Arthritis? But I'm too young

`The last thing I thought of was old-fashioned arthritis'; `Sitting became impossible for more than 10 minutes' `The average person takes around a million steps each year'
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Indy Lifestyle Online
At 52, Stewart Anderson was struck by the bone-wasting disease. Now he has become one of the 60,000 a year who undergo a hip replacement

Lying on a bed being wheeled under the atrium roof of the new Chelsea & Westminster Hospital in London, I was on my way to an appointment with an orthopaedic surgeon. My hip-bone was about to be disconnected from my thigh-bone.

Not that I minded anything at that moment. Despite a potentially fatal allergy to general anaesthetics as well as pain- killers such as morphine, a cocktail of drugs had ensured that my brain was switched off.

The prospect of a hip replacement operation with local anaesthetic was an interesting one. I knew I would havean epidural placed in my lower back, which would mean that I would be numb from the waist down. They had reassured me that I would not be upset by what they did to me because of the tranquillisers.

I remember something that sounded like a circular saw but I was so completely detached from my normal consciousness that whatever was happening seemed to be happening to somebody else. I was, literally, spaced out and not concerned in the slightest during the three hours of surgery.

About a year earlier, I had gone cross-country skiing for the first, and maybe the last, time. Twenty years of oral steroids for asthma had left my bones in a somewhat parlous state. I tried the sport, knowing it wassupposed to be hard work but relatively safe compared with downhill skiing.

But as my skis approached a right-hand corner one day, the left one parted company with its partner and went off at a tangent, choosing a badly cut track. The result was a nasty rending noise as I did the splits. While I didn't feel there was any damage at the time, a similar movement climbing out of the bath three months later left me with a roaring, burning pain in the inner thigh.

The last thing I thought of was plain, untrendy, old-fashioned arthritis. That was something my grandmother had, not Nineties Man. As it turned out, at the relatively young age of 52, I did have arthritis. The skiing accident had somehow triggered it.

In the following months I tried acupuncture, osteopathy, Chinese herbal medicine, homeopathy and physiotherapy. What I had, however, was a mechanical problem that required a mechanical solution.

The pain, meanwhile, had changed in character and grown out of all recognition. Anyone who has not had arthritis should give thanks. It is a curse that ruins lives, causes excruciating pain and blights not only the daily existence of those with the disease, but also those around them.

I had osteo-arthritis and the lining between my femur and pelvis had worn away.This meant, in plain terms, that I was rubbing bone on bone. Sitting became impossible for more than 10 minutes, walking was an unbalanced nightmare and the nights became a matter of alternating between cat naps and disappearing downstairs for two or three hours while I waited for painkillers (co-dydramol and diclofenac) to take effect.

It is not just the pain in your hip. In fact, that is the least of it. There can be referred pain throughout the leg, which can mislead the patient into thinking that there are problems with knee and ankle.

This meant that movies and theatres were out, while there were few restaurants that really wanted patrons who leapt up every few minutes and stomped round the place cursing and swearing.

Work was difficult because if the pain did not stop me thinking, the lack of sleep and the painkillers did. In other words, my lifestyle and that of my partner were severely disrupted. By early January, the physiotherapy department at the Chelsea & Westminster had tried everything from ultra- sound to traction via exercises and gentle massage. Nothing had helped.

It was at this point that my surgeon, Warwick Radford, entered my life. "Can you walk 400 yards without pain? Can you sleep at night?" he asked. The answer to both was no. A hip replacement was the only solution. Examination showed that I had muscle wasting in the thigh and a severe lack of flexibility in the hip.

Mr Radford explained that at my age the new hip would last for around 15 to 20 years. "That means that you may need a replacement when you are around 70 years old," he said. "Currently, joints are lasting from anything up to 30 years, but much depends on how you treat them."

He went into detail: "The current technique means that we'll cut off the top of the femur [the ball part of the joint], insert a tapered-fit chrome/cobalt alloy stem with a new ball into the bone, ream out a new socket in the pelvis and insert a lining into the hole. The ball is made of ceramic and the lining of the new socket in the pelvis is a metal shell with a polyethylene insert.

He told me that the stem would be cemented into the femur but the lining would be a push-fit into the hole of my pelvis. The cement helps to prevent any rotation within the bone, which in turn minimises wear. The socket lining is push-fit because bone grows on to and around the metal shell. This, plus constant pressure, helps to interlock the new lining into the hole.

Given that the average person takes around a million steps each year, it is hardly any surprise that hip joints wear out.

It is a major operation, as I realised from the moment I regained all my senses. Needles to the right of me, tubes to the left of me dripped and gurgled. Over the next three days, I had three units of cross-typed blood; three antibiotics and three steroids as well as glucose and saline drips plus painkillers every four hours. I was well looked after. Each morning I had a subcutaneous injection of low-dose herparin, which helps to avoid blood clotting and which stung likea wasp.

But that grinding, tearing, burning arthritic pain had gone. It was amazing. From the moment the tranquillisers wore off, I was aware that I had been handed a whole new life at 52.

One day, three physiotherapists got me up on a walking frame, for a few minutes. Day four saw me on crutches in the morning and sticks in the afternoon. Day eight saw me leaving the hospital for a new "hospital at home" programme.

Having been assessed for my suitability to join thisscheme, I was being sent home about seven days earlier than normal. I was visited daily by a district nurse, a physiotherapist and a carer.

By the time I arrived home, I was virtually looking after myself; the district nurse came until the clips (stitches) were taken out and the physiotherapist until he was satisfied that I understood and could do the exercises. This took a week.

I have been told that for three months I run the risk of dislocating my new hip. I must be careful about chairs; I cannot drive in this period (my insurance will not cover me if I have a crash); I must not even be a passenger for the first three or four weeks; I must shower, not bathe, take care getting in and out of bed and when seated I must keep my knees below my hips.

This is nothing compared to the relief from the pain of arthritis. I have been lucky to recover so quickly,and, yes, my age had something to do with it. Nobody wants major surgery but if, like me, you have become a pain not only to yourself but to those around you, and you are offered a hip replacement, my advice is - take it.

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