Friday, December 10, 2010

Quick update..

Two months to go! This time two months from now I will be in the hospital in Sydney, probably in recovery or being hacked up or getting prepared for being hacked up... not sure yet as I don't know what time I am booked in for. I haven't received any of the paperwork from the surgeons office yet and it's been 4 months since that appointment. I figured out that my private health doesn't even cover the full cost of the op, and I am yet to find out how much it is going to set me back from out of my pocket. I think I am mentally prepared for this but probably not financially prepared. I have two months off work from Feb and unfortunately the rent and bills won't pay themselves!
I've had bouts of feeling sorry for myself lately. There's so much I want to do now like go overseas, go back to study and get qualifications in something I will actually love doing for a living..things like that but I have to wait a year until my hips are sorted.. boohoo :P
The pain has progressed; every step I take there is a painful clicking (in both hips!) and the pain in the groin area, as well as the constant dull ache just around the whole area in general. After a day of more walking than usual I get sharp pains shooting down my leg. Again, pain meds don't do any miracles for me but I've mainly been having just paracetamol, ibuprofen and other anti inflammatories.
On the up side: Holidays in 10 days! Can't wait to get away :) then when I return to work next year it's only for one month before I'm off again for my op!

Friday, November 26, 2010

Hello!

So that last post was very long but that was me bringing the blog up to speed.

I am now still waiting for my left side PAO which is booked in for 10 February 2011, still a little while away but the time has been flying past so fast!

Almost as soon as I had my x-ray report and diagnosis in November last year I called mum to tell her. She promptly and wisely joined me up to a private health fund as I had never had private health insurance before. She must have had an inkling that I would need surgery and I was not going to bother joining private health insurance until I was convinced I really needed it, otherwise I thought it would possibly be a waste of my money. But I am glad she went ahead and joined me to one because otherwise I would be waiting a lot longer than I already am for the surgery.

The private health insurance has a 12 month waiting period policy on pre-existing ailments. This means I have to wait 12 months before being able to claim the hospital cover I need for the PAO. I’m not sure how it works with the public health system but I’m sure there would be a waiting list which could mean waiting years. That was not an option as the cartilage on my hip is being worn away more as time goes by and the less healthy the cartilage is, the less chance of success for the PAO.

It has been a year since joining private health so I am now able to claim hospital cover however we have booked in for February because A) that is the only suitable time my mum can take off from work to come down and take care of me and B) I would like to have my summer holidays Christmas and New Years free from being disabled. Also, Feb/March is a better time for me to take off from work as well, except for the appalling fact that I will be missing out on Soundwave festival in late Feb which only has the best line up of rock bands ever! L

My hip has been aching more and more every month and is just frustrating and annoying and sometimes I just want to stab it! But not really. But I refuse to give up wearing heels. I didn’t think it affected my hip anyway but now I find it is a little more difficult on my hip walking in them. But I will keep wearing my favourite high shoes until I physically cannot anymore. Which will be a large chunk of next year L

I have sort of decided that if I am to have both hips operated on, I should get it all done and over with, in one year so that I can get on with my life as soon as possible. That means the plan is to have left PAO in Feb, and 5 months to fully recover, then the right PAO in August, and be fully recovered by the new year after that... 2012?! It seems do far in the future! And that’s a lot of time off work in one year, but I don’t really mind and I’m sure we’ll all manage. My work is a desk job so at least I don’t have to stand all day or anything.

I really want to go travelling, spend some months in Europe and I can’t until all my hip shindigizzle is sorted out, and not to mention have some savings to go.  I feel like I need to put my life on hold until after I’m all fixed which will take too long and so much effort its frustrating. Errgh listen to me whine! There is so much worse things that could happen or that others are going through medically, I have no right to whinge! So I apologise.

I am looking forward to being pain free though.

I am also looking forward to my time off over xmas and new years up in QLD and see my friends and family! YAAY

Wednesday, November 24, 2010

First blog entry!

Peri-acetabular Ostoetomy (PAO). It’s been a long time coming.

It has been over a year since my x-ray and surprising diagnosis of acetabular/hip dysplasia, a year since my MRI and about 11 weeks until PAO surgery. Pretty much, this year has been spent waiting and mulling over an upcoming surgery, as well as putting up with hip pain and slightly obsessing over it, over-researching, over-analysing, worrying and anticipating. This year, has gone alarmingly fast!

I’ve read blogs by others online who have conveniently kept a detailed account of their story with hip dysplasia and consequent PAO surgery, which has helped me a lot in understanding the surgery itself, the preparation and the recovery.
When I first heard about hip dysplasia after receiving my x-rays, I had trouble finding info about it online (except canine hip dysplasia, a lot of info about that!) I found even less info on the corrective procedure the Ganz Periactabular Osteotomy or PAO for short. So, having access to the personal accounts from others who have experienced it all was really helpful, interesting and reassuring.

Now, it’s my turn to journal it and maybe my story could benefit someone else who is in a similar situation. There is only one other Australian blog on this topic which I could find and that is by Sarah, aka; turtlegirl26 on Live Journal: http://turtlegirl26.livejournal.com/ But there are many others from UK and USA which I will list for anyone interested in reading them. Surgeries are different everywhere and depending on who the surgeon is and what technique is used but it's still a useful read.

I am also writing for myself, as a means to express myself  and what I may be feeling and to just keep a record for myself as a reminder of this experience. Also, I am sure my partner is sick of hearing about me talking and complaining about my hip and fretting about the op etc, so this is a way I can offload all my ranting online. ;)

From the beginning:

My left hip started hurting from mid-last year after I bought a treadmill and started running on it almost every day in a bid to get fit after an indulgent winter. I had never had any problems or trouble with my hips as a baby or child like a lot of people with hip dysplasia usually have, except for some clicking and popping which I disregarded thinking it was normal; just like when elbows and wrists click.  So anyway I thought the pain was because I had pulled something in my hip running. As usual I ignored it for a while and kept running. I have been known to be a bit of a hypochondriac, but usually when something is wrong or I have pain it goes away after I ignore it for awhile but this didn’t. When I was limping from the pain I eased down the treadmill use and went to the local GP clinic. Fortunately, he sent me for an x-ray and ultrasound of the hip area but just as a precaution as he thought it was nothing but strain or stress from exercise which some stretching could fix before excursing.

A lot of people go years undiagnosed because their doctor simply sends them to a physio without doing any tests and physios give stretches and exercises which don’t help the real root of the problem which is the shape in which the hip socket has formed. It does not seem to be a well known problem and is often overlooked by medical practitioners in patients such as myself.

** When a friend of mine told me of her symptoms and problems with her hips which were similar to mine I suggested she go to her doctor just to make sure. When she mentioned the words hip dysplasia her doctor laughed and said that it’s very rare and uncommon and just sent her off without any tests or examinations. This is an example of how little info and help there is out there in regards to dysplasia.**

Anyway once I finally had the x-ray and ultrasound and could be bothered to go back for the results, the doctor and myself were surprised at the outcome as we both assumed there would be nothing wrong.

The x-ray report states:
There is evidence of significant developmental dysplasia of the left hip with increased angulation of the narrow acetabular roof on the left side compared with similar but milder changes on the right side and with no significant lateral subluxation of femoral head on these images.

Left hip ultrasound report states:
Ultrasound shows a collection of small simple cysts and the anterosuperior margin of left hip suggesting synovial cyst or labral degeneration.

Appearances suggest early degenerative changes complicating mild developmental dysplasia.

Here is a pic I took of that x-ray:


 
The GP explained this to me and made it out like it was a big deal while at this stage I was still clueless to what this all meant and he wasn’t sure of the details either.

I was then referred to a local Orthopaedic surgeon, who mentioned the PAO surgery, and since then have seen 3 different orthopaedic surgeons and had an MRI.

I decided to go with a surgeon in Sydney (Dr Michael Solomon), even though I currently live in Canberra I felt he was more experienced and knowledgeable, he did seem confident and seemed to know what he was talking about. He said I would be the perfect candidate for this surgery as I was young, fit and my dysplasia had not progressed to the point where my cartilage was too damaged to be operated on.

PAO is pretty much the only alternative to a total hip replacement which would be fine for a 70 year old but I am 22, therefore out of the question. PAO is a major bone operation (more major than a THR) but the surgeon was confident that I will come out better off and hopefully my hip will be pain free!


This operation means 6-8 weeks minimal weight bearing on crutches and 6-8 weeks off work, with the first couple of weeks in need of full time 24 hour care (thank you mum!). It could take up to 5 months until the muscles etc go back to normal.

This pic basically illustrates what a PAO looks like (anterior view of the pelvis):


Also this link is very helpful in understanding exactly what hip dysplasia and PAO is:
http://hipandpelvis.com/patient_education/periace/page1.html

And also this link:


While at my appointment with Dr Michael Solomon in Sydney I asked about my other hip (the right one) as it was playing up and was clicking and clunking, I thought this was due to compensating for the bung left hip and although I knew it also had mild dysplasia I did not expect to hear about any operating on that one. Apparently that one will need a PAO as well within the next couple of years, with doc informing me that the two can be operated between 5 months of each other. ‘Great’ I thought, two major pelvic operations to look forward to. But in a way I have been anticipating it as I think I am just over the hip aches and pain and not being able to walk for more than 5 mins without having to stuff painkillers in my face. I feel like an old lady and I am only 22! So I am looking forward to getting ‘fixed’.

My mum came to the appointment with me in Sydney which was very nice of her as she lives in QLD but it was also a good excuse to meet up for a girls weekend and shopping in Sydney as well as the doctor stuff. Anyway, she asked him why this hip problem has come up now and not when they checked me for hip problems as a baby -as they do- and he said the checks they do to new babies only pick up really bad hips like dislocated ones and the only way to pick up this type of hip dysplasia is to x-ray every baby, which obviously doesn’t happen. So a lot go undiscovered until they become symptomatic after exercise related activity as a young adult. Which is what seems to be the case for me. When you hear of the term developmental  dysplasia of the hip, this just means when the hip develops, it has not developed properly in the ball and cup manner rather, the socket, or the ‘cup’ is too shallow to hold the ‘ball’ being the femur head at the top of the thigh bone and puts damaging pressure on the cartilage over the years, leading to premature degeneration/arthritis.

Alright well this post is verrry long so I will stop there otherwise I could probably rant on forever..

Until next time!