Living Life

The last month has been has been really busy.  Though the improvements are still happening, life is happening as well and that has been taking up a lot more time, time that I used to use for my blog posts.

I'm still improving my ranges and I'm still expecting to exceed the surgeons six month estimate of another 10 degrees.  I'm just over halfway to that goal on the left side and the right is just under.  

I'm still keeping up with my physio, hydro and pilates and fitting in real life around these activities.  My hours at work have increased and I'm starting my study back up again at the end of the month.  I'm not sure where this is all going to lead me but wherever that is, I'm well on my way.

I probably won't be checking in here too often as time goes on but I receive comments by email so if you have any questions about any of my posts or my experiences, please comment!

More spam...

Apparently I need some help understanding what a hip replacement is.

I received the following comment overnight:

This is surgical procedure that replaces damaged hip joints. Generally, the damage to the hip joint is due to severe osteoarthritis or possibly necrosis (defined as death of tissue) of the hip joint.

No shit, Sherlock.

It's spam for a Las Vegas ortho centre.  Not really very appropriate.  I had kept an earlier comment from this person as they had offered encouragement as well as posting their site but following this, I got rid of both.  I have no problem with people providing comments that relate to what the post is about and linking to their website especially if they have expertise in the the area.

Comments like this show that they haven't actually read the posts properly, nor have any real respect for me or my readers.

If you want me to link to your site, please contact me and offer some content that is of benefit to my readers or actually read the posts and provide some real information that is at least interesting.  I'm interested in talking hips and I'm sure my readers are too - it's not too difficult to engage people by providing content that they actually want.  You are wasting your time telling me what a hip replacement is.

If I don't know what it is by now....

Another MOM bashup

Today Tonight and their 'ethical' reporting have done an article on ASR and other MOM hip replacements.  It's reminiscent of the article that ABC aired a little while ago.  They took it a step further and made it sound like all MOM devices were trouble in their usual sensationalist style.  The class action that has been launched against Du Puy is the catalyst for the article and once again, they fail to address and report any positives of MOM devices nor do they report the exceptional success rates of other MOM devices in the hands of top surgeons.

My comments on the earlier ABC article on MOM resurfacing.
McMinn addresses MOM on the resurfacing site.

I know what Today Tonight is like and I shouldn't let it bother me.  It's irresponsible reporting at it's finest and it really makes me mad.

Would I recommend bilateral BMHRs?

johnnybravo84 said...
Hi Lori, I'm in need of bilateral hip replacement due to Avascular Necrosis in both femoral heads. My Doctors in Madison, Wisconsin, USA, has advised me to consider BMHR and am thinking about flying overseas to get it. Have looked at Dr. McMinn in Birmingham, UK and Dr. Bose in Chennai, India. Just wondering if you would summerize your entire experience thus far as a good one. Also, would you advise to do both hips at once, or did it prove to be somewhat "too much"? Thanks in advance for your reply!

Short answer:  Yes, the experience has been positive for me and I think if you can do both at once, it is worth serious consideration.

The long answer:  Even though I had a pretty rough time immediately post-op, I don't regret the decision that I made.  I made the right decision and I am already seeing just how much more I will be able to do.  I'm not a medical professional and my experiences are my own and are going to be individual to my particular case but I hope that sharing these will help others in both the decision making and rehabilitation process.

I'm happy to hear that your doctors have given you options that aren't just within their realm of expertise and services that they provide.  From some of the stories that I have heard, it isn't the norm unfortunately.  If you are a candidate for a BMHR, I would certainly recommend this over a THR based two things that were important to me: the BMHR is more bone conserving allowing for easier revision many many years in the future and the information I've read indicates that there are less restrictions on this prosthesis as compared to many total hip devices.   If '84 is your year of birth, I'd give your doctor's suggestion some serious thought.  Conserve as much bone as you can - you don't know what will be around in 20+ years when you need revision.

As part of the pre-op process, I signed authority to the surgeon to make the final call on this once he'd cut.  There was a small chance that I would need a total hip.  I wouldn't have wanted just any surgeon make this call. It was the first question I asked when I woke up.  I probably got a little too invested in the BMHR being the solution for me but my research had made me extremely positive about this option as being the 'one' for me.

My reasons for requiring hip replacement were related to damage caused by juvenile arthritis.  The damage had been there for a large number of years and my body had been compensating for this damage for almost as many years.  It has been explained to me that how our bodies recover very much depends on the condition that we are going in.

I don't know much about AVN so it really is hard for me to compare our experiences so that I can  have a guess at how well you will feel post surgery.  The two surgeons that you have mentioned are leaders in the field and I am sure that they will be able to give you a far better indication as to when you will be up for travelling home after the surgery.

I have seen a lot of information relating to travel and surgery on a discussion forum called Surface Hippy though most relates to BHRs.  Though not completely the same there are a lot of similarities in our recovery processes and some of the experiences that the members who have AVN and travelled might help with your decision making process.  The people are awesome there and no matter which decision that you make, I would highly recommend posting your question as they will have a lot of helpful things to add about the process that might differ from mine.

I have come across one BMHR lady who travelled on a forum.  It's only relatively new and there aren't as many people there so I'm not sure how successful you will be in contacting her there.  Rosemary references being a part of the yahoo group hipresurfacingsite so she may respond to a message there.  (I haven't really used yahoo groups as I loved the surface hippy group of people)  She travelled to McMinn for a ceramic BMHR recently and had her early recovery time in the UK away from home.  If you can find her, I'm sure that her story will be of great interest to you.   From what I can gather she spent about four weeks in the UK before travelling.  I would expect for bilateral, it should be at least that.  At that time, I don't think I could have handled a long plane trip home though from the stories I have read, many resurfacing patients have done it sooner - so it is possible.

You can't get better than Bose or McMinn.  There are a few others in their league though given the choice and that you have to travel anyway, why not go for the best!  McMinn was involved with the development of the BMHR and has the longest history of using them.  If you haven't already, read every page of his website! 

I believe that I couldn't have coped with one at a time as I would have chosen my right side to be done first, my left unoperated leg would have been the 'good' leg, the one that I would rely on a lot more.  I don't think it would have held up and actually quickly become the one that let me down and caused pain.  I don't think that I would have had the same opportunity for long term successes with one at a time, though this is really a gut feeling.  Unfortunately there is no 'control group' for scientific exploration of what is the best option for anyones exact particular experiences.   

The one thing that I wish I knew going in was that I was allergic to the hard drugs.  If I hadn't of had the hallucinations and nausea from the endone and oxycontin, I think that I would have had a bit more of a kick start the recovery process.  It might not have put me too much ahead now and there will be little difference by the time my new parts are a year old but I think that mentally/emotionally I would have been better off.  Major surgery is major surgery and if you have trouble with the meds or any other complications it's going to happen with one side or two.   Both at once means that your risk periods are going to finish at the same time and at twelve months you are going to have two new hips working well where as if you did one, the old one will probably need to be done by then starting the whole process over again.

Attitude is a big part of the recovery process for bilats.  You need to be prepared to put in the hard yards and fight to stay positive and do whatever you need to do get the best possible outcomes.  It is harder but I don't think it's 'twice' as hard.  There were moments where I thought I made the wrong decision though this was in the early days where I just felt like absolute shit.  I think the memories of this are already fading though as my husband chastised me the other day for saying something was worse than hip replacement (Mildly of course!).  He couldn't understand how I could speak so flippantly about that time.  I guess the good that I can see now outweighs that time so much so that the memories have faded. 

I really thought it would be easier than what it was.  In that regard, my expectations were a little unreasonable.  Time is the only thing that I've been off with though.  Everything else is looking great and I don't regret it at all.  In a way, my timing was right as the other set expectation was that at three months out, I was no worse of than pre-op.  At that time I was significantly better in a number of areas.  I guess that I just didn't quite realise exactly what that would mean.  The piece of wisdom that can be gleaned from this, it is probably not wise to set conflicting expectations!

I did this at the best time for me and the outcomes so far have been stellar.  I'm no longer on pain or anti-inflammatory meds.  I have a range of movement that I don't ever remember having.  I'm already doing things that I couldn't do before and though these might seem minor to some, these are huge to me.  I still have another 7 months of improvements before the progress levels off and I'm expecting big things!

I wish you well on your search for information to help make your decision.  Please feel free to ask any other questions that you might have.  Please keep us posted as to what you decide to do and how you go!

Surgical Review Day

I was actually on time to see Paul this morning even though it has probably been the earliest appointment that I have ever had at the clinic.  Some of the muscles are already better than they were pre-op and everything else is coming along nicely.  I was pretty confident that the day was going according to schedule when I arrived in at the hospital before 10am even after stopping for a takeaway coffee on the way.

I headed into QScan to get the x-rays required for my appointment, only their machine was broken and I had to find my way to QLD X-ray to have them done.  After a few navigational errors, I found myself ready for a long wait.  At a few minutes before my appointment I wasn't sure that I was going to make it since my x-rays hadn't come back yet.  Thankfully the surgeon's office was still going to let me come to see him even though I was late.  A few people had already been delayed by the same issue so it turned out ok.  I really should have gone to have them done on a completely different day to allow for things to go wrong and though I would have been disappointed to reschedule, I would have understood.

The surgeon is happy with my progress so far and I got told to keep doing what I'm doing.  The x-rays look good and I'm due again for review on 9 April next year.  Providing there isn't anything requiring closer monitoring, I will go onto an annual review schedule from there on in.  

I asked the question about the ranges and was told that I'm actually doing ok with them and will continue to see improvements until at least the 12 month mark.  How far I actually get is going to depend on not only what I do, but the condition pre-operatively is going to affect the outcomes.  I did understand this going in and already everything is better than it was going in, but I am still optimistic that there is more that I can get out of this.  The flexion estimate is about another 10 degrees active (around 100 - 105 degrees).  Apparently what I have now is on par with the outcomes of a lot of total hips that are in the condition that mine were pre-operatively.  I see this as a positive sign for my progress this far.  It makes me feel a little bit better about not being on par with the BHRs and other resurfacing components on a number of discussion groups.  This doesn't often bother me, but every now and then it's nice to be reminded not to compare too closely.  I started off a long way behind them and I think that in the long run I will be far better off as I don't have the 'hey day' to compare my achievements with.  I was never a ballet dancer or a taekwondo black belt that I'm aspiring to be again. These people are likely to recover to a higher standard as they are likely to be in better condition going in but the loss of even just a little bit is going to hurt.  I am all gains, which to me, seems to be the better view.

I also saw a ceramic BMHR.  I even touched it.  They are pretty.  I think my shiny MOM component is better looking but the ceramic is nice (Not that you choose these items for cosmetic reasons!).  Dr Journeaux has done one of these in the public health system so far.  They haven't been approved for use by the private system yet even though the MOM's are (Of those his count is over a hundred and for the BHRs, I think it was nearing a thousand).  Still early days for all surgeons doing them though it is all positive (I linked to McMinn's info on the Ceramic BMHR over the weekend).  There are no revisions for BMHRs for my surgeon at this time which I think is a really good sign.  It means it's tracking well with the longer term statistics available for the BHR.

There are always changes in this field and regardless of what happens next, I got what I needed and at the right time.  The common consensus seems to be that it will be for a long time too!

I'm starting to get a little tired.  Probably due to the change in routine for today.  Though I tried to get to sleep at a normal hour last night, it really didn't work out since I'm used to later nights and later mornings.  I'm sure I've probably missed something in the summary of today, so feel free to ask questions.  If I think of anything more I'll add a new post later!

Surgical Review and Physio

Tomorrow is my next surgical review.  I'm a little nervous.  I shouldn't be as my progress has been steady and I've been doing a lot to work towards getting the most out of the surgery and I have been happy with the results so far.  I also know that I am going to get so much more out of this than I ever imagined.  It's difficult to explain why I'm nervous at all.  The closest thing I can relate it to is maybe parental approval, though that's not quite it.  Besides my surgeon is way to young for that!  If I figure it out, I'll let you know.

It will be an early start tomorrow for a work day (well for me anyway!).  I kick off at 8:30am at physio with Paul before I head in to the hospital to have xrays done in advance of my appointment.  I don't actually see the surgeon until 11:30am but I'm not sure how long it will take at xray as you just turn up and wait your turn.  It means that I'll have a new CD of images of my new parts too.  There really shouldn't be anything new to show there but it is kind of cool anyway.

This will be the first time that I've seen Paul since before the operation too.  It will be interesting to have his thoughts on the differences he sees.  He has seen me quite a bit when I have been at the clinic to see Reese and also outside of the clinic, so he has a good idea of where I'm at but treating will actually give a little bit of a different perspective.

I'll be back at Milton later in the day to get some work done and hopefully wrap a few things up that will leave me free towards the end of the week to start to get ready for my sister's wedding on Sunday afternoon.  It's going to be a great week.

What to say...

I've struggled with this post.  I've tried to write it a couple of times but the words just won't come together.  I'm at a bit of a loss to explain a negative experience that I've had and do wonder if I should just leave it be and keep going with my life as it needs to be or think about it a little longer and share it with people who might be going through something similar.

I have had a lot of really positive experiences over the past week and I do wonder if it is just the contrast that has upset me, that perhaps it wasn't such a 'big deal' and I have made it into one.  I know that I need to accept that some people just won't be able to understand what I've been through and the journey that I am still on and this ignorance isn't necessarily malicious.  It could even be argued that it's because I don't complain enough and make my limitations known more obviously that I shouldn't be hurt when they are overlooked by people that I think should know better.

I've never been comfortable complaining about the things that I can't do.  At some level, I didn't really want people to know the extent of my limitations and as such there were very few that actually knew what it really was like pre-op.  These people were limited to those that 'needed' to know.  The rest would probably knew something was going on but didn't really 'get it' and I never really elaborated.  Post-op, things have gone really well and the limitations that I had pre-op are diminishing quickly but you can't get rid of two decades worth of limitations and compensations in a couple of months.

After such an awesome week, it was a little confronting to be isolated because I still couldn't do something.   The isolation was made more difficult when I was made to feel like I was causing trouble by 'snobbing' the rest of the group.  This has been one of the lowest points I've had for quite a while, one where I felt extremely alone.  A phone call and a tweet helped me to get through the rest of the evening.  I guess that all the other unnecessary tension at the event made me a little on edge to start with and as such I was probably not quite as well prepared for criticism as I usually would be.

Some of the people that I truly expected to understand haven't.   I guess that I had higher expectations of them that were perhaps unreasonable.  

The people that have truly been there for me have been amazing.  You know who you are.  Thank you. 

Ceramic BMHRs

The McMinn Centre has released some information about the Ceramic BMHR.  This is pretty exciting for people that have metal allergies that preclude them from being suitable candidates for the MOM BMHR or resurfacing.  I'm sure we'll see more information about this prosthesis as it becomes available!

It's all good!

Another great day. Feeling great. Lots of sunshine.

Two in a row.

Awesome.

Hydro Wednesday

How can you not be happy on a beautiful day like today?  I'm not sure what happened this morning but I woke up and I just felt great.  Maybe even a little hyperactive.  All a little strange really.  I reinforced the hyper with a little caffeine and I think that the proper adjective for me this afternoon is 'bouncy'.  Not that I'm jumping around the office this afternoon (still a little while before the femurs will like that), but I was jumping around the pool this morning.  I had a good session today and spent an extra half hour in the pool literally jumping around.  I'm wondering if the muscles will ache a little tomorrow.  It will be a good ache, so I'll accept it gratefully! (Well there may be minor whinging if it's really bad but in a positive and amazed way!)

It's starting to feel like the more I do, the more I can do.  I've never felt like that before.  It was always the more I do, the more I have to figure out what I can not do to balance it out.  I'm sure that at some point there will be a wall that I will fly into head first and I find what my new limits are.  They are moving so quickly at the moment, I'm not really keeping up with them which is why it seems like I can keep going forever at the moment.

I'm at work at the moment, having a little afternoon break while my printer goes to work.  It's been a good day here too.  I'm slowly starting to take on more work and getting on top of the handover from the previous person looking after a lot of it.  It has been a big week so far and I'm just half way through.  I'm likely to have a few more big days this week and I'm actually ready for them.

Friday Pilates

We took a few pictures at Pilates on Friday to submit to Body Leadership for the article that was being published for Body Leader of the Month.   I'm not sure if the one on the left is leg circles or adductor stretching.

In the next, each leg take turns in pushing forward while the other lifts.

I've talked about the next exercise in a pre-op post about Pilates. (Long Spine) I just started this one again on Friday.  Controlling the movement fluidly is a little more difficult that pre-op but still feels really great.   It is working that troublesome glute really well!  There is another one were I am lying on a box on my stomach facing the left (towards the picture of the skeleton on the wall that you can see in the first picture) but I haven't included that one - it truly is the definition of a bad picture!  The increase in the amount of exercises that I can do changes dramatically from week to week and things that I didn't like and weren't comfortable with pre-op aren't all that bad anymore.

In particular if you remember my intense dislike to the reverse knee pulls, well, that's changed.  It isn't that much of an issue any more.  I thought it was because I didn't feel comfortable looking down at the ground thinking that I would fall flat on my face.  I guess it must have been just general discomfort that I wasn't interpreting correctly.

I'm also back on the foam roller and balancing quite well.  I tried this exercise with both arms up off the ground at the same time but I'm not quite stable enough for that yet and get a little wobbly.  Maybe by next week I will have the strength back that I require!

I'm back on the bosu as well.  I can stand and do squats and also from standing transfer weight from side to side.  I stood pretty close to the wall when I got onto the bosu since though I really wanted to try it out and see if I was ready yet, I didn't want to fall on my ass either!

Friday was a very productive session.  I am starting to see how much more I will be able to progress past what I was able to do pre-op.   There are a few exercises that I was doing about six years ago that I am yet to try again but I think that I will be quickly moving on to more that I wasn't able to do at all.   One of the main that I was able to do back then requires me to stand on the reformer (one leg on the bit that I'm laying on in the top pictures and one on the other where the wooden panel and the feet support it - the bar bit goes down).  I'm not quite comfortable with the idea of getting up there just yet but I'm sure after a few more times on the bosu, I'll gain enough confidence to get up there and give it a go.  I don't think that the exercise itself will be difficult for me in the slightest, it's just being that far off the ground that I'm not quite 'good' with yet.  I'll keep you all posted!

Body Leader of the Month

Hey check me out, I've been awarded the title of Body Leader of the Month!

I've answered some different questions as part of the interview than I've covered here in the past so the article might be interesting to you.

A couple of notes about the article and pics:

Yes, Lori is short for Lorraine.  It's funny how different people know you by different parts of your name.  My husband calls me Lorraine (just as I use his full name rather than Mike as just about everyone else calls him) and this usually extends to certain groups of people where I've been introduced by him, or introduced where my 'legal' name has been provided. My brothers and sister still refer to me as Rain. One of my best friends used to call me Miss Rainee and that's now Mrs Rainee since I've been married.  Mostly though people call me Lori.  It's a lot easier to spell for people, too!

For the locals, you should be able to spot the venue of the first picture.  This was my very first outing and I wanted it to be somewhere that I felt safe so it's somewhere that I spend a fair amount of time. You can see my crutches in the picture.  If you can guess where it is, there might even be a prize for you!

The Pilates picture is actually from this morning.  We took a whole series of them and I'll post some more of them here.  This is a picture of roll ins from curls (bridges).  I've been doing these for a little while and think that some of the other exercises are a little more impressive, so I'll post those soon!

The final picture is from the hospital when I was first learning to walk again.  At this time I was still using the rollater so there was a fair amount of weight being put through my hands on the rails to walk.  The white lines helped me with my alignment.  There was a lot of looking down and focusing on my feet while I was walking within the rails.  In the beginning it almost felt like the messages from my brain  didn't get through to my feet unless I looked really hard at them!  (That plan doesn't really work all the time.  Sometimes you can look really hard at the offending limb and it still won't move.  They do now, so that's the main thing!)

Caffeine Sensitivity

WHAT?!?  How did that happen??

I had a coffee yesterday afternoon at my sister's kitchen tea and I had a really restless night last night.  I don't understand where the girl that went out in the evening and drank 5 flat whites and went home to bed. I know that was some years ago now and I don't drink as much coffee as I used to but, c'mon, it was 4 o'clock - not even dark!

Though most of today was in a little bit of a lack of sleep haze, I felt good.  I saw Reese first up this morning for physio and my body did quite well considering the demands that I put on it over the weekend. My muscles turned out being no where near as tight as what I thought they'd be and there were actually a few parts of today's session that felt relaxing.  (Note:  Only a few! Sounds a little crazy I know.  Maybe I was too tired to feel pain!  No, really, some of my lower body muscles are starting to behave normally, it really is amazing)  I have a new exercise to add to the plan.  I love the new challenges.  This one could be a little bit interesting 

I came home and played with Jack for a while.  I still love the little guy.  He smelt a bit like dog today which I wasn't overly enamoured with but he is a dog and this will happen from time to time.  I played for an hour before I came home.  Not all of his family is home yet so I still get to visit so that he isn't alone too much.  He's taken to help me stretch and move and expects me to follow him around.  If I don't, he'll sit and look at me like he's waiting for me.  I guess he has decided to be a part of my rehabilitation programme.  You don't say no to a little face like that spurring you on!

I'm getting a little bit of work done tonight so tomorrow isn't as busy a day.  It will likely to be a big one since I have a lot to catch up on from last week so anything I can do now will take the pressure off a little bit.  I don't exactly know what happened but somehow I got behind in a few things.  I'll be back in bed in a couple of hours and relaxed and ready for tomorrow.  

Baking up a storm

Saturday involved about six hours of baking in preparation for my sister's kitchen tea today.  There were red velvet cupcakes, butter cupcakes, chocolate cupcakes, chocolate mud cupcakes, mini lemon meringue cheescakes and amaretti (almond cookies) all in rather large quantities.

I was tired at the end of it all and my feet hurt.  My hips didn't.  There is no way I could have handled that much baking pre-op without some serious consequences.  Pre-op I would have started to have pain after about an hour and would have been hobbling around and feeling a rather intense amount of pain in my right hip.  By the end of the effort, I would have been leaning on walls, tables or anything close to get anywhere as my full weight on my right hip would have been screaming at me.  I would have felt the pain even when I sat and wouldn't have been able to get comfortable enough to sleep.  It is likely that I would have taken a couple  of panadeine forte to try and take the edge of a little bit, just enough to try to relax.  The pain relief wouldn't always take the edge off and never took the pain away completely.  The muscles around my hips would have been tight like rope and there would be some muscle spasming causing sharp stabbing pains as I tried to relax.  This was a a kind of pain that was significantly worse than my post-op pain levels.    

This pain would last for a number of days and see me fatigued for days after that.  My sister's engagement party saw me out of action for the best part of a week.  During that time I was on increased anti-inflammatories and additional pain relief.

Now, the day after, I'm just a little sleepy from having a busy weekend.  There is no pain. My calves and the muscles that run down the back of my feet are a little tight, as are my shoulders but this is what I would consider normal types of muscle tightness after standing with poor posture for that many hours.  I must have been hunched over to be tight across the back of the shoulders.  Awesome, hey!  I really do mean that.  A normal body reaction to poor behaviour.  Normal.  No meds.  Wow.

The countdown to my sister's wedding is on.  Next weekend we have dress fittings, the weekend after the 'Girls Night' and then the next after that is the big day.  I'm going to be in pretty great condition by then.  It's all happening.

Down for the count and a week of updates

Since my last post, I was down with a cold/flu for about a week.  Three of those days I slept for almost the whole day and in my few lucid moments, I thought that I might have felt worse than when I did when I was in hospital after my op.  I'm not sure if the memories have faded or whether the fog of congestion distorted the true state of things, but at the time it was the worst thing in the world.

I couldn't even help puppy sit on the weekend which was quite sad.  By Tuesday I felt a lot better and though I wasn't totally on top of things yet, the massive difference between not being able to scrape myself out of bed and being up and about made Tuesday feel amazing.  I spent most of the day looking after the puppy from across the street since his human was away for a few days.  The little rascal is a bit of a Houdini and I spent a good part of the day getting enough exercise to make up for the few days in bed.  I think that Jack, aka the little rascal, had realised on Tuesday that I was one big sucker for that cute little face and that I would be his human for a few days while his was away.  He really is a good puppy, it's just that puppies have a lot of energy and I'm not quite there yet.  I did get a good sleep when his human came home on Wednesday night.  The handover was kind of like giving him away which is a little weird since we were only puppy sitting, though I guess that I had fallen for the little guy some time ago.  I can still visit him there and maybe sometime soon, I'll be able to take him for some long walks.

I missed physio on Monday but made it in for a session on Wednesday.  Even though I walked in without the cane, the big 'look at me' moment was walking up and down the stairs without holding a railing or using the cane.  It's something that I have been practicing for quite a while.  In the last two weeks I had become brave enough to not hold on to the rail but I would still hover my hand near it - just in case.  My active ranges had dropped a couple of degrees, though I am not surprised or disappointed as I really did nothing for the best part of a week and was still a little fatigued.   The fact that I could breath through my nose again was just too much of a natural high for a couple of degrees to dampen my spirits.I have no doubt that I will be back and improving those again in no time.  

After a big sleep in today, I headed into work to catch up on a few things.  I've been walking around a lot more without my cane, though I still carry it around in my laptop case (it folds down!).  The only real place I need to use it is when I go to the bathrooms.  The main reason for this is the large step at the door that has no where to lean.  I could probably manage it, though I am still a little wary, especially in areas that could be wet and slippery.  Every now and then I have those 'almost could have been really bad' moments where I'm reminded that I still need to be careful.  I'm still six or so weeks away from the point where the risk of fracture to my femurs reduces.  Six months and twelve months are the points where the risks drop off quite substantially.  

Tomorrow, I'm back at Pilates.  Looking forward to reformer time!  I'm starting to think that my left leg not only has more range than it did pre-op, it is also stronger than it was before.  It's a pretty amazing outcome.  The surgery has been a massive success and I'm looking forward to see what the outcomes as my strength continues to increase.

Hydro and the sniffles

It's not cause and effect, both just are today.

It's the holiday for my area for the Brisbane Exhibition (the EKKA).  I'm not sure if the term 'exhibition' translates globally.  It's like a town fair or show.  I'm not going.  I've never been a huge fan though this is likely because there is a massive amount of walking around and standing in lines.  I associate EKKA time with colds and flus which seem to propagate wildly amongst the thousands and thousands of people that congregate at the RNA show-grounds each year.  Somehow, this year, I've picked up the EKKA time sniffles. (Or maybe from my husband who came home from Melbourne with germs.  I'm sure that he would prefer that I don't blame him.  I actually think that it is unlikely that they are his germs as he has been back for longer than a cold incubation period, so it must be EKKA germs!)

I was fine this morning at hydro and I got through a pretty full session.  It was a beautiful morning when I headed out.  Sunny and warm, I didn't even need my jumper on the way out.  The pool was empty by the second half of the session so we were a little sneaky and took some video of me walking and jumping in the water.  There is a big sign at the door that cameras aren't allowed but I figured that if we were the only ones there and there was no one to see us take the video, it would be ok.  At some point I will string all of the footage together.  It will end up being a pretty interesting look at my progress over the past couple of months.

By the time that the session was over, it was overcast and chilly.  It wasn't too cold.  I've defiantly gotten out of the pool and had it be a lot colder than this earlier in winter.  It was a shame really as I was looking forward to having my coffee on the porch when I got home to make the most of the sunshine.

A few hours after being home, I had eaten lunch and was sitting on the couch with my laptop starting to catch up on the daily reading and set up do a little work.  It didn't really work out like that as after about an hour, I'd started to sniffle and feel exhausted.  I ended up going back to bed and spend about four hours there.  I feel a little better since I've woken up but it still feels like I'll be fighting these bugs off for the next couple of days.  I need to kick it tomorrow really as I can't take germs with me to Pilates.  That would be rude.

Fear of Falling

I've noticed that the idea of falling has been on my mind a lot in the last couple of days.  Most of the time when I'm walking I am conscious of every foot placement, though there have been a few times in the last couple of days that I have found myself somewhere else and a not completely conscious of the journey.  Every time that I walk past the top of a staircase I have an irrational fear of falling down the stairs.

I don't know what would happen if I did fall.  I'm still a few months out of the 'danger zone' for my healing femurs.  It still wouldn't be too good to fall too hard after that but it wouldn't be as bad.  I wonder if the feeling that my body is going to uncontrollably launch itself off the top of the stairs as I walk past will go away at that point.  I don't know where it has come from but I have these horrible pictures of falling on a reasonably regular basis.  I guess it's keeping me from doing anything too stupid too soon, so it isn't entirely a bad thing.

I've always had a fear of falling.  If I felt safe, I'm fine.  Things like floor to ceiling windows in a high-rise without ledges, couldn't stand near them.  Mental images of me tripping and pushing the window out with me following closely behind.  Balconies and verandahs without balustrades, I'd hug the wall meters away in case I accidentally threw myself over the edge.  I lived on the tenth floor of a building for 5 years and was fine as I had ledges.  The balcony had concrete walls.  There was no accidental falling happening and no mental images of falling either.

It's not exactly a fear of heights.  I can go on roller coasters and to the top of tall buildings.  Just last summer we went to the lookout on the top of the Marina Bay Sands Hotel and had no problems.  It is an almost rational response to my surroundings.  I guess in a way the situation is the same, it's just that I've changed and I'm no longer as confident in my footing at the moment so the risks around me seem greater.  The damage done in a fall could also be a lot greater, thus increasing the perceived risk.

It will be interesting to see how quickly things go back to my normal and how I will feel trying new things as my strength grows.  I think that I'll always keep the touch of cautiousness - or crazy, depending on how you look at it.

The week in review

For the first couple of days this week my lower back has been a little bit sore.  I had some trigger pointing on Monday which released it but it was pretty quick to tighten up again.  I've kept moving and applying heat when I'm seated and it has helped.  I think it might be a combination of not setting my core properly for the whole pilates session or compensation and adjustments due to changing my cane to my left hand.

I'm not sure if I covered the change to the left hand for the cane.  It has been just over a week that we decided to give that a go.  My walking isn't good enough for no support at all when I'm out of the house and walking distances but I don't need very much assistance anymore.  As my left leg has become the stronger side with more range we have swapped over.  I walk a little straighter holding it in my left hand but it feels a little odd.  The positive is that it feels a little odd in both hands now that I'm not really using it a great deal around the house.  A couple of times I've opened the front door to go out and realised as I went to lock up that I didn't have the cane with me.  It is progress.

So the focus of my daily exercises, hydro and pilates is to bring the right side up to scratch, focus on setting the core and getting the right glute firing as well as the left.  Alignment is taking a lot of concentration as I learn where everything should go.  I've spoken about this quite a bit in the last few months and it is still something I am conscious of all of the time.  Well, maybe not when I wake in the middle of the night to go to the bathroom or am in a hurry somewhere but most of the time.

I do wonder if maybe I didn't do enough glute squeezes when I was in hospital.  As I've progressed and hospital was so long ago, I do question whether I did enough.  If I look back through the old posts, I don't think I had the energy to do much more but you always wonder about these types of things.  I have to add a few more in to the repertoire.  I learnt a new way at Pilates on Friday.  Laying on my stomach with my knees apart at neutral and bent so my heels are in the air.  The heels are together like frog feet.  Then its squeeze, hold, release patterns.  Both sides and then one at a time.  Funny things is, that in that position, I can actually really feel the difference between the left and the right.  I can't remember what the name of them is so I can find a better description of what it is.  I'll ask again next Friday and try find a picture as I really don't think that I've given you a proper description.

Though it's been busy, I am pretty happy with how life is turning out.  Even though I'm not there yet and there are a lot of unknowns, I do feel that I am on the right path in my life for the first time in a very long time.  There is a couple of people who seem to think that I should be miserable and trying to find issue with things.  I think this comes from the fact that things are very different from how they used to be.  I have been focused on what I need to do to get the best results possible out of the surgery and this has meant that I haven't always been available to others.  I was usually the one that could always be relied upon to do what everyone else wanted me to do.  Now that I am focused on me instead of them, there must be something wrong.  I am busy and I have a lot to deal with but I am fine to do that on my own.  When I'm up to it, I need to work in the spaces between rehab activities.  I need to make sure that I'm preparing healthy meals and eating well.  I need to get enough sleep.  I need to be engaging my brain and getting back into things.  There isn't too much time left over after that.  After a period of time things will normalise a bit more and I won't need as much rest on weekends to catchup and rejuvenate and I'll value that extra time a bit more than I used to.  I don't think I've become particularly selfish.  Just enough to be healthy.

Thursday wasn't very fun.  My husband's iMac blew up.  (Well my iMac but there is some question of ownership since I have claimed the MacBook Air!  I suppose it is his now it has been in his office since I got the 27" iMac at the start of last year and possession is nine-tenths of the law, right?  By that logic, I'm on the Air now typing my blog post, so it's really mine right?)  That was a truly tragic day.  There are still other Macs around but this one just can't be replaced.  It's one of the 24" aluminium case ones that they don't make anymore.  My husband's office seemed so sad without it.  It was taken to the doctors and we didn't have a huge amount of hope as to its recovery as the magic smoke had been released after a bit of a bang and that bad computer smell that happens when bad things happen.  Usually there is no coming back from that.  Somehow, this Mac was special and is alive again.  I don't know how but I am thankful!

With the resurrection of the iMac, a switched off telephone and an afternoon nap, today was a good day.  I ruffled a few feathers to have a time out day today to spend with my husband but it is worth it.  With so much going on, I need to remember not to take time for granted and continue to make my priorities a little closer to home.  There has been no 'big issue' to prompt this revelation.  It started with the closure of the last business that I worked for and has progressively become more of a mission.   This was part of the catalyst to do the surgery this year.  It might seem a little bit of a drastic response to the end of a job and it is a little bit more than that.  It is a new start and my body wasn't really up to a new start without the surgery.

I finally received my leave entitlements from the liquidator on Thursday and banked the cheque.  It was a little reminder to stick to my mission.   I did end up doing a rather long day that same day as the young girl at work resigned without notice leaving a rather large mess of uncompleted work.  I was happy to help out and the balance for it today was not doing any work.  I need to be careful not to sacrifice my recovery for work or health.  There are only so many hours in the day and some things will need to be sacrificed, just not anything that will cause me not to reach the full potential of the new joints.

I'm not sure what the plans are for the weekend.  There is likely to be a big sleep in and possibly a coffee run and a hunt for JaMocha Almond Fudge (my latest Baskin Robbins favourite).

Derek McMinn addresses Metal on Metal AZ May 2011

Patient Advocate of BHR's, Vicky Marlow has interviewed Mr Derek McMinn at the recent Arizona Orthopaedic Conference and compiled the information on her site here:  McMinn on Metal on Metal

I haven't read the information in full yet as I'm in the process of actually getting a post together covering what has happened this week.  I'm sure it will be an educational read.

RPA: A bilateral hip replacement on TV!

Last week there was an episode of RPA of a bilateral total hip replacement.  The episode is still available on line, if you would like to see for yourself.  I don't normally watch medical programs as I don't do to well with the cutting and opening part which is before anything actually happens.  I tried to watch the BMHR procedure that McMinn has on youtube but failed to get past the first couple of minutes.  I have it on good authority that it is an interesting series of clips (I have a friend who is not squeamish and quite interested in these types of things).

When I got home last week on Wednesday, with my takeaway from work and just about to collapse on the couch, I got a message telling me about it.  We'd only just been talking about these types of programs that morning, so I took it as 'meant to watch' tv.  In the interests of research, I watched the whole episode to see the bits about the hip surgery.  There was a fair amount of unrelated surgical procedures that I had to get through to watch it too!  I persisted though and it was actually quite interesting.

I'm not sure that I would have wanted to know that much information pre-op.  After the fact it was at it's limit.  The cut of the femur was fine, I've come to peace with that part of the op!  The hammering in of the acetabular cup using a mallet not unlike the one I have used to put together Ikea furniture, not so much.

The lady having the surgery was probably about 20 - 25 years older than me, so it was a bit of surprise that the surgeon had elected to do a bilateral procedure.   The surgeon did say that one of the key reasons that he elected to do it this way was her attitude.  Yes, she was healthy enough but attitude was the surgeon's key indicator for success.

The program made it look like a piece of cake.  I had a very positive attitude going in and I didn't look anywhere near that good in the first week post-op.  It goes to show that everyone reacts differently to surgery and some bodies just handle it better.  To be fair, a positive attitude can't make up for the extra two units of blood they gave me before I started to be a bit happier.  She didn't have any drug induced hallucinations either which I'm sure made part of the difference!  Everyone is different as are their outcomes.  You just need to work out what the best possible outcomes are for you and work towards them.

The message really is that you have to have the right attitude going in.  You need to try to get up the day after surgery and start rehab.  You need to work at it to heal.  If you can prepare pre-op to be stronger and more healthy, all the more the better.  Give yourself the best possible chance to wake up looking as well as well as this lady was.

I think over the longer term, I have caught up and my walking is better but its probably not a good comparison given that I can't be sure how far post-op she was in the final scenes of the program.

If anyone does watch it from the link above, feel free to add the extra info in the comments and I'll update the post!  I just can't bring myself to watch it a second time.

You might want to close your eyes for the mallet.  It isn't fun.

Back to Pilates

I went back to Pilates yesterday and it was awesome.  I knew that some of the things that I would be able to do would be things that I've never done before so it was pretty exciting.  The new ranges that I have that have no pain at all, mean that I'll be able to strengthen more muscles and get more out of both the Pilates sessions and my new parts!

Some of the regular exercises that I used to do have been cut back a little bit as far as the number of springs that I am using on the reformer.  I also skipped some of the balance ones that require standing on a bosu and the like, as I'm not ready for those yet.  My strength has dropped a little from my pre-op levels, though I was a little surprised at just how much I was able to do without any difficulty at all.  I'm not quite up to the long spine where the pelvis is lifted (as I spoke about and had images of in Late to Pilates) but I am doing the first part and it is a little wobbly and harder to control than pre-op but still pretty awesome.  I'm not yet doing reverse knee pulls yet - which is also pretty awesome since I really don't like them!

The biggest issue I had was with maintaining alignment.  My brain doesn't seem to know what is straight and I need someone to keep me in line (in more ways than one, but that is a story for another post).  My alignment is significantly better than it was pre-op and I am slowly starting to get things to move in the right way.  Some things feel a little weird, like correcting the inward rotation of my femurs.  I stopped it post op, but as I have been getting stronger and doing more, I have fallen back into my old bad habits.  I'm didn't think that would happen as I didn't do that post-op but maybe muscles had to heal and gain some strength before they wanted to do what was 'natural' to me.  Those so called 'natural' movements weren't really the way that the human body was supposed to move but pre-op it had no choice.  Now, I have the choice to train it properly.

It might take a bit more time yet.  Being able to add Pilates to my already busy schedule means that I'm still moving forward and will be the next step towards being better than ever.

Range Update

Measurements were taken at physio on Monday and for the passive ranges of hip flexion I'm at 100 degrees on the left and 91 on the right.  Active ranges are a couple of degrees less. They weren't that good pre-op and I'm still getting weekly improvement.  That has to slow at some point and I won't be disappointed when that happens.  I think that side of my progress is more of a bonus now with my focus on improving my gait.  Ranges are all in functional ranges now and though there will still be exercises to improve them further, I will be ok with slower progress.

I still get a little confused about the logic of how the left side got so far ahead of the right.  The left started off well behind with the drop foot and a splint that I really didn't really wear for that long.  When I started walking, the left was the side that was most difficult to lift.

The best guess to the logic as to how it took over was that while the right side was taking most of my weight and compensating for a lack of strength on the other side, the left could spend its days actually working on range.  The muscles on the left aren't as tight and the movement on that side feels a lot more fluid in the higher range.

Changes

Life is changing pretty quickly at the moment.  I'm still doing a lot of rehab type activities, like physio, hydro and an at home program but the other parts of life are visibly changing.  I have learnt a lot about the people who have gone through this process with me and unfortunately things I didn't want to learn about the people who didn't.  I'm starting out knowing exactly where I stand with people which is a strong platform to start again from.

I am back at work doing stop gap type work and I am adding things in that interest me.  That's led to a lot of reading and being back online just browsing, something that I've not really had the time to just enjoy for a very long time.  I think that's really some of the reason to have gone through this really.  To change that life that really wasn't working out for me work-wise, that was filled with pain and limited by joints that didn't work the way that they were supposed to.  The start to all of the changes was something beyond my control but it really was something that needed to happen.  It's scary not knowing what happens next.

I've not taken on so much that I've cut back on my rehab activities but more than enough to fill my days so I have been neglecting to write as much here.  The things that I do know is that there will be more opportunities that I will be able to take.  Little things like being able to work in the city without paying ridiculous amounts for parking since I'll actually be able to catch a bus.

I was baking on Sunday night and my sister came past to be an 'official taste tester' before I took the cupcakes in to share with the people at physio.  She asked me a hip related question at some point during the conversation and I realised that I hadn't thought about them while I was baking.  It came as a bit of a surprise that the question kind of seemed out of context even though it did relate to me and what I'm doing at the moment.  I suppose that will happen more frequently as time goes on.  It will be more difficult to forget when I start doing things that I haven't done for years.  As I meet these milestones I'll be excited by the accomplishments.  Some of the shine might wear off as I progress further but I think that there will always be some things that will always bring wonder and excitement with them.

I just have to make sure that I don't screw it up and forget the lessons that I've learnt.

Sleep In Saturday

I didn't really get out of bed this morning.  It was after twelve by the time I decided that I was too hungry to nap anymore and needed some breakfast.  I wasn't home too late last night and there was only one glass of red wine but I have been paying for it all day!  It has been a full week and there were a few nights there where I didn't sleep well, so it isn't too surprising that I needed to catch up on some snooze time.

Last night I went out with some of the people that I used to work with.  As I was getting ready to go out, I figured that I might give boots a go.  Last winter I couldn't wear them unless I had some help to do the zippers up.  The zipper runs down the inside of the leg right to the sole of the shoe near the arch.  Pre-op I couldn't reach that.  I managed to get tights on and my boots which I was pretty pleased by.  I did joke to my sister that I might need her to come around this morning if I couldn't get them off when I got home last night.  As I headed out, I really wasn't sure if would be able to get them off when I got home but I wasn't too concerned about that.  I've slept in my shoes before after a night out and overdone it.  Things can only get better from here on in so it was worth a try.

It was good to catch up.  Everyone has gone on to do different things and has new stories about the things they are doing.  It would be awesome if there was a project in the future that we could all work on again.  We had a really good team there.  It really is a shame that it all ended.  Sitting around talking about the good old days is surely a sign that I'm getting older.  This was a very quiet night for this crowd.  Likely another sign that we are getting old.  It was a good night.  We should do this more often.  Life just gets busy and moves on to different things.  I'm not quite sure what mine is moving on to.

Progress Update

This morning I got out of the pool using the steps.  This wasn't something that I could do pre-op so it's a pretty big step (literally and figuratively!).  I led with the left which is the side with the greater range.  I did need to pull up a little with my arms until my right foot was about 30 cm from the pool floor.  From that point on, there was more weight through the left leg to bring the right side up.  I went up step at a time with the same side so the next goal will be to alternate and then to start with the right leg up.

Next week I'm going to start pilates again.  I was cleared by my physio to do this a couple of weeks ago but I wasn't quite ready for the getting up and down off the floor.  The actual exercises I was and am looking forward to.   It means that I'll probably miss out on hydro for a week or two while I realign all my appointment times to fit everything in.  I'll still go to the pool on its new day - it will just be on my own until everything fits together properly.

Cooking Dinner

About six weeks pre-op, I increased the amount of vegetables that I was eating in an effort to make sure that I was getting all of the vitamins and minerals that my body would need going into surgery.  I got bloods taken about a month before to confirm that everything was looking good.  Even though this wasn't a big concern to anyone but me, making sure that my body was as healthy as it could be just made sense.  I've always been a big fan of fresh food and I made the time to make sure that I was eating well every day.

I didn't eat this well while I was in hospital as they don't really cook with a large selection of anything fresh.  It was something that I really looked forward to coming home for.  Since I've been home, I'm getting back to my pre-op eating habits.  My favourite at the moment is a lot of stir fried vegetables with bean thread noodles.

One of the things that I missed out on yesterday was the stir fry that I had planned for dinner.  Since last week's market run wasn't very successful, I was craving a good fresh mix of vegetables and when I missed them on Friday night, they moved to Saturday.  That's actually a lot of days for me not to have a fix.   Now that it is winter, the selection is less and the quality isn't as good.  This week's shopping expedition was actually quite successful and I managed to get a good selection.



The interesting thing that I found when I was out shopping were purple carrots. I thought that I would give them a go as apparently they are the new super food.  I'm not sure where I heard that and even if it isn't completely true, I'm a big fan of using as many colours of vegetables as I can when I'm making stir fry.  They feature front and centre in the veges that I pulled out to cook dinner with tonight.   I was a little surprised when I cut them to see the white rings.  I'm not quite sure what I expected.  They taste like orange carrots.  More like baby carrots than the larger ones.  They are a quite sweet.

I used the cutter that I normally do when I add carrot to stir fry.  It kinds of cuts them like little noodles.  I added some regular carrot in as well just to see how different that they tasted after they had been cooked.  I used chilli, garlic, ginger, soy and oyster sauce as I often do at the moment.  I'm a huge fan of bean vermicelli as well which I added in.  The weird thing is that the carrots released more liquid than orange carrots do and it turned the sauce a bit purple.  My noodles also ended up a bit purple too.  

The whole thing was just a little bit too sweet.  I'm not sure if I overcooked them, used too much or just needed more chilli and soy to balance the flavour.  I have leftovers for tomorrow that I might try to fix as I don't think that I want it again as it is.   It will be interesting to see how the flavours come through overnight.  It might be even sweeter tomorrow.  I hope not!  If it doesn't work out this time, I have two more still in the fridge so I can try again from scratch later in the week.

[Edit:  I recooked with extra chilli and garlic and it took away enough of the sweetness.  Noodles and mushrooms were very purple today]

Recovery Day

The post that was made yesterday was written on Friday morning after I read the RA Guy's post and was scheduled to post.  I was going to check it before it went out but I ended up doing very little yesterday except for sleep for most of day.

Friday was a big day.  I started off with Hydro and stayed in the pool for an extra 45 minutes after the end of my session.  I had to pick up a computer in town and then I headed home to read email, news and blogs and wrote a few comments like my post.  By the afternoon I was out doing grocery shopping.  This time, I went to the supermarket that was a longer walk from the car park to the store and only used the cane.  I was pretty tired by the time that I got home and hadn't expected to go out again.  There was a tentative plan to go to my sister's house to see her wedding dress that had just arrived, though I had expected that it would move to Sunday as when we had spoken about it, that seemed to be the preferred option.  This isn't how it worked out and I was out again very shortly after getting home.

The peak hour traffic south was pretty bad and a trip that would normally take about 20 minutes ended up taking more than twice as long.  The trip was ok and I was fine with the stairs to her apartment.  I had one of my niece-to-be's help carry things up the stairs but I think that I would have done that anyway even if I wasn't still sporting my cane.  The dress is perfect and my sister looks like the perfect bride.  I'd love to post a pic since I'm sure you would all agree that she looks perfect but that would be just wrong.  It's starting to get exciting now.  I just hope that everyone behaves themselves.  Weddings don't always bring out the best in people.  I'm not really up for arguments yet and tell people they are out of line.  I will though, if it that's what needs to be done to keep them in line and behave themselves.

There is still about 8 weeks to go until the wedding by which point I need to be walking without a limp.  I'm pretty sure that it is an achievable goal to halve that.  I've been practicing my walking every day.

Practicing walking is different than actual walking.  Practising means concentrating on everything to get everything right.  Even when I'm concentrating really hard, it's not quite there yet.  I guess that once I get it right, I'll have to practice wedding walking.  I don't want to confuse my brain too much too soon.

I got home by about 8:30pm and was pretty wrecked by then.  I was overtired though and didn't go straight to bed.  It took a while to wind down before I finally passed out.  That led into a whole day of naps as I got back on top of it.

Unified Healthcare

The RA Guy

I read an awesome blog post on the RA Guy's blog called: Rheumatoid Arthritis Healing Center.    It's an old post definitely worth revisiting.  The key idea I love about in this post is that all your health professionals are in one place and work together to help you have the best possible life all in a spa like setting combining the traditional medical appointment with your rheumatologist  with everything else that can make a difference; yoga, acupuncture, Physio, hydro, support groups, psychologists, doctors in other specialties and more.  The list was pretty comprehensive and the only thing I can think of to add is Pilates as it's something that has made a big difference for me.

I think that bringing all of the health professionals together like this would be awesome.  The people that would choose to work in this kind of environment would be ones that I would want to see.  People who understand that it isn't going to be just the medicine that is going to help.  Healthcare is slowly changing and the professionals that I have found to work with have been great.  For a long time and for a lot of doctors that I have seen anything out of the ordinary is seen as 'new fangled hippy rubbish' that doesn't do anything.  I once had a rheumatologist remark that the physio treatment I was receiving probably wasn't doing anything for me.  I was pretty upset by that as I when I came to him I was so happy with the increases to the range of movement that I was seeing and the improvement in my overall health and wellbeing, I couldn't believe that he would discount the effectiveness of the treatment.  Seriously, even if it was all in my head, what was the harm?  Why criticise? He went on to tell me that I couldn't afford to put on any weight and I pretty well had no options to improve my quality of life.  I found another specialist.  Thankfully, not all doctors are in the stone age. The team that I eventually found is one that I would expect to fit in to this concept quite well.

Attitudes are changing and it isn't just health professionals that need to come to the party.  We do too.  Having a community centre like feel will help visitors to maybe explore other services that will help them reach their full potential.  All aspects of life and body maintenance in one place is an awesome way to kick start the process.  The alternative is to spend years finding them which is something many don't have the confidence or resources to do.

The RA Guy has since updated his concept and posted it on his blog at: Autoimmune Wellness Center.  There is even a picture of what it might look like.  Check it out.  I'm sure you'll like it as much as I do.

Do you think that I could jog 5K?

Not now - that would be a pretty daft idea.  I can't even walk properly yet and my femurs aren't up to the impact of running.  It's off the list for at least a year.  Some argue that femurs are finished healing six months but I don't think it is worth the risk.

So maybe, September next year?
Bridge to Brisbane
I've never done anything like that before.  I'm not even sure I like running.  There is a possibility I could though.  I don't think I'll get into marathon running or anything like that.  Every now and then I hear of some activity that one of my friends is going to do and I think, maybe I could do that.

This is a very new experience for me.  I'm not quite sure what to make of it.

Bilateral Hip Replacement Recovery Time and Answers to this Week's Search Terms

So you came here looking to find out just how long it takes?

The answer is:   well it all depends...  not really what you were looking for?  Probably not!
 I'm not completely there yet but I am back at work part time and a lot of my day to day activities are at a similar level to what they were pre-op.  The limiting factor now is fatigue rather than pain and as time progresses the fatigue is reducing.

The big thing that I have learnt through this process is that everyone is different.  People heal at different rates dependent on so many different factors.  I've read so many stories of single hip recoveries and the variances in those are incredible.  Some people are off and walking without a cane in a week, while others are in excess of eight weeks.  Bilateral just makes the variables in the process increase as there are two hips to consider.  I've heard stories of bilateral resurfacing that are better than ever within a month.  I think that a lot of it depends on how fit / strong / healthy you are pre-op as to how quickly you bounce back.

Not everyone is offered the opportunity to get both hips done at once.  This option is at the surgeon's discretion and will be based on how he/she determines you well you do.  Some surgeon's don't do them.  Their reasons for not doing both?  I don't know.  I could guess, though that's all it would be, a guess.  It is a longer surgery and would have more risk associated with it.   Some might weigh this against the risk of going under twice.

As you would have read in some of my earlier posts, I really do believe that the more you can do to 'train' for the procedure, the better your post-op results will be and how rehabilitation will go.  I've referred to it as prehab and pre-op preparation and for me this included diet, physio, exercise and mental preparedness.

Things didn't go exactly to plan for me but things could have been a whole lot worse if I hadn't made changes in my life to prepare for this surgery.

Another term that I've seen pop up in the search terms today is "hip replacement game".  I'm not exactly sure what that is and wouldn't think that it would be a very fun game to play.

"physiofirst", well yes I did but I'm not sure whether that was the point of the search.  If you are looking for Physios who can help you pre-op and post-op to get the best possible outcomes, I'd suggest the team at Body Leadership.  The bias I have for them has been earned through years of helping have the best life I can possibly have.  I'll keep plugging them because I believe in them and the difference that they can make in your life as well as mine.

This leads into "planning bilateral hip replacement".  The most important things that you can do is find a great physio who can help you create a pre-op program to help you get the best outcomes possible.   A healthy diet should also be a part of your pre-op planning to make sure that all your vitamins and minerals are in healthy ranges.

Getting all of the 'housekeeping' type things out of the way before you go into hospital is usually a good idea.  You aren't going to feel like sorting out your taxes when you get home.  I also got all of my insurances in order and made sure everything was up to date.  This was more me being having an irrational desire to have everything in its place.  I think it was something to focus on instead of what was going to happen.

I'm still getting queries about the four corners piece on MOM implants.  I have commented on this before but recently I have expanded on the earlier thoughts and posted the following on a website after someone referred to this 'terrifying documentary on BHRs' lumping in the Birmingham device with others that are not in that league.

I have MOM devices, specifically the BMHR. I discussed the MOM issues with my surgeon and did a lot of research before finalising this as an option for me. The program focused on the ASR recall, and this should not be used as a basis for all MOM implants as there are many that have been highly successful.

I would suggest reading Mr McMinn's response to the ABC Four Corners program at: http://www.mcminncentre.co.uk/response-abc-corners-program.html as well as the other information on his site that shows his successes with a well placed, well designed MOM implant. There are many reasons to consider this as an alternative to THR if you are a suitable candidate, for example these devices are far more bone conserving and will make later revision easier for younger patients who are likely to require revision as some point down the track. As an example, I am 34 and even if I do get 20 - 30 years out of my BMHR's, I'm still looking at revision at 54 - 64.

Even for THRs, MOM implants allow less restriction to patients activities post operatively which is a huge benefit to active people.

Rumour has it that McMinn has started working with ceramic BMHR's for patients with metal allergies. If you are in the UK, I would seriously consider checking this out as even though they are new, McMinn's stats on his other devices are exceptional, including those that were done many years ago when they were new.

Cup placement is a huge factor in the success of MOM implants and research shows that those with a steep angle have a higher instance of edge loading and wear. It is imperative to seek out a highly skilled surgeon in this process. The site http://surfacehippy.info has a list of surgeons with 500+ surgeries with excellent statistics to consider talking to if you want more information on this procedure. There aren't too many listed for Australia. If you are in Brisbane, I can highly recommend Dr Simon Journeaux at Mater. He practices both publicly and privately. I went private so I'm not sure of what the wait times are like to see him publicly.

I really want a bath!

I'm just not sure that it would be the best idea.  I don't have anyone here to help fish me out if I get stuck at the moment.  I'm not even sure if I could sit in it at the moment.  It's a bit shorter than I'd like - so it's probably not worth the hassle even if I could get out.

I saw one of these walk-in bath tubs in the TV guide when I was in the hospital and am dreaming about it right now. Amazon has them and they aren't cheap:  American Standard 2848.100.WRW 28-Inch by 48-Inch Walk-In Bath Whirlpool System, Right Side Drain, White


I think I could find a pretty awesome jacuzzi for that.  It's not really in the budget but I can dream!



I'm going to the pool tomorrow so that will have to do.  It's not the same though.

[Edit] I realised about 3 hours after I posted this that it was actually the 100th post of this blog.  The 100th post really should have been reserved for something insightful, thought provoking and just awesome.  Oh well...  Maybe for the 1000th post?  Maybe I can get one in a little earlier and make 250 the next big milestone!

Your Questions Answered!

If you've ever had a question that you wanted to ask, now is the time to ask it.  If I can get enough questions sent to me either as replies to my posts or by email, twitter (lmcia) or any other social media, I might make this a regular event.  There aren't any stupid questions.  I'll try to answer everything I get sent.

How high is the chair you have to sit on at work and how long are you sitting at any one time?
They are height adjustable chairs, so I make sure that I have them adjusted so that my feet sit flat on the floor.  I'm most comfortable when my hip angle is just a little bit less than ninety degrees.  I think this is habit after many years sitting this way so my body feels most comfortable in that position.

I should be getting up and walking around each hour and that would probably be about right when I am in the office as I get a little uncomfortable sitting in one position.  This could be the chairs in the office or  me, I'm not sure.

When I'm at home, I sit with my feet up in a recliner chair with my laptop so I sometimes sit for longer than an hour working away.  I usually have to get up for something every hour or so anyway.  Sometimes it's to get more papers to get some work done, other times it's for a drink or something to snack on.  Sometimes it's just to move around.

Do you have trouble walking after you have been sitting for a long time?
I do limp a little bit more when I first stand up.  It usually takes me a few steps to start to loosen up a bit. It's the same in the mornings.  The elliptical helps get me moving in the mornings.  It's a little bit of change to pre-op.  Too much movement used to be what slowed me down.  It's a positive change.  One I'm not quite sure I've come to terms with yet.

As a woman how did you cope with not getting your hair done for the 6 or 7 weeks :D no serious, I'm a fella and my hair looks like a mad scientist, I can't wait to get a hair cut!
Just before I went into hospital, I had a hair cut, colour, got my eyebrows waxed and tinted and I did ok for a little while.  I had to get my tweezers brought into the hospital as the eyebrows started to bug me before anything else did.  The next thing that bothered me was my legs.  I really should have waxed those too as shaving was out due to hip restrictions.  It was totally gross.  I wore long pants a lot.  The compression socks also helped hide my legs!

When I did get home, I had my hair cut at home.  Even before the op, my hairdresser came to my friend's house and we'd all go there to get our hair cut and coloured.  When I came home, the venue changed to mine, so I didn't have to go anywhere.

When you go to the grocery shopping I assume you need your crutch to get into the shop, how do you deal with the crutch/trolley situation?
In the beginning, I took the walker with me so that I could sit down if I needed it.  I did need to sit down a few times when I first went.  When I was going with the walker, I needed someone with me as I wasn't driving yet.  Even if I had been, I wouldn't have been able to get the walker in and out of the car on my own.  I'm really not sure how the older ladies and men overcome that issue.  It's quite an awkward size and shape to lift in. It might just be that it doesn't fit into our car really well that I have so much of an issue with it.

Now I'm walking a bit better I take my crutch and put it in the trolley.  I noticed another lady doing the same thing when I was there last.  She was a little older than me but it seems to be the common solution to this problem.  Putting pressure on the trolley instead of the cane helps to stop me limping.  Shopping is becoming a little easier as time progresses.


Thanks to Tony for the questions for today!  I look forward to getting more sent through to me!

Things I can and can't do

Things that I can do, that are getting easier but are still difficult:

• Reaching down to pick up anything off the floor.  It all depends on the height of the item.  Paper is still out.  So is the lid for the butter that always seems to land face down.  It seems like I drop a lot more things than I used to or is it just that I notice it more?
• Lifting my legs in and out of the car.  Still feels like it should belong to part of a workout.
• Holding my legs in the air....  Why would anyone need to do this?  The only reason that I can think of is because it is on a list of exercises to do.  I can't really think of how this might fit into day to day life on a G rated blog!
• Getting socks on.  Requires the use of the reacher still.  Once the toes are in though, it is heaps easier to get them over my heels.
• Getting up of a low seat.  I am still using the toilet seat raiser in the toilet at home, not because I have to, more because it's still a pain to get up and down, especially at night when I'm half asleep.  Given that I am out a fair bit now and using regular height toilets quite frequently, I'm not in a huge hurry to get rid of it completely.
• Getting to the pool from the car park...  this still feels like a really big walk.  I've been using two crutches but tomorrow, I think I'm going to have a crack at using the cane.  I'll keep the crutches in the car, where they have been for the last couple of weeks, just in case I need them.  
• Getting onto the elliptical.  That step up still seems huge. The step to get into the ladies toilets at work is still a bigger effort...  a much bigger but required effort!
• Putting on pants.  For the benefit of others this is something that I practice every day!
• Working all day.  I'm getting closer to doing that but I'm still capping out at about 6 hours before I'm totally wrecked.  
• Carrying things.  I still ask for my coffee to be in a takeaway cup when I'm at work as I couldn't carry a cup on a saucer up the stairs to the office.  I am limited to using one hand when I walking outside of the house as I rely on a crutch or cane.  At home, I will walk short distances without and can use both hands to carry light items.

Things that I can't do yet that I'm looking forward to:

• Use the step ladder at the pool.  I couldn't do that pre-op so it's a good range tester
• Wear shoes with laces and tie them myself.  Again, no go pre-op.
• Walking long distances without pain and mobility aids.  By long distance, I mean an entire morning or afternoon shopping without a cane or crutch.  
• Walking without a limp and without a mobility aid

I can't think of too much else to add to the list at the moment.  If anyone has any ideas of day to day activities that I really should comment on, please let me know!