It’s not always the hip replacement…

A refreshingly calm and well organised annual hip appointment took place this week. My surgeon kindly allowed me to describe my various symptoms but assured me that the x-rays show no change and, more importantly, the hips look stable.

What had preceded this was the usual months of anticipation because of changes and worsening of symptoms and general trepidation of what this might mean. I am always aware of the age of my hips, rightie is 20.5 yrs old and leftie the 3rd (a revision hip replacement) is 5. In my mind, I’m very conscious that these hips will be loosening and wearing out. I realise now that I’ve been viewing these as ticking bombs almost.

The consultant believes my symptoms are due to problems with muscles and tendons. This is hardly surprising given how much my hips have been through, combined with changes in hormones of a woman in her 40s. It all plays a part.

This is good news in that my replacements are solid but physio awaits. Never good in my book! Hopefully I can get things back on track without invasive interventions in the future.

The difference since this appointment is huge. I have continued to have the pains in my thigh and side of hip, I’m stiff on moving and tiring easily. However, knowing the hips are not loose has changed how I feel about it. I’m not panicking. I’m not catastrophising, as a psychologist would describe my previous responses.

I’ve always maintained that understanding what is happening, having explanations, helps me to manage the symptoms better. I feel this is proving it.

At the same time, I am reminded of a physio I saw aged 23, after the first replacements were done. She told me I hadn’t fully accepted into myself my hips. I have always been able to understand her reason for saying it but I think the phrasing was so off putting I dismissed the meaning more than I should. But I’ve always remembered it and there have been times it has come to mind. This week is one of those. Perhaps if I embraced my new hips more and trusted them, instead of fearing what might go wrong or when they will need revising, I might not be so inclined to catastrophise.

It’s only taken 20+ yrs to realise this…

The empowered but ineffectual patient

Last week I saw a physiotherapist about the pain I’m experiencing in my wrists. It was interesting for me as I now engage with these appointments somewhat distantly. However, that distance seems to be making these interactions tricky for me.

The pain I’m experiencing is a side effect of using walking aids intermittently for 30 years (consistently for the last 16). For some time I’ve experienced pain and nerve problems in my hands, wrists, shoulders, arms, etc. It seems to be joint, muscle, nerve and tendon based, to different levels in different areas. When it first became a significant problem, in 2001/02, I found a change of crutches and sticks to those with ‘comfy’ handles to be particularly helpful (something I was stopped in the street to be asked about last week):

I’ve touched upon trying to reconcile the patient with the academic and being the daughter of four medical parents (including step-parents) previously. The tricky nature of the interaction with the physiotherapist last week arose in response to being asked one of the standard questions,

‘What does the pain feel like?’

There are various responses that instinctively come to mind, some more constructive than others! However, what I (also) found was that I began thinking about the reading I’ve done regarding the difficulties of communicating pain, of describing it, measuring it, the subjective nature of it but also the importance of descriptions and metaphors for diagnostic purposes.The result was that I felt unable to give any response without being prompted. This was a different inability to describe the pain to that discussed in the reading I’ve just touched upon but the result was the same – an inability to know what words to use.

I now begin to wonder whether, as something of a medical sociologist, I am in a position of being an empowered patient or merely an ineffectual one. At times I feel that I’m trying to limp a fine line between being aware, self-reflective, and informed, and receiving effective medical care. Of course these things shouldn’t be incongruous (indeed, rather the opposite!) but there certainly seems to be a balance that presently eludes me.