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THE HIP OF MY HEART 2010


“You’re limping”

“What? What do you mean I am limping? I am not limping...”

Was I? I hadn’t thought about it and any way it was no one else’s business. But other people confirmed it, apparently  I was.

And so began a long rite of passage.

Eighteen months ago it became obvious that something was wrong with my walking but it took another six months before I faced up to it, and another major event in my life to spur me on to do something about it and my health generally.

A year ago my brother in law dropped dead. He suffered an aortic aneurism which is like flipping a switch. He was sixty three years old and the previous night had been sat with us at dinner . He was in fine form when we waved him off as he walked home. By lunch time next day he was gone. He had seemed in good health but was a lifelong smoker and liked a drink. He had also avoided any contact with a doctor for over a decade.

It was a mortality check. Here I was sixty years old, 18 stone, limping, sweating too much and   suffering from a fear of anything to do with medicine. I had grown up in a NHS household with my father, a dentist, who always wore his “whites” and looked after my teeth, which often involved a deal of pain. My childhood was dominated by the comings and goings through our front door of strangers in pain. A psychotherapy banquet for someone I am sure.

I felt irresponsible towards my family, my friends, and in particular toward my daughter who at eleven would want me around for at least another twenty years.

If I wanted a chance of carrying on then I had to take action. But what? I didn’t have a regular doctor and my medical contacts were non-existent. The only person who I felt confident of was my chiropractor , a scary woman in her forties. So I went to see her.

She took one look at me.

“Your left hip’s gone”

“Oh”

“And the left leg is shrivelled and shorter than the right, which has been compensating”

She then took my blood pressure.

“ And your blood pressure is dangerously high” At 180 over 120 this was an understatement. I pleaded that I suffered from “white coat syndrome” but even after a long pause the pressure was still up there.

She persuaded me to have an x-ray and to book to see my doctor, and two days later at her clinic  there was the evidence.

My right hip looked ok but the left looked like a bit of amateur origami. I needed a new hip. But I was overweight and with the blood pressure issues it was probable that no one would operate on me. She then recommended me a surgeon who she knew and who was, in her opinion, one of the best in London. “He does all my patients, and you’ll like him.” Let’s call him Mr M. “But only your Doctor can take your treatment further and refer you, you have to go and see him first.”

I asked if I should take the x-rays and my chiropractor said that I could if I liked but that GP’s were not now trained to read them. I was learning a lot.

“What do you want to do?” asked Dr K at the Chiswick Health Centre. He had taken my weight at 120 kilos and recommended blood tests. I was obese but not morbidly (which was something I suppose) and my BMI was better than expected.

But his question was a surprise. I hadn’t been prepared for the fact that in the UK now it seems that Doctors don’t say “do this or that” they ask you, the patient, to suggest a way forward.

“I want to lose the weight and bring my blood pressure down, and I want to do it without using any drugs. ”

He looked at me for a beat. “Ok, how?”

“No alcohol, and a no fat diet. I can’t give up carbs as I am about to travel to places where I am going to have to eat bread and potatoes or starve.”

He nodded and then said that as I was over 60 I was entitled to a new fat busting drug called “Xenical” and gave me a prescription for it. This pill, which is now available as “Alli”, works well if you really do go low fat. It basically latches on to fat in your diet and takes it straight through your system so that  it isn’t absorbed into the body.

“So what about this hip then?”

I showed him the x-rays. He was delighted to see them as he said he didn’t see many nowadays.  He agreed it looked busted and then, again, he asked what I wanted to do. Armed with the information from my chiropractor I said “Well there’s this Mr M that I was recommended?” “Good idea,” he said, “I’ll refer you’” and that was it.

And so began a wait to see if the surgeon would accept me and a regime that wasn’t a diet but a complete change in life style. I needed to alter my behaviour patterns as I wanted to sustain a recovery and not just relapse after a diet blitz. So there as to be no alcohol, no crisps, butter, cakes, biscuits, cheese or pastries, no sweets and no snacking. In their place would be fruit and veg and juice. I was going to think myself thin.

I created a life style which had a breakfast of juice, a bowl of ‘original’ Alpen with some semi skimmed milk, a mug of tea again with milk and a no fat yoghurt. After some experimenting I settled on the Weight Watchers ones which taste the best. Lunch was two pieces of really good brown bread with a piece of ham in between them with whole grain mustard plus fruit juice and fruit, and dinner was what came along but in moderation. I just eat smaller portions of chilli, spaghetti Bolognese, roasts, sausage and mash and so on. I was never proscriptive as the household would have been disrupted if it had had to cater to my needs as well as everyone else’s. I had one mug of coffee a day as a treat.

If I felt peckish then it was another yoghurt, or piece of fruit or a raw carrot. The fruit was apples or fresh fruit salad but absolutely no bananas which I haven’t eaten now for over a year. I had no fizzy drinks as my chiropractor had stressed that they both stimulated appetite and conflated the stomach.

I’d be dishonest if I said I planned all this. It just sort of fell into place. I discovered that I didn’t have an addictive personality and could give up alcohol immediately and completely. The absence of alcohol is essential for a drop in blood pressure. I have always loved fruit and crudités and we already had a healthy cooking regime in the evenings.

The referral to Mr M worked and I was seen at his NHS clinic in October. In ten minutes he did an examination, looked at my x-rays, confirmed the hip was busted and needed a complete replacement. He also confirmed that the blood pressure was an issue. He stressed that thinking had changed (this was a theme I was to meet a lot) and it was the lower figure that was crucial, the higher now being seen as less relevant. If the lower figure was 100 or above then his anaesthetist would not allow me to be operated on. He conjured up a picture of some sort of avenging angel which was an added spur to getting the damned pressure down.

He told me that I should have the operation done soon as the NHS was strapped for cash and that the average wait of three months would rise in the next year. So we agreed to proceed on the understanding that I would lower the blood pressure and get the weight down. I persevered and even at Christmas managed to control things, breaking the alcohol fast for Christmas Day itself and New Year.

Then at the beginning of the year I had a note in the post that my pre-op check was to be January 16th and that the operation was normally two to three weeks after.

I decided that first I would revisit my GP to see if the regime had worked. I had kept religiously to the plan. Whenever I told anyone what I was doing they would say “Oh I couldn’t give up alcohol, or I couldn’t give up cheese.” I came to the conclusion that the British are a nation of cheese eating drunks. I knew some of it must have worked because I had gone down two dress sizes and my waist was now 38 rather than 42.

And this change of life style, plus trips to work in the heat and humidity of Nicaragua for eight days, Namibia for a week and Malaysia for ten days had meant a steady weight loss of two pounds a week. Dr K confirmed that from 120kilos in August I was now at ninety nine kilos, a drop of twenty one kilos in all or nearly three stone. My blood pressure was down to 145 over 95 which was still too high. This was depressing but it was below 100 and the anaesthetist would hopefully allow everything to proceed.

When Dr K had done all the checks he just laughed.  

“ I am laughing,” he said, “because you are the only patient this year who has actually done what they said they would do and succeeded” Which is gratifying but doesn’t say much for our ability to act on our Doctor’s advice. He also said if I kept it up, the blood pressure might just keep subsiding.

Then began a wait. The date for the op never arrived and I became increasingly depressed. I kept to the life style but I was becoming more restricted by the hip’s deterioration and I couldn’t really exercise. I was now walking with a stick which helped but my morale was being sapped. I had work and various projects to deliver but by May I felt I had fallen off the system. I was also scared stiff by the whole idea of the operation and I suppose avoided hassling in the hope it might all go away or somehow I would survive without it.

But finally I rang the Waiting List Office, left a message, and two days later the operation date arrived. It was in six weeks but I needed to have another round of pre- op checks.

By now the blood pressure was 140 over 90 and the weight was 94.2 kilos. I was ready to go. The NHS attention to detail was extraordinary. My bloods had been tested three times leading to reassurance as to kidneys, liver, prostate and much else. I had two ECGs and an electrocardiogram ultrasound which confirmed that my heart was “sound” which was good news. I was still terrified but everything was in motion and the operation was looming. The regime had worked to the point I just did it all naturally and without thought and after the first month at no time did I feel hungry. All that remained was for the hip operation to be a success.


Chris Swann June 2010
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Christopher Swann,
7 Jul 2016, 02:57
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