Surgery done, here comes the Physio!

The start of Physiotherapy after my Tibial Osteomety

February 1st (Day 1) 2018

Feeling misty, can see things in the distance, but slow down, its a journey!

I woke up at 6:30am and watched some television and read the Economist magazine that Aroon left me. The article on Google, Facebook and Amazon becoming larger than economies and becoming monopolies questioned their business ethics in terms of acquisition was rather interesting. I remember reading that the new bargaining currency of DATA is a dangerous issue – this will cause governments to sue these large companies – they are no longer immune…..

Anyway that was my riveting morning as well as developing constant hiccups.

I sat up on my bed and could not see any change in swelling around my knee but I did see a big change in my leg’s alignment. My only worry is that it has been overcompensated, but the swelling on the inside of the leg (where the op took place) is surely distorting it.

Breakfast arrived at about 8am and had an English fry-up –  polished it off as well as 2 cups of tea. The doctor came round with the pharmacist and physio. The doctor explained what happened to me the night before and he explained to me the cause. He reassured me it was a cause of the drugs and I should not have another episode.

The physio mentioned she would return later and that due to the nature of the operation, they will take it very carefully. She wanted to start me on a walking frame followed by desired crutches. They removed the pillow under my leg and mentioned they will return later in the day

I waited for Loiza to arrive and when she did , she brought magazines with her as well as her smile. We read some magazines and my lunch arrived and was the best meal so far in hospital – chicken with gravy.

Later on the physio arrived. They got me out of bed and with crutches added weight to my leg. As I stood up the pain in my leg was felt. My calf muscle was hurting as well as my ankle. They helped me walk with the COGS process (Crutches, Operated leg, Good leg, Step). It worked. As Loiza recorded me walk i made my way out of the room and in to the corridor. It was a relief to be able to walk however the pain was immense. I could feel the tightness of the skin and my bone was hurting.

As I sat on the chair for the first time, i had to remember that I had taken strong pain killers to numb the pain. After the physio left, Loiza let me walk a little more in the room. I also called my parents to give them the good news that i was able to walk.

Physio Staff at One Hatfield Hospital starting the rehab

The physio returned to help me walk up a flight of stairs. We walked a longer distance (as I had now changed my clothes and wasn’t wearing a revealing hospital gown) and went to the stairwell. I stepped down and then back up, The joy was felt as well as the pain. The 2 physios brought me back in a wheelchair. It was at this point that I decided to stay another day in hospital as I was not ready to go home. My tolerance to pain at this moment was low, and I did not want to risk any damage by being at home.

The Physio team are critical post operation, they are key to focusing your mind on the power of the human body and the program of activities that inevitably impact on a speedy recovery.

Thanks again to @OneHatfield Physio team and to Mr Minhal Chatoo.

Day of the Tibial Osteotomy Surgery

January 31st (Day of op)

I didn’t have a good sleep the night before so got up early. No food or drink as prescribed by the hospital so getting ready was quick. Priya was awake and gave me a hug before she went off to get her breakfast. Aroon was asleep so i gave him a shove. Time of arrival to the hospital is 7am. I remembered for the last 4 or so weeks repeating to myself “this is the last time i do….in a while”…well that the end of the line now.

We arrived at the hospital on time and taken to my room. All sparse but the TV was good. Not sure how many people have used the room as its all very new.

Mr Minhal Chatoo (Surgeon and specialist ) came in and spoke about the operation and highlighted the risks. This is expected as he covered risks in tibia under/over correction, risk of cutting a nerve and rehab time. The good news from what he said was movement on the Knee will be possible as the cuts will be below the knee. He was very reassuring as he drew an arrow on my leg

He left by saying that i am the second person on his list and that the anaesthetist will be round later. We sat until 10:20am and then was taken down to the operating theatre.

I remember an Australian lady and Joan Washington (Sister) taking me down on the lift; i made a comment about the disco lights in the lift (nervous energy!).

I was led into the operating theater and laid on the table. At this point another chap who was administering the drugs noted my DOB was incorrect – born in 1953? That was corrected quickly.

Once the anesthetist came back, he mentioned the drugs and an additional injection in my right thigh to aid the operation. We chatted and had a giggle for 10-15 minutes as their actions were completed. I noted the time was about 11:40am.

The operation was to cut below the shin on the right leg. A wedge 11mm wide would be cut out. A bone graft applied. The gap create in the leg will have metal strips screwed in to support the bone growth to correct my leg.

The drugs took action and i passed out

Coming round after surgery

I came around at about 1:30 and i was in agony – a sawed leg, 2 metal pins and bunch of screws added to my leg. 2 nurses were near by. They talked and administered drugs once they spoke to the anesthetist. I was left downstairs for a while. Once the pain was tolerable, they wheeled me back upstairs. I was glad to see Loiza in the room.I held her hand. I cannot remember if i fell asleep again but i guess it was on and off. They gave me oxygen and connected me to saline and heart rate monitor.

Mr Chatoo then called us to talk about the operation. He said the procedure was on plan and that he was satisfied. This was a relief. Loiza and I reflected and after  a while and then she left for home. I fell asleep again. I remember waking up as Joan was taking my Heart Rate when i complained that i wanted to vomit. I felt that i was losing consciousness and could feel my self sweating and my heart pounding. The Doctor lay me down and i could hear them telling me to keep my eyes open. I was struggling but they pulled me through. After laying flat, i felt much better. My blood pressure dropped due to a reaction of the drugs. At least that gave me something else to worry about rather than my leg.

The pain in my leg is prevalent but didn’t feel like it was sawed, had metal strips and screws put in. the air pumps/ cushion on both legs is helping my blood circulation. Dinner arrived and it was seabass with potatoes. It tasted dry but i finished it so quickly.

Loiza, Aroon and Priya arrived at 7:30ish..if felt like they had been gone for a long time. The  kids made me a card for “Brotato”.

Priya read her “grand designs” magazine with me and Aroon talked about his Physics lecture at school. He mentioned the speaker was very enthusiastic about her subject matter. We sat chatted and i just watched everyone -i was just happy to see them and didnt want them to leave.

Joan came by with her shift replacement and went over my case notes. A shame to see her go as she really looked after me as i came round. She was calm, direct and very precise,

Loiza and the kids left and i fell asleep again. Another nurse came in and administered pain killers. They kept the oxygen running. I was a little impatient on waiting for things but the nurses must be busy. Anyway things went as per plan anyway. Every 2 hours they came in and checked my vitals. The pain was bearable and was able to move my toes. I didnt want to risk moving any more than that.

The day before the Tibial Osteotomy

30th January 2018 (Day -1)

On 30th January 2018, I went into hospital (https://www.onehealthcare.co.uk/hatfield/) for my surgery.

Initially the Osteotomy surgery date was meant to be on 17th January but the surgeon had to push the time back as there was a risk of overrunning on a more complex surgery that was planned earlier in the day. For me, I had programmed my mind (at home and work) that surgery would be on a specific date so felt prepared. With that moving, it was tough trying to adjust and refocus on work but it had to be done.

Work for me this month was very manic; recruitment, interviews, dealing with sales staff in the corporate world is stressful. Also, with my manager being unable to take my workload, this didn’t help the stress levels. This actually helped me avoid thinking about the surgery.

So now i am sat at 6:30pm on Tuesday feeling a little numb. I’m not sure how to react other than to ‘go with the flow’ tomorrow.

In terms of the ‘what will i do after the surgery’ quandary, not too sure what that would entail. The thought of the surgeon drilling through my tibia, taking a 1.1cm width of bone out, drilling holes and adding metal plates is daunting. What will the pain be like after a few days? How will i go to the toilet, shower and dress myself. Also being stuck in the house with a wounded legs for a week or so is not riding well.

I’m not sure what Aroon or Priya are thinking. Aroon is wrapped up in his own things and Priya is busy being a girl. As long as they support Loiza, thats all goodness.

I’m going to go early to watch Priya at football practice and see how the day ends, Its NIL BY MOUTH 12 hours before the surgery and need to get to the Hospital by 7am.

A Quick note about me

Hello There!

I am Jayesh (“Jay”) Lad, married to Loiza Lad and we have 2 children, Aroon and Priya.

We live in a suburb just outside London, UK where we have joys of being very close to the countryside and 20 minutes away from London, one of the greatest cities in the world. We live an active lifestyle and enjoy spending time together as a family and with extended families.

Life is about staying healthy, bringing up the kids, paying the mortgage and going on holidays.

In 2018 I underwent a surgery called a Tibial Osteomety at the One Hatfield Hospital on my right leg. After a year of recovery I decided to blog on my recovery process with the aim of helping others who may be thinking of taking their journey, or like me, on their journey right now,

My background

I have always been active.  When I was young, I was a regular in the schools football and basketball teams from U11’s to U18’s. I also played for clubs outside of school. Training, playing and winning was the poison growing up. I also took on Kick Boxing and other martial arts outside of school and was very good at it. 

During University I kept up with Basketball but other sporting activities may have been replaced by going to pubs and clubs.

As I started work and changed jobs (from teacher to Trainer to IT consultant) my job entailed a lot of travelling by car and by air. 

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I guess I was in my mid twenties when I noticed pain in my knees. If was was sat driving for over 2 hours (such as commuting to work), I would experience stiffness and then going for a jog after was something I did not do too often. I just lived with it.

In my 40’s I decided to take up Sprint Triathlons, Mini Marathons. I had to shift my weight (109kg when i am 1.82m) – this certainly takes its toll on recovery and ability. I know this did not help. In my mid 40’s i just had to stop as the pain from running was very specific and very painful. I had to make a change

 

Arthoscopy compounding the underlying issue – Osteotomy the answer?

In early 2017 I underwent an Arthroscopy and debridement procedure on my right knee. Essentially they removed loose cartilage debris and to shave my knee bone where there were abnormalities. This was a symptom of the early onset of arthritis in the knee and a possible knee replacement in my later life.

Whilst i was undergoing physiotherapy, there was a noticeable remnant pain in my right inside leg. I was recommended later in the year to meet with a knee specialist. Physiotherapy outlined another issue with my knee. Loiza and the kids also noticed that after my leg surgery that my right leg was becoming more “bow” as well. I was unable to run, even on a treadmill and i added weight on.

Something had to be done. I met with the recommended Surgeon Mr Minhal Chatoo in Hitchin Hospital.

Mr Minhal Chatoo,  Consultant Orthopaedic Surgeon 

I underwent a MRI scan as well as a full leg X-ray. All this happened in November/December 2017. On meeting with Mr Chatoo, he recommended a Tibial
Osteotomy (https://orthoinfo.aaos.org/en/treatment/osteotomy-of-the-knee/).

Prior to having the surgery i looked for blogs, use cases of people who had undertaken this type of surgery so that i can understand this type of surgery- its very thin.

Is the remedy an Athroscopic Debridement

I visited a local Physiotherapist in 2016/107 as  I found that running on a treadmill and even jogging was becoming painful and recovery was taking much longer. My plan to train for the summers Sprint Triathlons was on the balance.

I was refered to a private hospital in Enfield where the specialist reviewed my x-rays. He noted the rhumetism in my righht knee for my age (47 at the time) was severe and that I would need a knee replacement in a few years.

As an interim, he would carry out an Arthroscopic debridement procedure. In my own words, its a day case where the surgeon washed the debridement from within my knee and cavity and provide some resolution to the pain I was getting.

They say the recovery is quick…well not for me. I could’nt walk for weeks and underwent Physiotherapy for over 6 months to recover