Of all places, I was at a funeral when I first noticed that my right leg seemed an inch shorter than my left.
Friends had remarked on my limp over the previous six months, but, when I stood tall, the inch-wide gap between the sole of my shoe and the floor was something new.
The idea of it being, as I later discovered, drink related – that my love of grog had given me a pirate’s gait – didn’t occur to me. As I perched precariously on my left leg, all I could think was: ‘What’s going on?’
That was July last year. Within six months, my condition had deteriorated so that I was in almost constant agonising pain, taking up to 30 painkillers and anti-inflammatories a day.
I couldn’t walk or function normally, let alone do my regular job as a writer and translator.
Mornings were the worst, as I lay in bed drumming up the courage to move. The pain was so bad that it could take me an hour to get out of bed, go downstairs and sit down – actions that would normally take less than two minutes.
The problem? Avascular necrosis (AVN). Alcohol had eaten away my right hip.
AVN is defined as the death of bone cells due to interruption of the blood supply. In my case, the interruption was due to excessive alcohol. It seemed alcohol had ‘diluted’ my blood, preventing vital nutrients reaching the bone.
The bone structures then collapse, causing pain and loss of joint function. As the word necrosis (it means ‘dead’ in Greek) suggests, my hip joint had quite literally died.
The condition usually strikes people in their 40s or 50s. It is most commonly found in the hip, but smaller bones such as the wrist, shoulder or jaw can also be affected.
Early diagnosis delays the need for joint replacement, but without treatment the condition is almost always progressive, leading to joint destruction within five years.
Although there are no figures for the number of people affected in the UK, in America, AVN accounts for more than 10 per cent of all total hip replacements – and there are more than 50,000 of these annually in Britain.
The condition can be attributed to a number of causes, ranging from trauma – after an accident, for instance – to infection, or as a rare side-effect of chemotherapy.
The beauty of hindsight
At the age of 33 – still a young man – this was not where I had imagined myself. If ever I needed a drink, it was after the doctor’s appointment when I was told that I needed a hip replacement.
Alcohol had been one of the dominant factors in my life from childhood. My father was an alcoholic (though, thankfully, he has now dried out), and his brothers had kept up the family name.
Idea of a family dinner was of my mother, sister and I sitting around my father, who had passed out on the floor.
At that age, I didn’t understand alcohol or what ‘to pass out’ actually meant. Such things didn’t seem wrong: I thought everyone lived like that.
It’s only with hindsight that I realise how unusual a childhood it was, peppered with amusing tales of family jaunts out that ended up with us miles from our intended destination because my father was drunk.
Even so, as far as I can remember I had never met anyone physically disabled by alcohol alone.
My own drinking had never seemed a serious problem. It had started with trying to keep up with my peers, and had eventually progressed to two or three bottles of wine a day for about five years.
Yes, it had destroyed my marriage and my career as a journalist (alcohol and deadlines don’t mix). But those bottles – my bosom buddies – were dependable, did not talk much, and kept me going through days when I could think of little else but the next drink.
It was a very happy relationship – or so I thought until I started limping.
Soon, this ‘one leg longer than the other’ thing was starting to cause me excruciating pain most of the time. I finally plucked up the courage to see my GP, who took one look at me – a bloated, bleary-eyed, sweating, limping wreck – and immediately referred me to an orthopaedic specialist, Dr Roger Wolman, doctor to the Olympic team. I was in safe hands.
Following an X-ray and MRI scan, I was diagnosed with AVN. The first thing Dr Wolman asked me was did I take hard drugs – especially anything cocaine-based – on a regular basis. For once, when cornered on the subject of vices, I could say ‘No’ honestly.
But then he asked how much alcohol I consumed – which brought me down to earth with a bang.
Those two to three bottles of wine a day added up to roughly 170 units of alcohol a week. That was eight-and-a-half times the recommended weekly limit.
I was referred for an ultrasound to check for liver damage, and an aspiration procedure, where a needle is inserted into the space between the hip joint to collect fluid that is tested for infections.
Thankfully, the damage to my liver was minimal. It’s a very stoic organ, apparently, and by stopping drinking the damage would be reversed in five years.
But the aspiration procedure revealed that my hip had already fractured – the cause of the agonising pain I’d been experiencing.
I was taken to the Royal Orthopaedic Hospital at Stanmore, London, for immediate surgery to replace my right hip. It had been almost one year exactly from seeming normality to the operating table, and I’ve been left with a 10in ‘trophy’ scar.
Of course, I couldn’t drink in hospital – so I quit there and then. A week after the operation I was discharged, and I resolved to remain off the bottle.
The next ten days were fairly grim; I’d decided to go it alone, with no counselling and no medication to help, just cold turkey. But while the sweats and the shakes were bad, they passed pretty quickly.
on, after physiotherapy and exercise, I can walk normally again. My new right hip – made from a combination of titanium steel and Kevlar – is bullet-proof. I’m part man, part machine. Bionic.
The recovery has not been all plain sailing. I will need a further hip replacement at some point in the future (a prosthetic hip has a lifespan of about 15 years), and the NHS is loath to perform such operations on someone of my age, with good reason.
The surgery isn’t cheap, costing ?6,000 to ?8,000, and can cause further medical complications.
I’ve been told the AVN has gone, and there is no conclusive proof that it could spread should I return to drinking.
I can’t help but worry, though, that it might develop in other joints should I reach for a bottle again. That’s a sobering thought – so I now live the life of a teetotaller and am a better man for it.
Having gone to the operating table and back, made all the pirate jokes and popped the painkillers, I can still remember how crippled AVN left me – and all because I liked a glass (or bottle) too many of wine. I have no wish to repeat the experience.
Having come out of this relatively unscathed, I feel strangely lucky. Alcohol has far more wide-reaching physical effects than impacting on the joints: it causes depression, hepatitis, cirrhosis, chronic heart disease and heart failure in young and old alike – all of which I think I’ve avoided.
While once I was in agony, I now feel great. I try to live healthily and appreciate the things that were important to me before I allowed alcohol to take over my life – writing, music, friends and life in general.
I haven’t found the pot of gold at the end of the rainbow, but I haven’t given up trying; and that is what alcohol took away from me – hope. I know I’m lucky to have a second chance.
I enjoy the freedom and control over my life that sobriety gives me – and I’ll never have to worry about going to the front door and falling over in agony again. Been there, done that. Make mine a lime soda from now on, thank you.