20/10/23 Anniversary, and CT report

Six years to the day since I fell down those steps at Liverpool Street Station and broke my shoulder. And, until we didn't realise it for years afterwards, my neck as well. Hence the titanium metalwork that was very successful inserted in Jan 22.

Finally got hold of the report of the CT scan done last May and which should have been sent to the RNOH long before my recent appointment. It should be there now...

The main thing, I think, is the references to other lesions in the area - first I've heard of those since the early days. And there is no mention of any bone re-growth, re-mineralisation, or the like. All the rest is only to be expected with advancing years. And good to know my prostate looks ok!

14/10/23 Hip x-rays

The images arrived from the RNOH in this morning's email. The two (one taken lying flat, the other halfway onto my right side, constitute what is called a "Judet view". M.Gerrand appeared interested in the flat one only. Clicking on the images will give a larger view.

Have to say the right hip joint doesn't look all that great to me either... That's the one on the left side of the image.

This is the other position:

This is the relevant bit of the first one, zoomed in:

and again, annotated:

10/10/23 Not a good idea

 08:21, not a time when I often do blog updates...

What's the worst thing I could possibly have done before breakfast? Fell out of bed and landed on my left hip. It's a long way down, thanks to the 11" "orthopaedic" mattress. 230 mornings since we moved in, and the first time I've done that. 

Seems to be no serious damage done, but I can't keep on falling on this hip. Something will fail eventually.

09/10/23 RNOH no-decision decision

Here's the news from my long-awaited appointment at the Royal National Orthopaedic Hospital's Assessment Unit in central London. In short, the decision is not to make a decision.

Yet.

Not helped by the fact that the CT scan I had done locally in Chelmsford and in double-quick time back in June, specifically to provide more evidence for today's consultation, hasn't arrived at the RNOH yet. You could have glued the report to the shells of a convoy of snails, and it would have made it from Chelmsford to London by now... Just another example of the terminal incompetence of the NHS over the simplest of administrative jobs.

Am I incandescently furious about the waste of my time and money going to this appointment when the basic information needed for it hasn't been delivered in time? I'm trying to hide it, but you can guess... Not to mention the waste of consultant time.

However, it was not a complete waste. I had a couple more X-rays done. Consultant thought there was a possible suggestion of some new bone growth since the last X-rays done in May, but I couldn't see it. But what he did spot, and no-one else has commented on for the May X-rays or any earlier imaging, is a perfectly clear small fracture of the acetabulum (socket) of the hip joint - see the image (it's not my pelvis, it's an image I found online!) The green dots show the socket, the area outlined in blue is the lesion, which is a fluid-filled cavity where there should be solid bone, and the red X marks the fracture.

Consultant's position is that as I am getting no pain from the hip at this stage although mobility is reduced, and as I've lived with this issue for four years now (while believing that the lesion had largely repaired itself for most of that time) there is no cause for immediate intervention. I replied that even so, the joint is clearly unstable / precarious / whatever and liable to catastrophic failure with another fall or any other incident, and I don't at all enjoy living with the constant awareness that one mis-step or miscalculation of a bit of lifting could be all it needs. On top of the constant awareness that the myeloma might relapse at any time and complicate the issue further. I would want to intervene as soon as possible and get this sorted out rather than wait for it to turn into an emergency without, perhaps, the time to plan and perform the best possible option.

On the subject of "best possible option", consultant thinks that an orthodox hip replacement would be the way to go, although I can't see how there's enough good solid bone there to take one - and that was the view of the orthopaedic surgeon in Chelmsford, and the reason why he referred me on to the RNOH...

Be all that as it may the decision, such as it is, is to wait and see how it goes for another eight weeks, at which time we review, re-image, and re-think. A particular point is whether any pain develops, so I shall keep a particularly close record of that. And wait another couple of months...

Meanwhile, I understand that a crack team of NHS tortoises is at this moment being dispatched towards Chelmsford to collect the CT scan from June and whoosh it (in tortoise terms) towards 45 Bolsover Street...

I have also requested copies of today's X-rays. Needless to say there's a mountain of bureaucracy to deal with, they can't just email the images straight to me, but I hope to have them within a few days. Or weeks. I'll post them when they arrive.

06/10/23 Stanmore update

Early the following morning I got a reply to that email and it really was the right secretary after all. Yes, it's definitely at Bolsover Street, and I should have had an email with all the details. I've had a very thorough search of all my email records - no trace of it. I asked her to re-send and that one arrived straightaway. And the same thing arrived by post. Belt and braces, but should never have been needed!

04/10/23 Stanmore, NHS...

 Next chapter in my long-running saga...

My appointment at the Royal National Orthopaedic Hospital in Stanmore (Middlesex) is now less than a week away, on Monday. The original appointment letter, which I have somehow mislaid, said that another letter with more details would arrive "closer to the time". It hasn't arrived, and considering the combined inefficiencies of the NHS and the Royal Mail, quite possibly never will.

So I 'phoned the RNOH and after a couple of false trails got through to somebody at Joint Reconstruction who could answer questions about my appointment. "Yes, he confirmed, 2:10 on the 9th, see you then."

"Hang on," I said, "can you tell me the name of the doctor I'm seeing and give me a room number so I know where to go?"

Long silence...

Eventually, "It's Mr.Gerrand."

"OK, can you give me a room number please?"

Another even longer silence......

"It's not here, it's in Bolsover Street." That's the RNOH's other site in central London, near Regent's Park and Harley Street.

"Thanks for telling me, otherwise I'd have turned up at the wrong hospital."

The Bolsover Street place, I've since discovered, is the RNOH's Assessment Centre. At least that makes some sort of sense.

I went online, looked up Mr.Gerrand, and found both a 'phone number and a name and email address for his secretary. Obviously I wanted confirmation that the appointment actually is for Bolsover Street not Stanmore, so I rang the secretary's number. The recorded message gave a different name and said she was secretary for two completely different doctors, not including my man. So I left a message anyway asking for a call back to confirm the appointment. It might happen. And there again it might not.

Now going to try an email to a secretary who quite probably no longer exists. Or no longer works for Mr.Gerrand anyway. Also got to cancel the "Just Park" parking space I had booked just a couple of minutes walk away from Stanmore station.

Never a dull moment...

A bit more about the Royal National Orthopaedic Hospital saga:

Looking up Dr. Gerrand online, I found this link to the Daily Mail back in 2014. I had no idea things like this were being done nine years ago. It also fits with what my local orthopaedic surgeon said when referring me to Stanmore, that some such implant was probably the best way to go.

Dr.Gerrand in the DM 2014