Liz’ PAO surgery diary

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I’m Liz, a working mum. 45.  Symptoms presented late but apparently been there since birth. Diagnosed post second pregnancy after years of trying to get to the bottom of the problem.. Previously sporty but my symptoms were very gradually limiting  over a very long period. Then after diagnosis the pain increases and quickly became limited in the last year before surgery. It was a slow onslaught, like being run-over by a milk float!


After I had been diagnosed with hip dysplasia and already agreed verbally to go on the waiting list for PAO, there were  COVID related delays. I worried I may lose the opportunity and this helped to make May outlook more positive when I was offered a date!

I received  a call out of the blue with a date and then followed a meeting with the consultant, where they have to talk through what is essentially is risk assessment of every possible worse-case scenario (no matter how unlikely) - I.e.anything that could wrong at any point and what they will do to avoid that and if they can’t avoid, how they will fix or not.

Before this meeting, I had already decided quite plainly that my options were to do it or not do it!! But my journey to get offered the PAO was long and had a short window to get it done before it was too late.

To anyone feeling anxious this meeting could be a terrifying prospect as the risks can sound pretty drastic!! For my journey, I started in denial, then I did my research, spoke to many people and found none of them had regrets. I’d gone back and forth on this many times, but then once I finally decided I couldn’t go on as I was, that was it and I was doing it!! It’s important to understand the risks fully but anything in life comes with a risk - sometimes not taking any risks, cans be an equally risky and bleak prospect.


When you arrive, you are checked-in and go through standard checks with the nurse. The consultant came to see me and talk through any last questions. The anaesthetist also came to talk through the process. You have a gown, a compression sock on your non-operated leg and they drawer an arrow on operation side. Once ready, I walked down to the operating theatre with two nurses. The anaesthetist was waiting there and made me feel comfortable, talking me through every step of the process. I sat on the bed whilst they put in the cannula in to my hand and then sat forward on the bed and the nurse reassuringly stood with me whilst the anaesthetist was behind me putting in the spinal anaesthetic.. This was something I was dreading this but whilst it was a weird, slightly unpleasant feeling, it did not hurt. The next step was I was given the general anaesthetic and gently fell off to sleep within a few seconds.


I woke up in recovery. I had no pain at all, in fact, I felt well and couldn’t stop chatting to the nurses! (Probably the drugs)!

I had a drip hooked up to the cannula in my hand and a catheter had been fitted whilst I was asleep. Also, a point in operated leg was connected to the a ‘nerve bomb’ which is a plastic container that blocks out feeling to that area. Plus I had a button to press for additional morphine. I didn’t really need it but I did use it before they rolled my bed to the ward, just in case! You can’t overdo it as it has a setting will monitor the amount so you can zap away when needed but knowing it won’t let you exceed the dose allowed.

I then was in my own room to recover and they monitor you every half an hour to start with, checking blood pressure / heart rate / pain levels / any nausea. The first night my operated leg was out in a raised brace that gently kept it moving and this was with me on and off until I was up and about.

I felt very sleepy for the first couple of days and just slept every opportunity. I didn’t really feel like concentrating on anything. But I was able to call my family and send text messages to everyone who was waiting for an update. I also had some lovely nurses and very lovely lady who brought me tea and biscuits which kept my spirits up.

The consultant visited me to say he was happy with how things have gone and talked through the plan. He explained that the injections I’d had would continually daily for 28 days, They are standard to prevent DVT. I’ve no issues with injections but did not enjoy these! They don’t hurt to do but can leave a little bit of a sting after. To be honest they have annoyed me having to do these at home (but rather do that then have DVT)!!


I had an X-ray. I pumped a fair bit of morphine in preparation for being moved but didn’t really need that much! They moved me swiftly from the bed to the table and also had a bit of a laugh about it. (Again, I chatting as was a bit high and asked them to wheel me to the pub)! It was a bit uncomfortable but not painful. Although I was a bit hazy with the extra pain meds I’d treated myself to’!

Physio came and got me up on day 2. I was stiff and very delicate in my movement but managed to get off the bed. I felt like I’d been kicked in my lower back. My operated leg was a bit of a dead-weight trying to move it. The top of the leg felt like the nerve endings were very sensitive and you have to support the leg for any movement to make sure it doesn’t hurt. I started to feel a bit light headed and they decided not to get me in the chair as my blood pressure dipped.

The consultant came back either day 2 or 3 to say he was happy with all the scans and all was going to plan.


I had a CT scan first thing and decided not pump a load of morphine this time and my pain levels were fine. I was better able to then get out of bed with the physio and use a frame to get the chair. This felt a big achievement! I sat in the chair for an hour or so but was exhausted later and went back to bed for an afternoon sleep! This was a bit of a reality check in terms of how uncomfortable it was to move and how frustratingly slow everything took. This did mean though that I could ditch the night time moving leg brace and later have the catheter removed. The catheter was a real concern for me as I worried about this being painful or getting an infection. I had no issues with this, it was weird/ but didn’t hurt and was just glad I didn’t have to get up to go to the loo while I had it!

I was told by the visiting Orthopedic doctor  my CT scans looked good, so all heading in the right direction!

DAY 3-5

Day 3-5 was transitioning from removing the morphine drip and then later on removing the nerve bomb (which I was clinging on to and not keen to lose as I really had very little pain at this point but suspected this might change)!

The transition was tricky for a few hours, I felt a bit nauseous but realised my pain levels have gone up. So they adjusted my pain relief and gave me anti-sickness. That was soon under control, and I was independently going to the bathroom on my own and getting to the chair. I was getting up and washing myself-balancing with the frame. I also had some very basic exercises to do daily from physio.

There is no time to get bored, there was a succession/ blur of physio’s to get me moving and visits from OT to arrange equipment for my home. I found crutches much easier than a frame and day 4 managed the ‘pretend’ stairs pretty convingky. I always made sure we did this after my meds has kicked in.

The nurses regularly checked my body for any signs of sores from lying down. I had a couple of very small rubbing marks but that was about it. But one piece of tape blistered - so it’s worth keeping this checked.

At a real push I could have left hospital on day 5 but I’d still not managed to go to number 2’s and OT were arranging a chair for my home as I didn’t have a suitable one with arms! As it happens, I was glad of the weekend to feel more recovered and more prepared to travel home. Also, going to the number 2’s had alluded me and really was becoming an issue. I eventually agreed a plan for a ‘dynamite’ as they called it - aka suppository! This worked but I did have ongoing issues with my stomach when I returned home.

The week after being discharged from hospital I was very tired. I gladly accepted help staying with my mum even though I’d been reluctant as this meant being away my children for longer. This was difficult but was the right decision for me.I had a lot trouble with my stomach for a few days and felt exhausted. I had to adjust pain relief, which is a bit trial an error. The stairs, I’d been so confident with in hospital, seemed initially more tiring. I’d use a small over the shoulder bag to carry my things like my water bottle and phone/ charger downstairs with me.


Week 2 was about sleeping, enjoying home cooked food and sitting around with my leg up to keep swelling/ inflammation at bay. Getting the medication right and on time (we kept a bit of the time and what was taken at the start). Keeping the number 2’s going is also so important!! (I dropped the codiene early on - probably too early, but this was my personal preference to deal with the discomfort over risking any further constipation)!

I was generally uncomfortable week 2 but have slept with loads of pillows around me. I had some nerve pain in my lower back and tingly sensation in the top of my leg, the feeling is not entirely back yet.

I dropped things a lot more than usual - and couldn’t pick them up.  I had to laugh at myself, even though I sometimes could do with a cry! I moved slower than tortoise and was a bit grumpy! I refused visitors apart my husband and children, and just spoke to anyone else over the phone. Little wins were -pulling up my own pants and having my hair washed.


By week 3 I am starting to feel better in myself. I’ve had two good days in a row - I am able to sit and stand for longer periods. My stomach is fine and a good appetite.  I have made it in to the garden to sit in the sun for a bit and I am able to move slightly faster than a tortoise without pain.....and my concentration levels are improved, as I’ve been busy writing this for you and hope you find something in here of some use to you!

I’d recommend doing some research about hydrotherapy pools and see if this is something available and ask if your GP give you referral post- operation. (You cannot do this until your wound is healed but I think you can from about 4 weeks post op).

I’m doing the basic exercises given to me but not pushing in to pain. I’m listening to my body and will skip some if it’s not right and so what I can.

I’ve been told to source a standing in-door bike to use from week 4 and build up gradually.

My physio first session is booked for week 4. The consultant review is at 7 week post surgery. I believe I remain only touch-weight bearing until then. But I may then progress to gradual weight-bearing with one crutch and possibly driving an automatic -providing all goes well!

Hope this is useful in some small way!

Be brave and just get it done so you can get on with your life.

Wishing the very best of luck to you! X

November 2021

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