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PAOs and pregnancy July 3, 2014

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When I first found out that I was pregnant one of the first things I asked my midwife was whether my PAO surgery would affect my pregnancy or childbirth in any way. She wasn’t sure and marked me down as a ‘high risk’. I was told I should have an additional consultation with an obstetrician.

Then a few months later, I had a routine check up with the hip clinic at UCL hospital. I wasn’t able to have an x-ray this time around so just had a consultation with one of the registrars. He immediately put me at ease by explaining that my PAO surgery was done on my hip – not my pelvis – so wouldn’t affect my pregnancy in any way. He said that lots of women are concerned about how hip surgery may impact on pregnancy and seemed frustrated that neither my GP nor midwives had been able to reassure me.

He wrote a letter to my GP following my appointment which included the lines:

Of note, it is just to clarify that a periacetabular osteotomy does not affect child birth and there will be no problems with a normal vaginal delivery or a caesarean section. This procedure should not complicate the pregnancy.

With two weeks to go until my first baby is due, I am happy to report that my hip hasn’t given me any problems at all. I expected to at least have some aches and pains as I put on extra weight and my muscles loosened up, but I haven’t. I have had regular check ups with my midwife and didn’t need to see an obstetrician after all. So far, so good…

So apart from generally worrying about the pain of labour and how on earth I am going to take care of a baby, all I have to remember to do is ask the midwives to check my baby’s hips as soon as she’s born. If she is born with dodgy hips as well at least they can hopefully catch it straight away.

 

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3 years on & lots to celebrate June 7, 2013

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I haven’t updated this blog for a long time but recently received a comment which showed that least a few people were still coming across it and finding it useful.

So, in case anyone else finds these pages and is wondering whether to go through with a PAO or not, I thought I would write another quick update to let you know how well I am getting on.

It is now almost 3 years since I had my surgery and I’m feeling good. Apart from the occasional ache in my hip when the weather is very cold or after carrying a heavy bag on one shoulder, it doesn’t bother me at all. I discovered pilates and found that to be a huge help for returning flexibility and strength back to my hip. I am finding I can bend and stretch in ways I was never able to before which is really motivating!

Last September I went for my annual check up. The doctors were really pleased with my progress and said I wouldn’t have to come back for 2 years unless there were any problems.

The fact that my hip isn’t on my mind very often at the moment must be a good sign that the surgery was worthwhile. I know there will come a time in a few years (hopefully quite a few years) when it may start causing me trouble again but I’ll worry about that when the time comes.

My sister found out a while ago that she has the same problem – but not with out lots of persistent questioning to her unhelpful doctors. One kept telling her that some people just get pain and have to deal with it!! Unfortunately, after a delay in her diagnosis, her health authority now won’t prioritise her surgery so she is having to wait even longer.

Hopefully she’ll be able to get it fixed soon and I can pass on my lovely stockings!

How a PAO is done – in layman’s terms March 1, 2010

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A doctor and fellow PAO patient recently described how a PAO is done:

The cutting is done in part with mallets and chisels (exactly like a carpenters!) and a small electric saw… The leg is moved from straight to bent at hip and knee throughout operation but very little twisting, to ensure freedom of joint movement and to get to the joint. He [the surgeon] puts a big screw called a swhanz screw into the pelvis near acetabulum and once all the bone cuts (or osteotomie) are done uses this to mobilise the acetabular fragment and with use of x-rays gets it into the best position. Then uses 3-4 (4.5 mm wide and 10-14cm long) screws to fix it in place.

He then reattachs the two muscles he cuts to get to the hip join back to the pelvis with fibre wire. Stops all bleeding and closes. It’s obviously a lot more complicated than that and takes about 2-3 hours.

Simple as that!

Long time no blog February 27, 2010

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4 months post-PAO

It has been over three months since I last posted anything on this blog. Time has passed so quickly!

Since November I have gone from one crutch to no crutches. I met my personal target of spending Christmas crutch-free which was great. I also went back to working at the office in November as well. It was hard at first as it is a 20 minute walk from my flat to the office but I think it helped me to have that regular exercise. It was just in time before I went stir-crazy being stuck in my living room all day.

I had my 3 month check-up at UCLH at the beginning of February and the bones have healed up very nicely. My screws don’t seem to be causing any problems so they will stay put which is fine by me.

I completed my six week course of hydrotherapy which I LOVED. It was so wonderful to spend time in the warm pool whilst it was snowing outside. And it was very motivating to see my leg moving about under water in ways that it couldn’t do when gravity was taking hold. I am still going to regular physiotherapy once every few weeks. Progress is steady but my muscles are still not working 100%. I have aches in my groin and buttocks – seemingly in different places everyday. The pain is not bad enough to warrant painkillers but I am frustrated that there is still pain at all.

The main problem that I have now is my coccyx/tailbone. Since Christmas it has been hurting and isn’t getting any better. I have asked my surgeon, physio and GP if it could be a side effect of the surgery. Nobody knows and worst of all, nobody has any suggestions on how to make it better. I am convinced it is because the allignment of my pelvis has shifted slightly and the muscles around the coccyx are still weak. I hope it goes away – just when my hip pain goes away something else comes to replace it.

So overall, I am happy with how things are going. I hope by the time that the summer comes I won’t have any regular aches and pains and I can spend at least one day without thinking about my hip (or coccyx).

Both feet on the ground November 6, 2009

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I have been really looking forward to my six-week check up. It always helps to have something to look forward to when you are flat-bound and every day starts to blend into one. Most of all, I was looking forward to seeing what Mr Witt had actually done to me. I only got three screws but they are whoppers!

6 weeks post PAO

The two girls who did my x-ray let me pop around the screen to have a look. My response: “Oh. My. God. Those screws are massive!” I still don’t really understand how on earth surgeons can do the things they do. But then, I don’t understand a lot of things like how television or the internet works!

After starting physiotherapy last week (5 weeks after the operation – my only real complaint about the NHS) I have felt much more positive and finally feel like I am on the road to recovery. I am hardly taking any painkillers now and am getting dangerously close to getting a good night’s sleep.

In the last week I have even managed to go out all by myself! I hopped down the road to meet with three other hip women – Suzanne (who is practically my neighbour), Annick and Nena. It has been brilliant to put faces to names and share experiences in person. It is amazing to think that less than 6 months ago, I had never heard of a PAO and now I am part of  huge community of women who have been through the same experiences. I will be eternally grateful to all of the hipwomen for their advice and encouragement.

Mr Witt was happy with the way the hip is healing so I am allowed to put weight on my right leg – hooray! No more standing like a flamingo to brush my teeth or make lunch! I can now walk on both legs but have to keep the crutches for another two weeks. Then I can go down to one crutch. I hope this doesn’t mean I have to start doing the washing up.

Post-PAO exercises October 21, 2009

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Dont try this at home!

Don't try this at home!

Around three weeks after my operation I had quite achy knees as well as the hip. It was suggested that this was because I was sat in a chair all day and not moving enough. The hospital didn’t recommend any exercises for me to do between discharge and physio (though I think this would happen in most cases). Huge thanks to Annick who suggested the following exercises, they have helped a lot!

[Don’t try these unless you are certain you can do them. If you do, take it slowly – I don’t want to be responsible for anyone hurting themselves]

1. Ankles – point and flex feet alternatively, do briskly and keep legs straight, will stretch calf muscles.  Repeat 10 times.

2. Bend one leg and put your foot on the bed and put a cushion under the other knee.  Exercise straight leg by pulling your foot and toes up, tightening your thigh muscle and straightening the knee (keep knee on cushion) Hold for 5 secs approx.  Lower slowly and repeat 10 times.

3. Both legs together and straight.  Bend your ankles and push your knees down firmly against the bed.  Hold 5 secs, relax.  Repeat 10 times.

4. Bring your leg out to the side and then back again to mid position.  Use dressing gown belt or similar hooked round foot if needed to help.  Repeat 10 times.

5. Bend and straighten your leg.  Repeat 10 times

6. Lying face down hips straight and knees together.  Bend knee as far as poss keeping hip straight and ankle flexed.  Repeat 10 times.

7. Lying face down, bend knee to right angle and lift foot towards ceiling.  Repeat 5 times.

8. Clench and release your buttocks. Repeat 10 times.

28 days later October 20, 2009

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One month today since my operation. I can’t believe it! Time has actually gone quite fast.

I had hoped to bring you an update today my first physio session but it was cancelled just hour before! I am so disappointed. This was my first major milestone and now it could be delayed by as much as two more weeks. Hopefully I’ll get a cancellation but I won’t hold my breath. Thankfully, another hip woman has given me some exercises to do (I’ll add these in another post) to stop me wasting away completely.

My pain levels have dropped a lot this week and the last of the surgical glue was come off. I am finally feeling like I am making a recovery now. I hope it lasts. The only bad thing to have happened is that I have had a really bad reaction to some moisturiser that I put on the dry skin around my scar. It is red, bumpy and VERY itchy. There’s always something…

Scar status: Glue is all off now. Scar looks okay, a bit uneven in places but has healed well.
Pain levels: Pain was really bad at end of last week but I started to do some more regular exercises and that seems to have helped a lot. Hardly any pain now, just the odd twinge.
Medication: Hardly any!
Crutch ability: Have been out most days now and definitely building up some stamina.
High point of the week: Leaving my local area yesterday for the first time in a month. The world hasn’t changed at all.
Low point of the week: This morning when UCLH called to cancel my physio appointment.
Lesson learned: People really don’t make concessions when they see someone on crutches. They’ll just walk into you.
Main achievement: Going to a meeting yesterday.
Gains: God awful rash around my scar.
Losses: A stomach full of pills and surgical glue.

The video I wished I hadn’t watched! October 15, 2009

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This video, presented by the amazing Andi Peters, is from City Hospital in 2005. Jenny is undergoing a PAO. Just look at the fricking tools they used. No wonder it hurts!

Sleep is no longer my friend October 14, 2009

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I used to look forward to going to bed at night. I love sleeping; I can’t get enough of it. It was one of my favourite things and I was good at it too.

Now, I don’t want to go to bed any more because I know it will be painful and uncomfortable. I’ve tried every position (apart from laying on my bad side) and have tried putting cushions everywhere and anywhere. It’s no use.

Help! Does anyone know of any exotic sleeping positions guaranteed to be comfy for a whole night? Please let me know.

Week three update October 13, 2009

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I found this picture on Matt’s blog today which is a helpful illustration of the carpentry done on my hip. You can see how they have to cut the pelvis to make the socket a bit deeper. I know I have three screws but until I have my next x-ray I won’t know exactly what position everything is in now.

What I do know is that I am now in real discomfort. Even immediately after the operation it didn’t hurt this much. I think I was getting too smug that I could manage on headache tablets (paracetamol and diclofenac) and this is my body’s way of reminding me who’s in charge. It feels like there are pins being stuck into different parts of my hip and thigh and it isn’t nice. I am hoping it is just the nerves starting to work again rather than a sign of something I have done wrong.

I have done really well so far in keeping weight off my right leg. I am flamingo-like in my ability to perform tasks balanced on one leg. It all went wrong on Sunday when I went to return some books to the library and tried to hold the door open for a lady who was coming out. We had an awkward moment of “after you”, “no, after you”. Since I was the one on crutches she insisted…as I tried to release the door that I was holding I lost my balance and had to put my foot down. It didn’t hurt at the time but felt tingly for a while after once I had sat down. I don’t think the pain I have now (Tuesday evening) is because of that but not sure what else it would be.

Scar status: Glue is really starting to peel off now and looks disgusting. The actual scar is showing through and is very neat and pink. If the whole thing is like that then it shouldn’t look too bad.
Pain levels: Most of the week has just been a manageable ache but the last 24 hours have been much worse. Strange firework sensations in different parts of my leg. Hope that’s the nerves fixing and not something bad.
Medication: Paracetamol and diclofenac still plus some co-codamol for nights. Purchased in bulk from the chemist.
Crutch ability: Went on a 15 minute journey back from Nandos which was exhasting. Need to get out more.
High point of the week: Visits from friends on Saturday (karaoke and curry) and Monday (lots of laughter, homemade food and wine). The wheelchair makes an excellent extra piece of furniture.
Low point of the week: Last night – hip pain + period pain is just not fair.
Lesson learned: Don’t try and open doors for other people when you are the less able.
Main achievement: Going out three times and not falling over.
Gains: Pretty flowers, get well cards from overseas colleagues and homemade macaroons.
Losses: The novelty of working from my living room and my love of sleeping.