Cycle or Running event ? decision made…

In January 2018, I underwent a Tibial Osteotomy operation 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.

It has been a long time since I posted a blog, recovering from an umbilical hernia and then getting mad busy at work have caused distractions.

This is the second year of operations for me and requiring time to recover (removal of metal plates from leg and then an umbilical hernia repair) just makes things look shitty as you are forced to make life adjustments to make sure recovery is good. Now I have clear runway to do more challenging things..

I met with a good friend this week who wants to do a few triathlons, 10k runs and cycle sportive in 2020 and he got me excited – however a reality check is needed.

So…I have been scratching around on what I can do physically….I’d love to take part in running. I can run on a treadmill but road running is painful. Also my knee is still suspect to heavy workouts…if I walk more than 8km, I feel swelling and pain. I have been adding muscle mass to compensate but the pain is still there.

Cycling it has to be !

Maybe a few 30 and 50 Mile events in the UK for starters that commence in March. At least there is a target and a training plan to make up; from now until then..

Later in the year, would be great to take part in the UK Coast to Coast cycle, a few days on the road on a MTB. See here

Some days I feel like I can swim, bike and run, other days it feels like I need to get an electric bike and pretend to burn the calories.

A slip whilst walking, my knee resembles a balloon

In January 2018, I underwent a Tibial Osteotomy operation as I had been suffering from the onset of arthritis on my right knee and needed an alternative to a knee replacement operation.

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

nothing like a good slip on the sidewalk !

In October 2019, I took the family to San Francisco for a 5 day break. Flying non-stop from Heathrow was great as the flight left the UK early and arriving in the USA at 1pm, this meant we still had a full day; however American immigration had other ideas as we queued for over 2 hours to go through passport control.

The holiday was going well, I was walking freely and pain free and I did forget about my operation earlier in the year until day 2 when we were walking to a breakfast diner and slipped on the pavement. As I walked over damp metal grating, I lost my footing. All I remember was trying to retain my balance as much as I could so that I don’t look like a complete lemon as I hit the deck.

I hit the ground with my right knee (my operated leg) and boy did I feel it. The kids and Loiza helped me up; I didn’t want to make a fuss.

As we sat in the diner, my knee began to throb and by the afternoon, I had to switch out from the trousers I was wearing and into a pair of shorts. My knee was aching and the swelling around the knee was excessive.

I didn’t take a photo of my own knee but the image below sums it up..

Sums up the size of my knee!

I felt annoyed and sorry for myself (stupid, I know). I am seriously doubting if my health can ever be 100% again if a simple fall can set you back.

I ended up buying a knee brace from CVS to help me walk (and cycle over the San Francisco Bridge) and taking Naproxin to reduce the swelling. 4 days on and the swelling and pain is under control.

Doubt is now creeping in about my recovery – thinking I am back to normal to soon.

On a side note, I did manage to walk up to the Coit Tower to take this amazing picture of the bay bridge.

Quickfire questions – 1.5 years after Tibial Osteotomy

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!

Was having the Tibial Osteotomy worth it?

No doubt there have been some days recently where I have been questioning myself on the same point. I have started to feel some of the pre-operation pain from time to time in the last few months. As I had the metal plated removed 6 months ago, there is still some pain and swelling as the bone re-grows- I may confusing this pain with what I experienced a few years ago. I need to see in another 6 months.

The Osteotomy is not a miracle cure: rather it has halted the arthritis and its pain giving the patient many aspects of an active lifestyle back.

The inevitable action of a knee replacement is just deferred and on that point I would say yes, it has been worth it.

What would have happened if you didn’t have the operation?

It would have been expensive physio sessions and Cortisone steroid injections while I wait for a knee replacement (partial or full). I am still in my 40’s so what happens after 15 years ? Knee replacements are meant to last between 15-20 years right?

What changes have you noticed?

My leg is a lot straighter than it was before. I am more active now and travelling is back on the agenda.

I am losing weight but its not fast enough. I guess I am more cautious in not pushing myself too much and I need to rest up more.

What lifestyle changes have you made since the operation 1.5 years on?

  • Eating a healthier diet and trying to lose weight.
  • Keeping to the physio strength exercises as a regular routine
  • Building strength and stamina around the knee (I never did this before and has made a big difference)
  • Knowing my limits and resting more

Would you have the same operation on the other knee?

I am experiencing pain in my left knee but it is not as painful as my right knee. I am 50/50 at the moment as the operation/ recovery time/ adjusting to work is not easy and takes a lot out of a person. Maybe a question to ask next year.

If you have any questions, drop me a question in the comments boxand I will be happy to share my experiences with you.

Guest Blog : My souvenirs from Mexico and their meaning

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!

Some of my memories of Mexico are that there are a lot of tourist souvenir shops that sell tequila, sombreros, magnets and decorative shot glasses. However there are a few boutique shops which sell some really unique and charismatic souvenirs which tell a story at first glance.

This decorative purple skeleton represents a typical Day of the Dead tradition. This festival is a Mexican holiday that celebrates the lives of the deceased. The holiday is actually celebrated for two days. The first day, also know as All Saints Day, is the day to remember the deceased children. The 2nd of November is known as All Souls Day, meaning remembering those friends and family who have passed away.

The pink skull below represents a typical sugar skull that would be made for the celebration. The skulls are meant to reflect the happy and joyful memories associated with lost loved ones.

Another souvenir we picked up on the way back from a tour was a mini Mayan mask made out of Obsidian stone. Obsidian was widely used in the Mayan and Aztec times and it is created by the rapid cooling of lava. It is a strong protective stone and in the Mayan era it was used to make sharp objects, such as spears and knives. As a family we all thought that this was an unusual stone and we liked the peculiar design.

Post Tibial Osteotomy- recovery from the removal of metal plates

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!

Its been a while since I last blogged an update as my daughter guest blogged about our family trip to Mexico; she is writing another post and will appear once she is done. 

OK, so my last post ended with me returning home after the removal of the metal plates that was conducted by Mr Minhal Chatoo at the One Hatfield Hospital in March 2019 (earlier this year).

Whilst at home I realized that I get a very bad reaction to Codiene so had to stop taking that pain killer; rather stayed on the Ibuprofen and paracetamol.

Lets focus on the recovery points..

2 Days after operation

The swelling had reduced. Pain killers were working and I was able to move around slowly on crutches. The arrow was drawn on my leg by the surgeon (so he doesn’t carve open the wrong leg).

2 Weeks after operation

Mobility was better as I was using the crutches on occasion and visited the gym to do light cycle work. I wanted to build up stamina. It did help that prior to this operation that I had continued doing the exercises given to me by my physio as well as the work done in the gym. This way I was moving and recovering much faster than the previous year.

3 weeks after the operation

So a close up of the scar and I am pleased with the outcome. No infection but just the pain expected from further bone healing after the removal of the plates and screws.

In my next blog I will return to a Q & A post sharing questions I was asked by friends and family.

If you are about to go into surgery or at home in recovery mode, why not shoot me a few questions?

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.

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’

Flying post Osteotemy and managing pain in the USA

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 April 2018 I traveled on business from London, UK to Detroit, USA – a journey with 2 connecting flights and over 15 hours of combined travel time.

I do like the F250 type truck, this one will do also!

In my previous blog, I forgot to mention that I continued taking pain killers such as standard Ibuprofen, Paracetamol (when needed) and calcium tablets. The purpose was to manage the pain; after 3.5 months, the swelling and pain was still prevalent, advice from the Physio was to take the tablets when needed; pain management is key, you cannot be a hero as the healing process is still ongoing.

So on the flight over, I did not sleep, I kept moving on the aircraft. I decided to work on my laptop standing up and it really worked. When I landed in Chicago (1st stop) I was able to walk OK and the swelling was not bad. I did get some assistance from ground staff, which was great. At my next check in for my flight to Chicago, I boarded first, placed my crutch in the compartment above my seat and rested up. The rest of the journey from the Airport to the hotel was uneventful.

As soon as I did get to my hotel room (around 2pm), I crashed for a few hours and then drank a lot of water. Again, no pain!

A fancy head, in a restaurant!

As I adjusted to the timezone and to the extended work day, pain management and rest was key. The key thing was not to slack off but to keep to the routine to date. I was also conscious of not acting like I was a special needs case – If I needed to use the crutch I would otherwise I would try to walk and ensure my posture was correct. Its so easy to get back pains, impact the good knee or develop hip joint pains; a symptom of overcompensating.

I have seen this building in a movie shot in Detroit, the city is changing by the way; more gentrified

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.

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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!