Tuesday, 1 April 2008

Baby Boomer - Less Hip these days

This first posting is by way of an explanation of both the name and purpose of this blog.

After 4 hip replacement operations in the course of 27 years (2 of which would be regarded as successful and 2 as being troublesome) I succumbed to a post operative infection. After 4 years of large doses of antibiotics taken by mouth this eventually overwhelmed me and required removal of all implanted metal work to combat the infection before a potential 2nd stage operation to implant a new hip joint could even be considered.

I returned from hospital today (31 March 2008), after a 12 day stay as an in patient. I have a follow up out patient appointment booked for 6 weeks time. The district nurse is due to visit in about a week's time to check that the sutures have dissolved and if not to remove any still in place. I am also expecting to see a community physiotherapist on a weekly basis for the next 12 weeks or so.

In the meantime I am having to live without a functioning hip joint in my right leg. So I am (almost by definition) a less hip baby boomer than I used to be!

Other postings will look back both to what led up to this point and to some reflections on the gradual changes in lifestyle that ensued. In general though I will try to share what life is like coming to terms with what my daughter described as being a one hip wonder. My daughter reserved the Blog name for me, while I was in hospital, in the expectation that I might want to share my experiences. I had independently come to the conclusion that, as there was no patient leaflet to prepare me for what I was experiencing, it might be a good idea to create one. This blog will therefor serve as a valuable source of raw material for such a patient leaflet in the future.

By virtue of the descriptions of medical conditions and procedures that will feature in some postings readers should be warned that this blog will not be for the faint hearted!

As an example of the potential X rating of this blog I will try to describe the extent of the filleting that took place 12 days ago.

I was told that, as well as removing all metal work, some bone would need to be removed - if it was found to be infected - and that the space would be filled with anti biotic pellets following a general anti biotic wash out of the soft tissue. Any infected soft tissue would also be removed.

The surgeon concerned reported that the operation had been "interesting". His senior registrar however showed, through his concerned features whenever I saw him, that "horrific" might have been a more accurate description. When I asked him how much soft tissue had been removed he replied "a significant amount - about a cereal bowl full" The consultant however played this down as "not very much". Now some of this difference in opinion might be down to the different degrees of experience of such operations but I think the Senior Registrar's concern is the one that will guide me in the next few months.

Originally I was expected to partially weight bear through my right leg after a few days and then gradually to progress to being able to weight bear without any concern. In the event I have been told that I must only partially weight bear for the next 12 weeks at least. I can contemplate "touching my right foot down as I walk - first with a zimmer frame and then with luck with elbow crutches - but nothing more than the lightest touch.

When I saw the first X-ray of the operation I was enlightened as to the level of concern.

In the event I have about 4 inches left of what I estimate to have been about a 16 inch long femur. Some of this had been removed during the 2 previous operations on my right hip but I think I have had a further foot of bone removed because it was deemed to have been infected!

In its place is a load of cement fashioned into something looking like a femur with a rounded knob at the end. Through the middle of this runs a rod to provide some support. I'm not yet sure if this is made of metal or some inert material. Given that the original metal was thought to have attracted infection I do hope it is not metallic.

The cement is impregnated with gentomycin which I understand will be released slowly over the next few weeks - so perhaps a case of more being better. Unfortunately this length of cement is not as flexible as a similar length of bone. It is therefore more likely to break under strain - definitely a case of less being better!

So think of this blog as an X rated horror suspense story. Whether it turns out to be a thriller as well - only time will tell. I will however try my best to make it "interesting"!

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