By Jo, Southampton, UK.
At the age of 19 I helped out on a sheep farm in my spare time. I was young and fit and loved being outside. We had 5 fields of sheep and I spent my time running between the fields and the barns checking on ewes and lambs. To save time I didn’t open the big metal gates between the fields, but easily swung myself over them. One day I swung myself over one of the gates, as normal, but something went and I was immediately in pain in my right hip.
The next day I couldn’t weight-bear on my right leg. I hobbled around for a few days, with it not getting any better, before going to the doctors. I was told to take ibuprofen and rest it. Over the next three months I went back to the doctors a few times and eventually he agreed to refer me for an X-ray. Six months after initially hurting my hip I finally got an X-ray appointment.
My x-ray was reviewed by Professor Clarke at Southampton General Hospital and his immediate reaction was “no wonder you can’t walk!”.
He told me that I had bilateral acetabular dysplasia (with my right hip being more severe than my left). He prescribed me pain killers and told me I was young so I should continue with my life.
I’d never had any problems with my hips before this and they had never been of concern when I was a child. I was a first born girl (suggested higher chance of DDH) but I wasn’t a breech baby and routine screening was not done when I was a baby. As a teenager I became aware that I had a slightly strange gait and my hips were very mobile, box-splits were easy, but they had never caused me problems before.
Eventually my hip did ease and I returned to “normal”. I had annual check-ups at the hospital but my symptoms weren’t severe enough to justify doing anything.
Over the following ten years my hip slowly deteriorated but because I could push through the pain, I never considered that it was severe enough to take action.
In 2009, at 29, I fell pregnant with my first child. Amazingly my hip symptoms eased during my pregnancy and this continued until I stopped breastfeeding my son when he was 13 months old in January 2011 (I had a natural delivery with forceps with no problems from my hips). Almost immediately the symptoms returned. Professor Clarke said that the hormone “Relaxin” which is produced during pregnancy and breastfeeding could affect symptoms, either making them worse, or improving them!
A month or so later I had a steroid injection into my hip. This took effect immediately and really helped for about 4 months.
When this stopped working Professor Clarke suggested that I have a think about surgery and suggested a Periacetabular Osteotomy (PAO) where the bones of the pelvis are cut and repositioned to increase the acetabulum coverage of the femoral head. He told me to go away and think about it.
The decision was taken out of my hands though; because I found out I was expecting my second child. Again I felt great relief in my hips during the pregnancy and my daughter was born in April 2012. She stopped feeding around Christmas time and again the pain returned, only worse.
I started struggling to keep up with my toddler and baby. It was hard to sit on the floor and get up again and running around in the park was a complete no-go. The more I did the more it felt like someone was tightening a clamp around my pelvis, restricting my hip movement (I now know this was due to internal inflammation).
In Early 2013 I returned to see Professor Clarke. He didn’t seem keen to do surgery because my children were so young. My daughter was close to walking, but not quite there. How could I be out of action for at least a month when they were still so dependent on me? He told me to come back when they were older. I was devastated. I felt like I was letting my kids down. I couldn’t do normal things with them and I felt like I was holding them back. It wasn’t fair on them. I wanted to get my hip “fixed” whilst they were still young enough to not remember mummy being broken. I wanted to be fixed by the time they were at school and needed mummy to join in at sports days etc.
I was thrown a bit of a lifeline when it was highlighted to me that I would be covered under my employer’s private medical scheme.
In the mean time I had joined a group on Facebook for young people with hip problems who needed joint replacement surgery. I got some fantastic support from other members of the group and was recommended a surgeon not too far from me.
In August 2013 I made an appointment with Mr Hussell at the Spire in Portsmouth. I took my husband for moral support and seriously thought I would be turned away again. I was 33. Everyone I spoke to was of the opinion that I was too young for hip surgery.
Mr Hussell was amazing though and never once questioned my motivation for getting my hip “sorted”. He ordered X-rays and a CT scan. The X-rays showed some movement of the joint since the last ones I’d had done (before having my children). The results of the CT scan would determine what our next action would be… could I have the PAO?
…to be continued…
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