Part 1 of a multi-part story of middle age arthritis, and my journey to a total hip replacement. This part describes the reasons, the issues and what I tried to do to avoid having a total hip replacement in middle age.
- Part 1: Midlife arthritis and the underlying problem
- Part 2: Total hip replacement decision
- Part 3: Total hip replacement pre-op assessment
- Part 4: Surgery and hospital recovery: Days 1 to 5
- Part 5: First steps to recovery. Days 6 to 21
- Part 6: Hip recovery limping along. Weeks 3 to 7
Last night I cried out in bed. No, it wasn’t what you’re thinking. It was because of the pain of middle age arthritis. It was loud enough to stop my wife snoring, which was some consolation. But as I lay there trying to get back to sleep, I couldn’t help feeling a stab of regret that now in middle age the injuries, aches and pains stayed with me. Gone was the default “give it a couple of days” recovery process. Now it is more of a “get it checked out” process. My body used to fix itself, but sadly it doesn’t any more.
I’ve always been active. Football, squash, rugby, golf… in fact any sport was my thing. I was never great, but I was a trier. Of course that was a recipe for injuries, and I’ve had a few. Broken arm, hand, collar bone, nose and dislocated finger. Add to that torn cartilage (both knees), stitches in my head and chin (multiple times) and many others and you get the idea. They say God loves a trier. I think he was having a giggle with me.
However when I reached middle age I noticed things change. I couldn’t recover as fast and gradually the sports started to drop off. It finally hit the buffers with a visit to a specialist about hip pain that was not going away. I was still playing squash at the time, along with other overweight middle aged blokes (who liked playing games inside in the warm as I did). It was my thing. And unusually for me I was quite good.
Middle age arthritis. At my age? Really?
“You’ve got grade 4 hip arthritis,” said the consultant jovially. “Worst you can have. Both hips, but the left is particularly bad hence the pain.”
I smiled back. “So how long before it’s better?”
“Ah. That’s the point. This doesn’t get better until you have a hip replacement. It’s degenerative. It will only get worse. You also have FAI. We can try and treat that, but unfortunately I think it may be too late for you. Middle age arthritis is becoming increasingly common. You tried too hard. ”
- Femoroacetabular impingement (FAI) syndrome is a disorder of the hip.
- It is the result of an abnormal contact between the femur (thigh bone) and the acetabulum (the socket).
- In the US surgery for hip impingement increased 1800% between 2003-2013 while in the UK it rose 442% (Reiman and Thorborg 2014)
I was staggered. A hip replacement was for old people, not 40-somethings. It turned out I had been playing the “wrong” sports. With my funny shaped hip joints, the twisting and turning had worn away pretty much everything between the bones. Apparently I was unlucky. Middle age arthritis is uncommon but not unheard of A different sport, or less sport, and there would be no issue.
The number of hip replacement operations on people aged under 60 has risen 76% in the last decade, NHS figures for England reveal.
In actual fact Andy Murray had the same problem, so at least I was on a level with other sporting pantheons. Although obviously he was younger, fitter and had a wealth of healthcare support alongside him.
“Does that mean I won’t be able to play squash any more?” I asked nervously.
Then came the killer blow. “Well, not really. I mean, you have to look at yourself. You’re not a young man any more.”
So there it was. Old. No recovery without some serious medical intervention, and even then if I had a replacement hip now, I’d probably need another later on (assuming I lived into my seventies).
For me this was a hammer blow on many levels. Something I’d once said was more fun than sex (squash that is) was now denied to me because of my age (a bit like sex, but that’s another story).
Operation and recovery. Of sorts.
I sulked for a few weeks. I tried all the treatments – a steroid injection, pain killers including CBD, but to no avail. My body which had used to fix itself now couldn’t be fixed.
I ended up having the hip arthroscopy where they tried to reshape my hip joint to remove the spur that was causing the pain (FAI), and the arthritis. Aside from some time off work, sympathy, and the chance to watch a box set or two it didn’t really help.
Eventually I roused myself to consider alternatives to keep me sane. I invested in some Lycra and started cycling. I went swimming. I even became a gym bunny. Well, if you can call a middle aged bloke in saggy shorts and t-shirt a gym bunny. It all helped, after all exercise is good for the mind and soul.
However it has taken me a long time to come to terms with the finality of middle age arthritis. No more squash, football, or rugby. They’re lost to me now unless I try for the hip replacement. Middle age, for all the self help guides and encouragement, is the beginning of a decline. It hasn’t helped being made redundant.
Keeping yourself sane is key, so alternatives must be found. The positive is that no one cares what you look like anymore, so you can invest in the Lycra and reveal all, or sweat like a pig in dodgy t-shirts. Failing that just grow a belly in the pub.
The story of middle age arthritis and how I decided to resolve it with a hip replacement, and the whole hip replacement recovery story continues here (part 2).