Saturday, 3 October 2015

The Operation

For as long as I’ve been blogging, I’ve been mentioning the ongoing issue I’ve had with groin pain and general discomfort, which I first noticed back in June 2013. It took a long time before I ended up under the care of Mr Khanduja, a consultant in Cambridge who specialises in knee and hip surgery, but I was confident as soon as I was referred to him that we were finally getting somewhere – he certainly appears to be highly regarded in his particular field.

Even with his expert care, it still took 10 months from my first appointment with him before I finally had the first of two operations that should – fingers crossed – finally sort out the problem. But in that 10 months, I had X-rays, an Ultrasound, an MRI scan, Hip Manipulation – and all this led to the conclusion that the pain has been caused by a problem in the hip area, and that there was a need for a hip arthroscopy on each side to confirm and then rectify the issue.

What happened in Surgery?

For a start, we needed the camera to confirm the exact nature of the problem, and so it was good news to discover there was a clear cause. I’m unsure if “bone spur” is the correct term (I’m going to go with it because it sounds like I know what I’m talking about,) but essentially there was too much bone at the top of my femur, where it fits into the hip joint – this would have formed many years ago whilst I was still growing, and is most likely the result of a sporty childhood: I used to do a lot of gymnastics when I was a kid, and chatting afterwards, the nurse felt this may well have been the cause. Anyway, whether or not this was the reason is irrelevant – the point is, this excess of bone then became a problem in later life when I took up running, and eventually resulted in a labral tear, as a result of the friction.

The labram is an area of cartilage that lines the hip socket and a tear here can lead to groin pain, so it fits perfectly with what I’ve been experiencing. The physio who first referred me to Mr Khanduja had thought the problem may be a sportman’s henia, and a google search for “labral tear” does state the symptoms of the two conditions to be very similar. The physio did say to me at the time that even if it wasn’t that, then the referral to this particular consultant would definitely result in the problem being resolved. I’m now very confident he was correct – and it transpires that keyhole surgery on this condition has only been possible in recent years, with very few surgeons capable of carrying out the operation, so I’ve been very fortunate in some regards. The operation took just over 2 hours, and involved two “fixes” – firstly to repair the tear, which involved putting in an anchor in, and secondly to shave off the offending bit of bone, to stop it happening again. There is an assumption that exactly the same situation exists in the other hip, hence the need for a second operation later on to correct this one too.

Mr Khanduja did mention to me that the hip joint wasn’t in great shape in general, but he seemed confident that what he’d done would fix the problem – of course, the difficulty is that we won’t really know even once everything’s healed up, because the other hip will then need doing, and we need to allow at least 16 weeks for the full recovery of the right hip before we can do the left. And because the discomfort is central (deferred from both hips) there’s unlikely to be any obvious improvement until both hips have had the procedure completed. However, given that a significant problem was found – and fixed – then I have to assume that it will do the trick.

The rehabilitation

Well that could have gone a bit better
I’m writing this almost 6 weeks after my right hip has been operated on, and it all seems to have gone very well. After the first couple of days, when I was in an amount of pain and needed the codeine tablets I was sent home with, I was pleasantly surprised at how quickly I recovered – I was done using crutches within 2 weeks, and experienced very little discomfort in general. I mentioned in my last post that I was moving in to a new property two days before the operation, and the priority was to get everything heavy moved into the correct position beforehand – but in fact I found I was mobile enough the day after to continue to get the house sorted, and the two weeks rest I had before starting my new job was plenty – I was absolutely fine to drive and work with no problems at all, although attempting to mow the lawn was probably slightly too ambitious...

I was given a set of exercises that I needed to follow, 3 times a day, to ensure I regained full movement in the hip joint as soon as possible. The first week’s routine involved isometric exercises and some gentle stretches, to work the thigh muscles and the glutes in particular. To work the hip abductors I had to use a belt around my thighs and push against this, working the muscles but restricting movement since any external rotation of the hip needed to be avoided for at least 6 weeks. Week two added in some internal rotation movements, and was followed by the first outpatient physiotherapy appointment.

My physio, Emily, is a runner herself, which is exactly what you want when you’re on the road to recovery – someone who understands how keen you are to get back out there. She showed me some additional exercises, and two weeks later I was back again to have even more added to my programme, which now takes longer than most of the training runs I used to do! Each type of stretch and movement has become gradually easier over time, suggesting the rehabilitation is going well. As an added and unexpected bonus, I think I understand how to stretch effectively far better than I did before – having a trained physio showing you certainly helps – and I intend to dedicate more time every day to this important aspect of overall fitness and wellbeing, even once I’m fully recovered.

When can I run again?

Best news of all is that I am allowed to commence running again next week. This is much earlier than I originally thought, although I’m not entirely sure what I’ll be able to achieve when I do get back out there, since it will only be a matter of time before I need to stop again for the second operation. I imagine it’s going to take a while to build up from 6 weeks off – I had intended to use the gym regularly in the meantime, but my new job has taken up nearly all of my time, and I’ve only been a few times. Today for the first time I tried out the cross-trainer, and was surprised at just how unfit I appear to have become in such a short time. The extra stone and a bit I’ve put on isn’t helping either! I can’t believe I’ll get back to proper race pace before it’s time for the next operation, but it seems to me a good idea to go into the second op having rebuilt as much fitness as possible, so that once I’ve had the other hip sorted, I can get back quicker – a much better idea than simply abandoning all exercise until both are done, which would mean having to start running again after at least 23 weeks out - a much harder task!

I wasn't sure how much to push the music degree - I think
I got the balance just about right
I’m also hugely relieved that the initial recovery was so quick, since it means I can pretty much accept any date for the second operation – there doesn’t appear to be any need to take two weeks off afterwards, let alone the four to six week period they officially recommend. Knowing I was able to move about quite comfortably within only 2 or 3 days of the procedure means that, whilst I shall still book some days off to be on the safe side, I’m confident I’ll be able to hobble along to any tutorials or meetings, and therefore not miss out on anything important. I’m very fortunate that the graduate programme is open to anyone with a degree, regardless of age (and indeed, regardless of what subject that degree was in, since mine is in music, which is not an obvious fit!) – I’m one of the oldest of the new recruits, but I still have plenty of years left to build a good career there, with successful completion of the course guaranteeing a managerial position just for starters.

The course is hard work though, and it’s taken all my time and effort over the last few weeks to keep on top of it. This has no doubt helped divert my attention from the fact that I can’t run – on particularly tough days I do desperately miss not being able to pull on the trainers and run off some anxieties and worries, but in the main I’m not sure I’d have had the time most days for any kind of decent mileage. 

This situation will no doubt ease as I get more used to the new position, and hopefully by the time of my next blog, I’ll have had the go-ahead to get back out running again – if so, I know I’ll find the time to do so.

1 comment:

  1. I'm so so glad that there is finally a resolution to your problem!!