Week 14 #hipreplacement

Archive, Arthritis, Health, Hips, Hypermobility, Hip replacement, SURGERY

A week of mini victories, first I had walked down the stairs once without holding on for dear life, and one step at a time.

Next I put on trousers standing up, wasn’t totally graceful but I did it!!

I’ve bought some skinny jeans for my out out evening Friday. Skinny style though not a skinny size (but that is something I am and I will work on) They both have a stretch in them so they aren’t too weird over the scar. As I still don’t like seams over scars.

Slowly slowly I’m regaining myself back which is wonderful news.

Then of course I’m going to a techno night out on Friday night, a night a friend runs in Birmingham. Chapel Of Chaos

So I can’t do too much physio this week, so I save my energies for this. We’d bought tickets for this before Christmas,and before my surgery dates changed too. Determined not to miss another one. Does anyone else rest a lot before a thing? I know I have too.

Heres week 14 scar, looking pretty deep still at the top, but almost disappeared at the bottom, looks as faded as the two scars that are either side of it. Should be fine wearing shorts if we get some sunshine this summer.

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Day 97 Does Size Matter #hipreplacement

Archive, Arthritis, Health, Hips, Hypermobility, Hip replacement, SURGERY

Ever since I knew I could find out the size and dimensions of my implant (my hip replacement) I’ve been on a journey of exploring why? Is it large or small? Cemented or cementless?

Why do I want to know?

Well I don’t really need to know, as I trust my surgeon to know what is best. But I’m nosey and why not find out.

So I sent off the form to National Joint Registry here and waited a fair few weeks to get the results. And here they are.

Pretty much confirmed what I thought I knew already. That my hip is made of Ceramic on Ceramic and that #Symbios is the manufacturer. And that I’m cementless (1 thing I wanted confirming) and then the sizes of the ball (I was really keen to find this out)

So does size matter?

The size of the ball joint of the natural hip joint (name is femoral head) actually varies and usually ranges from 40 to 54 mm (with smaller sizes in females). During the initial beginnings of hip replacement, the surgeons tried to make the implants which would mimic the natural size of the natural femoral head.

Does natural size work?

However, it was soon realised that when a large metal ball articulates with a plastic cup, the plastic part gets worn out quickly due to “volumetric wear”. To decrease the “wear” of the plastic, Sir John Charnley (who was one of the pioneers in the development of modern hip replacements), opted for a smaller 22 mm metal head (which is much smaller than the natural femoral head) in the design of Charnley hip replacement. This design was the commonest hip replacement done in the UK until recently.

Studies have shown that with this technique, there were fairly good long term results in patients who are not very young and active. However, these came with some restrictions placed, limiting what the patients could do to avoid dislocations (this is when the ball comes out of the joint) and a high dislocation rate following hip replacement has been common with smaller “ball size”

Small or larger femoral heads?

Many surgeons over the past few years have started using slightly larger size femoral head (28 mm) which is still within the range of conventional metal on plastic bearing. However, still it is smaller than the natural femoral head. The problem of wear and dislocation is still a potential concern.

Concerns?

Dislocation still remains a major reason (17%) for revision of hip replacement (NJR data 2008). I don’t know any hip replacement patients that aren’t worried about dislocation.


stats


Dislocation is the main reason people need revision hip replacements. Which can result in loss of more function, which no of us want, we are all striving for more functionality.

While the cause of hip dislocations is from multi factors, it is thought using a larger ball could decrease the incident of dislocations. However, we’ve seen the size of the ball was limited by the material properties. So that was another thing that needed looking at.

How things have changed?

Also much younger and more active patients are being offered hip replacements now at much earlier times in their hip journeys. And the expectations of young and active patients are alot higher as they strive to go back to their active lifestyles and sports with little to no restrictions.

To improve the durability of the hip replacements, material scientists have come up with modern solutions (alternative bearings). As no longer could an implant last 7- 10 years, now they are required to last 30-40 years.

New materials give new dimensions?

There are essentially three types of alternative materials – cross linked poly (plastic), ceramic and metal. These alternative bearings mean they could allow larger ball sizes to be used 32 mm, 36 mm and even 40 mm. However, these sizes would be limited by the cup (socket size) and also some material allow slightly bigger ball to be used with the same cup size compared to other materials.

So to end here, size does matter.

From looking at my sizes 32mm I have a reasonably larger ball so it’s probably the reason I don’t have restrictions, it’s fitting into linear of 46/50 which they recommend for 32mm balls. Reading all this I see this hip is designed to give me as many decades as I can of activity, and more adventurous living. Obviously running would cause faster wear and tear, but overall it helps me appreciate the gift I’ve been given.

Day 96 post #hipreplacement

Archive, Arthritis, Health, Hips, Hypermobility, Hip replacement, SURGERY

Last night I hit a victory!! On the last time I walked down the stairs, I walked like a ‘normie’ one foot one step at a time. Loving the new strength to do this. But keen not to tear it or set myself backwards.

So it’s Monday, and I’m feeling reasonable, a bit of mid thigh pain leads me to think of doing upper body exercises instead of lower body.

  • Shoulder Press 15 reps x 1
  • Bicep Curl 15 reps x 1
  • Later Raise 15 reps x 1
  • Bicep Row 15 reps x 1
  • Tricep Kickback 15 reps x 1
  • Goblet Squat 15 reps x 1 (knees weren’t happy, so not a squat persay)
  • Kettle bell Swing 15 reps x 1 (again knees not loving bending even a bit)
  • Chest Press 15 reps x 1
  • Butterfly Raise 15 reps x 1
  • Tricep Overhead 15 reps x 1

I feel like I could of done more, but today has been the first day my shoulders and hands haven’t hurt a lot, so I don’t want to change that.

Not sure why knees hurt, could be from doing the stairs yesterday. So again I’m not keen on doing too much to then make them an issue.

Day 95 Sunday Funday

Archive, Arthritis, Health, Hips, Hypermobility, Hip replacement, SURGERY

At weekends we are normally at our busiest with visiting family members, so there’s never a chance of physio. Although I do class climbing their stairs as physio. As I don’t have stairs at home to practice on like others do.

My hands have been feeling a bit calmer since Saturday morning, is it from weather or taking ibuprofen religiously? Not sure yet, either way it’s definitely welcomed.

Using ankle weights certainly kicked my butt, but huge improvement from how I was before to how I am now, so that’s encouraging. But I am waddling all the time if I walk unaided. Aarrrgggghhh super frustrating. Am I waddling from this hip, or maybe other one? Must ask physio on Thursday.

Anyone else thinking their weekend just flies by in a blink? I know I do. I feel like it’s over in a split second and boom its Monday all over again!!

I’m glad I use weekends as my main rest days, as I truly appreciate them, and it’s easier to just enjoy being with family, rather than trying so hard to squeeze in physio, and being exhausted.

Day 94 Weekend vibes

Archive, Arthritis, Health, Hips, Hypermobility, Hip replacement, SURGERY

It’s a warm ish looking weekend, so it’s a nice day for my belated Mother’s Day meal with my eldest daughter.

Off to Aston Marina for an extra special treat. An afternoon tea.

So no physio exercises for me today, it’s full on family time this weekend, making all that work during the week worth it.

Though walking up this bridge felt like physio, I did it unaided (no walking stick) but boy oh boy that was HARD.

I love boats, there’s something relaxing about water and the boats there. The wildlife around them too. It’s a lifestyle I envy, but I’m realistic and don’t think my body could cope with boat life sadly.

The meal was Afternoon Tea, which I can confirm was absolutely delicious!! And extremely filling too.

Four types of sarnies, salmon, cream cheese and cucumber, cheese and tomato, ham and mustard. And a HUGE sausage roll slice.

Next was the scones with clotted cream (cream first for me) and strawberry jam. We had a plain and current scone.

Lastly it was the choice of the little cakes, a cherry bakewell, brownie, macaroon, and raspberry tart. With the cutest flowers on too.

We didn’t walk far but I was walking unaided around the marina, and it was good practice. Though totally exhausting.

Day 93 #hipreplacement #EhlersDanlosSyndrome

Archive, Arthritis, Health, Hips, Hypermobility, Hip replacement, SURGERY

After receiving a comment from a fellow blogger (find them here) they suggested I should explain more about #EhlersDanlosSyndrome and honestly I should.

What is Eds?

So Ehlers-Danlos syndromes (EDS) is a group of 13 individual genetic conditions, all of which affect the body’s connective tissue.This Connective tissue lies between other tissues and organs like a glue, keeping these separate whilst connecting them, this glue is tasked with holding everything in place and providing support.

In EDS, there is a gene mutation (like an X Man, the nerd in me loves this!!) that causes a certain kind of connective tissue, what kind will depend on the type of EDS (which type out of 13) (Hypermobile Eds, Hypermobility spectrum disorders, Classical Eds, Vascular Eds. They all fit under these umbrella labels)

This gene mutation is usually a form of collagen, this causes it to be fragile and stretchy. This stretchiness can sometimes be seen in the skin of someone with EDS (NOT ME) My skin has never stretched like that, but I scar and bruise incredibly easy. Individuals with the condition may also be able to extend their joints further than is usual (This is ME) this is known as being hypermobile, bendy or double-jointed. As collagen is present throughout the body, Everyone’s bodies, people with EDS tend to experience a broad range of symptoms, most of them less visible than the skin and joint differences. These are complex syndromes affecting many systems of the body at once, this makes it hard to connect and diagnose, despite this EDS is often an invisible disability.

Symptoms commonly include, but are not limited to, long-term pain, chronic fatigue, dizziness, palpitations and digestive disorders. Such problems and their severity vary considerably from person to person, even in the same type of EDS and within the same family.

Now it’s important to remember my #EDS isn’t the same as another #EDS as we are all individuals, and with that said it’s also why it’s incredibly hard to diagnose. We have a collection of symptoms, that are easily explained away and not connected.

I mean who thinks, velvet soft skin is connected to a thundering heartbeat because you stood up? So they came up with a series of movements to test for it.

The old way to classify Ehlers Danlos Syndrome was to use the Beighton Scale. The Beighton score is a set of manoeuvres used to judge if there is evidence of joint hypermobility. There are 9 points, and a score of 4 or more is considered a sign of there likely being generalised joint hypermobility present.

Now at the time of diagnosis in my early 30s I scored 8 of 9. Now there’s a more comprehensive way of scoring, found here Now I’m older and a lot more stiffer, so flexible I am not anymore. Therefore I would fail this tests above, but that doesn’t mean I don’t have it.

But these new ways of scoring takes that into account. So if you could touch the floor with flat hands without bending legs, bit no longer can you still score a point.

This helps the reclassification of certain symptoms, so I was diagnosed with EDS type 3 which is the Hypermobility type. Now it’s known as hEds Hypermobility Ehlers Danlos.

How does it affect you?

How does it affect me? Good question that I’m not entirely sure of myself. I know I feel pain all the time, from holding my own skeleton together and in the correct position. It’s so easy for my shoulders and hands to go beyond their natural range. Now I personally find this extra lax during my menstrual cycle, it’s like every joint I have comes out of joint, super super easy. It’s due to hormones creating the environment for this to happen around the cycle.

But as I said earlier it affects how I heal, so bones take longer to knit together, but likewise I’ll produce more scar tissue inside healing sites. Scars are often keloid or stretched and wrinkly. I bruise from being barely touched at times.

My three biggest ways I’m personally affected is the early onset of Osteoarthritis, my hip was grade 4, my mobility is awful, but I use to do gymnastics and horse ride. Now I can barely walk unaided. My hands are stiff and painful as they too have Osteoarthritis too.

My teeth are weak and crumbling, and dental visits are scary. For many years I have cried and complained that the anaesthetic doesn’t work, but no one listened to me, and then a few years ago they found it was an EDS symptom!! I have dentist now that knows about this and adjusts accordingly.

Finally how does it affect me, in a major way it screws up painrelief, I’m in pain but the meds don’t work. So fentanyl strongest drug out there? Nah doesn’t work, worst way to find out was when I had my first big op, it was a triple pelvic osteotomies and valgus femur lengthening. I was given Epidural (this does NOT work either) and Fentanyl, worst week of my life. But some gps out there, think you are attention seeking or drug dependant. You need these meds to function, to complete normal daily living, not to get high!

Since my first surgery, we’ve adjusted it to spinal, and morphine pump that I control. Now surgeries haven’t been as bad since thankfully, as I’ve had another 9. I find natural morphine better for me than synthetic versions of it that don’t work.

Now I’ve prattled on long enough, I best let you go. Hopefully by now you’ve learnt a bit more about Ehlers Danlos Syndrome. I’m still learning myself.

Day 92 post #hipreplacement

Archive, Arthritis, Health, Hips, Hypermobility, Hip replacement, SURGERY

It’s been a week since I saw the GP about my hands, and I’ll be honest the increased ibuprofen and ibuprofen gel hasn’t really made that much of a difference painwise. But maybe a week is too early to tell? So I will give it longer.

Wearing the splints help get things done but are cumbersome and irritating. But wearing the gloves at night are good, so that’s a win!!

Splints with weights are Interesting let’s say that. It’s hard while my hands are like this to actually hold weights, so in place of weights sometimes I use resistance bands instead.

Its not the weight itself I find difficult, more the grasp, it could be a pen at times and I simply can’t hold it. Frustrating to say the least.

So working the hip it is today, give the hands and shoulders a break. Though I’ve decided I’m staying away from any exercises that mean I have to lie on my operated side. It’s too dreadful for words.

  • Hip Flexion ankle weight 15 reps x 2
  • Hip abduction ankle weight 15 reps x 2
  • Hip extension ankle weight 15 reps x 2
  • Calf raises ankle weight 15 reps x 2
  • Heel to butt ankle weight 15 reps x 2
  • Mini squat 15 reps x 2

Not too much today, as joints are extremely lax this week. It’s the old Ehlers Danlos coming out to party, and by party I mean utter misery ball of pain.

13 weeks post #hipreplacement

Archive, Arthritis, Family Adventures, Health, Hips, Hypermobility, Hip replacement, SURGERY

Goals for this week is to keep up my red band resistance exercises, but maybe try and add some ankle weights in some exercises, such as step ups, hip abduction, extension and flexion. (as the band gets hard to use at times)

To roller my scar area, to try and awaken some nerves and break down scar tissue. The area is still NUMB as hell. I feel pressure if I press down, but the sensation of touch has gone altogether.

Had another #Geocaching adventure, I love this as it gives you a purpose to get outside and walk where you might not of thought to visit. It’s chilly, but wrapped up from the biting wind, we set off to find 1st of 3 caches, first one gives co-ordinates to the second and so on, so no treasure, just hunting the clues.

First cache above, have us numbers for the second cache below.

More numbers to add, to find the third

Oh no, cache 3 is missing (we have found it a few years ago) instead this tree had an egg in the trunk. So careful not to disturb, took photo to share with the cache owner.

Oh well had fun finding the clues, time to head back after walking in heather and weird spongey grass (adder fear was real at this point)

On the way back to the car, Mr Moon spotted on the GPS another cache close by, so we headed to this one, making it 4 in one day!!

Erm…. This wasn’t hidden, it seems someone forgot the memo. Not to worry logged we found it, and carefully hidden once again.

As much as I love all this walking, my hip still has its pain moments, and nags to go and rest. Walking is good for me, mentally especially. But physio works on the actual muscles I need waking up, so it can’t replace that for me.

I was pleased to get home and rest my aches with a hot water bottle, knee twinges and thigh pains are still real here. And I am still on a walking stick, just not strong enough to walk unaided outside.

Day 90 #hipreplacement

Archive, Arthritis, Health, Hips, Hypermobility, Hip replacement, SURGERY

It’s always up and down health wise, I guess it’s the #EhlersDanlosSyndrome not really helping. But I’m pleased to say it’s not actually my hip causing any grief at the moment.

And because it’s that time of the dreaded month, every joint comes out to play. Cleaning the cooker, my shoulder decides to pop out!!

So with this is mind, I’m thinking I need to keep on going with the occupational therapists shoulder stabilizer exercises.

  • Ball on wall circle left 20 reps x 3
  • Ball on wall circle right 20 reps x 3
  • Ball on wall up + down 20 reps x 3

  • Band shoulder abduction 10 reps x 3
  • Band shoulder internal rotation 10 reps x 3
  • Band shoulder external rotation 10 reps x 3
  • Band shoulder extension 10 reps x 3

All this exercise is always to help stabilise my joints, help my muscles and tendons do the work the joint should actually do.

Day 89 #hipreplacement

Archive, Arthritis, Health, Hips, Hypermobility, Hip replacement, SURGERY

Yas!! The sunshine has returned, it’s a little nippy out, but dry, which means it’s a good day to get outside for a walk.

With a mission to go Geocaching to make it a little more fun.

#

Geocaching is an outdoor recreational activity, I think of it like treasure hunting!!, in which participants use a Global Positioning System (GPS) receiver or mobile device and other navigational techniques to hide and seek containers, called “geocaches” or “caches”, at specific locations marked by coordinates all over the world.

These can be filled with little gifts, like a pencil sharpener, or pretty pebble, or just paper to write that you found it and what the date is. Really good ones have disposable cameras to take photos of you finding it.

I love Geocaching, the aim is to take you off the beaten track a bit, and show you an area that is pretty, or stunning views.

Came across a Deer bone first. Not sure it’s treasure we want, but still privileged to see it.

Aiming for the funny tree, let’s see if we can find one?

Path isn’t always easy though.

I see one!

No good gifts, but logging that we found it. Back to hiding it again. Making sure #muggles don’t see us.

Sarnie break, and much needed leg break too. Though I can feel such improvement in this hip. Hope other one stays behaved. Hand is particularly sore on my walking stick though.

Another cache to find, but harder this time and definitely prickly too. But we had success. Again no gifts as it was an old camera film container.

Hidden once more, it was time to meander home. The routes have took us on uneven grassy tuffs, and heather filled areas (bit scared of adders)

Only beast we found was a millipede.

Nice to see new growth coming through, and the dead old brambles disappearing now.

Following husband’s footsteps so I don’t stumble, though I did kick a rock which hip did not like at all.

Once home we were all shattered, I ached everywhere, especially glutes and quads.