Again with the stupid....

Guess what I forgot to take before bed last night!

I got cocky, thought 'hey, this week has been fab, maybe I could just take the next pain med in the morning'. I don't want take the pain meds for many reasons - they mess with your stomach, digestive system, constipate you and NSAIDS can actually damage your cartilage (well, the cartilage that is left in the rest of your body!). Perhaps maybe I got the balance of medication right, once every 12 hours and I'm feeling fab. Always in hindsight!

I'm currently in so much pain I cannot get my boots off. I cannot put weight through the joint without tears coming to my eyes. I want to scream at something and throw things across the room its so painful. I feel angry and I feel emotional. I can't remember what its like not to be in pain.

I know it will be better tomorrow. Until then, could someone come get my boots off?

Consultation day

The day I've been waiting for, the results and 'what's next'. I've been having strange dreams recently about my orthopod turning round to me and saying 'there's nothing wrong, what are you complaining about!'. Well, there's most definitely something wrong. There's a serious lack of cartilage over the major load-bearing region. The pelvis shape looks distorted on the right side, that's due to the pelvic osteotomy I had (there are two remnants of titanium pins lodged in the pelvis too).


The lack of cartilage is due to problem number two (or is this a 'which came first, the chicken or the egg?). A proliferation of osteophytes (bone cells/spurs) on the back of the femur head. This has caused the femur head to protrude forward away from the socket and, as the new bone is nobbly, it's worn down the cartilage.

What's next? A hip resurfacing. I have to call to make an appointment but the earliest available time would be easter apparently. I've also been offered a hip block in the mean time - I said I'd think about it. I think it would probably be a good idea though given that treatment could be months away. Scary, giant needles! (have your pelvis realigned no problem, giant needle eeeeeeeeek!). I think I'm just relieved to now know exactly why I'm in so much pain (and what's making that funny crunchy noise....mmmm) and that treatment is on the horizon.

Playing catch up

The other morning I forgot to take my pain meds, clean forgot, and instantly remembered the minute I started walking to work. I then made a bad decision, not to stop and take some but wait until I got to work to take them. Big mistake, huge! By that point I knew I was going to be playing catch up for the rest of the day. And I was going to be on my feet all day. My leg was aching from hip to knee by the time I got to the office and shovelled the first dicloflex down my throat. By lunch it was still raging - down went two paracetamol. Nup, no effect. I waited til 4pm before taking the second dicloflex. By 6pm it was easing up slightly but by this time both legs are feeling like they've been exercising for two days all the muscles are aching. Spent most of the evening with hot water bottles glued to the hip, took another dicloflex about 10.30pm and went to bed. Woke up totally pain free. First thing, took dicloflex before leaving for work. Will not be forgetting in future!

What an awful day pain-wise. I think most will forgive me that I burst into tears about 9pm thinking it'd never go away. I hate being dependent on painkillers. Hopefully next week's consultation will bring some sort of hope of treatment, although I'm slightly nervous about the results of the CT scan.

What's in a name...

I've been having a fabulous week, hip-wise. Last friday I got a repeat on my pain meds. I'd popped into the surgery during my lunch break to get the prescription and then wandered across the road to the local pharmacy, as usual, except this time I found them shut for lunch! Great, I'll have to pop into Boots later on my way home from work instead I'm thinking. This turned out to be the biggest blessing in disguise!

I've been taking diclofenac when I get hip-related pain as it is really the only thing that 'works'. I'm sure there are stronger painkillers I could take, but I get very sick with the likes of Tramadol or codeine-based painkillers. So, normally I get whatever brand of diclofenac the local pharmacy stock. Whatever Boots brand of diclofenac stock (which happens to be Dicloflex) is like a completely different painkiller!!! Since friday I've felt very little hip pain whilst taking them. The other brand has been making me think the worst about the deterioration in my hip as they were only ever able to take the edge off the pain. I'm beginning to wonder if perhaps the painkiller just wasn't up to the job? Or a bad batch? Or maybe I really am just having a good week and the joint is less inflammed?

It's hard to say. Part of me doesn't care either, it feels good! This is when the guilt sets in, 'I'm a fraud, the hip is totally fine mr.orthopod, honest! I'm sure you have better things to do'. I wonder if other people find the same with different branded painkillers. Voltarol is probably the most commonly recognised brand name of diclofenac and I know they 'work' for me too. I might have to do some research into how the drugs are constructed to figure out whether different brands deliver differently. As far as I'm concerned there's a massive change in one's quality of life with a painkiller that works and one that doesn't.

Here's hoping I haven't just jinxed myself either :o)

A few notes on physiotherapy

"What do you expect to achieve through physiotherapy?"

"I want to improve muscle tone to help improve and maintain stability around the joint". I don't expect physiotherapy to eliminate my pain. I hope that I can ease a little pain though! But honestly, when it's as bad as this, physio very often aggrevates and enangers the joint. My physio goes by the principle that you 'work to tiredness' not to pain. Most of the time this does work, but psychologically you feel like some weakling who can only repeat 3 times and has to stop as if she ran a marathon. Oh well, that's between me and the physio ;o)

I want to keep my muscles as strong as I can get them (we're not talking olympic status here!) in case I do have to have some form of surgery in the future - could be next year, could be 10 years, who knows. Hip sugery will significantly reduce your mobility for a short period of time and whilst your bones heal, your muscles waste. But, muscle has a form of 'memory'. The better the tone they had prior to any surgery, the faster they bounce back afterwards with exercise.

Sometimes its hard to commit to the exercises due to tiredness or pain, but its so important to do them as instructed. I'll admit, I only ever managed to fit in 2 of the 3 times a day my physio asks of me, I'm not gonna beat myself up about that. But I make sure that when I do them, its quality not quantity.

This is out-patient physiotherapy. In-patient physiotherapy is something else altogether!

Doughnut day

Well I had the CT scan and x-rays today. Two hours down to Birmingham, half an hour in the hospital, and back home again! No waiting at the ROHB this time - turned up a little early for the scans, as requested, and they took me straight in. There was only one other person waiting. Mind you, the longest I've ever waited for an x-ray at the ROHB was 10mins, compared to 1.5hrs elsewhere! This is the NHS, not private, very impressed.

I love the CT scanner, its like a giant doughnut! This time I guaged how high up the bed goes though to get you through the centre - about 4-foot from the floor, wouldn't like to roll off the rather narrow bed you lie on!



It also dawned on me earlier that its been exactly 4yrs to the date of my TPO surgery. How odd to be back there today.

Online Chicken Soup for the painful soul

I have become acutely aware that a pain patient blog can become an uncheerful place, a place to have a moan or rant, a place that might give a false outward appearance of the persons self-esteem or confidence. But its place, by its very nature, cannot avoid the dark that pain creates - but shedding light on it by blogging or joining online communities can alleviate some of the psychological and emotional burden. Most of the time I do not think about my condition or focus too hard on the constant daily waxing and waning of pain - or I'd probably not get out of bed in the morning. Ironically, I'm a pain scientist so I do actually think about pain all day in a different context, but it has allowed me to compartmentalise what I feel into physical versus emotional.

When I was told that surgery was my only option to alleviate the progressive arthritic hip pain, and at that time I could barely walk half an hour before giving up, I spent a lot of time researching all I could on the subject. I also submerged myself in the world of online support sites - HipUniverse, SurfaceHippy, HipsRUs(UK). Some of the people on these sites gave me the most tremendous support and advice - I cannot thank them enough as it made my hospital experience and recovery a much better time. When your leg swells up to double its size post-op not many people will have thought to tell you to bring some knickers a size up from your norm to accomodate it!!

I have great respect for the people in these online support communitites that have taken the time to answer questions and provide insight to what you can expect for a variety of situations. There are far too many out there that suffer alone as they can't communicate their pain with their families and friends, either through a lack of understanding or fear for the future. It does not have to be that way.