About the patient: 38 years old female. Appears fit and healthy. Adds value to the society through volunteering and social care transformation projects.
Diagnosis: multiple joint pains, involving both wrists, ankles, knees and hips. Complex tear of the right acetabular labrum and paralabral cysts on the left acetabular labrum, possibly due to an old tear. Hypermobility in joints.
Patient reports chronic pain however doesn’t take pain killers.
Patient loves walking. Walking helps her maintain healthy weight, with managing depression and ADHD symptoms.
Patient already had injections in both hips giving mild, temporary benefit.
Recommendations: Surgery on both hips to repair tears. It will lead to the patient staying 5 days in the hospital and several months of rehabilitation. Patient will be using a walking frame for a prolonged period of time.
The surgery may delay the need for hips replacements (which would be a more expensive procedure. Due to patient’s young age, she would require another one in aprox 20 years time).
Challenges: patient leaves in a house with stairs. Single mother of a 11 year old child. Immigrant with no family to support.
Outcome: Patient refused to have the procedure …..
Next visit booked for 6 months time to see if she changes her mind…
The patient:
Who’s going to take care of my child. Who’s going to do the school runs? Who’s going to take him to his after school activities?
Who’s going to look after the house?
How will my bills get paid? Who’s going to manage my little business?
What will happen to my weight if I’m unable to walk? What if something goes wrong? What it will not help?
What will happen to my mental health? How will it then affect my son? His mental health? Will my operation impact his future achievements?
Will he end up on the streets causing trouble, because I will not be able to keep watch?
The surgery might not help at all. They can’t guarantee it will work. Other doctor at Royal Orthopaedic Hospital told me previously that due to hypermobility in joints the surgery is pointless and very temporary.
Is it worth it???
Why are they not asking me those questions?
And directing me where I can find the answers???
Future Case Review:
Things went wrong…
Was it preventable?
