Sunday 28 February 2010

One week to go

Okay, now that I've ascertained that the actual date of my surgery is in one week (and I'll be checking up on that!), how am I feeling?

Overwhelmed. And not due to the surgery! I have so many things to be wrapping up by the end of this working week, throw in a job interview and a ball for good measure, and I'm trying to work out when I can do silly little things like laundry prior to going down to Birmingham next sunday. I'll be begging for that anaesthetic just to shut my brain up!

My priority is this job interview. Given that academic job interviews are tantamount to exams, I'm stressed with all the studying whilst trying to ease my right hip off inbetween. I did take saturday off from work to go to the Thackray Medical Museum (Leeds) with a couple of friends. As I might be leaving Leeds in the coming months I thought I'd take a gander up the road for a visit - that and they currently have an exhibit on 'old for new', being bionic (being a cyborg!! sounds like something that escaped from Dr.Who than your average grandmother!). We spent nearly 3.5hrs going round the museum! Even though I've been using my crutch daily for about 2 weeks now, I was completely wiped out despite having 5 minute sit-downs every half hour. I was hoping to come home and study a bit more, but I had to take a bath to help my poor muscles, and after that I was too tired - watched a movie and had an early night. Gosh, I'm such party animal for a 31 year old!

Because I got most things ready for hospital for last monday, I don't really have much organising in that department, just laundry. I think after the disappointment of the surgery date being put back it has made me realise that even if I get nervous I'm still going ahead with it, so why worry too much. No doubt I'll be more nervous next weekend and on the day, I can't imagine anyone not having those nerves on the day! But for now, I'm focussing on wednesday's job interview, the masquerade ball on thursday night and a friends leaving do on friday night!

My brain's fried, I need sleep..... zzzzzzzzzzzzzzz

Thursday 25 February 2010

Another Amendment!

Being disappointed the first time around they shifted my surgery date, then getting a letter stating it was 2 days later than what she told me on the phone, I decide this morning that with 2 weeks to go I'd call the hospital to confirm my date (again!). This time she said "oh that's odd you're the monday list not wednesday! I will call Mr. Orthopod's secretary right away to confirm".

Oh yes, the surgery date they told me on the phone orginially was correct and the letter was wrong! Which baffles me because you have to phone to confirm your bed, which I did and no one at that point told me that either the day or date was incorrect. I never had anything like this last time, I could have missed my surgery!

It will be on MONDAY 8th MARCH. I said "you'll forgive me if I call back next week to check!". Oh I will.....probably more than once....

Monday 22 February 2010

The Waiting Game

~2 weeks to go (again!)

I'm getting fed up now. I should have had my shiny new hip today, but I'm hanging-on in here for another 2 weeks for Mr. Orthopod! Woke up this morning, fine and dandy, and as I was putting on my boots for work - my hip got stuck!! Like stuck. It sorta clicked as I was leaning over to hook my boot onto my foot. When I tried to straighten up, I couldn't....cue the panic!! It probably only lasted 2 seconds, but it felt like 2 mins before there was the most horrific grating sound and a pop which released my joint back. I'm still cringing thinking on it. Let's just say, it 'stings' a little.....like it stings when you drop a bookshelf on your foot! It gave me such a fright too, brought tears to my eyes.

Once I calmed down and the sharp pain had subsided I discovered that full weight on that leg wasn't happening today. I'm sort of sat on the sofa with my right leg extended out in a strange manner, fearing to bend it now.....it is not comfortable, and there are aches where I had none before. I'm trying to get work done at home, but I'm having to shift a lot due to these strange aches, so its not efficient (not that it would have been efficient in the office either).

Pesky orthopod's diary! Pesky boots once again!! Boooo......

Sunday 21 February 2010

My Biggest Fear

My biggest fear is having a hip replacement. More specifically my biggest fear is going in for hip resurfacing and waking up with a hip replacement. Waking up from surgery and being told that it didn’t all go to plan.

I don’t actually have a problem with having a THR itself, although given the choice between keeping my femoral head or not, I go with keeping it! I think most would. But I know I cannot live with the arthritic pain as it is now and sometimes I think I would happily agree to some sheep’s cartilage or a leg transplant!

I didn’t realise until last week how much this had been sub-consciously playing on my mind. I had been ‘rummaging’ through the older archives on the surfacehippy group messages and had been reading a lot about revisions of BHR to THR, failures, dislocations, going in for BHR and waking up with a THR. Quite frankly I was voluntarily working myself up into a tizzy about it all when the realisation hit me – I am terrified of going in for one surgery and coming out with another. As soon as I had that eureka moment I was able to address it, and let the fear go. This is not without the help of some friends, but at this moment in time my anxiety has been significantly reduced. I’ve been sleeping soundly too.

I will go into my BHR surgery with an open mind. I really want a BHR, but if I do wake up and find that I am the proud new owner of a shiny THR, I will be temporarily disappointed but I’ll let go of it quicker. At the end of the day, it will serve its purpose. Many young people are very happy with their THR’s, I will not consider myself some sort of failure to be joining them if it enables me to get on with my life. There has been too much THR-bashing going on and I’m not surprised so many of us awaiting hip surgery are horribly anxious pre-op. I have a preference (BHR), others have theirs.

BHR versus THR

I decided I should highlight the differences between hip resurfacing (BHR) and total hip replacement (THR). Many people have asked me what BHR is and what are the differences to THR. This will also be a prelude to the next blog post.

Hip resurfacing is NOT where the orthopod goes into your hip and smoothes everything out, as the name might suggest. BHR is actually a metal-on-metal (MOM) hip prosthesis. It comprises a metal acetabular cup and a metal femoral head cap. The metal used is chromium cobolt nickel. THR's to date can be composed of metal and plastic, ceramic and ceramic, and the newer ones are large-head MOM. The biggest difference between a BHR and THR is in the femoral component of the prosthesis. In a THR, the head of the femur is amputated and a metal rod/spike is inserted into the femur which has a ball on the end acting as your new femoral head. In BHR, the femoral head is maintained, it is only reamed down ready for a metal cap to be firmly inserted over the top of the head.

Just for comparison here's a great image from the Mayo Clinic (http://www.mayoclinic.com/health/medical/IM03868):




BHR is therefore more bone conserving and is proving more beneficial to younger people with hip disease as it has allowed many to go back to more higher impact sports and activities compared to a traditional THR. However, it should be noted that the newer MOM THR's are allowing all ages to do exactly the same. The survival rates of BHR prosthesis have shown to be significantly higher than traditional THR at 10 years. But THR surgery has been around a lot longer than BHR (~15 yrs for BHR in UK; only since 2006 in the US), plus there is a skew in the age groups recieving either. So far the data falls in favour with BHR for younger people, but only time will tell.

I don't want to get bogged down with the pro's and con's here, I merely wanted to describe the main anatomical differences between BHR and THR.

Monday 15 February 2010

Postponed with 1 week to go

I'm not a happy bunny today. The hospital rang to say that for whatever reason my orthopod will be out of town next week and has had to put my surgery back 2 weeks to the 8th March.

With 1 week to go, everything organised, I'm absolutely gutted. I didn't realise how much of a toll this takes on you emotionally until I got that phonecall. Three more weeks of this pain! Urgh. The cortisone has worn off and I'm painfully reminded of why I'm having this surgery. When it's only 1 week to go you tell yourself it doesn't matter it won't be long. But when the goal posts shift unexpectly at the last minute, your heart sinks at having to put up with the pain and subconscious anxiety for even a minute longer than you thought you'd have to.

I know I will feel better in the morning. I guess I'm just going to have to occupy myself the next couple of weekends with something that takes my mind off this. I'm also going to be phoning the hospital a week in advance of this new date to double check. Mr. O'Hara said that only he would do this surgery, that his registrars weren't competent to do the procedure on me - I'm sure they are competent surgeons, but BHR surgery has a very very steep learning curve, and that's on regular hips, not dysplasic ones like mine! I'll wait however long for Mr. O'Hara, but I don't have to like it..... :o(

AMENDMENT: I got the letter through from the hospital this morning (tuesday), the surgery is on the 10th March. Harumph, another 2 days!

Friday 12 February 2010

Cortisone injection update

It's just shy of 4 weeks since my hip injection of cortisone and I think it's beginning to wear off. The pain is still fairly minimal, but the stiffness has returned and when I stand up from sitting for a while its difficult and sore. Given how bad the osteoarthritis is right now, I'm happy to have had 4 weeks of relief and not having to pump my body full of analgesics. I would have it again, but given that you're only supposed to have 2-3 shots of it in a year and several uses can actually damage the joint, it's definitely a last resort.

Oh well, only 10 days to go! Bring it on.....

Saturday 6 February 2010

Preparing for Hotel NHS

2 weeks to go!

This week has been particularly mad and I'm trying hard to compartmentalise all the stresses lest it all tips me over the edge. I had a job interview on wednesday and also found out that my grandmother is seriously ill and in hospital. It's all a bit hectic really.

So this weekend I thought I'd focus on what things I want to take with me to Hotel NHS and then subsequently the things I'll want with me at the family home (which is over 200 miles from where I currently live in Leeds). Having spent a fabulous 8 nights in hospital when I had my PAO, I know exactly what I want with me this time. Even that one night I spent there prior to my hip injection has reminded me what a difference it makes when you know what to expect.

Armed with a shopping list, off to the shops! For the hospital we have... Clotheswise: Now I prefer pj's to nighties to sleep in, but having your hip operated on makes it a pain having to deal with pj bottoms - 2 new nighties, check. Also, one's hip swells up beyond belief after mr. orthopod has had a good rummage around in there and it takes a long while to go down again - therefore, best to get a weeks worth of knickers one or two sizes bigger than your normal size, check. If you don't have any sweat pants, these are a good idea for staying comfortable when you leave the hospital and at home - I have a few pairs anyways and didn't feel the need for new ones. Other clothing items that are good to have - slippers, dressing gown, loose tops, flat shoes that are easy to get on. Toiletries: you won't need more than this - shampoo (2 in 1 is great for hospital), shower gel (I love my Liz Earle! smells fab and lifts the spirits), dry shampoo (Bastiste is good - for when you can't shampoo hair the first day or so), facewash, moisturiser, tooth brush and paste, lip salve, sponge (I don't like using theirs) and wet wipes (invaluable!!! Get a big pack). No need for razors, nail files etc, honestly you won't miss them! I think I spent the first two days last time just using the wet wipes!! But I do recommend the lip salve as the air con and heating in hospital tends to dry your lips out something chronic.

I also have my food package! To be fair, and this varies between hospitals WIDELY....the food at the ROHB was alright. Unfortunately, as I've mentioned before, I was as sick as a dog due to all the drugs and toxins floating around my body and ended up eating whatever whenever. Which included grapes, pringles, chocolate mainly....none stayed down for long. I went for high fat just to get some calories into me. So this time, I've put together a food package - things like choc covered raisins, nut bars, cashews etc. All high energy in case I need it. I'm hoping it won't be as bad this time.

For home it'll just be casual clothes and easy to get on flat shoes really. I'll be with the family so I don't have to worry about meals too much. I also won't have to worry about those fabulous surgical stockings either - pain in the ass to get on without help! So sexy!!

I'm not too nervous now. I did have a couple of moments the other night, but I just want it over with now. The hip injection is still working quite well, I've had a few aches at night - and that's when I'm glad I'm having the surgery. 3 weeks from now, hopefully I'll have been discharged from hospital and recovering in the family home. :o)