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Guest Blog : go visit Mexico and get involved in their culture – Chichen Itza

This weeks blog is written by my daughter Priya, a budding blogger still at school. If you enjoyed reading her blog entry, don’t forget to like, follow, share and comment!

Hi, I’m Priya and I recently went to Mexico with my family. We stayed close to a small town near Cancun; called Playa Del Carmen on the Caribbean Sea.

As you may know there are many archaeological sites in that area. If you visit Cancun, then I highly recommend you go and visit one of these sights. They all belong to the native people of Mexico who are called the Mayans.

So, who are the Mayans?

They are an ancient civilization who were prominent in central America around 900 A.D. The Mayans were a huge civilization, at their prime, it is said that their population reached 22 million. They used to build temples for their Gods made from stone and only royalty would be allowed to touch it.

2 hours from our hotel was Chichen Izta, which is a massive Mayan temple, and is one of the new seven wonders of the world. 

 Chichen Itza stands 98 feet tall and it has 91 steps on each side which totals 364 steps. Plus the one large step on the top, the Mayans created 365 steps – matching the number of days in the year. The Mayans were ahead of the game, by understanding time and how the earth rotates the sun. The temple is a huge pyramid like structure in the middle of a clearing in the centre of the jungle!

 When I first saw it, I was in awe of its size and condition, as it was very well kept. I stood there wondering, how on earth did they build this.  IT WAS SO BIG!!!

There are also other ruins on the site, such as a Mayan sport court. They played this game that was similar to hand ball (and Quidditch!) but much harder, they have to use all of their body to get the ball into a goal over 3m above them. It was very interesting to hear and see what they did for entertainment. Our guide told us that the winners would sacfrice themselves at the end of the game as a reflection of their devotion to the gods. I was surprised to hear that, as was everyone else. What an amazing place!

I learnt a lot from going to Chichen Itza and it was definitely worth it.

My advice when visiting this site is to go as early as possible, many tours leave at 7am and get there around 12, at that time it is intense heat and very busy. If you want a calm cool(er) time then try and get there as early as possible.  😀

In my next blog I will write about my trip to the Mayan ruins of Coba.

Returning to the operating table – removal of metal work. Osteotomy concluded

In January 2018, I underwent a Tibial Osteotomy operation at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

If you enjoyed reading my blog entry, don’t forget to like, follow, share and comment!

Returning in 2019 to remove the metalwork

The osteotomy had given me a lot of improvement. The physio work and muscle built around my knees in the gym has given me 90% of my life back. The knee issue hasn’t gone away but I feel so much stronger, some pain does remain but this differs from day to day – that’s just the ageing process!

RHS shows healed bone

As the metalwork in my leg did irritate me from time to time, I took my surgeons advice and booked myself in to have the metalwork removed on 27th March 2019. Mr Minhal Chatoo would be my surgeon again. He was brilliant.

The metal work extraction procedure would be a day case. The procedure would take up to 1 hour to remove the screws and plates. Due to the nature of the operation, I would be under general anesthetic, meaning the time in the operating theatre increases to allow for the time to recover as well.

Upon arrival and being allocated a room at the hospital, one of the nurses came in and read my BP, went through standard paper work, handed over a gown, pants and socks – I’m not sharing any pictures of that!

Shortly after, the anesthetist came round as well and confirmed that Mr Chatoo would be operating on me as the first patient of his day.

Mr Chatoo came in to mark my leg before the operation and we had a light hearted conversation. He mentioned the operation is very quick and low risk so was happy to proceed.

Once he left, I was taken downstairs to the operating theatre. As I walked down someone talked me through the procedure again and kept me assured.

Once I was asked to lay down on the bed, I was connected to the ECG and given the anethestic. In seconds, I was out.

Coming round after the operation

I felt groggy after the operation. It was about 10:20 am as I noticed the clock. They showed me the metalwork that was removed from my leg – 2 pins 4 inches long, 3 screws 3 inches long and 6 other smaller screws. They told me I was unable to keep the screws due to protocol; though I wish I could have kept them as a souvenir…

The pain was unbearable and the nurses gave me strong pain killers. 20mins later, it still felt bad so they gave me more – but I think it was codeine. 

Shortly after I was taken back upstairs to my room and Loiza was sat waiting. 

I remember falling in and out of sleep and still in pain. To me, this felt much more painful than the osteotomy last year. 

It took a while for me to eat lunch (soup and a sandwich), just the tiredness from the drugs and the pain. 

I remember the Physio “Saul” visit . He got me out of the bed and made me go for a walk. We made it to a stairwell and then down a flight of stairs. He did say the pain will be high but I will need to get moving sooner. The recovery period would be :

  1. Next 2 days full rest and some movement
  2. Use crutches for a few days after that
  3. Walk without crutches thereafter
  4. Keep moving and apply icepacks if there is swelling

The recovery period was a lot shorter but I kept in mind that there was a deep cut, stitches and several holes in my tibia that would take time to recover.

I was able to walk however I was very tired due to the drugs. I made it back to the room and then met Mr Chatoo again. I remember him telling me that he placed “wax plugs in the screw holes!” to reduce the bleeding from the bone. 

Mr Chatoo also said the operation was uneventful- this is good news.

I rested again and of course, fell asleep. When I came round again I was still in pain and was given more painkillers. 

The nurse mentioned that I could be discharged once Mr Chatoo comes round at about 5 pm. The discharge was quick and easy and everything was set for me to go home.

I was wheelchaired to the car – We drove home in my Audi. The ride was great as I was glad to be going home. 

When I got home, we took the picture below.

I was exhausted. I slept in Aroon’s room and was out as soon as I hit the pillow. I know I woke up in the middle night and Loiza had to help me to go to the restroom – it was still to early and I was unsteady on my feet – the drugs were not helping and as it transpired I had a bad reaction to the codeine.

Comparing Pre and Post Osteotomy scans – a single view of change

Just a short Blog this week. As per last week I wanted to share single point of view on the positive impact of the Tibial Osteotomy can have. The image below was taken from the One Hatfield Hospital’s monthly publication.

You can see in the left hand image the surgical requirements Mr Minhal Chatoo orchestrated pre-operation. On the right hand side you can clearly see the surgical correction.

Accuracy of the surgery has to be at 95-98%. For all the planning it really is up to the expertise and training of the surgeon. I cannot recommend Mr Chatoo enough. There are a number of experts like him in the UK and worth looking into this type of operation as it saves on having a knee replacement operation.

Should I have the metal plates removed 12 months after the Tibial Osteotomy?

In January 2018, I underwent a Tibial Osteotomy at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

In December 2018, I was thinking more seriously about going back into hospital to have my plates removed. In the last couple of months I was experiencing more irritation caused by the metal plates in my leg. My surgeon did mention this could happen when during my last consultation. I spent a lot of time thinking the knee pain returned, but simple self investigation by pressing on the affected area, it was clearly in the region of where the metal plates were located. The pain would appear in the following ways:

  1. Swelling beneath the knee area – The remedy was to use ice packs to reduce the swelling.
  2. Itchiness beneath the skin- not much I can do other than trying not to scratch the scar area.

In retrospect I didn’t really feel 100% fully recovered and did experience stiffness and pain in the knee area that was brought on by the following :

  1. Tiredness caused by lack of sleep
  2. Stiffness when sat in the same position in a chair in the office
  3. Excessive exercise such as treadmill running.
  4. Leg pain for standing up too long.

The remedy really was to take painkillers to reduce the swelling and of course, to rest.  In conclusion I saw myself as 70% recovered – still much better than what I was like before the operation. I found my picture below from our family trip to Athens, Greece where I raced my wife on the ancient Olympic track. Who would have thought that Will I run again!

Just the action shot of me running . Ok Loiza beats me at the end

Clearly I can run again!

My thoughts on returning to the hospital were something else….it would be my 3rd operation in 3 years – I was fed up with going into hospital and then taking time out (a good few months) to rehabilitate thereafter. I am softy at the end of the day!

A lot of points to consider…..

Loiza felt I should go ahead with the plate removal. Due to my private health insurance, I would be able to go back to the same private hospital (the OneHatfield) and have the operation done on a day that is convenient for me. It would be silly if I did not do do this.

Well thats it for now….I need to find a simple view/photo of my Tibial Osteotomy showing pre-operation planning and the affects of the surgery. As soon as I find it, I will post it.

Thanks for stopping by!

Coping with Tibial Osteotomy months 8 to 12

In January 2018, I underwent a Tibial Osteotomy at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

So our family holiday in August 2018 was amazing, we ate, shopped and visited many attractions around the Chicago lakeside area. Going for a bike ride on the lakeside was my favourite experience.

We were lucky that our hotel had an indoor basketball court ( well, Chicago is home of the Bulls) so I was really able to test out the progress of my recovery and it was a success! I was able to play 1on1 with my son – run, jump, turn and shoot and it felt great!. We were in Chicago for 10 days and we played every other day. It had been over 2 years since I was able to engage in a physical sport in that manner, so this was a massive achievement for me.

In terms of strength building I was able to spend longer in the gym and I felt stronger than possibly 2 years ago. I was making a real effort to lose weight and to change my diet. Over the summer I did notice that if I drink alcohol, I do felt aches and pains the day after – so the message here is to drink sensibly ! 🙂

As the UK weather in autumn/ early winter changes to being colder and damp, I noticed the metal work causing me pain in the areas where the plates and screws were.

Sometimes there was swelling in the area and soreness around the scar but taking ibuprofen eased the pain.

Oh and in October, we decided to have a short holiday in Athens, Greece. Strong recommendation from me and the family!

To get to the Acropolis you negotiate a steep climb and in places, over uneven surfaces. Great fun!


Positive change post Tibial Osteotomy – 6 months on…

In January 2018, I underwent a Tibial Osteotomy at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

I did get the chance to visit Chicago in the summer. Perfect weather!

By June 2018, I was signed off my Physio. He felt I made good enough progress to get my life back to a normal state and gave me some tough exercises to continue with. This was coupled with my surgeons recommendation to return on the 12 month operation anniversary (Jan 2019) to have the metal plates removed. This is a big deal as it means the cycle of pain in the knee could be reaching its end point. A weird part of me wanted to keep the metalwork in my leg as its a great conversation opener or filler (“I have a bionic leg”) however I was experiencing the odd skin irritation or swelling where the plates were located. Mr Chatoo (Surgeon) did mention a number of patients having the same experience. I set my mind to return in January for the final operation.

The gym workouts were going well. I was able to run 5k on the treadmill, lift and pull leg weights that was a clear improvement to pre-operation. I kept to a routine of fitness as well as cutting down on my alcohol intake and losing as much weight as possible, through healthier eating.

In July, I had to take time out from work to help my parents. My dad went into hospital to undergo a Quadruple Heart Bypass operation.

My dad is doing well 12 months on but it was a very tough time for my immediate family. Thank you to the NHS!

At the end of August and as a family, we decided to spend our 10 day summer vacation in Chicago, Illinois. For a Brit living under the cloud of Brexit some destinations were becoming very expensive and we felt that Chicago was a great location and is excellent value for money. Also we booked at the last minute and found a great value deal.

I felt much more confident in travelling and doing more outdoor activities; a real turning point as I felt my confidence was coming back.

Yes, there are some great beaches on the lakeshore. Fresh water also!

6 month check up after Tibial Osteotomy

In January 2018, I underwent a Tibial Osteotomy at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

So in late April 2018, I went on an overseas business trip to Detroit, Michigan and stopped over at Chicago on both legs of the journey. I would strongly advise to call your airline to explain your condition and request assistance – it takes a lot of stress out of the travel.

After my surgery, I had booked 12 physio sessions with the One Hatfield hospital (https://www.onehealthcare.co.uk/hatfield/) and had completed 10 of the sessions; I tried to keep to a visit every 2 weeks and the physio ensured he pushed me hard with challenging exercises. Here are a few that I still do today:

  • Bosu Ball – hop on and hop off on both legs
  • Strengthen calf muscles – slow raises holding a weight dumbell. Alternate on both legs
  • Strengthen hamstring with leg raises and using resistance from a large (elastic) band
  • Lunge exercises
  • On the treadmill, jog – I am now getting to 5km
  • Cycling
  • All leg weight training in the gym.

It is fantastic that I am exercising a lot more. It helped with the swelling being reduced (not using icepacks as much), stamina and my mental health.

May 2nd 2018 marked the 6 month review with my surgeon Mr Minhal Chatoo. I was booked in to have an x-ray prior to my consultation.

He had received feedback from my physio and so he knew I had been pushing myself. He then took me through some strength tests and was pleased. He then shared the X-ray results (below)

He explained the bone healing was progressing as planned and filling out correctly. He also mentioned the correction was 97% accurate to his planning.

Within the blue circle you can see the faint grey – bone growth.

I shared the following concerns I had over the last 6 months:

  • Swelling does flare up from time to time . RESPONSE – the bone is still healing, it will when tiredness sets in.
  • Feeling pain that feels similar to that prior to the operation. RESPONSE – irritation can be caused by the metalwork and that can swell, so the pain is really where the metal is located on the leg.
  • I had lost sensation from the front of my leg (shin). RESPONSE – the operation is intrusive and some nerves are affected. He recommended I keep track but no action to be taken as it was not affecting my day to day life. Nerve endings need time to heal, so the sensations may eventually come back.

He recommended I should not hold back and get back to full activity (other than playing football and hard surface running) BUT also to lose as much weight as possible, At 6ft tall, I was 110 kg and had dropped to 105 kg – he recommended to get to 96 kg for body longevity.

My surgeon then recommended the following :

  1. book in for a 12 month review
  2. plan for the removal of the metal plates as a ‘day case’

Physio improving; getting ready for flight overseas

In January 2018, I underwent a Tibial Osteotomy at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

By continuing physio exercises at home every day is making a big difference. I took advice from the Physio and bought a Bosu Ball.

Amazon.com is the best place to get a Bosu Ball

Among previous strength building exercises were :

  • walking up and down stairs holding the banister
  • simple lunges
  • balancing on 1 leg

Using the Bosu Ball , the key exercises I practiced were:

  • Stand on 1 leg and balance (as the image below) – this is good to build up core strength. Alternate on your legs as you would have lost strength on your good leg.
  • Jump and hop onto the Bosu ball and then jump off – this is harder the first time, but the shock impact is needed to build core strength.
No, its not me, but shows what is needed

I gradually built strength in my legs so I could stop using the single crutch. In part I used the crutch as a “”safety blanket” as I had restarted my commute into work ( a 20 minute train ride to Kings Cross, London) and had to make my self visible to keep people at distance and not bump into me. However I also found that by the end of the working day, my leg was painful; I still needed the crutch.

At the start of May I had to travel to Detroit for business – this would mean 2 flights to get to my destination; London to Chicago (7.5 hrs) and then Chicago to Detroit (1.5 hours). Three weeks before my travel, I met with my Physio and asked for advice on how to stay on top of things and he recommended the following:

  • Take at least one of the crutches to help in case I get tired
  • Keep moving my leg by walking around
  • Don’t sleep for too long on the flight
  • Drink lots of water

I was flying with British Airways from Heathrow Terminal 5. I decided to park my car at the POD car park. You get a driverless car taking you straight into the airport terminal. As my flight was at 8am, the the whole airport was quiet at 5am. At the baggage check-in desk, I was advised to call a service line after security check-in so that a porter can take me to the terminal in a wheelchair.

Security was simple as the staff helped me pass through the scanners. When I met with the porter, he wheeled me across the large terminal; he warned me that people are ignorant to people in wheelchairs and he was not wrong! So many people are in a dreamland state and either do not move for you or bump into you – and its your fault!

Anyway, the nice chap helped me board the aircraft as one of the first passengers and the BA hostess gave me an aisle seat within a row where I had nobody sitting next to me. At least I could stretch out. Great job BA!

In my next blog, I’ll share my time on the plane, the connecting flight out of Chicago onto Detroit and the state of my knee.

Until the next blog!

Tibial Osteotomy photo review – Post op to 6 weeks after. Part 2

In January 2018, I underwent a Tibial Osteotomy at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

This image has an empty alt attribute; its file name is knee.jpg

As a follow on from last weeks blog, I am sharing photos taken from pre-op to 6 weeks after. During the process of finding the pictures after 12 months and knowing that I am much better now, it does bring memories back of the journey of recovery and change. When you are in the moment, it is tough but as I noted in a previous blog, the human bodies capability to repair is incredible. The is light at the end of the tunnel!

Day 3- 5 Swelling and bruising


#After 3-5 days, expect bruising and discoloring to appear – the healing process

Days 6-8 I want to remove the bandaging!!

So in total I have 16 metal clips. Awesome!

Days 14 Metal Clips are out

Removal of clips are not that painful. Now I can think about Physiotherapy

Week 5-6 and the wound is healing well!

Healing in progress and Physio kicking in.

I hope the helps you out there. If you have any questions shoot me a message. See you next week!

Tibial Osteotomy photo review – Post op to 6 weeks after. Part 1

In January 2018, I underwent a Tibial Osteotomy at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

For this weeks blog, I am sharing photos taken from pre-op to 6 weeks after. On creating this post, you have to realize the human body has amazing recovery capabilities, the repairs to the bone, muscle, tendons and skin are simultaneous!. When you are going through it on a daily basis it can feel like sh!t – don’t worry, you will get better!

Pre-Op mark up

Pre-op and before the leg shaving, Mr Chatoo marked my operating leg.

Post Op – compression bag on leg to reduce swelling

May be 2-3 hours after i came round from the op, you cannot feel a thing.

After 1 day, compression bag removed

There is a lot of bandage, but where is my other leg?

Day 2 – Getting ready for home, remove the bandages

This is the best part, time to go home.

Looks like I have run out of space, stay tuned the next post will continue the journey.

Putting the Physio advice into action

In January 2018, I underwent a Tibial Osteotomy at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

My blog charts the diary I kept as I went through the rehabilitation process. I am not a medical expert and is only my experiences that I share. Please click through my earlier posts using the menus on the right!.

I applied all the advice from my physio Craig into practice to build my muscles up. Loss of muscle mass and body control after an intrusive operation means getting back to normal needs a lot of work.

Lets keep this in perspective, an Osteotomy is a major operation

Feeling more stable on my feet and better stamina is making the recovery feels more real.

I am now able to walk correctly (with crutches) but the funny thing is ‘relearning walking’…to put the foot on the ground with the heel and moving the foot in a smooth rolling movement is key; I wanted to avoid dragging my foot or worse still, walking like a penguin; I really have to concentrate. At best it will improve posture, avoid back pains as well as ruining my other leg/knee.

I am able now to walk to the coffee shop and walk further without getting tired.
Working is still the pain, as its cold outside, and laying on the sofa – cabin fever, the irritation of medication and mobility just ends up with being negative to people at work. I expect this to subside as well. Just need to keep the routine going.


Quickfire questions on life before and after Osteotomy procedure.

So this blog is written by Priya. We met with my surgeon Mr Minhal Chatoo at the One Hatfield hospital on 8th May and he recommended Priya interviews me to share how life has changed pre- and post- Osteotomy.

Hi, Priya here. I thought of a bunch of questions to ask my dad about his progress.


This is Hertford Castle, near where we live and where we went for a walk.


How has the pain around your leg changed since the Osteotomy operation?
Every day and every week I notice that the pain is getting less. However I do notice new pains appearing. The swelling in my leg is still there but is gradually reducing. The Osteotemy does entail bone cutting, drilling, cutting deep into flesh, muscle and many nerves. It does take a long time for the healing process to complete.

What life changes have you made since your first diagnosis?

I have made an effort to lose weight and eat the right foods. I have cut down alcohol, sugar and some types of meat. I have had to stop jogging due to the impact on my knees however I have now started going to the gym more where I run on the treadmill, use the cross trainer and lift weights to strengthen my core. If I can lose more weight I may be able to run again.

How has the operation influenced your life now?

To be more aware of long term health. I know I cannot run as much or kick a football about as much, so I need to find new sports/pass times to get involved in. Also life is about longevity so doing the right exercise is key.

How might the operation impact others around you?

As his daughter I have seen a urge in my father to lose weight and really exercise more. The effect this has on me is that as a family we go out and walk in different new locations on a weekly basis. This is a more active effect on my life and it’s for the better, as we are also eating healthier and experimenting more activities.

How do you think you can help others?

If you are young enough and want to continue having an active life, there is an alternative to a knee replacement surgery. The operation does give you the chance to defer such an intrusive operation for a number of years. The psychological impact of getting your life back to a normal balance is very important.

Post Tibial Osteotomy and returning to work as well as starting Physiotherapy

Recovery in weeks 3 and 4 (Feb 2018)
In the weeks surrounding returning to work, I did find it tiring in the afternoon. I was able to work from home for a reasonable period; it helps the sense of things returning to normal.

Trying to balance a laptop, having a bag of frozen peas (to reduce swelling) and laying flat as much as possible does get uncomfortable – be aware. The swelling is getting less and some mobility was returning. I am going out more for a walk around also.

Starting Physiotherapy (at last!!)

Physio day (at the One Hatfield hospital) was something I was really looking forward to. In the same week, the UK was being braced to abnormally cold weather. Very challenging journey indeed to the hospital!

Loiza was worried on the day to drive. The outside temperature was around -1 to -3 centigrade on the day but snow was very light. In my mind I was completely set on going and would have driven myself to get there. I say this because I had set my mind to get to this milestone-  its where the expert can tell me if my recovery is going well and what i need to do to get better. Having stopped work at 2pm, we set off.

I have to say that just sitting in the car and going for a drive is something i really enjoyed.

We waited for the physio to arrive and sat with a coffee.

We met with the resident physio, Craig. He started by testing my strength, assessed flexibility. He then went over additional exercises. Examples for strength exercises are :

  • Lying on the floor and lifting the leg up 6 inches and lowering slowly
  • Tensing the Quads and pushing the knee down
  • Bring the knee to your body
  • Roll up a towel, rest under the knee and straighten the leg
  • Stand up and hold a ball behind the knee and push the leg back

Craig said he was happy that I had been exercising- he could tell.

The final task was to walk and alternate the walking sticks – aiming to move me off 2 crutches and onto 1.

Having concluded the session, the task was to continue at home on a regular basis and get some core strength back.

Removal of metal clips after Tibial Osteotomy – Feeling lighter!

Removal of the clips

3 steps to Osteotomy. Simple!

On the 14th February ( and yes on Valentines day!) we returned to the One Hatfield Hospital for the removal of the stitches/ metal clips.

The resident nurse took us away. I had Loiza and Priya as my support team; or rather for Priya to watch me pass out and make a mess of myself.

The nurse was very helpful and knowledgeable. We didn’t know that Osteotomy’s in the past resulted in patients having their leg in plaster for over 8 weeks. She mentioned surgery now is much more accurate and less evasive. I have to thank the surgeon Mr Chatoo for his expertise.  

Initially I thought the removal of the clips would be very painful, it was the opposite. Using a pair of metal clips, she pinched the clip in the mid point and that forced the clip to bend and pull out. Out of the 17 clips, only 3 hurt when they were removed. I didn’t have any local anesthetic.

The wound feels very raw but the good thing is it is healing without an infection.

Clips now removed. Another milestone achieved

And a closer look where you can see the ink marks from the surgery. External healing is definitely a “work in progress”

As a treat for Valentines, Loiza took us to a well known fast food establishment serving fried chicken- this is payback for when Loiza and I were dating at University and i took her to this place when I was broke. Anyway I loved it!

On going to bed, i asked Loiza to add a bandage to cover the wound as i didnt want it to catch or split whilst i was asleep.

The pain in the knee and ankle remains however the shooting pain on my shin is less painful. Also the red bruising on my calf muscle has almost gone. For the pain, Loiza set up a call with a GP who administered stronger pain killers. This is working, the swelling on the knee is  less so and i am able to walk a little easier. However the ankle pain remains. That will need gravity and ice to give me movement back over the coming weeks.

Q &A How the Tibial Osteotomy became the recommended solution

I thought I would take time out from my diary blog in order to answer a bunch of questions that friends and family have asked me in the past.

Q: Was the cause a Sports Injury?

A: When I was younger, I was very active. Loved Martial Arts so trained 3-4 days a week; did this for over 12 years to a high level. I also played Soccer, Basketball for school, college and clubs. When I got older (into my 40’s) I took on Sprint Triathlons and 10k runs. The training takes its toll. Also I would consider myself overweight (or heavy boned 🙂 )

Q : You had an Arthroscopy and Debridement – thought that was the fix?

A: You would think that, but in effect brought on the pain more, my right leg became bow. (keyhole surgery where they wash lose cartilage from within the knee and shave some bone)

Q: Who recommended you for the tibial osteotomy?

A: I was undergoing Physiotherapy for my arthroscopy at the time and I complained the pain was getting worse. At this time, the physiotherapist recommended me to arrange a consultant session with a specialist, Mr Minhal Chatoo. He was doing some great work in surgeries that avoid having a knee replacement. I was referred to Mr Chatoo.

Mr Minhal Chatoo, Consultant Surgeon

Q: What happened during the first meeting with Mr Chatoo

A : Prior to meeting with Mr Chatoo, I went for an MRI scan and a full leg X-ray (starting from my hip down to my foot – 2 X-rays merged to 1). Mr Chatoo analysed the X-ray.

On meeting with Mr Chatoo, he shared his diagnosis and then outlined the course of correction that an Osteotemy would provide and more importantly deferring a knee operation. He also shared success stories of his previous patients. He considered me as a candidate as I was young and capable of making the right recovery.

Q: At high level, what would the surgery entail?

A : I am no expert so can only share my recall…….Mr Chatoo used software to outline where a line of gravity should pass after surgery (A line should move from the hip, down the middle of the knee and to the middle of the ankle). There was a lot of wear and tear on the inside of my right leg/knee. As my leg was bow he showed me where the line of gravity was passing versus where it should be. To achieve this, he will cut my tibia and remove enough bone (in a triangle) to allow correction. Steel plates will be applied to allow the bone to grow back and straighten my leg and to conclusively reduce the pain caused the rheumatism. I was a borderline candidate but Mr Chatoo was confident of success.

Q: Why did you proceed with the Surgery, sounds painful

A: The surgeon, Mr Chatoo was the reason. He was caring, knowledgeable, confident and human. He has a great success rate and convinced me of a decent recovery.

Right, that’s it for now, I’ll post more in a few weeks. If you have questions, post them to me and I’ll add them to another post.

Living with the Osteotomy – venturing out of the house!

The next 4 days

Hello there! I took a few days off from blogging as the weather in the UK is just amazing.

Shoreditch, London. Keeping the rich out of our common places

Forcing a routine of getting up and resting is just something that has to be done. As Loiza and others tell me when I become impatient, the importance is for a full recovery of :

(1) the soft tissue beneath the skin

(2) the bone that is missing coupled with the metal work

(3) tendons and muscles that are affected by the surgery

It is so important to recover well in order to have the right level of mobility, otherwise the surgery will not be as effective.

The overarching pain at the moment is the joint pain. My knee is still stiff and swollen. Slowly movement is coming back but I am conscious of keeping my muscle mass however it will be noticeable that I am losing muscle. My ankle now is the most painful. The swelling (and blackness of the bruising) is more painful and keeping my knee above the rest of my body is easier said than done.

I am now negotiating the stairs and taken showers by sitting on the stool – the stair climb is painful as pain is felt on the outside of the knee (as the alignment takes effect).

On the 12th February Loiza took me out for a walk and I covered the longest distance (ok it was about 20 metres there and back). Compared to the last time I went for a walk, I have trebled the distance. The issue is the continued pain in the knee.

Get some loose clothing and get some exercise.

The pain in the evenings is interesting, I get shots of pain from the top of the tibia to half way down. A throbbing pain as well as the area around the stitches. If this is the healing process then great but they are heavy bursts of contracting pain. I really cannot wait for the clips to be removed, I won’t miss the protruding metal clips i can feel within the bandage.

Revealing the staples after Osteotomy

February 7th (day 7)

Nothing to do with my operation, but a snap from my holiday to Langkawi, Malaysia in 2017.

When you are unable to walk and get out of the house for a number of days, it does drive you a little crazy. There is only so much daytime you can take before insanity sets in. I also noticed that my swelling from the leg has traveled to my ankle. Late in the morning, I was sat on a stool in the kitchen in the sunshine as my mother lunch. I must have been sitting for 30 minutes. After I sat back at the sofa, my ankle did begin to hurt.

Additional bruising, the case for gravity.

One of the more consistent pains I am experiencing is the pain of standing up. The shin area of my leg is really tender and when I stand up, that area becomes overbearingly painful for a few minutes. So much that I am unable to walk. Do watch out for this after your op.

Loiza planned to replace the current bandages and so we took off some of the tape around the wound to see if we could proceed. Unfortunately the replacements provided by the hospital were too small so had to wait. What we did see (as below) are metal clips. The points where the skin are pinched together still look raw and I can understand why I have so much pain in my shins.

Markings made by the Surgeon and the staples appearing. Too soon me thinks.


February 8th (Day 8)

My nights sleep was very uncomfortable, a combination of heartburn and leg pain. I also felt that I was coming down with the flu. I did go back to sleep after a warm glass of milk but felt rough in the morning.

My breakfast routine of tablets, porridge, fruit juice and fybrogel continues. Today my mother took over as Loiza went to work early,

My parents were going to leave to day, a little sad but i think my dad was getting a little tired. I will miss them as they helped me during the day and kept me company.

Today I found walking even more painful than normal, walking by sliding my foot just made it easier for a short time. Unbearable today. Also I fell asleep on the sofa with my leg resting above my head; i jerked my leg for no reason and woke me up. The pain was a 9 out of 10 – right on the stitch lines on my leg. It took 5-10 minutes for the pain to die down.

Once Loiza returned from work, we removed the bandages and had a chance to look at the stitches. There was also blood on one of the stiches – may have been a result of knee moving while I was asleep earlier

Ok, so it is a major operation guys!. Recovery will be gradual.

I didnt want to speak much for the rest of the evening; also the pain and swelling from my ankle was at a 8 out of 10. Loiza gave me a salt bath to soak my ankle. Helped a bit


Osteotomy recovery on days 3 , 4 and 5

The bruising appears

February 3rd (Day 3)

I may have woken once last night for painkillers and so felt well rested. The pain was less and felt like I had some more mobility. I was able to wash and change by myself however Loiza did helped me. I sat in the day room and watched Priya get ready for her Saturday league football match. Aroon was going to stay with me for the morning and keep me company. I felt a lot stronger today and walked a little with the crutches. The exercises and movement are so important and really helps psychologically. Having watched The Punisher on Netflix (which is just awesome) I fell asleep for an hour – tiredness hits you and comes in waves. I know it helps with the healing.

The key thing is to remain mobile and to keep the joints moving. I have started doing ‘light weights’ to keep the upper body muscle mass although need to be careful as not to pull any tendons in the leg.

I stayed up until 10pm and then was helped to bed.

February 4th (day 4)

I only woke up once last night for painkillers (3:42am) and I could feel the pain. Waking up at 7:20am thereafter and I was really thirsty. I did drink ¾ of the water bottle but could not go back to sleep. This morning the pain level was very high.

The length of my tibia was painful. Loiza also noticed that I had new bruising on the back of the knee. Also the swelling is more prevalent this morning and appeared purple and red towards the bottom of my leg.

Red bruising appearing after the operation

I did get a chance to walk more. Distance and frequency is improving but the stiffness around the ankle and knee is still there.

February 5th (Day 5)

Monday morning and I woke up at 7:20am. I was able to sleep on my side although felt uncomfortable when i woke up. Loiza still had to help me out of bed and had to take the day off; it was the right thing to do. I cannot manage by myself just yet.

I think i have one more day of the co-didromel pills afterwhich i am on 400mg ibuprofen and the paracetamol.

Sitting with Loiza today and i am continuing with the icepacks on the leg. I did notice that my knee is stiff and getting new pains in the knee. Also as the picture below, more new bruising is appearing and this time in the back of the knee.

Further bruising appearing on the back of the leg

I was able to walk a little more than yesterday so at least my mobility is improving however by lunchtime I am exhausted. I know that movement is still needed otherwise mobility in the joints reduces and becomes harder.

My parents arrived at 3pm and so i sat, chatted and stayed awake until about 10pm.

Recovery starts at home!

February 2nd (Day 2)

The One Hatfield Hospital, Hertfordshire, where the
Osteotomy was conducted

Last night I only woke up twice in the night. I was given stronger pain killers and the sleep was so much better. I was able to go to the bathroom by myself, major result in getting some independence back

Later in the morning I met with the resident doctor, pharmacist and physio again. The doctor mentioned 6 weeks recovery for the bone and 2 weeks for soft tissue. This sounds tough but I need to recover properly. I guess I will be house bound for the initial duration of 2 weeks at the least.

I was taken for a walk with the physio at 10:46am and they got me to walk much further. This was tiring but a great milestone reached.

Other than the nurse washing my leg this morning I really want to go home.

Right now it is dealing with tiredness, loss of leg muscle mass and taking drugs to control the pain is what I need to acknowledge. I need to make sure I am doing exercises every hour to ensure recovery is fast.

Loiza arrived just after 11am and we chatted; I was excited about going home. People came and went to check my BP, O2 and administer more pain killers. The pharmacist came round and mentioned providing me with Co-didromol and ibuprofen. The pain will be high for the next week or so as the soft tissue heals.

Mr Chatoo came round at 1pm, he helped remove the bandaging and reassured me again on progress.

He recommended ice packs to reduce the swelling and pain killers to manage the pain. I was happy to hear from Mr Chatoo, a person who does take his work very seriously.

At Lunchtime, I was discharged from hospital. At last!

Getting into the car was not as painful as I thought and Loiza. I really enjoyed the ride home; I was finally out of hospital and moving around.

As I made it into the house, I felt relief of being back home; sitting in a hospital watching daytime TV drives you mad but also have my own creature comforts around me as well as the kids.

I sat on the upright sofa for a while and then lay flat once the pain started.

Movement is getting better but the swelling is causing discomfort in terms of knee movement and feeling my skin stretch across my calf. This in turn causes me to itch.

The pain and tiredness came in waves today and after having dinner (lentils) i fell asleep whilst watching tv at about 9ish. I just could not get warm and could not tolerate the cold peas. Hoping tomorrow would be better

Surgery done, here comes the Physio!

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.

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,