiotherapy for hips….

16th April 2014

….not for me! Not anymore! No way! You will know by reading this post about the Lack of Physiotherapy in the NHS that I count myself extremely lucky to have had physio after total hip replacement for a whole 14 months.

Yes, I have been discharged! However, I still keep up with my squats, my stretches and walking. I am walking further despite my general fitness being low. Stretches whilst awaiting for the kettle to boil, squats whilst the bath runs. You can do these exercises pretty much ANYWHERE. And continue you must-for physiotherapy, despite the lack of appointments, is for life.

You must keep up this exercises, ensuring you hip flexors, quads and glutes stay strong. Being able to stand on one leg and balance is quite something when you have not been able to do it since being 11 years old! Maybe I will get to play netball again someday hey?! Stretching is equally important, and when getting lazy, I know about it, because my hamstrings get tight and I have to rework on those stretches again to keep them in check. DO NOT GIVE UP. Do not give up because you can do it. Your body is able to fix the things that went wrong. You have to persevere. A LOT. You may be frustrated, I know I have been many a time in the past 16 months. You just got to keep it up.

Set realistic goals. There is no use telling yourself that you will climb Mount Snowden in 2 months time, if it is not realistic. Tell yourself that you will walk 500 metres, 1 mile, 2 miles. Then aim for that goal. Small, baby steps. You will achieve your goal, because if you are reading this page, you can bet your bottom dollar you have had some kind of difficulty walking at some point in your life, for some kind of reason.

Just keep on smiling, keep on setting your goals, achieving them and then setting some more. I believe, if I can do it, YOU CAN, ANYONE CAN.

 

 

 

My New Best Friends-Doc Ms

Doctor Martens! My new best friends in the fight to keep my feet straight! So far, so good,  and they’ve also provided more stability for my ankles. Who knew they were so bloody comfy? ! These are pivotal in my (ongoing) recovery. The only boots which my insoles and feet together will fit into!

Migraines and Dodgy Hips

I am beginning to wonder whether my migraines are to do with my gait and posture.
I started with migraine after the birth of my first daughter, in which I was pulled and tugged and manipulated in ways my body could not cope with (and now as a doula I know shouldn’t have happened! )
Over the years my migraines have progressively worsened and increased in frequency. I am knocked down fit a few days. My symptoms are typically the same: pain in left side of head and behind eye,  unable to see, increased pain and pressure upon standing, dizziness, auras (usually specks of light in vision and pins and needles in head). The pain is the symptom is love to remove-I think I could cope with the rest.
I have tried migraine specific medication,  meditation,  homeopathy,  hot water bottle, cold compress, dark room, even tying dressing gown belt around my head to squeeze it out in the theory that the brain can only cope with one pain at a time. …

Walking for a couple of miles seems to put sine awfully big knots in my back,  shoulders and neck.  I wonder if it is my bad posture and walking that contributes? After all, I’ve looked at every other trigger! Wheat, gluten,  sun,  cold,  chocolate (god no!) cheese….. the list goes on…. has your head been affected by your posture?