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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!

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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.

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.

Operation day (Tuesday) September 25, 2009

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I had hoped to keep a regular diary whilst in hospital but I think I underestimated how tired, spaced-out and sick I would feel. So here’s a catch up on the last three days.

I arrived at UCLH at 7am on Tuesday but it wasn’t my turn for the butcher’s block until 12.30pm. Apart from the boredom of waiting, the worst thing was not being able to eat or drink anything.

I was very brave up until the final moment and started to panic as they began pumping me with anaesthetic. Silly, as this really was the point at which there is no going back. I’m not really sure what I was scared of, probably just knowing that things are going to be a bit of a nightmare for the next few months.

I woke up 4-5 hours later feeling quite spaced out and with various tubes sticking out of me. After about an hour in recovery, I was taken up to my ward which I have been sharing with three VERY nice ladies who have all been looking out for me and for each other. We are on an orthopaedic ward so everyone has had dodgy hips or knees and is wizzing around (or attempting to) on zimmer frames or crutches. It is nice to see others reaching different stages in their recovery – something to look forward to.

I can’t tell you yet what they did to me but I have a nice big, black scar. It is glued together so there’s no bandage or anything to cover it up. This is good as I don’t have anything to remove but also gross as I can see how horrible it looks. The surgeon came over and said that it had all gone well. I forgot to ask how many screws they have put in.