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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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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.

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.

Home today!!! September 28, 2009

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I’m so excited to be going home today. My hip is pretty sore but I am fed up of being in hospital. My lovely 82 year-old neighbour is also hoping to go home today and we have decided we are going to escape together if anything goes wrong.

I have been having trouble getting to sleep the last few nights since the anaesthetic has worn off. It is impossible to get comfortable and I am not used to sleeping flat on my back. I tried to sleep on my good side but it didn’t feel right. I will check today if there are any positions that I can’t sit or sleep in. I am not really sure what could cause damage and I am terrified of knocking the screws out.

A higher state of consciousness (Friday) September 25, 2009

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Overall, today has been a very good day. I have had the catheter removed (it wasn’t as bad as I had feared, just stung for a sec) and have walked up and down the ward five times on my crutches. I’m no threat to Usain Bolt but I’m so relieved to have done it.

I have had lots of wonderful visitors to come and paint my toe nails, make my ward smell nice and generally entertain me with ridiculous stories.

Now that I am off all of the horrible drugs I realise how out of it I have been for the last few days. I brought lots of stuff with me to watch and read and managed to do none of it. Not even a whole puzzle from Pick Me Up. Just as well the internet wasn’t working before as I would have sent illegible emails anyway.

Ive heard the Features Editor is very good

I've heard the Features Editor is very good

My hip hasn’t been hurting much at all. It aches after I have walked about for a few minutes but otherwise is behaving well. Fingers crossed I can go home on Sunday as planned!

And, I found out I only have three screws in me.

Previous experiences in traction September 20, 2009

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Thank you mum for digging out these photos! Here I am, back in mid-1981, stung up at 45 degrees by my ankles and seeming to enjoy myself very much. There will be no traction or plaster this time but I expect I will still be less brave and cheerful than my younger self.

Introduction September 13, 2009

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I was born with congenital dislocation of my right hip and thanks to some surgery between the ages of one and four I have lived a normal life without any major problems. My right leg is definitely less flexible but this has only been a problem when attempting to do things like yoga.

Almost two years ago, I started to get pain in my hip after walking for long periods. This coincided with a move back to London so I put the pain down to marching around on concrete and being generally unfit. The pain got more regular and progressively worse so in summer 2008 I finally went to my doctor to ask for advice.

I was refered to University College Hospital and had a couple of x-rays and MRI scans. My x-ray (below) showed damage to the hip socket and that the ball of the hip was not in the ideal position.

Note - the ball was to show how big a hip replacement might need to be

I don't have a ball up my bum. It is supposed to show how big a hip replacement might need to be.

From this you can see that the ball is not sat in the socket properly

From this you can see that most of the ball is outside of the socket.

The various scans also found that my hip socket was quite shallow and that the top of the femor is also an irregular shape. So all in all, a pretty dodgy hip. And to make it worse, the surgeon told me that it is common for hip problems to resurface as you approach 30!

In May 2009 I had a hip arthroscopy to investigate the source of the pain in my right hip further. The surgeon found damage to the hip socket as a result of the ball and socket not fitting together properly. To prevent further damage, it was recommended that I should have a periacetabular osteotomy (PAO) to fit the two parts together. He told me that this wouldn’t enable me to cross my legs properly but had a very good chance of getting rid of the pain. He also told me that the surgery should delay a hip replacement – I will have to have one (or more) but not for a while hopefully…

So I am now booked in for my PAO on Tuesday 22 September. I have created this blog as a way for me to put down my thoughts and hopefully manage my nerves and frustration. I don’t expect anyone to read it but there might be others going in for similar operations in the future who will find it useful.