Is that why your face is so round?

Recently Isla and I celebrated mummy-daughter hip week, which essentially involves a two-yearly fake hip review for mummy and an ultrasound scan for daughter. I'm pretty sure it'll be the 'hip' new craze soon. Ugh, sorry.

As you may remember from two years ago, every two years I pay a visit to the surgeon who performed my hip replacement operation. It's now been six years since that life changing op, and due to my age and my active lifestyle even the cleverest of surgeons can't predict how long it will be before I need it replacing again. Pretty much everything about this appointment, whether it be my emotions on the day or the radiographer's 'Aren't you a bit young for that?' reaction to learning that I have had my hip replaced*, was exactly the same as two years ago so to save my arthritic hands the trouble of typing it all again, have a read of this instead. Most importantly though, like two years ago, I STILL HAVE TWO GOOD HIPS.

*I'm pretty sure she was the same radiographer that x-rayed my hip two years ago, asked me the same question two years ago, and looked confused two years ago.

When Isla was born she was found to have a slightly clicky right hip. Despite knowing that, although children can develop arthritis at a very young age, they are not born with it, my boyfriend and I couldn't help but exchange a slightly worried glance/awkward laugh at each other when we were told this. I wouldn't wish my disease on my worst enemy, let alone my own child, but I have to live with the knowledge that Isla (and any other children I may go on to have) is more likely to develop rheumatoid arthritis because of me. Despite being a rational doctor and semi-rational human being I know that every time she complains of the slightest pain in any of her joints at the back of my mind I will be panicking that this is the start of juvenile onset arthritis. This disease has taken away any chance I had of being a rational mother.

Clicky hips at birth are actually pretty common though, and more often than not nothing to worry about. Just to be sure though Isla had to have an ultrasound scan at 12 weeks old, which was absolutely fine. The consultant who performed the scan however was ABSOLUTELY NOT FINE. Our conversation went something like this:

Him: "Is there any history of hip problems at birth in your family?"
Me: "No, but I have rheumatoid arthritis and I had my hip replaced when I was 20."
Him: Are you on steroids?"
Me: "Unfortunately, yes."
Him: "Is that why your face is so round?"

I have several issues with this.
1. Why would you think it's OK to ask a girl why her face is 'so round'?
2. Why would you think it's OK to ask someone on steroids why their face is 'so round'?
3. Why would you think it's OK to ask ANYONE why their face is 'so round'?
4. IT WASN'T EVEN MY BLOODY APPOINTMENT.

But, seeing as he so kindly brought it up, now seems like as good a time as any to talk a little bit about steroids. I've mentioned them several times before, but never really gone into great detail about them. I have a bit of a love-hate relationship with steroids. I love them because they reduce inflammation, ease pain, and essentially help me to function in every day life. I hate them because...well, I believe this stunning diagram found in many a medical text book summarises it better than I ever could:

The steroid I take is called Prednisolone, which suppresses the immune system and in doing so reduces inflammation. If you take Prednisolone for long periods of time like I have you become particularly prone to infections because your immune system is weak. These infections may also be much more severe than they usually would be, so I have to be careful to avoid exposure to infections such as chicken pox and measles. I am also eligible for the seasonal flu jab along with the elderly.

As you can see from the incredibly attractive diagram above, the side effects don't end there. In fact, the NHS website lists 77 potential side effects of Prednisolone in total. Mood swings and changes are common, which means one minute I can be happy and the next sad, and I can be extremely short-tempered. My boyfriend would argue that I'm pretty short-tempered anyway, however I'm willing to blame this entirely on my medication and not on my flawed personality. He won't argue with this because I'm short-tempered due to my medication.

Although I wouldn't go as far as saying I have an 'obesity' problem as the diagram suggests, I currently weigh more than I did when I was pregnant. I WAS CARRYING AN EXTRA PERSON FOR CRYING OUT LOUD and yet still not as heavy as I am now. This is in part due to water retention and partly because steroids also increase your appetite, so I am always hungry. Prednisolone also tends to cause your face to begin to resemble the moon or, to give it the medical term, 'moon facies'. So in answer to your question Dr Insensitive, yes that is why my face is 'so round' and I'd like to take this opportunity to thank you for making me feel even more self-conscious about it than I already do.

As we learnt a couple years ago long term steroid use has also left me with osteoporosis, which means my bones are thinner than they should be and are more prone to fractures. I'm also currently covered in bruises, and I have two tiny cuts on my leg that have taken over a month to heal.

That all said, Prednisolone is doing a great job at keeping me going at the moment until the time comes to start the new wonder drug. I have already had the mandatory chest x-ray and blood tests, so now it's just a case of waiting for the call. In the meantime I'm off to find some doughnuts.