I can’t believe it’s been more than a year since my knee replacement. And if I’m honest, I can’t believe I’m still having to use walking aids of some sort quite regularly. I guess the nice English euphemistic phrase would be that the outcome of my surgery is ‘not quite what I’d hoped it would be’. I have to get used to having less mobility.
The medical bit
There is nothing wrong with my new knee itself – surgically speaking that’s a success. And after a visit to my hip surgeon at the start of the year we can see that my left replaced hip, now 20 years old, has not deteriorated as a result. In fact, it’s in great shape for something that’s supposed to have a life of 15 years. My right hip – dysplastic but never bad enough to be replaced – is not orthopedically affected either. However, its rotation has been changed by straightening my leg, and so my hip flexor does limit my knee flexion which is an interesting new twist. In short, my right hip worked better with a valgus ‘knock’ knee to compensate for its limited range. But that’s why my old knee wore out on one side!
In short, whilst each of the parts in isolation is OK, something about the whole combination is more limiting. For the first time in 20 years, I feel disabled again, not just differently-abled. And having less mobility has taken some time to get used to.
Transport challenges
I have written about the social model of disability before. In essence it acknowledges that it’s the world around me that’s disabling. As well as having to use crutches to get on and off trains (high steps, wide gaps, limited handrails, people in the way, time pressure) I also have to consider – and frankly over-plan -any journey. Spontaneity is difficult. I have to think ‘do I know the station I’m going through? does it have lifts, are the steps crowded, can I hold onto a right-hand side handrail not a left-hand side one?’ I have to consider carefully what I can carry; I need the lightest backpack possible and I can’t carry anything in my hands. I can never buy a coffee and carry it on and off a train, I have to pack a flask that fits in my rucksack. When I get to the train, what happens if the seat reservations aren’t working because there are half the number of planned carriages (a regular on East Midlands Trains) – will I even get a seat? And then of course other people are unpredictable, moving hazards; equally I am a hazard to them. In short, any journey is a continuous risk-assessment from start to finish and that makes it exhausting.
I’m lucky that right now my job allows me to work from home most of the time. When I was recently looking for a new job, there were many where the 2 days per week commute into central London meant I didn’t even apply. So many employers these days are brilliant at reasonable adaptations once you get to work, but they can’t control the journey. And being the only team member who doesn’t turn up onsite can be isolating.
Leg length discrepancy
One of the other disabling factors is having to manage my leg length discrepancy. For five years prior to my hip replacement, I got used to having both an external shoe raise and inner insoles but for the last 19 years I was able to just use inner insoles that could fit into most shoes. I’m now back to having just four pairs of adapted shoes and them all being sensible, robust shoes. First world problem obviously, but still annoying. If I’m travelling with a small rucksack I can’t carry a spare pair for evening vs. daytime. And walking with bare feet is no longer an option with one leg so much shorter than the other.
It’s not all bad news…
There are lots of positives here. I’m pretty fit and healthy and with the right shoes and sticks I can walk. I swim well, I still sing, I manage to garden in small bursts albeit with painkillers, I can work, I have a supportive family and partner who does all the physical work when we go camping so I can still enjoy that experience. And compared to many people with hip dysplasia, I am not in constant, chronic pain and I am so thankful for that.
My knee doesn’t hurt much and it won’t degenerate rapidly like it was without the surgery. I have only had one posture-related migraine in the last year, whereas I was having them once every 2-3 weeks in the year before my last op. (The strain of my shoulders/neck trying to hold me steady can give me a headache which becomes so bad I develop a migraine – especially after singing or walking a long way). I’m not missing those!
And with my straighter right leg and the left shoe lift, I am officially taller (well on one side at least). For the first time in my life, I’m the same height as my sister!! It took me 51 years and 13 surgeries but it’s a win 😊
I have lived my life knowing that I can’t always take walking for granted. In the last year I have had to learn to live my life with a little less mobility. But still live it well.
Jill Pringle was born in Sheffield in 1971 with bilateral hip-dysplasia. She has had several surgeries including open reductions, leg lengthening, hip and knee replacements. Her blog raises awareness of living and walking with the condition and to raise money for Steps Charity Worldwide – you can donate here.
