The Journey to a New Hip | a diary, part 1
Hi Everyone, hope you're doing well in your respective worlds. I saw the recent VA post about creativity helping folk with OA and, well, am trying to do something useful for myself and anyone who may be going through a similar situation. Last Friday 23rd May, 2024 I underwent a Birmingham Hip Resurfacing op and am in the early stages of recovery. I'm trying to capture/diarise the before and after in written and audio form, so I can share it with the community. Eventually, I'd like to also create a podcast with the community's help to bring what we go through to a wider audience and support those in the early stages of diagnosis, living with, or replacement. Hope it helps you as much as you've helped me…
October 2023
One Sunday a couple of months ago, I sat with my wife and, in the blink of an eye, started to lose my mind as a doctor told me that I had severe arthritis. At 53.
Today, I’m frequently angry, frustrated, or sad - all the fun emotions. Frustrated at being sad. Angry at feeling broken. It scares me to think of what it must be like to live with me when like this - an emotional bag of frogs, a loose screw.
In April 2023, I was a different person: laughing, working, running, living. But I was becoming frustrated by an ongoing pain - a sort of dull, sporadic ache triggered by specific movements. Strange I thought, but I’d had numerous strains and injuries in the past. For someone who loves being active, I’ve actually been pretty good at injuring myself - shoulders, wrists, knees. I do wonder sometimes if there’s an inherent wisdom in couch potato’dom.
But I kept up the running, yoga, regular walking – a full range of motions in pursuit of one of the things that makes life feel terrifically worthwhile - being healthy, fit and vital. It’s not about looking good, more about feeling fully alive, capable. One day, that zombie apocalypse could just start, we could wake up to a drooling horde rampaging our streets, guttural snarls and decaying teeth gnashing for blood. When that day comes, I want to be ready, I want to be Brad Pitt in World War Z.
After months of stretching, running, twisting, more yoga - near constant movement in service of trying to ‘correct’ my body, to try and stop this persistent feeling that something was twisted, caught in the groin area – it became apparent my self remedies and treatments were not working. If anything, I was making things worse.
TBC
Comments
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Part 2
This pain reached the point where running, a regular love for more than half my life, had to stop - an incredibly tough decision. My final run was July 28th, a Friday. Even walking had reached the point of a begrudging limp, tearily coming back to the house having lost yet one more activity that gave joy. My wife suggested talking to a doctor - never one to come up with a bad idea, I agreed.
To my surprise, they suggested an MRI - I remember thinking, wow, it seems a little early to bring out the big guns, but why not.
On the day of the MRI, I was in a great deal of pain. Good, I thought, they won’t think I’m wasting their time. Lying stationary in the machine for its relentless, grinding 20 minutes was unexpectedly unbearable. Just lying still was remarkably sore and, once through this deafening ordeal, softened only by a playlist of bland soft pop supplied via headphones, I found myself embarrassed, in front of the nursing staff, having reached the point where just tying the laces of my right shoe was an agonising feat of acrobatics.
Then it was all about waiting for the results. I wasn’t worried. I knew they were going to tell me there was swelling. I was certain they were going to confirm my suspicions of some sort of adductor muscle or tendon tear or twist.
The results arrived on Sunday morning. I asked my wife to sit with me as, while not overly concerned, it felt prudent to have another pair of ears present. Over a video call, a young doctor told me, with very little cushioning (no pun intended), that I had severe osteoarthritis in the right hip. That I should probably stop running altogether. That I may have to consider a hip replacement.
I’m not sure I remember much of the call once she dropped the O Bomb. As she spoke, there came a point where I realised I was expected to speak - I think I’d been asked how I felt about the news. 'Well, it looks like I may not be able to run, exercise or work without pain - I feel bereft, like I’m losing all the things that make me feel alive.'
In a trance, the call ended. I looked at Charm and started hyperventilating, then howling, then shrieking. Never in my life have I experienced such a sudden, powerful, guttural burst of pure anguish and terror. I was vomiting grief at the loss of my identity.
There was a moment when it felt like my mind was on the verge of being lost. But Charm coaxed me back to the moment, to her. Calmly, we reviewed what had been said. That this was not a death sentence, this was fixable. That great expression, lifestyle changes. Instead of yoga, do Pilates. Instead of running, use a recumbent bike.
The following weeks were… tough. An active, 53 year old, freelance filmmaker with an arthritic hip. Adjusting was not easy. Grief swamped my thoughts - of loss for a life I thought I was going to have, for the runs I’d no longer enjoy, for the simple joys of intimacy without a gnarly discomfort in the pelvis - an anatomical essential in the bedroom.
I was referred to a consultant to discuss options and, by options, I mean hip replacement. Life is not without a sense of irony. Only last year had my mum received her own hip replacement. And only while waiting for my MRI results had she dropped the clanger that I’d been born with a ‘loose hip’, some form of congenital joint defect. This was stark news to me. Probing further, it seems the doctors advised her to use two nappies on me as an infant, a form of bracing to hold the right hip in place.
TBC in Part 3
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Part 3
The consultant was excellent - smart, top-of-their-game. Subtle they were not. He was discussing hip replacement like it was a given - but first he wanted me to try an injection into the hip. The idea was this - osteoarthritis causes inflammation and swelling, leading to pain. Therefore an injection of anti-inflammatory steroids will do one of two things. If nothing changed then chances were that the pain was not the result of arthritis. If, however, the pain subsided, you were looking at a pretty solid diagnosis.
A month later, I’m lying on my back, jeans down at the hips to reveal a target location for a different doctor’s disconcertingly large needle.
These situations are odd - in a way I’m familiar with as a filmmaker, often working alone. On the one hand there’s the elephant in the room, otherwise known as the doctor (or in my case, the camera). This is the thing everyone’s a little nervous about while pretending they’re calm. Then there’s the pacifier, the person who’s there to help distract you into a state of calm. Usually, this person is me putting the interviewee at ease but this afternoon, it’s a nurse who gamely engages in smalltalk she’d rather not be making to distract me from the methodical preparation involved in injecting large volumes of steroid into the body.
One injection later and an Uber home, I sleep.1 -
Part 4The next day is a revelation. The pain is already around 30% of what it was. I simply can’t believe it, it’s incredible! But rather than think that this confirms the diagnosis of arthritis, I’m just happy the pain is ebbing and imagine that I’ve just been really lucky, that this could be it for me - I’m fixed!
Over the next two days the pain vanishes and I’m in seventh heaven. I walk, I work, I laugh again. This feels so unbelievably good; I hadn’t realised how unhappy I’d been until I heard the sound of my own laughter again.
At the physio, they rather callously remind me that these injections often have a fast effect then wear off quickly, usually in a couple of weeks. For a moment, I loath her directness but also appreciate she’s possibly trying to stop me getting my hopes up – too late – I am invincible.
Two weeks later, from nowhere, the pain starts to rapidly return, like an unwelcome guest. Like a prophet, the physio is proved right and I am not invincible. I am vincible and utterly, painfully gutted. But that’s not the end of my delusion, my fight to be right, my right to be well.
Partly because of the positive way my body is responding to Pilates, I decide that the pain I’m feeling is actually due to adductor muscle tightness with an added pinch of nerve pain. Together with the physio, we work at relieving this tightness and it feels like I’m on a good path - the pain feels a little less, the muscles a bit looser.
Due for a follow up visit to the consultant, I feel it’s only fair to forewarn them that their years of experience has not served them well in my case and I write to them in advance of our meeting:
Dear Mr X,in advance of our meeting this coming Oct 28th, I wanted to send a note regarding changes in my situation, as I think they could help. As you may recall, from the start of this discomfort, my strong feeling has been that something internal has been twisted/misaligned, resulting in pain and swelling.I fully acknowledge that my right hip is arthritic, however, I do not think this has been the primary cause of pain. I believe in March this year, perhaps aided by a congenital ‘loose’ right hip, that I overstretched during yoga, leading to slight dislocation and trapping/misalignment of adductor tendons. In an attempt to alleviate the discomfort I was feeling, I overstretched the adductors, all while continuing to run, leading to a large degree of swelling.With thanks,BarryWhat an idiot. With hindsight I realise it was just literally impossible to accept the reality of the situation. A world-class expert in the hip world had told me everything I was feeling was due to the hip - but no, I knew better.
When I saw the consultant again, he patiently listened to me explain why he was wrong before telling me that everything I’d written, everything I was experiencing was exactly what you’d expect from an arthritic hip. The question was, when would I accept this fact and, as a result, decide to take action.
After both laughing at my hubris, we started to discuss the very real, very unnerving possibility of replacement surgery.
It’s Halloween and I’m going to give myself a month. A month of acceptance, of not trying to fix an arthritic hip through Pilates, willpower or denial. A month (hopefully) without pain medication, to see what it’s actually like to try and get through the day to day of normal living. After this period of time, I suspect I’ll make a decision - to stay as I am, or to let a professional turn me into a bionic human.
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Part 5, Making The Decision
Making the actual, can’t-go-back-decision to have a replacement is hard. On the one hand, it’s the devil you know; you’ve grown to know the discomfort over a – usually – long period of time, you feel you know it’s edges and have learned to live with it, albeit grudgingly. But then you start to think about the future.
In my case, the deterioration had been rapid. In the space of a year, I’d gone from minor symptoms to a situation where I felt I could no longer trust my body in the world – working, moving, lifting, filming. As I remarked to my wife, it felt like there were three of us in the marriage: me, her and the hip. And honestly, I’d become less fun, more grumpy and I realised both me and everyone I cared about deserved better than that.
The actual decision point came when visiting friends in Canada, early March 2024. We went on a wee hike, barely more than an hour, predominantly flat terrain. Afterwards, sitting with a cuppa, I was in serious pain and it was a powerful reality check. This was something I used to do all the time, without thinking - it should have been easy! But, like ageing, the arthritis had slowly modified my behaviour back home to a point where I was increasingly doing things that were tolerable, which meant doing less of everything pleasurable.
When back in the UK, I went to see my consultant to say, let’s go. It was an interesting chat. He had always known I’d get to this point but that I had to know it in my own bones. He went through the process and risks: Birmingham Hip Resurfacing, anaesthetic, unconscious, 50min op, out next day, six weeks to ‘normal’, possible risk of infection, clots, allergy. There just comes a point when it all seems worth it. They booked me in for late May and, unexpectedly, life felt a little lighter.
TBC
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Thanks so much, @frogmorton :)
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Thank you so much @Nurina Hope it's helpful :)
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Thanks @Bevdav123 Part 6 should be here soon :)
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Part 6 Prehab
There’s an new energy I didn’t expect. A massive part of the mind was preoccupied with the whole, ‘should I, shouldn’t I’ thing and that’s now been put to bed. Now, it’s all about the future, looking forward with positivity, rather than fear.
The first thing I want to get right is prehab. When the running and yoga had to stop, it was replaced with walking, recumbent cycling and Pilates. Those three are going to remain the cornerstone of getting ready for the op but I’m also going to add some weights to the mix; nothing crazy, just some dumbbells and a few Fiton workouts a week after a warm up on the bike.
Creatively, in the absence of paid work I’m keeping busy (read ‘sane’) by writing fiction, this diary and trying not to spend too much time pondering careers. It will come in its own time: health first.
A few weeks before the op, a physio, Lara, calls me up asking a few questions about the house: bed height, sofa height, toilet height, location and number of toilets, stairs? She’s great, warm, helpful. She asks if I’d be interested in doing any specific exercises usually reserved for after the op – I can’t see why not. This means that in addition to the above, I’m now doing ten other exercises each morning. Largely, they seem to revolve around strengthening the thigh, buttocks and surrounding hip muscles. After a week of this, my wife tells me my butt looks good – I’ll take all the compliments I can get.
I’ve become obsessed with preparation. How to move after a hip op – get in an out of chairs, bed, on a toilet, dressing, walk on crutches, the 90 degree rule. I’ve watched a dozen ‘how to’ videos, cross referencing them to make sure I don’t screw up. There’s a kind of foreshadowing to all this, a sense that the recovery phase will have it’s own challenges. But that’s for later.
Then there’s the tools: a pillow designed to sit between the legs (keeps the legs in the right position while sleeping, helps stop turning), the longest comedy shoe horn I’ve ever seen, a thing for helping put socks on that looks like a catapult, a grabber on a stick for dressing, a toilet riser and a chair riser. I am Amazon’s BFF.
The Pre-op involves blood tests, kidney tests and a chat with a senior nurse. Entering the hospital I feel tears, this is getting so real. While it may be one of the world’s most routine operations, it is far from routine for the person having it done. But everyone is so lovely, chatty, that it can’t help but reassure.
Five days before the op and I’m in some kind of decontamination phase. Every day, I have to use a special shower and nose gel to completely wash my body, to remove any resistant bugs, I’m told. Along with this, the bedding is changed each day, along with clean clothes. The washing machine is on constantly, my life now a continuous cycle matching the washer and dryer in constant use. There’s nothing left to do except keep moving, keep clean and keep positive.
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Part 7 | The Day of the Operation
It’s 04:45, Thursday 23rd May when the alarm goes off. I’m feeling a weird mix of fear, excitement and resignation, like that feeling you get on the runway, just before take off – like it or not, you’re going.
We pre-booked a taxi for the trip to Birmingham, so Charmaine, myself and the driver pass the hour making small talk about the upcoming election and the overall state of the country. While participating, none of it feels terribly important right this minute. It’s too early and the mind is elsewhere.
We arrive 06:40 for an 07:00 admission. Paperwork done, we sit, waiting for the nurse. The waiting room gradually trickles full of youngish people, all of whom require some sort of medical intervention. Bang on time, we’re taken to the ward and so begins the wait.
A senior nurse talks to me about how, once the surgery is over, I need to let blood pressure equilibrate before standing, otherwise I could fall and he really doesn’t like it when his patients fall. My consultant pops in to say hello, as does the anaesthetist, both of whom ask me to sign wavers. The consultant draws a ‘this way up’ arrow on my right thigh to indicate the target hip. Somehow I feel I’ve managed to insult the anaesthetist by saying he seems really experienced which I worry came across as implying he looks old.
After our wee chats, I’m encouraged to get into the gown I’ll wear for surgery, one of those flattering, ****-to-the-wind jobs and from around 08:00 until 12:45, Charmaine and myself pass the time. We talk but all we can think about is the upcoming op, the fact so much time has past – we were sure the admission time meant I’d be done around 0900.
When, at last, it’s time, Liz arrives from the surgical team and escorts me to surgery. The goodbye to Charmaine feels too sudden and I don’t want to leave her with tears in her eyes but like an obedient pet I follow Liz away.
I’m scared. We enter a kind of pre-surgery room, with three people in it, one of whom is the lovely anaesthetist. In the room beyond, I can vaguely see the movements of the surgical team, a flurry of bodies and arms preparing the space. One of the two women in this room is wearing a batman scarf to keep her hair back. I start to shake with fear as I lie on the table and a cannula is inserted into my left hand and I talk to the woman about Batman, Marvel and my agnostic stance on superheroes – as far as I’m concerned, they’re all brilliant. The anaesthetist is talking to me, telling me it’s all OK, I’m safe, I’ll have a lovely, gentle sleep and then I’m gone.
In the dream, I’m talking to two woman I’ve never seen before. We’re just chatting and then, just like that, consciousness returns and I see two nurses in front and above me, ‘Oh, hi!’, I say, like it’s the most normal thing in the world, just three people passing time.
One of them tells me that that’s it, I’m all done and it take a moment for me to realise what she means. I’m in Recovery, my temperature is low, so they’re warming me with a heated blanket. My legs are completely numb. I feel like I’ve woken up from the best sleep. I’m incredibly thirsty and drink everything they give me.
At 15:15 they wheel me back to the ward and Charmaine who welcomes me with such a warm smile I melt. Part of the reason I’m doing this is for her, so I can be a better version of me, able to enjoy life more fully again, together.
Again, both the consultant and the anaesthetist pop in on separate occasions. The consultant tells me the hip was very arthritic which is as good to hear as the fact he’s very happy with how it all went. All that doubt about whether I was doing the right thing just evaporates. The anaesthetist has tips for how to pee after I get my legs back - he encourages me to sit on the edge of the bed, to allow gravity to take over. At this point I’m just nodding, little realising how important that intel is, I’m just glad to be alive with a new hip. This is day 0, from this point onwards, life gets better.
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So glad you’ve had the op, here’s to a speedy recovery for you 😊
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@BJG So happy to read it all went well for you. I imagine by now everything is getting a bit easier day by day. Thank you so much for writing it - so much there I can relate to as my new hip is now almost six months old, and I've sat here nodding in agreement.
Take care, I'm sure in a few months you will be amazed at your progress and enjoying your life again!
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I've just read the whole thing through. Things will get a little better every day from now on. Soon you will be doing activities that you thought you would never do again.
Some of what you have written is very familiar, especially the self talk. It took me a year to feel it was the right thing to do.
I had my first THR 1st of Feb and the second 3 weeks and 1 day ago.
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@alwayssewing It is great to see you on here supporting and advising other members, I hope the THR replacement recovery is going well!
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Thanks so much @alwayssewing I've just past two weeks and the difference is remarkable. Fingers crossed this continues. I'm a different person!
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Thank you @olivia_b :) Taking one day at a time - but with an optimistic outlook which is something I thought I'd lost. This forum is so important – it's helped me tremendously and also helped me grasp how vital it is that we can share the benefits of our experiences. This is hard stuff, the more we can help each other, the better 😊
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This is amazing to read. I'm like you. Active 46 year old female. Lovely husband, amazing kids and severe hip arthritis which progressed very quickly to the point where I'm now awaiting a hip replacement. I'm also angry and grumpy a lot of the time and basically miss my old me. Happy and always on the go. Now I walk with a stick ( much to the disgust of my 12 Yr old 🤣). It gets me down a lot. I try not to let it but sometimes I can't help it. Best of luck with your recovery.
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Thanks so much @desfrites you’ve pretty much nailed why this forum is so important - this can be such a weird, isolating (and grumpy!) journey. I’ll be writing about the rehab phase after the op soon (got my mum visiting at the moment so must make her top priority:) but what I can say is you will find yourself again. And then some. Hang in there, the future will be bright. 🙌🏻
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@BJG your post op diary takes me back to my surgery four months ago! I can't believe it is four months when reading your story it feels like yesterday as it is so vivid and yet it seems like a lifetime ago now that I almost feel I am back to normal fitness.
It is truly amazing. Good luck with your recovery, you're doing great 👍🏻
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Your diary sounds really good. Hope you make speedy recovery. I am at preop stage at the moment.
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Thank you @olivia_b I'm pleased to say I'm doing OK and have just posted my rehab journey to hopefully help others. Recovering is a weirdly private thing - partly because you've no idea how it will go until you 'get there'. So far, so good. I'm now 11 weeks into my recovery - still early days apparently - but feeling far, far better :)
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