Trying to Get Back Into a Rhythm

For me, the hardest thing about depression hasn’t been low mood, it’s been my complete lack of motivation. I go to work, I come home, and I spend every evening and weekend on the sofa eating carbs. From swimming 3-5 times a week and pilates at least once a fortnight for the past couple of years, this year from January to April I swam twice other than class. I’ve put back on all the weight I lost in the last 2 years, which doesn’t help my dodgy hip, and just urgh. Swimming is very important to me; it’s cardiovascular and strengthening, it supports weight loss, it helps me sleep, it’s mentally relaxing and can be almost meditative for me, it relieves and prevents pain in my hip, it’s something I can do comfortably and confidently, or I can challenge myself to go faster, use better technique, improve my weaker strokes, and it’s something I enjoy. No matter how pissed off I am when I get into the water, no matter how annoying other people in the pool can be, the act of cleaving through the water makes me feel better. So not being able to motivate myself to go has been difficult for me, in lots of ways. I took annual leave the week beginning 13th April, and the following Monday & Tuesday. I had hoped to use the time to get back into an exercise groove and I wanted to swim every day and do one or two classes as well. In the end, I only managed to swim three times. To be honest, I’m disappointed I didn’t manage more than that, but I’m trying to look at it as a good start rather than a fail. Stroke development started again on Friday after the Easter break and I headed up to it, but there was a power cut at the pool and it was cancelled. Owing to annual leave I was only at work Wednesday-Friday last week and I’d aimed to swim at least once on Saturday or Sunday, but I just couldn’t do it. I sat on the sofa with a loaf of sourdough and a jar of peanut butter, feeling that I was letting myself down. I think work is taking it out of me more than I realise, and I think that because I have started to feel better, I’m assuming I’m better than I am and I’m expecting too much of myself. The good news is, a meeting finished early today and I took advantage of that and was in the pool by 1630 and did a kilometre. I also managed what might be my fastest ever 50 metre length, 67 seconds, and my average speed per length was pretty good (for me). Months of eating carbs obviously agrees with me. I might not make it to the pool again this week before Friday, I might not make it there next weekend. But I might. And if I don’t, that’s fine, and if I do, that’s great.

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150km

Since I started swimming regularly on 25/08/13, I have swum 150,250 metres. That’s an average of 438 metres a day, or if you discount the whole of June when I couldn’t swim because my legs were bandaged, 480 metres a day.

I find if I swim every other day, it keeps the pain in my hip at a tolerable level without needing to use painkillers.

Discharged

Had my review appointment with the surgeon this morning. Told him how the injection had gone and he feels that confirms his diagnosis of the beginnings of osteoarthritis in the joint. He’s hopeful it’ll be a slow progression. We talked about repeating the injections – the effects are not cumulative, and I feel the NHS really isn’t getting value for money for them with me, so we’ve agreed not to do any more. He was delighted to hear about the swimming and the weight loss – 12lbs up to Christmas – and is encouraging me to keep active. Repeated what I already knew – use the painkillers as and when I need them and before activity I know will aggravate things. He doesn’t feel he needs to see me again at this stage, and it’s quicker to get a new appointment than a review one, so he’s discharged me with instructions to go via my GP if and when I want to see him again. If I can get more weight off and get lucky with a slow progression, I’m hoping it might be 15+ years before I have to go back.

Two quick things, entirely unrelated

I had my appointment with the orthopaedic surgeon. Nothing showing on the X-rays. They think I need an arthroscopy, which is keyhole surgery to get a camera in to have a look at the hip joint. Hip joints are quite tightly held together, so they have to put the leg into traction to get the head of the femur out of the hip socket to make space for the camera to go in. Because of a risk of dislocation afterwards, I expect to be on crutches for 6-8 weeks afterwards. How extremely inconvenient.

I really hope they do it under local and let me watch the screen.

In other news, the Olympic Torch came up my street this morning. I took me camera out to see it but didn’t realise the batteries were dead and then had that indecisive “do I have time to go back for batteries, or will I miss it?” I didn’t go back, so of course, I would have had time. I got some crappy video on my phone though.


http://www.youtube.com/watch?v=CIowL–qGao&feature=youtu.be

I’m really underwhelmed. I somehow expected more than two crappy orange vans and a bloke in a shellsuit.

I bloody knew it! Or, I am broken.

At some point while I was home at Christmas, I remember saying to mum “I don’t care what the X-ray says, I am convinced I have a small fracture somewhere. It just doesn’t feel right.”

Well, I was still having pain so on Monday this week I went back to A&E. A nice doctor did another examination – no clues from where the pain was as to what might be wrong (because everything he made me do hurt) – and arranged another X-ray, and the X-ray didn’t show any fracture. And this is where I got lucky. He believed me when I said it was sore and not right and he wasn’t happy to leave it as no bony injury, rest and painkillers, and he made an appointment for me at fracture clinic on Wednesday, saying that he was worried there was something not showing up on the fracture, perhaps my femoral head jammed into the acetabulum and nipped a bit of cartilage and he wanted me to be seen by the orthos. So I went back to work on Wednesday and headed off to my # clinic appointment in the afternoon.

The surgeon (reg or senior reg, I think probably senior) was looking at the X-rays, I looked at them, I laughed because I could see my IUD and my mooncup. He laughed and said the gynaes could probably tell what sort of IUD it was just from the X-ray. He confirmed there was no visible fracture, did another examination and went away to consult a consultant, leaving me still looking at the X-rays and laughing. Then he came back and frightened the life out of me by saying there might be a non-displaced fracture somewhere and I had to swap to crutches and be only toe-touch weightbearing until they could get me an urgent MRI because if the possible fracture suddenly collapsed it would be “life-changing” and I don’t think he meant in the Euromillions sense.

Bear in mind I’d had the injury 2 weeks, been walking about using one stick and managed a 400-mile round trip on trains with suitcases.

It’s really hard to manage your life as toe-touch weightbearing with two crutches when you live alone in a second floor flat and don’t have anyone to fetch and carry for you, so to be honest, I wasn’t as conscientious as I should have been. In fact my friend (OT in ortho) described me as a bloody terrible patient. And also, my crutches technique turns out to be terrible. The physio who gave me them and “assessed” me on the stairs was really quite stunned, I think, by how poor I am with them. Not too bad on stairs, but bloody awful on the flat – could not get the hang of crutches and bad leg together, with my bad leg a second behind.

The surgeon said he’d ring me yesterday re an urgent MRI either yesterday or today. By two pm I was wondering if he’d forgotten or just not had the chance to ring me so I phoned the clinic and someone’s very nice secretary said she’d chase him up. He rang this morning, and asked if I could get along to MRI for 2.30pm, which I did. On and off buses isn’t that difficult on crutches. It’s certainly easier than making a curry on crutches, which I attempted last night and gave up on the crutches very quickly.

I’d never had an MRI before. It’s both horrible and not too bad at the same time, with a touch of Logan’s Run (or how I remember my childhood impressions of Logan’s Run anyway). I was lucky in that because they were scanning my hip, my head was sticking out of the other end so it wasn’t as claustrophobic as it would have been otherwise, but I did make the mistake of opening my eyes while I was being pushed through it and that was very unpleasant. Didn’t like that. It was like being in a weird plasticky coffin. So I shut my eyes again and waited for them to put the music on. I listened to Take That’s Greatest Hits and got all of Never Forget, How Deep Is Your Love, Pray and Back for Good while they scanned me. That was the best bit really.

Then I got dressed, put my nose stud back in, etc etc and waited for the radiologist and the surgeon to confer and decide. But the radiologist turned up and said the surgeon (the senior reg from Wednesday) was scrubbed up in theatre so they’d spoken by phone but he couldn’t come down to talk to me himself. The radiologist told me there’s a tiny fracture in the right superior pubic ramus (I knew it!), it would heal in about 6 weeks and meanwhile I could be fully weightbearing again. Best news ever. Oh, and he said there was no way an X-ray would have picked it up because of the size and location of it. I’m not too concerned about that, I know pelvis fractures can be really hard to spot on an X-ray sometimes so I wasn’t blaming anyone for not seeing it before. He said the surgeon would be available in about 90 minutes if I wanted to wait, but I was happy to leave it at that. So I wandered off to physio to swap my crutches for a stick – good job they took my word for it because I didn’t have anything from the surgeon to confirm I’m back to fully weightbearing, promised to self-refer to community physio if I think I need it, and headed off to go home. Texted my OT friend in ortho, who was about to leave, and got a lift home with her, narrowly avoiding running into an ex-boyfriend by about a second and a half. Lucky escape, so not in the mood to deal with him. The surgeon phoned when we were in the car, just to say yeah, fracture, gradual improvement over 6-10 weeks, no follow-up required, if any more problems see your GP. Excellent service.

I’m so very relieved. I’m relieved there is something wrong because I would hate to be having this pain and be told there’s nothing wrong when I’m sure there is. And I’m relieved that it’s only a tiny pubic ramus # when it could have been something nasty and impacted leading to major surgery with the possible risk of complete dematerialisation of my leg. And I’m very very glad that the nice doctor I saw on Monday wasn’t happy to leave it as no further action.

I’m intending to go back to work on Monday and negotiate lighter duties for a while – no manual handling and nothing too far away involving too much travelling. If a week of that is too painful I’ll ask for redeployment to the contact centre for a few weeks because that’s a desk job and they’d be delighted to have me. And I might ask for an occupational health referral too, just to cover myself in case of further requirements for time off, and because our new sickness policy is an absolute cunt of a policy, excuse my language, apart from it lacks both the warmth and the depth.

Don’t know when I’ll be back on the bike. Probably try it when I can walk without pain. I think sitting on a saddle is likely to be pretty sore for a while.

So, I’m sore, but essentially quite chuffed there is something officially wrong and very chuffed it’s only a pubic ramus fracture.

Still glad of the stick

Well, ten or eleven days post-off, how are things?

The pain continued to be pretty bad for most of last week. Couldn’t sit, stand, or lie comfortably, and the movements required in changing from any position to any other position were exquisite agony. Met a couple of friends for a pizza on the Thursday before Christmas (22nd?) in Prezzo restaurant, part of Aldo Zilli’s business empire. Had to use the loo. Didn’t fancy the long narrow twisty flight of stairs down to the loos so decided to use the accessible loo on the ground floor. Door blocked by a bin, door locked. Asked waitress to let me in, she had to unlock it with a knife. Once in, the toilet was like the Trainspotting toilet if you let it dry out for six months. Unusable. Struggled, crossly, up and down the stairs and sent ranty email to the company about their requirements under the Equalities Act.

On Saturday, Christmas Eve, I was on my way to Yorkshire for Christmas with my family. Friend kindly helped me to the station, carrying my stuff down the stairs from the flat for me and dropping me off in the station. Managed to get help to get bag on to both trains (one connection) but not off, so struggled with that. Hip was just about singing a tune by the time I got there. Mum’s house has no banisters and the stairs are steep and narrow – good job my stick on stairs technique is pretty good! On Boxing Day we went into town and I walked the length of the main street and back (with stick) so probably 1.5-2 miles, and was just knackered afterwards. Got home, fell asleep in chair.

On Tuesday my lovely lovely boyfriend arrived and on Wednesday we went into town and went for a walk in the park, which isn’t a huge distance but it was very windy and I was struggling. Very tired and sore afterwards. We came back here yesterday and it was great having someone to help on the train with the luggage, made for a much easier journey although I was still v sore when we got home. This morning we got the bus round to Stores to collect the bike and then walked back with it, which was about 2 miles in total and I was a bit out of sorts afterwards, out of sorts enough that I couldn’t face walking over to the Bike Co-op to look at the sale. Walked about another mile this afternoon which wasn’t very troublesome, but my hip is lightly throbbing now.

It’s easier to find a comfortable sitting position now, but it’s still hard to lie comfortably in any position. Getting into bed, getting out of bed and turning over in bed are still very very sore, twisting is sore, sometimes sitting down and standing from sitting are sore, and sometimes bending is sore. I know they said the x-ray was clear, but the pain I have doesn’t feel like muscle pain, and it feels like the bones are a bit wrong, so I think there is a fracture and it just didn’t show up. It’s very common for pubic ramus fractures to be undetected on first x-ray, and the treatment would be rest, painkillers and mobilise as able, so I don’t think it’s worth going back to A&E although they said to go back if it wasn’t better in a week. I’m getting about the house without the stick, other than first thing when I’m just up and sore and last thing when I’m tired, and I’m managing stairs much more easily, but I wouldn’t feel comfortable walking outside without it yet. I’m not sure I’m steady enough on uneven ground (and everything is uneven round here, cobbles, holes, knackered tarmac), and I’m tiring quickly, and it acts as a warning to other people that I’m not quick or nimble just now, so I’m sticking with it for now. Ha ha see what I just did there.

I had wanted to go to the torchlight procession tonight but I just wasn’t up to it. And it’s pissing down, so that worked out ok. 😉

In cheerier news, my lovely lovely boyfriend is here and will remain here until next Wednesday, and that automatically makes everything better. 🙂