My New Bionic Hips

By Delphine

Story of my wonky hips 

I started having hip problems ten years ago. I vividly remember that it just hit me one day when we were in Paris. Grant and Arabella went to the Eiffel Tower, while I was strolling around town with 18 months old Alex in the pram, when for no reason I suddenly felt a shooting pain from my right hip down my leg. The pain was so intense that I couldn’t walk for few minutes. That was the beginning of a decade of on and off hip pain.

While we were still living in Shanghai, I saw Dr Jason Brockwell, a HK based orthopaedic doctor and he diagnosed me with osteoarthritis (degenerative disease of the hip joint that causes loss of cartilage). CT scan showed my femur bone substantially twisted which might have contributed to the degeneration of the hip joint. Nobody in my family has ever had a hip replacement so why I got bad hips at such a young age is a mystery. A second orthopaedic doctor confirmed the diagnosis and both doctors said I would eventually need hip replacement at some point, maybe in 5 years, 10 years or even longer, depending on how I cope with the pain and how my quality of life is affected.

Over the years, my hips went from good to bad to good to bad… Five years ago after the birth of Azania, I started exercising rigorously and worked with a Hong Kong physiotherapist Elton Ng of CORES. Elton was amazing and really helped me when my hips were acting up.  I also had a personal trainer Ivan and did a lot of strength training and went on super long hikes all over Hong Kong. I was strong and fit, and my hips were fine most of the time.

Since coming on the boat, I continued to stay active and my hips weren’t too bad.  But in the last year, the hip pain somehow got worse. It was affecting my sleep, walking and general well being. Slowly but surely, I was taking painkillers and sleeping pills regularly to help me sleep as the pain was always most intense when I was trying to sleep.

Short family visit to HK

We had planned a short three-week trip back to Hong Kong while Grant went to Europe to attend the Rugby World Cup games. This is the first time we went back to Hong Kong since we started sailing two and a half years ago. Aside from seeing families and friends, this is also the best opportunity for all of us to do medical and dental check ups.  On the day of our arrival, I went to see my orthopaedic doctor Dr. Brockwell for a check up and see how my poor hips are doing. I got an xray done of my hips and the diagnosis was: both hips have end-stage osteoarthritis with complete loss of cartilage (thus bone-on-bone). Tönnis grade 3.

Yikes! Dr. Brockwell said it’s possible for the hips to continue to function with moderate discomfort, but it is unpredictable and could get worse suddenly. He recommended me to consider bilateral total hip replacement surgery as definitive treatment to regain ‘normal’ hips. I explained to him that I am sailing on the boat with my family and that my schedule wouldn’t allow me to have the surgery now. He told me to reconsider and discuss with Grant. He was however very clear that I should not sail over the horizon until at least 6 weeks post operation. Well, we were only going to be in Hong Kong for three weeks. We couldn’t delay our departure from Australia to Indonesia as the cyclone season commences in November. If I don’t return to the boat, Grant will be too short handed sailing up the long coast of Queensland by himself and Arabella. In addition, there were so many technical problems with the boat and Grant would need all the help he could get.

I told Grant what the doctor said. He said he would support whatever decision I make and he would find a way if I decide to have the surgery. He left for France the next day. It was such a sudden unexpected turn of event and I really didn’t have time to think or do any research about the surgery. My main thoughts were

1) perhaps it is not a bad idea to get the hips fixed once and for all

2) in Hong Kong I have tremendous support from family, friends and helper

3) if I don’t have the surgery now, I’ll probably have to wait at least another year or more until we complete our sailing journey.

The more I thought about it, the more I became keen… but arranging a bilateral hip replacement surgery isn’t so simple… I had to do blood test and CT scan and there’s medical insurance, doctor’s schedule and the hospital operating theatre availability to deal with. The next day, Dr Brockwell’s nurse Emily told me that the only possible surgery time slot would be on tues in 4 days time. What?! So soon?!! Let me think about it… o well… sure… let’s do it.

I called Grant to tell him that I would have the surgery on Tuesday and he was a bit stunned. ‘So soon?! O dear… I should come back… let me check the flights. it’s a big surgery and you’ve never had general anaesthetics before…’ I told him that he didn’t need to come back. I have all the support in Hong Kong and I would be fine. I know how excited he was to see his friends and to watch South Africa play in the World Cup.

The next few days went absolutely frantic as I was trying to get everything done before the surgery like renewing passports and ID cards, seeing friends and relatives, taking girls to see dentist and orthodontist, etc. I also rearranged the furniture in my bedroom and set up a dining table and massage table in the study and a chair in the shower. I was having mixed feelings about the surgery.  Excited and looking forward to getting the hips fixed on the one hand, and nervous and scared that I might react badly with the anaesthetics, or something goes wrong during the surgery. There’s always a risk with any surgery.

Surgery Day

Took my little suitcase and ordered an Uber to check into the Matilda Hospital on the Peak.  It was the first time I went there and the place felt like a resort. The hospital is in a low rise colonial building and I got a private room with a balcony overlooking the sea. Amazing view! I could even see my apartment building from the balcony. Can’t believe in an hour’s time at noon, I’ll be in the operating theater. Pretty insane how the whole thing unfolded so quickly. It was surreal.

Lying down at the operating theatre staring at the ceiling, I recalled the room was extremely cold and was very noisy with people moving things around to prepare for the surgery. My anaesthetist Dr Menon came to me and said he was about to inject the anaesthetics. Dr Brockwell came to my sight with a smile and said “see you after the surgery”.

When I awoke, it was half past six already. Wow, I had a six hour surgery. It felt like I had just woken up from a dream. Dr Brockwell told me that he operated on my right leg first, and then my left. Everything went smoothly. I could learn how to walk with crutches the next morning with the physiotherapist. I could feel my right leg feeling quite good and relaxed, whereas my left leg was a bit tight. I didn’t dare move too much. The nurses pushed me back to the hospital ward and there I saw my parents, sisters and the girls waiting for me. So happy to see everyone! I called Grant immediately as I knew he would be worried. He was relieved to hear my voice. My family stayed and we had dinner together. I had no appetite at all. I didn’t feel pain but just heaviness in my legs. I also felt exhausted. I took a concoction of oxynorm (a wicked little orange pill… strong opioid painkiller), panadol and stilnox (strong sleeping pill) and I managed to sleep a little.

Here’s some technical information about the surgery. The method of surgery is called a SPAIRE approach. Due to the twist of my thigh bone (femoral anteversion and tibial torsion), Dr Brockwell used a special titanium femoral stems with ceramic heads which allows torsion correction (20 degrees in my case). For the sockets, he used polyethene acetabular cups.  The surgery is a posterior approach which means the incision took place at the backside of my hips and I now have two 12cm scars as memento of the surgery.

For the next six weeks, I was supposed to follow these dislocation precautions:

1.    Do not flex beyond 120 degrees, i.e. no bending forward.

2.    Keep knees apart

3.    Keep toes pointing outward.

4.    Do not cross knees.

5.    Under 2000 steps daily for first few weeks

The most important advice Dr. Brockwell gave me is simply ‘don’t fall’.

Week 1 Post Op

Excited to learn how to walk and then climbing stairs next day. Not too difficult at all. I could put my body weight on my new hips. I walked around the hospital corridor and did some simple exercises. Received many messages of support and well wishes from friends. My family came to visit me everyday. Feeling blessed. Struggled to sleep though. Normally I sleep on my side, and because I had both hips operated, I had to sleep on my back which gave me awful lower back pain.

Grant called me and said his brother Craig confirmed to fly to Whitsundays to help him sail up the coast. That’s a huge relief. I know what a competent sailor and engineer Craig is. (See Grant’s post – Thank you Craig. https://horsfield.travelmap.net/posts/thank-you-craig)

Dr Menon and Dr Brockwell visited me daily to check on me. They were happy with my progress. After three night stay at the hospital, my sisters and my mom came to drive me back home.  Amazing to be home.  Never ever did I spend so much time in my bedroom since I moved into the house. Some nights we even had big family dinner at the tiny dining table. I felt so fortunate and privileged to be home with family (my parents and Elkie were staying with me) and helper looking after me. I didn’t have to cook, do dishes, clean, shop for grocery, do laundry or look after kids except for organizing activities and playdates. Honestly I don’t know how other patients living in other countries cope without helper or family’s support after a surgery like this.

I felt quite sturdy on my feet and didn’t need the crutches when I’m in my room. Going up and down the stairs was a different story though. Climbing 2 flights of stairs from living room to my bedroom felt like climbing a steep mountain, and I would feel tight and sore by the time I got to my room. In addition I felt as if my legs have been twisted outward and I was walking like a penguin. Very strange sensation. Hopefully it will pass.

The days were definitely easier than the nights. I kept waking up in the middle of the night and couldn’t go back to sleep. It was impossible to find a comfortable position. Kept moving pillows around, got up to walk around the room, sat on a chair or stretched my back and legs.  I suspect my bed is a bit too soft and my pelvis sank as I slept, which gave me terribly sore back. Had to take the little magical orange pill pretty much every night. Reading on my kindle was a life saver in many of those sleepless nights.

Week 2 Post Op

After 10 days of staying at home, I finally ventured out to see my old physiotherapist Elton. My sisters and Arabella came along to help me get in and out of car. I haven’t seen Elton in almost three years and so it was quite a shock for him to see me coming in crutches with two brand new hips. He read my entire surgery report and said the surgery was successful and well performed, but my butt was very swollen with fluid and my hips have grown two sizes up. He was also concerned that I only had six weeks of physio before going back to the boat. Normally his patients would need minimum 3-6 months of rehabilitation. He suggested that I go see him three times a week and he would design an expedited rehab plan for me. For the time being, he was focused on relieving the swelling through massages, acupuncture, electrotherapy and cupping and manual manoeuvring. I also learnt some simple exercises to do.

Sickness has spread in our house and I got a low grade fever and cold from the girls. I arranged masseuses to come to give me massages to relieve muscle pain. It would feel amazing immediately afterwards, but then the muscles would tense up again in just a few hours time.

As I couldn’t sleep anyways, I followed the rugby World Cup final between South Africa and New Zealand. It was a nail biting game and South Africa won by one point. 11-12. YAY!!!! South Africa was back to back champion and the only 4 times winner in the Rugby World Cup. Incredible achievement. Grant called me and he was crying and laughing like a little kid. How special it was for him to be there in person amongst his best friends who have flown in from South Africa. (See Grant’s post Rugby World Cup 2023. https://horsfield.travelmap.net/posts/rugby-world-cup-2023)

Week 3 Post Op

Grant came back to HK and stayed two nights before flying back to the boat in Australia with Arabella and Alex. He was totally broken when he landed and I could tell he just wanted to sleep to recover from his time in Europe.  So sad when they left for the airport. Azania would stay in Hong Kong with me for an extra month while I recuperated. She cried hysterically and held onto her sisters and didn’t want them to leave.

I had physio on Monday, Wednesday and Friday morning. The rest of the days I would do exercises at home. Using crutches while in town was quite helpful, as I could mark my territory in the crowd and people would avoid bumping into me. I felt better and stronger compared to last week, but my scar muscles still felt very stiff and tight.  My hips and legs were weak and I got tired easily. The swelling remained and the wounds had taken longer than usual to heal. I continued taking oxynorm and stilnox in the night to help manage pain and sleep.

Week 4 Post Op

Continued to struggle with regaining strength and mobility. Walked a few blocks in Central after physio and felt like I ran a marathon. So exhausted. I know it’s still early days post surgery and I couldn’t really rush things but I worried about my recovery which was slower and harder than my expectation. I could barely walk for more than 10 minutes. Hopping on and off a boat?! No way.

How come the pain is getting worse rather than better? I wasn’t having this lower back pain and I was sleeping better before the surgery. These days I was just obsessed with sleep and managing and alleviating pain. I was taking oxynorm and stilnox daily. I started reading about opioid addiction and I told myself that I needed to stop taking it. I hid the pills in the cupboard. It was hard being awake at 4am and all I thought about was the little magic orange pill. Now I understand how people get addicted on opioids. I have profound sympathy for people who suffer from chronic pain as it is so debilitating and takes over your life completely.

Azania was my main source of joy and laughter during this difficult period. She has slept with me since I came home from the hospital and she’s my little carer. She was always helping me pick things up, applying lotion on my legs, bringing me slippers, moving pillows around the bed for me and going up and down stairs to get things or pass along messages. She always asked how I was feeling and if my hips were hurting.  We read a lot of Mr. Men books together. One night the two of us had dinner in the study as I was too tired to walk the stairs. We played ‘Just the two of us’ spotify radio playlist and sang and laughed and danced.

Week 5 Post Op

It’s 4 weeks post operation. Finally I had a breakthrough.  I felt dramatically better and stronger which was reassuring. Climbing stairs didn’t give me such muscle tightness and exhaustion as before. Elton said my joint mobility has improved well but I still needed to regain strength in my muscles. I rode on stationery bike and tried brisk walking on the treadmill. I could rotate my hip joint slowly. My right leg is noticeably stronger than my left.

Socially I became more active and met up with friends for lunches and thanksgiving, and attended my friend Sin Sin’s opening at M+ museum. I even went out for dinner to see my old ‘Shanghai’ friends Tiffany and Chloe Reuters, who were visiting from London. It was so nice to catch up with everybody in Hong Kong after so long.

For the past few weeks, I think I’ve become a VVVIP client of Uber as I always took an Uber even for short distances. This week, I took the MTR for the first time post-surgery and walked for over 10,000 steps a day without feeling overtired. That was an achievement to celebrate.

Week 6 Post Op

I ditched the walking stick! I felt strong and stable enough that I didn’t need it anymore even when I was out and about. Elton was happy with my hip strength and flexibility. He said I was about one month ahead but he wanted to make sure I could manage on a rocking boat. He made me do a lot of squats, lunges, jogging, walking sideways and backward, single legged hopping and balancing, etc.

During this recovery period, one of the biggest challenges is finding a comfortable position. I couldn’t stand or sit or sleep for long, or my legs or back would feel sore. Need to change position and move my hips and legs often. I could finally roll to my side in bed though it’s still uncomfortable to sleep on my side.

Week 7 Post Op

6 weeks post op doctor visit. Dr Brockwell tested my mobility and strength, and was pleased with my recovery. He asked that I send him a photo when I return to the boat. He has a picture gallery in his clinic of his patients doing all sort of active sports and activities post hip surgery. I am very grateful to Dr Brockwell for encouraging me and fitting me in his hectic schedule in such short notice. I imagine it would be impossible to arrange a hip surgery in four days time anywhere else in the world. I reckon it would take at least four weeks or possibly months to just get a consultation appointment with a specialist in Australia.  Hong Kong is amazingly efficient.

Went to physio for the last time. Elton and I were both confident that I would be fine on the boat, though I needed to be vigilant and careful. I also needed to continue rigorously with the strengthening exercises and stretching. Really grateful to Elton and the CORES team for looking after me so well. It was pretty miraculous that I went from limping on two crutches to being able to walk briskly and jump and hop in just 5 weeks time.

While Azania and I had a good time in Hong Kong for the last two months, we both missed the boat and our family and were eager to go home. Grant has sailed the boat 1000nm from Airlie Beach to Darwin.

My dear parents and sisters sent us off to the airport. My sister urged me to arrange wheelchair assistance. It was my first time sitting on a wheelchair and we skipped all queues to the gate. We flew to Singapore and stayed at our friends Anthony and Qian Qian’s house for one night. Lovely catching up with them and for Azania to meet little Archie and Eden. Next day we flew from Singapore to Darwin. We were so excited and happy to finally get back to the boat and see everybody. We had delicious oysters to celebrate in the evening. Grant and the girls had built a super cool Christmas tree with empty beer and wine bottles. It’s been our tradition these last three years to make our own Christmas tree with found objects.

I love my super firm bed on the boat. For the first time, I could actually sleep on my side without feeling sore. I got my sea legs and felt stable on my feet. Grant and the girls did all the heavy lifting and made sure I am safe.  I set up an exercise area on the flybridge where I do my stretching and strengthening exercises whenever I could. I have a huge collection of gadgets – infrared heating pad, massagers, cupping device, massage oil and ointments. Swimming and doing aqua fitness in the ocean also felt great.  Most of all thank goodness I’m off opioid and strong sleeping pills.  I know I still have a long journey ahead for recovery and there’s a lot of rehabilitation to be done. Nevertheless I am very glad that I made the plunge and got the job done.

With my new bionic hips, I look forward to more snorkelling, scuba diving, wakeboarding and hiking in the final year of our sailing adventure across the Indian Ocean.

Final thoughts

Whenever I told someone that I had a double hip replacement surgery, they were all shocked that I had both hips operated at the same time. Honestly I had very little time to decide and I made the decision without actually fully comprehending the magnitude of the surgery. Only afterwards did I realize that most people only operate one hip at a time. There are pros and cons either way, but I am glad that I did both hips. Sometimes being dumb is a blessing. If you overthink it, you would worry too much and not do anything.

I am tremendously touched by the love of my family. My parents obviously worried a lot and it can’t be easy for them to see me undergo such a big surgery. Elkie and Queenie really looked after me well and helped me so much from driving me around, running errands, giving me massages and preparing delicious meals. They were also generous with their time with me and the girls and I didn’t have to worry about anything. The upside of having the surgery in Hong Kong is that we got to spend a lot of family time together.

Without Grant’s encouragement, I definitely wouldn’t have had the surgery. He respected my decision and supported me wholeheartedly. Arabella and Alex were always cheering me on and sending me love messages from the boat. The most special person for me during this challenging time is little Azania. Her smile, laughter, hugs and kisses were the best post op care I could ask for. I never thought I would rely on a 5 year old for physical and emotional support.  But I did and I was so touched by her boundless love and kindness.  Never underestimate the special power of a child.