It’s now just over a week since surgery, and I need to prepare myself psychologically for my first meeting with The Big Bruiser. 
Tomorrow is the first day that I can avoid this no longer; tomorrow my bandage will be taken off, sutures removed and there it will be, in all its hideous glory, The Big Bruiser #2. This time last year was the first of these wounds that I’d seen, so I’m assuming and hoping it won’t be as much of a shock this time around. It was bigger than I expected, as well as lumpier, uglier and more bruised, but what really stuck in my mind was how like a lump of raw battered meat it looked. My daughter came along to photograph it – yes, we’re close like that, we enjoy sharing gory stuff – and even now those first photos of it fill me with a feeling of extreme nausea. But, then again, as I keep telling myself, it’ll be much easier this time round because not only have I done this before, it was also very recent. Which begs the question, why aren’t I handling the whole situation better?
Orthopaedic surgery inevitably means bruising, not the genteel constrained type as in the picture above, but mega-bruising which can cover significantly large areas of your body. Bruising occurs following some kind of injury and your blood capillaries leak into the surrounding soft tissue thus creating discolouration on the skin’s surface. I’ve spent the past few days trying to deal with both the physical and psychological impact of post-surgical bruising, and have to confess to struggling a bit. For the first couple of days after surgery, there was some swelling and a bit of nasty bruising around the wound but nothing unexpected, but this swiftly morphed into the bruising bonanza of the past few days. Rather stupidly, I didn’t recognise it as such at first, what I saw was massive swelling in my leg and a lot of new pain which took me spiralling into panic mode, phoning the NHS out-of-hours services, and then feeling very foolish and selfish for wasting their time on something which is part and parcel of the process. Bank Holiday weekends are never helpful – when you’re panicking, everything seems a whole lot more urgent than it really is, and the fact that I had to wait around 12 hours before I could see a medic meant I was almost at hysteria level by the time they arrived and provided some desperately-needed reassurance. Since then, I’ve calmed down a bit – the next day, bruises emerged in the swollen areas and this reassured me about what was happening and continues to happen.
At the time of writing, I’m having another night of not much sleep. It’s the early hours of the morning, I’ve been up for a few hours already and have an ice pack slapped on my leg in an attempt to tame the swelling a bit. I suspect it’s a lost cause, but I’m trying because although I’ve now aware that I’ve hit ‘bruising phase’, I’d really like to reduce the swelling somehow in order to reduce the pain and enable a better level of mobility – ie. one where I can actually bend my leg and use it properly, rather than having to drag it around with me like an inflatable child’s toy. Bruising and swelling is difficult stuff, especially post-surgery because there is very little you can do to contain it. At present, I need to take anti-coagulant medication for a further 5 weeks – they thin my blood in an attempt to reduce the risk of blood clots – but in doing so, I am not able to take NSAIDs (anti-inflammatory medication) alongside these. Attempts at reducing swelling and managing bruising are limited to the simple things in life – keep the limb elevated, and keep slapping on those ice packs. Hardly the stuff of rocket science, but I’m hoping that if I keep at it, it might reduce the pain a little.
The other thing which has interested (and shocked) me about all this is how little I remember about this last time. I would’ve expected that it would be indelibly engraved on my memory forever, but apparently not. My other hip was replaced around a year ago, and I’m surprised at how much I’ve forgotten about the healing process, and how easily I slide back into trauma mode. I think the lack of mobility is partly to blame for this, because at present I really don’t have much flexibility – all I have is an awareness of varying degrees of pain in various areas of my hip or leg, but I can’t bend or reach down or touch to see what is happening. The inability to collect visual information about pain or a physical restriction is frustrating and a bit scary – I can’t see it to make a rational decision, but it feels bad so I’ll panic in my blindness instead and assume that something terrible is going on. I can conclude, then, that what are described as ‘the delayed symptoms of massive physical trauma’ (swelling, bruising) are now coming out to play, and alongside that are the symptoms of the psychological trauma I always seem to experience in this scenario. I’m generally not a weepy or panicky kind of person, but this stuff reduces me to a total coward and a gibbering wreck, and I really wish there was more post-operative support alongside these procedures. I mean, yes, there is – if I’m worried, I can call the hospital or get an ambulance to take me to A&E, but that’s not what I’m talking about here and not something I feel is an appropriate thing to do, unless I’m dying. What I want and need is more psychological support alongside the healing process. No, I’m not ill, but yes, I’m in pain, have all sorts of strong drugs racing through my body 24 hours a day, and my body is going through huge and varying degrees of change and healing which I don’t understand, and my head is, quite simply, fucked up. Meanwhile, my scheduled (read as ‘necessary’) appointments are as follows:
- 10 days after surgery, appointment with Practice Nurse to check wound, remove bandages and sutures
- 2 weeks after surgery, option of attending face-to-face physiotherapy appointments on weekly basis
- 6 weeks after surgery, appointment with Consultant surgeon to check progress of wound and mobility
I’m sorry, but for me, that’s not enough; I suspect that I’m not alone in feeling that I need some level of support with the psychological impact of this procedure, and that many more people would benefit from a more personal, caring and holistic approach to post-operative care. I’ve said it before and it seems that I need to keep saying this until perhaps one day someone will either listen or hear me: I AM MORE THAN JUST MY BLOODY BONES!! You’ve fixed my bones, now I need help dealing with the trauma in my head…
By freedom, I mean being able to be independent, to drive wherever I want whenever I want, to do stuff alone without having to have someone with me to help me do the most basic and mundane of tasks, to have some semblance of control over what goes on and what is possible, and to not be housebound and needing someone else’s co-operation, permission or approval to venture out. For me, this is the stuff of nightmares. I hate being dependent on anyone, really hate it; it embarrasses me, humiliates me, frustrates and angers me. I’ve never been especially good at asking for help, which is probably why I find this so difficult, but there’s a big difference between the normal scenario of asking for help with tasks which no mere mortal could manage alone, and asking for help to get up or down from a chair, to support you as you attempt to go up or downstairs at snail’s pace, and to ask for help getting on shoes, socks and even knickers. The latter situation will be my joyless existence for the next few weeks, and I feel massively irritated at the prospect already.
knee joint, had spread into both hips and my lower spine. It was sufficiently severe to require an immediate total hip replacement in my left hip. I was extremely shaken by this unwelcome news, and was still struggling to understand how this had happened, and perhaps just as importantly, how this had happened without my being aware of it even by the time when the surgery went ahead. A year on, and I am still rattled by this and have continued to worry and wonder about what could possibly have created such a situation? After all, I’ve spent many years struggling with pain, waited a long time for a knee replacement which offered the prospect of normal levels of mobility and an end to the pain, and yet here I am, after several decades, feeling like I’ve not only made very little progress, but am actually further away than ever in achieving a relatively mobile and pain-free existence. I suppose I’m a ‘logical’ kind of person, one who requires cogent reasons and hard facts to make sense of things, and I have never been able to accept “ah well, that’s just how it is” as any sort of explanation for anything. I decided to write this blog for a couple of reasons. Firstly, to get all this stuff out of me and written down, so I could take a closer look at what had happened and try to figure out why – if I can find the source of the problem, maybe I can find a solution or at least manage the situation better. I really don’t want any more nasty surprises like last year, and by gathering all the information together does it actually make it easier for me to make sense of it all? Secondly, I’m very aware that I have a huge amount of anger about having developed OA, most of which is suppressed, but some escapes into the real world every now and then; I hoped that by blogging I would manage to remove some of this anger, but so far I have found that in writing everything down alongside doing online research, I have actually created a complex jigsaw of events and situations which, at times, actually makes my anger worse.
Bare Bones 