I was awoken in Recovery - feeling groggy - a bit like a really bad hangover. I had no feeling from the waist down and had an oxygen mask on. Although I had no pain, I was uncomfortable and through slurred speech requested a pillow to go under my leg.
After an hour or so and drifting in and out of consciousness, I was returned to the ward and met by my parents. The operation had gone well, I was only under for two and half hours. I spent the rest of the evening trying to get my voice back and trying to get rid of the taste of the anaesthetic. Still fairly out of it, I had a surprisingly good nights sleep.
Thursday, 17 September 2009
8th June 2009...
Before I knew it, I was sitting in traffic on the M25 on my way to RNOH - the 8th June was finally here. I had finished work, rented my room out, drunk all I could drink and bought numerous pairs of new pyjamas!
The day started well, I had been allocated my own room - which Mum set about cleaning frantically and before I knew it, I had was changed into my gown and paper pants and being wheeled into theatre - sobbing.
I opted for an epidural, which was put in before I was put to sleep. Post-op pain control would consist of tramadol tablets - fairly strong opiate based painkillers, which I would start to take once the epidural was removed. As my cannula was put in, I was asked to count to ten, I think I made it to 3....
The day started well, I had been allocated my own room - which Mum set about cleaning frantically and before I knew it, I had was changed into my gown and paper pants and being wheeled into theatre - sobbing.
I opted for an epidural, which was put in before I was put to sleep. Post-op pain control would consist of tramadol tablets - fairly strong opiate based painkillers, which I would start to take once the epidural was removed. As my cannula was put in, I was asked to count to ten, I think I made it to 3....
Tuesday, 11 August 2009
2009
With the prospect of the year ahead, I decided to make the most of the first six months. I saw in the New Year in skiing - which was great fun and then had a further two skiing trips throughout the winter. The last trip was not quite so success as on day two, skiing some great off-piste powder I managed to slip and twist my knee causing me to be bloodwagoned off the mountain - this put an end to the skiing for this year. Slightly concerned about any ramifications this may have on my imminent surgery - after all it was my right knee - I undertook loads of physio. I am still not exactly sure of the extent of the damage, but have decided to get this over and done with first and then face any knee problems once my legs are sorted!
In advance of my next meeting with Mr Calder I had an appointment with the Clinical Nurse at RNOH. With my previous history and experience regarding the TSF I was going to need some help coming to terms with what I was faced with. I decided to attend the appointment on my own which surprised the nurse! Within minutes I was in tears, finding the whole situation very stressful. We talked about what went wrong the first time around and the fears I was facing this time. She found it very hard to believe the problems I had with the pain control and assured me that there was a dedicated Acute Pain Team on hand at RNOH who would be consulted before my surgery. We would able to discuss the best options available for me throughout the course of my treatment. I then took a look around the hospital - which stressed me out even further. Stanmore is a very bizarre place, it looks a bit like a Second World War field hospital than a centre of excellence - but, I told myself not to judge a book by its cover. There was a central corridor, with all the wards coming off it. The wards were large nightingale style wards, with 10-20 people per ward and they were really really hot. The majority of the patients were all old and frail - it was my worst nightmare. It made Harlow look like a private hospital. I was told the chances of getting my own room were limited, but it could be requested via the Bed Manager a week prior to my admittance. I left absolutely petrified and no less assured of what was ahead of me - the nurse asked if I had to wait until May to have the surgery as she thought it would be much better for me have it done sooner rather than later and get it over and done with - this was not an option.
My second meeting with Mr Calder did not highlight any surprises. The date was set for 8th June. I told Synergy who took the news very well - I would see through the GUINNESS PREMIERSHIP season and then finish - expecting to be off for the rest of the year. They were very understanding and supportive, which was a huge weight of my shoulders.
In advance of my next meeting with Mr Calder I had an appointment with the Clinical Nurse at RNOH. With my previous history and experience regarding the TSF I was going to need some help coming to terms with what I was faced with. I decided to attend the appointment on my own which surprised the nurse! Within minutes I was in tears, finding the whole situation very stressful. We talked about what went wrong the first time around and the fears I was facing this time. She found it very hard to believe the problems I had with the pain control and assured me that there was a dedicated Acute Pain Team on hand at RNOH who would be consulted before my surgery. We would able to discuss the best options available for me throughout the course of my treatment. I then took a look around the hospital - which stressed me out even further. Stanmore is a very bizarre place, it looks a bit like a Second World War field hospital than a centre of excellence - but, I told myself not to judge a book by its cover. There was a central corridor, with all the wards coming off it. The wards were large nightingale style wards, with 10-20 people per ward and they were really really hot. The majority of the patients were all old and frail - it was my worst nightmare. It made Harlow look like a private hospital. I was told the chances of getting my own room were limited, but it could be requested via the Bed Manager a week prior to my admittance. I left absolutely petrified and no less assured of what was ahead of me - the nurse asked if I had to wait until May to have the surgery as she thought it would be much better for me have it done sooner rather than later and get it over and done with - this was not an option.
My second meeting with Mr Calder did not highlight any surprises. The date was set for 8th June. I told Synergy who took the news very well - I would see through the GUINNESS PREMIERSHIP season and then finish - expecting to be off for the rest of the year. They were very understanding and supportive, which was a huge weight of my shoulders.
Monday, 10 August 2009
Shock news
Our first meeting with Mr Calder did not go to plan... We arrived at Stanmore with plenty of time to spare - checked in with the receptionist only to discover that we were due in the outpatients clinic in Bolsover Street, central London and a ten minute walk from work! We hopped back on the tube and dashed to Bolsover Street, arriving only 50 minutes late!
Following a series of more xrays, I was once again stripped to my pants and asked to walk across the room so everyone to have a look at my funny legs. Mr Calder and his registrar were openly surprised at the current angle of my leg.
As expected, the xrays displayed an angular deformity, which could be corrected with the use of yet another Taylor Spatial Frame - this was shock number one... It also became clear that it was not just my tibia which longer on my right side to my left. My right femur is around 2cms longer than my left one - this is a a result of the very early surgery, where my growth plate in my right tibia was destroyed by the femur was allowed to continue to grow. Therefore, using another TSF to correct the deformity of the tibia would once again cause bone growth on my right side, which would increase the discrepancy by a further 3cms or so - therefore ultimately leaving me 4+cms longer on my right than left. This was something which was very hard to get my head around, as I was already 2cm longer on the right side and this was causing me problems with my walking and lower back. Mr Calder advised that the best way to manage this was once the TSF was removed, break the right femur, remove the required amount of bone to ensure equal leg length, rod the bone with an internal nail fixation and compress the break. This was yet another invasive and painful procedure which would see me in hospital for another five days and non-weight bearing for a further 4-6 weeks. I was looking at a six to nine month stretch incapacitated...
I decided that I would not do anything until the end of the GUINNESS PREMIERSHIP season in May 2009 as I was really enjoying the account and looking forward to managing the Final at Twickenham. We agreed to meet Mr Calder again in February 2009 to finalise our plans for the year ahead.
Following a series of more xrays, I was once again stripped to my pants and asked to walk across the room so everyone to have a look at my funny legs. Mr Calder and his registrar were openly surprised at the current angle of my leg.
As expected, the xrays displayed an angular deformity, which could be corrected with the use of yet another Taylor Spatial Frame - this was shock number one... It also became clear that it was not just my tibia which longer on my right side to my left. My right femur is around 2cms longer than my left one - this is a a result of the very early surgery, where my growth plate in my right tibia was destroyed by the femur was allowed to continue to grow. Therefore, using another TSF to correct the deformity of the tibia would once again cause bone growth on my right side, which would increase the discrepancy by a further 3cms or so - therefore ultimately leaving me 4+cms longer on my right than left. This was something which was very hard to get my head around, as I was already 2cm longer on the right side and this was causing me problems with my walking and lower back. Mr Calder advised that the best way to manage this was once the TSF was removed, break the right femur, remove the required amount of bone to ensure equal leg length, rod the bone with an internal nail fixation and compress the break. This was yet another invasive and painful procedure which would see me in hospital for another five days and non-weight bearing for a further 4-6 weeks. I was looking at a six to nine month stretch incapacitated...
I decided that I would not do anything until the end of the GUINNESS PREMIERSHIP season in May 2009 as I was really enjoying the account and looking forward to managing the Final at Twickenham. We agreed to meet Mr Calder again in February 2009 to finalise our plans for the year ahead.
Monday, 20 July 2009
Next steps
As the prospect of future surgery hung-over me, I began to realise that I would not be able really get on with my life until I had it all sorted. Realistically I was unable to change jobs, as no new employer would take me on with this on the cards. As Synergy had supported me once, the chance were high that they would support me again - for which I was very lucky.
Once again, I found myself getting back in touch with Mr Hill. At my last appointment, he had said that he would happily see me in the future to further discuss my options - be it for him to undertake any more surgery or to point me in the direction of someone else. It transpired that he no longer ran his clinic at Harlow, but now focused on his Private clinic at The Portland Hospital and his paediatric clinic at Great Ormand Street. He agreed to see me at The Portland. He told us nothing new - on reflection I am not sure what I was expecting to hear, although I had decided that I did not want him undertaking any further treatment and I simply did not trust him. He reiterated the options he thought best and suggested that we get in touch with a colleague of his at the Royal National Orthopaedic Hospital (RNOH) in Stanmore. RNOH is a centre of excellence for all things bones and therefore if they could not get it right there... we were stuffed.
Mr Peter Calder was the man for the job and within four weeks of the referral, we found ourselves in yet another outpatients department.
Once again, I found myself getting back in touch with Mr Hill. At my last appointment, he had said that he would happily see me in the future to further discuss my options - be it for him to undertake any more surgery or to point me in the direction of someone else. It transpired that he no longer ran his clinic at Harlow, but now focused on his Private clinic at The Portland Hospital and his paediatric clinic at Great Ormand Street. He agreed to see me at The Portland. He told us nothing new - on reflection I am not sure what I was expecting to hear, although I had decided that I did not want him undertaking any further treatment and I simply did not trust him. He reiterated the options he thought best and suggested that we get in touch with a colleague of his at the Royal National Orthopaedic Hospital (RNOH) in Stanmore. RNOH is a centre of excellence for all things bones and therefore if they could not get it right there... we were stuffed.
Mr Peter Calder was the man for the job and within four weeks of the referral, we found ourselves in yet another outpatients department.
Tuesday, 14 July 2009
The years between
Following the outcome of my surgery, I decided to get my life and career back to normal. December 2006 I hit the ski slopes which was fantastic!! Only four months after having the frame removed and I was skiing!! I got myself back to the gym and threw myself back into work. I loved being back in London.However, the results of my 'bodged' surgery were never far from my thoughts. My 'new' leg looked terrible. Totally out of shape - which made me very self-conscious. Finding suitable trousers became even harder than it had been initially. I had a constant limp due to having one leg longer than the other, which people always commented on and I could not get a full bend through my leg. The limp soon lead to backache and I was unable to stand for long periods of time, making going to the pub, cocktail parties or standing in queues very uncomfortable. I was given an instep for the left shoe, to lift my left leg slightly, however this was not enough and I could not have anything larger as I would not be able to hold it in my shoe. However, I continued with life as normal and started to train for a 10k run, went to the gym regularly and was back on skis!
My father was particularly disgruntled with the result and wanted to explore the legal possibilities and compensation which we may be entitled too. Our reasoning behind this was not purely mercenary, but if I was to have to have future surgery, then more time would be required off work and I would suffer loss of earnings. We also wanted to look into the private facilities available, however could not consider this as an option without some kind of financial assistance. We instructed a lawyer and started the legal ball rolling. Once we had received copies of all my medical records, we enlisted a medical expert to pull together a full report on my case. He would write a paper on my history and the operation and post-operative care and draw a conclusion on my care and if any negligence can be pin-pointed.
Several hundred pounds later (legal fees are expensive), we saw the report. I was not really sure what to expect, however it was far from conclusive. We felt that many of the questions and issues we raised had not been answered. The conclusion drawn was that my 'varus deformity had been corrected, which it had, but in the process I had been left with a valgus deformity' (the new shape of my leg). It stated that if this 'new deformity had been identified whilst the frame was in place, then it would have been a relatively straightforward to correct by re-programming the frame... However, a valgus deformity occurred and this should have been avoided if a careful eye had been kept on the patient in outpatients.' This is what we were hoping to hear, there had been some element of post-operative negligence throughout my treatment. However, the paper went on to say that 'despite this, the end result has been much better for the patient than the preoperative state'. So, medically I was better off than before the operation, in terms of a reduced risk of osteoarthritis, but I had been left with a limp, a leg length discrepancy of more that 2cms and I was starting to get associated pain in my lower back, my quality of life had been significantly reduced, not to forget that I would need more significant surgery in the future. How was this considered 'better off than previously'?
We decided to take the case to a medical negligence specialist to ask their advice, it agreed that a degree of post operative negligence had taken place - my leg was 8 degrees out of line with my hip and ankle, but this would be a very hard case to prove in a court of law. As the frame was self-adjusting it would be easy for the defence to flip the case around and blame my parents for the over correction. It was also advised that it would cost thousands of pounds to get this to court, it would be hard to create a solid case and if we were lucky then the settlement received would be minimum, especially in relation to the amount to get it through the courts.
We thought long and hard about the course of action we would take and we decided not to pursue with any legal action. The cost, stress and high chance of a negative outcome strongly outweighed any of the positive points. This was slightly frustrating as it was a dead cert that I would have to go through it all again in the future and therefore my career and life would once again be interrupted.
The results
Well, as anticipated the odd shape of the leg turned out to be slightly more problematic than any of the doctors were letting on. At my post-op consultation with Mr Hill it became apparent that my leg had been 'over-straightened' and therefore stuck out at the bottom and a rather peculiar angle. This, coupled with the new leg length discrepancy which I now had - my right leg now 2cms longer than the left, meant that I was considerably worse off than when we started. This was horrendous news to hear - the last three months had been a complete waste of time.
Mr Hill was relatively apologetic and admitted that this was not the ideal outcome. He did not exactly confirm that a mistake had been made, but did advise that further corrective surgery would be required to prevent degenerative arthritis in my right knee.
We traced back the appointments and the consultations we had had over the last few months. Everything pointed to the appointment we had with the registrar, when Mr Hill was not present and the re-running of the programme. If over-correction had been picked up at this stage we would have had the chance to correct it.
I left the hospital totally deflated, with the knowledge that I would have to go through everything again in the years to come.
Mr Hill was relatively apologetic and admitted that this was not the ideal outcome. He did not exactly confirm that a mistake had been made, but did advise that further corrective surgery would be required to prevent degenerative arthritis in my right knee.
We traced back the appointments and the consultations we had had over the last few months. Everything pointed to the appointment we had with the registrar, when Mr Hill was not present and the re-running of the programme. If over-correction had been picked up at this stage we would have had the chance to correct it.
I left the hospital totally deflated, with the knowledge that I would have to go through everything again in the years to come.
Life with the Frame...
Once the pain reduced, my mobility increased quickly and it was not long before I was managing with one crutch and then just a walking stick and within weeks, I was able to walk normally, well as normal as was possible with a TSF attached! I stopped taking all painkillers, the only thing which continued to be an issue was the swelling in my right leg and ankle and I was advised that this would not stop until the frame was removed.I was able to get out and about much more regularly. I was blessed with a beautiful summer and spent my days down at the beach or in the garden. My friends were amazing (and kind of took over from my parents). They were always picking me up and taking me to one BBQ or another. I even made it to the races and enjoyed a couple of glasses of champagne!!
The end of July quickly came around and we once again hit the M25 for a check up at the hospital. I was met with good news, my bone had fixed (faster than anticipated) and was now consolidating. I would be able to have the frame off in August!! Still concerned about the 'shape', we again mentioned this to Mr Hill and were once again told that it would be fine and he would assess it fully once the frame was removed and I could be x-rayed.
Removal day was set - Monday 14th August. It was a relatively simple procedure, undertaken in a day. I was only under for 30 minutes and when I woke up was delighted to see a 'normal' leg, with no metal work!! It was heavily bandaged, but I could just about get a pair of baggy pyjamas over it! I went back onto crutches for a week or so and then the bandage was removed, I had been left with 10 tiny holes in my leg. These healed quickly and before I knew it, I was back in jeans and back behind the wheel of my car!! I started back at work at the beginning of September with one day a week and by the end of the month I was back full-time as though nothing had ever happened. Although, unfortunately this was not the case and my TSF wearing days were not quite yet behind me.
Thursday, 18 June 2009
3 years ago...
In Spring 2006 I underwent serious surgery to have a Taylor Spatial Frame attached to my right tibia, to correct the mal-alignment. Mr Hill and his team undertook the operation at The Princess Alexandra on 8th May.
My mother and father took me up to Harlow on the Sunday before and I was petrified. I had no real idea what to expect and in retrospect the hospital did very little to prepare us for what we were about to go through. The days of the internet were relatively early (in terms of mass access) therefore we did very little research. After a fairly sleepless night, Monday morning whizzed past in a blur of appointments with consultants, anaesthetists and before I knew I was on the gurney sobbing, being wheeled in to theatre.
Four and a half hours later I woke up, very groggy and in pain, even though I had a epidural which numbed everything from my waist down. The following 24hrs are very blurry. I drifted in and out of consciousness and when I was awake I just howled with pain - nothing seemed to dull the agony in my right leg.
The Wednesday was slightly better. My catheter and epidural were removed and the physio got me out of bed, which was a totally terrifying thought as I was being encouraged to put my weight through something which was effectively holding my leg together. It took me a couple of days to be able to look at the frame, I terrified as to what it would look like. When I did pluck up the courage, it was not as bad as I was expecting and I was taught how to change all the dressings and clean the pin-sites. I had a stream of visitors over the weekend and on the Monday I was discharged, after making the first alteration to the frame, following the programme which has been created for me.
The weeks that followed at home were terrible. The pain was out of control, I spent three weeks lying on the sofa unable to move. I was up to eye balls in painkillers all of which has their own side effects - everything for mood-swings and hyper-sensitivity to constipation, skin rashes and nausea. Pin turning was the low point of everyday. I was given oramorph 40 minutes ahead of the pin turning, although this seemed to have very little effect. The turning process was excruciating, my mother or father would turn the pins for me as I simply could not see straight. The dark circles under my eyes got darker as I got moodier and the hospital did very little to support me. The local NHS facilities were slightly more helpful, the physio and district nurses visited me at home. Mobilisation was limited due to the pain and I could just about make it to the toilet and back, therefore muscle deterioration in my right thigh was quick. At one point I was unable to even lift my own leg without assistance. My days were spent lying on the sofa, unable to do anything. I could not watch TV as I was completely intolerant to the sound and I could not read as I had no attention span - all due to the drugs which I was taking. I was unable to sleep at night as I was very anxious and could not get comfortable, I was continually thirsty (yet another side affect of opiate based drugs), which in turned caused me to constantly need the loo. It was a vicious circle which I could not seem to break. I lost a lot of weight, the black circles under my eyes darkened as I became more reliant on the drugs.
Two weeks after being discharged we made our way back up to Harlow for the first check-up. Following a number of x-rays Mr Hill confirmed that everything was moving in the right direction. He decided that the pin-turning programme needed to be tweaked finally and as this was being undertaken the Internet connection in the hospital crashed. It was decided that the new programme would be faxed to me at home (how did we cope without email).... That evening the new programme was received and it became apparent that I needed a strut replacement. We were given the opportunity to head back up to Harlow or go to Mr Hill's private clinic in Great Portland Street, we opted for the latter and the next day, I was loaded back into the car and we made the journey to central London. As with all day trips, this was another traumatic experience, the pain rocketed and every lump and bump in the road was felt. The strut was changed, a new programme provided and we were sent home - by this time I was an exhausted wreck.
Pin-turning continued over the next week. The pain did not diminish and the painkillers continued to cause me no end of problems. I managed to get up to the physio for a couple of sessions, but movement was still limited due to the pain. Towards the end of the second phase of adjusting, my parents started to notice a change in the leg. My tibia started to swing out to the right (from my perspective, looking down at my leg) - we mentioned it to the physio who agreed that something did not look quite right, at my next hospital appointment we mentioned this to the Registrar, as Mr Hill was away speaking at a seminar. The registrar dismissed our concerns and put the mal-alignment down to the swelling associated with having the frame in place which re-assured us for the time being.
Eventually the pin turning stopped and I was allowed to heal. Within days, the pain reduced. I was able to stop taking the morphine and then suffered with the withdrawal symptoms (I was likened to a recovering drug addict). Once the pain reduced, I was able to start mobilising a lot more and slowly my life re-started and I even enjoyed my first alcoholic drink in several weeks.
Six weeks post-op I made the journey to my uncle's villa in the South of France - this was a brave decision, but the change of scene and warm weather was very welcome - at last it seemed that I was on the road to recovery.
My mother and father took me up to Harlow on the Sunday before and I was petrified. I had no real idea what to expect and in retrospect the hospital did very little to prepare us for what we were about to go through. The days of the internet were relatively early (in terms of mass access) therefore we did very little research. After a fairly sleepless night, Monday morning whizzed past in a blur of appointments with consultants, anaesthetists and before I knew I was on the gurney sobbing, being wheeled in to theatre.
Four and a half hours later I woke up, very groggy and in pain, even though I had a epidural which numbed everything from my waist down. The following 24hrs are very blurry. I drifted in and out of consciousness and when I was awake I just howled with pain - nothing seemed to dull the agony in my right leg.
The Wednesday was slightly better. My catheter and epidural were removed and the physio got me out of bed, which was a totally terrifying thought as I was being encouraged to put my weight through something which was effectively holding my leg together. It took me a couple of days to be able to look at the frame, I terrified as to what it would look like. When I did pluck up the courage, it was not as bad as I was expecting and I was taught how to change all the dressings and clean the pin-sites. I had a stream of visitors over the weekend and on the Monday I was discharged, after making the first alteration to the frame, following the programme which has been created for me.
The weeks that followed at home were terrible. The pain was out of control, I spent three weeks lying on the sofa unable to move. I was up to eye balls in painkillers all of which has their own side effects - everything for mood-swings and hyper-sensitivity to constipation, skin rashes and nausea. Pin turning was the low point of everyday. I was given oramorph 40 minutes ahead of the pin turning, although this seemed to have very little effect. The turning process was excruciating, my mother or father would turn the pins for me as I simply could not see straight. The dark circles under my eyes got darker as I got moodier and the hospital did very little to support me. The local NHS facilities were slightly more helpful, the physio and district nurses visited me at home. Mobilisation was limited due to the pain and I could just about make it to the toilet and back, therefore muscle deterioration in my right thigh was quick. At one point I was unable to even lift my own leg without assistance. My days were spent lying on the sofa, unable to do anything. I could not watch TV as I was completely intolerant to the sound and I could not read as I had no attention span - all due to the drugs which I was taking. I was unable to sleep at night as I was very anxious and could not get comfortable, I was continually thirsty (yet another side affect of opiate based drugs), which in turned caused me to constantly need the loo. It was a vicious circle which I could not seem to break. I lost a lot of weight, the black circles under my eyes darkened as I became more reliant on the drugs.
Two weeks after being discharged we made our way back up to Harlow for the first check-up. Following a number of x-rays Mr Hill confirmed that everything was moving in the right direction. He decided that the pin-turning programme needed to be tweaked finally and as this was being undertaken the Internet connection in the hospital crashed. It was decided that the new programme would be faxed to me at home (how did we cope without email).... That evening the new programme was received and it became apparent that I needed a strut replacement. We were given the opportunity to head back up to Harlow or go to Mr Hill's private clinic in Great Portland Street, we opted for the latter and the next day, I was loaded back into the car and we made the journey to central London. As with all day trips, this was another traumatic experience, the pain rocketed and every lump and bump in the road was felt. The strut was changed, a new programme provided and we were sent home - by this time I was an exhausted wreck.
Pin-turning continued over the next week. The pain did not diminish and the painkillers continued to cause me no end of problems. I managed to get up to the physio for a couple of sessions, but movement was still limited due to the pain. Towards the end of the second phase of adjusting, my parents started to notice a change in the leg. My tibia started to swing out to the right (from my perspective, looking down at my leg) - we mentioned it to the physio who agreed that something did not look quite right, at my next hospital appointment we mentioned this to the Registrar, as Mr Hill was away speaking at a seminar. The registrar dismissed our concerns and put the mal-alignment down to the swelling associated with having the frame in place which re-assured us for the time being.
Eventually the pin turning stopped and I was allowed to heal. Within days, the pain reduced. I was able to stop taking the morphine and then suffered with the withdrawal symptoms (I was likened to a recovering drug addict). Once the pain reduced, I was able to start mobilising a lot more and slowly my life re-started and I even enjoyed my first alcoholic drink in several weeks.
Six weeks post-op I made the journey to my uncle's villa in the South of France - this was a brave decision, but the change of scene and warm weather was very welcome - at last it seemed that I was on the road to recovery.
Wednesday, 17 June 2009
Taking responsibility...
Three years a go I bit the bullet and decided that I could no longer ignore the situation and should get my leg fixed once and for all.
I got back in touch with my surgeon (Mr RA Hill) whose care I'd been under at Great Ormond Street (GOSH). As I was now over 18, I was no longer able to attend GOSH, therefore I started to see him at his adult NHS clinic at the Princess Alexandra Hospital (PAH) in Harlow.
This was a huge step for me as I had successfully buried my head in the sand and tried to forget about the situation for a number of years. However, the time seemed right. I had been in my job as an event manager for a sports marketing agency for a couple of years and my employers were very supportive, I was also in the right place mentally to take responsibility and had fantastic support from my friends and family.
Mr Hill presented two options:
a) A closing wedge osteotomy - straightening my leg acutely on the operating table utilising a number of plates and screws to hold it on place
b) Application of a TSF and the slow and actuate correction of the deformity
Initially option a) looked like the most preferable... more pain up front but all the gore would be done in theatre and I would be in a full leg plaster cast post-op. However, looking into it in more detail and taking Mr Hill's advice this turned out not be the case... much to my horror! He explained that although option a) may seem favorable, it would not be his preferred choice. He advised that there was very little room for error with a closing wedge osteotomy, if the angle was not got absolutely accurate then there was no going back. However, the TSF option was much more versatile. The programme could be re-run and altered to ensure that the angle was corrected.
Therefore, against everything I wanted, I went with Mr Hill's recommendation of the application of the TSF - after all he was the expert. This was a tough decision as I had a phobia of the frames. They made me feel sick to the stomach. I saw them at the clinics I attended at PAH and I had to look away. How could anyone cope with having one of those attached to their leg? Clearly I had to overcome this fear before I was to go under the knife.
I got back in touch with my surgeon (Mr RA Hill) whose care I'd been under at Great Ormond Street (GOSH). As I was now over 18, I was no longer able to attend GOSH, therefore I started to see him at his adult NHS clinic at the Princess Alexandra Hospital (PAH) in Harlow.
This was a huge step for me as I had successfully buried my head in the sand and tried to forget about the situation for a number of years. However, the time seemed right. I had been in my job as an event manager for a sports marketing agency for a couple of years and my employers were very supportive, I was also in the right place mentally to take responsibility and had fantastic support from my friends and family.
Mr Hill presented two options:
a) A closing wedge osteotomy - straightening my leg acutely on the operating table utilising a number of plates and screws to hold it on place
b) Application of a TSF and the slow and actuate correction of the deformity
Initially option a) looked like the most preferable... more pain up front but all the gore would be done in theatre and I would be in a full leg plaster cast post-op. However, looking into it in more detail and taking Mr Hill's advice this turned out not be the case... much to my horror! He explained that although option a) may seem favorable, it would not be his preferred choice. He advised that there was very little room for error with a closing wedge osteotomy, if the angle was not got absolutely accurate then there was no going back. However, the TSF option was much more versatile. The programme could be re-run and altered to ensure that the angle was corrected.
Therefore, against everything I wanted, I went with Mr Hill's recommendation of the application of the TSF - after all he was the expert. This was a tough decision as I had a phobia of the frames. They made me feel sick to the stomach. I saw them at the clinics I attended at PAH and I had to look away. How could anyone cope with having one of those attached to their leg? Clearly I had to overcome this fear before I was to go under the knife.
Tuesday, 16 June 2009
A bit of background information...
I was diagnosed with Congenital Hemihypertrophy (CH) at the age of about 6 months old by my father who noticed I had one bottom cheek larger than the other when he was changing my nappy! CH is relatively uncommon disorder which in short leaves me with one side of my body slightly larger than the other. The only place this is noticeable is on my legs and it became evident from early on that differing leg lengths were going to cause me problems.
I was referred to Great Ormond Street Hospital and in January 1993 (I was 11 years old) I underwent my first operation - an epiphysiodesis of the right fibula and tibia. The aim was to destroy the growth plate in my right leg so that my left leg could catch up - this was undertaken just before my pre-pubescent growth spurt. At this stage I already had a 4 cm difference between my right and left leg - right leg being longer.
This surgery proved to be successful as my left leg caught up with my right leaving a minimal difference between them. However, as I continued to grow it became evident that something was not quite right. In 1997 it was confirmed that the growth plate in my right leg had not been destroyed equally causing the outside of my leg to grow at a slightly faster rate than the inside of my leg, causing me to develop a varus deformity of the proximal tibia - in other words a slight bowing of the leg from the knee to the ankle. I was advised that although I may not present any symptoms for 20-30 years there was an increased chance that I would develop degenerative arthritis in my knee if I left this un-treated. I was left to think about my options of either leaving it and living with the consequences in the future or undergoing corrective surgery in the future to correct the alignment of my leg.
On a day to day basis my condition does not effect me. I am a very active individual who attends the gym regularly, I am a mad keen skier and on the go constantly with a very busy work and social life. The knowledge that I would need further surgery hung-over me, however I decided to complete my schooling and get a couple of years of my career under my belt before continuing with any further treatment. There was also the possibility that as time progressed science would also progress and new and more effective techniques would become available as possible options.
I was referred to Great Ormond Street Hospital and in January 1993 (I was 11 years old) I underwent my first operation - an epiphysiodesis of the right fibula and tibia. The aim was to destroy the growth plate in my right leg so that my left leg could catch up - this was undertaken just before my pre-pubescent growth spurt. At this stage I already had a 4 cm difference between my right and left leg - right leg being longer.
This surgery proved to be successful as my left leg caught up with my right leaving a minimal difference between them. However, as I continued to grow it became evident that something was not quite right. In 1997 it was confirmed that the growth plate in my right leg had not been destroyed equally causing the outside of my leg to grow at a slightly faster rate than the inside of my leg, causing me to develop a varus deformity of the proximal tibia - in other words a slight bowing of the leg from the knee to the ankle. I was advised that although I may not present any symptoms for 20-30 years there was an increased chance that I would develop degenerative arthritis in my knee if I left this un-treated. I was left to think about my options of either leaving it and living with the consequences in the future or undergoing corrective surgery in the future to correct the alignment of my leg.
On a day to day basis my condition does not effect me. I am a very active individual who attends the gym regularly, I am a mad keen skier and on the go constantly with a very busy work and social life. The knowledge that I would need further surgery hung-over me, however I decided to complete my schooling and get a couple of years of my career under my belt before continuing with any further treatment. There was also the possibility that as time progressed science would also progress and new and more effective techniques would become available as possible options.
Why Blog?
A sequence of rather unfortunate events and surgeries have left me once again recuperating in West Sussex with a rather nasty broken leg, accomapnied by a Taylor Spatial Frame (TSF). This is my second time with one of these contraptions and I successfully buried my head in the sand on the previous occasion, therefore I thought I would document my experiences this time. It may not be of interest to many people but it may help anyone who is facing this procedure, which is a terrifying prospect. It may also be interesting for those who are supporting someone going through this, as I could not and would not want to go through this on my own. My family and friends play an instrumental part in my recovery.
I have undertaken some research on the web and there seems to be very little informaiton in terms of personal experiences of using a TSF. I plan on using this blog more as a diary, sharing my experiences as they happen. I hope you find this informative and interesting.
I have undertaken some research on the web and there seems to be very little informaiton in terms of personal experiences of using a TSF. I plan on using this blog more as a diary, sharing my experiences as they happen. I hope you find this informative and interesting.
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