‘Players should not be out of pocket’

Dear Frank,

Initially Colin Lane and I myself thought it was just a muscular problem and that it would go away with some physiotherapy treatment and by sitting out the odd training session. I got through the 2008 season still being able to play but by the end of it I noticed that the injury was after deteriorating and that it was now starting to affect me even in my general daily activities. Colin advised me that perhaps I just needed to take about three months of complete rest over the winter and that perhaps, this would suffice.

Unfortunately this didn’t work for me and when we went back training in Mallow at the beginning of 2009, the problem was after getting worse. I was named on the league panel for the first game against Meath but the Thursday night beforehand, I informed Conor I would be unable to even take a place on the bench. I tried various alternative options in the following weeks in an attempt to relieve the symptoms for example other physiotherapists, osteopaths, steroid injections etc., but unfortunately all to no avail.

Then in March 2009, Colin set up a meeting for me with the consultant Eanna Falvey in Mitchelstown.

He immediately knew there was something wrong with my hip so he referred me to a hip specialist in the Sports Surgery Clinic, Santry in Dublin, by the name of Kevin Mulhall. I subsequently met with him and he informed me that he believed I had cartilage damage in my hip and that this was the root of my problem. I had the operation in May and he removed extensive amounts of torn cartilage and both he and I presumed and expected that I would be free of my symptoms and be fit to resume playing football once again.

However, I began to realise very soon afterwards that my condition was no better whatsoever and that the operation had been of no benefit to me.

I then went back to Mr Mulhall and he then proposed giving me an injection straight into the hip joint and thought that this might work for me. Whilst it definitely made a difference for a few weeks, it wasn’t long until the symptoms returned again. The injection merely had a temporary numbing effect on the pain I was experiencing, until its effect wore off.

Once again I went back to Mr Mulhall seeking advice and answers. He basically told me that there was nothing more he could do and that the only thing for me was a major reduction in my activity levels i.e. giving up sport. I then went back to the consultant Eanna Falvey for his views on it and unfortunately his opinion was even more stark. He believed that I’d need a hip replacement in my mid forties and he basically told me that I have no other option but to give up playing immediately or I’d run the risk of bringing that date forward by three or four years for every year that I played on. When probed on it, he couldn’t see any other viable alternative.

I was now at a stage where I was having extreme difficulty even putting on a sock or tying my shoe lace on my right foot, such was the lack of range of movement in my hip. Just before Christmas after exhausting many other possible avenues, a physiotherapist in Bishopstown called David Angland, put me in touch with a group of surgeons in Calgary in Canada who were supposedly world leaders in their field. They specialise in hips and mainly deal with professional sports people with hip injuries. I sent over all my details, x-rays, scans and any other information I had in order to get an opinion on my condition. They subsequently sent back the name of a surgeon in the UK called Damian Griffin whom they believed would be able to sort my problem.

I then set up an appointment with him and flew over to meet with him. He took up-to-date x-rays, an MRI scan and a cat scan, and then physically examined my injured hip. According to him, the condition I had was called Femoral Acetabular Impingement which is a condition where the ball part of my ball and socket joint in my hip was too large for my socket. This caused friction every time I moved my hip which over time began to considerably wear away the cartilage in my hip joint. It was clear to him why Mr Mulhall in Dublin had to remove such a large amount of torn cartilage when he operated previous to this. Under normal circumstances when torn cartilage is removed by a surgeon, players resume playing again shortly afterwards. However, the cause of my torn cartilage and the disintegration of my joint was due to the friction in my ball and socket joint, so immediately after the surgery in Dublin, the cartilage once again started to disintegrate because of this friction. To get to the root of my problem, I needed surgery which involved debriding or filing down my hip bone which would stop the friction and therefore put a halt to further damage to my hip joint. This operation is not performed in Ireland and the surgeon Damian Griffin in Coventry is reputed to be the best in his field in Europe. I have been told I will still need a hip replacement at some stage in my life but that if I do the operation it should delay it by some considerable time. He also claimed that there was a possibility I could even play football at club level for another two years or so, albeit at a considerably reduced level. On the other hand, if I didn’t have the operation, simple things in life such as putting on my sock or shoe to simply walking without a noticeable limp, would become even more difficult for me, while at the same time my hip joint would be progressively deteriorating resulting in the need for a hip replacement at an extremely young age.

Taking into account the medical advice I received I decided to proceed with the operation which was scheduled for February 2010. Sport aside, I genuinely didn’t think I had any option, such was the bleak alternative of needing a hip replacement in the near future if I did nothing. I immediately informed Ger Lane (whom I must add has always been very co-operative and helpful) of my situation and of my decision, both by telephone conversation and email, weeks before I was due to go for the operation. I informed him of the cost of the operation £5,000 sterling (€5,900 approx.) which I hoped would be covered by the county board. He advised me to let it with him and that he would see what he could do. A few days before I was due to travel to Coventry Ger informed me that he had no luck in securing payment at that time for the operation and that I would have to write a personal cheque to the value of €5,900 in order to pay for it if I wanted to proceed with it. (He did inform me, however, that he would keep working even after the operation on trying to secure some financial aid for me). Even though this was a huge sum of money, and a sum which I admit I struggled to get together, I still felt that for quality of life alone I couldn’t back out now. I subsequently had the operation and paid the fee.

The operation in general has been a success for me. The surgeon spoke of three issues beforehand which he would be addressing.

1. He wanted to improve my quality of everyday living which had deteriorated considerably since my days of playing inter-county football not so long before that time. He wanted to, and believed he could improve the range of motion in my hip joint which was considerably hindering my ability to do everyday simple things such as putting on my socks and shoes, stepping over things, walking without a limp, and not being abnormally stiff and sore in my hip joint after even just a brief journey in a car. From this point of view it was a success. I still have some of the above symptoms but certainly not as severe or hindering.

2. He also believed that by having the operation, it would delay the need to have a hip replacement which I would ultimately need. By debriding the bone, I would reduce the friction within the hip joint, therefore reducing the damage being caused to the joint itself and ultimately prolonging its life. According to him, this has been a huge success.

3. Finally, the prospect of being able to return to playing sport at a high level again. He stressed to me before the operation that I would only have a 50-50 chance of being able to go back playing. He said that there had been extensive and irreparable cartilage and joint damage caused as a result of wear and tear over the years. I did manage to go back playing with my club Ilen Rovers during the year but I only managed one championship game and only a handful of league games, as well as sitting out most training sessions. Because of my stubbornness to accept defeat to this injury and because of my love for playing a game which I could almost say, up to now has been the fulcrum around which my life has revolved, I’m going to attempt to play next January and February once again. However I’m extremely aware that the chances are that I will be unable. If the symptoms worsen any little at all, I will immediately stop. From a financial point of view I certainly won’t be able to afford another operation but secondly, and far more importantly, I do not intend receiving a hip replacement for as long as I possibly can.

That is my current situation. As I previously stated, the operation which I paid for in the UK amounted to €5,900. Aside from this, which I didn’t mention or seek financial help for, I also paid the hospital £1,100 (€1,300 approx.) with my personal credit card for the initial consultation which included MRI scans, cat scans and x-rays. As well as this I personally had to pay for flights over and back three times, overnight accommodation, two steroid injections, physio bills, osteopath bills etc. All of which totalled well in excess of €2,500. This gives a picture of how much I am out of pocket; in total, more than €9,700.

As I mentioned earlier, Ger Lane informed me he would keep working on trying to secure some amount of financial help to off-set the cost and he liaised with me quite regularly. Some months later, I was asked to apply to the GPA Benevolent Fund and subsequently I received a cheque to the value of €3,000 from them. I understand that yourself, Ger and Conor Counihan helped in securing this for me and I genuinely appreciate all your efforts in this.

This still unfortunately leaves a shortfall of about €6,700.

I began playing with Cork football teams at the age of 15, beginning with the Cork U16 team, and progressing through to the Cork Minors, Cork U21s, Cork Juniors and finally the Cork Seniors. Since I began, between the various grades I’ve basically been playing almost every year with one Cork team or another until I had to unfortunately quit the panel through injury in July last year, 2009. It’s not just my belief, but a commonly acknowledged one that its players should not be “out of pocket” as a result of them dedicating their lives to playing at the highest level and in particular with one of the biggest GAA counties in the country.

According to the surgeon who performed my operation, Prof. Damian Griffin, the damage that was caused to my hip was as a result of a few years of wear and tear through high activity. My injury first came to light during the 2008 season while being on the team.

It progressively and rapidly worsened over the following months and it eventually forced me to inform Conor in July 2009 that I would have to quit the panel due to my inability to train or play anywhere near the required level or standard that one sets themselves at inter-county level. Quitting was a heart-breaking decision knowing that an All-Ireland final win possibly wasn’t far off; my only consolation being that the injury was outside my control. Prof Griffin believes one out of 10 men either through birth, or at adolescence develop the onset of this condition from which I suffer. However he states that for most men it doesn’t develop until later life with most not realising they have any hip problems until they reach their 50s or 60s simply because they haven’t led an overly active life.

As a respected and influential man in Cork and national GAA circles, I’m appealing to your good nature, your authority, or simply your influence — and perhaps all three — in an attempt to recoup some of the costs I’ve incurred. As I’ve alluded to already, the injury occurred while playing with the Cork seniors and as Prof. Griffin states, the injury came about as a result of the high level of activity associated with training at this level.

When I left the panel as a result of the injury, I regret to say that as far as I was concerned the County Board washed their hands completely clean of it offering no financial help whatsoever. Was it a case that even though I got injured playing with a Cork team, I was no longer needed and therefore not worth the hassle or the money? I find it very difficult to believe and accept the contrary and I’ve always considered myself a reasonable and open-minded person, always trying to see the good in people and situations. Even writing this letter doesn’t sit comfortably with me, but I feel like I’m left with very little alternative such is the enormity of the sum of money of which I am out of pocket. Were I to end up getting no financial help, I still don’t see myself as someone who would lambast the GAA at every chance. My whole life has been entwined with the GAA and almost every friend I have is as a result of my association with the games I love. However, now finding myself in this unfortunate situation, it’s certainly far easier to empathise with those who mockingly call the GAA the “Grab All Association”.

I’m not sure what avenues you could explore in trying to help me in my situation but what you can be assured of is my total appreciation of your efforts. Perhaps claiming expenses is one possible way of doing so as I never claimed expenses for the 2009 season right up until I left the panel in July. I’m not sure if this is feasible. I’d appreciate a personal response from you informing me of where I can go from here and in your opinion whether anything can be done or not. Thanking you.

Mise le meas,

Diarmuid Duggan

Kilkilleen,

Church Cross,

Skibbereen,

Co. Cork.

14/12/2010