Thursday, March 31, 2011

Busy Day

I started out late today and managed to get an unmetered parking spot at Spring Hill on the first pass and made it to my appointment with my dentist a little early. I have no cavities :), so it was just a scale and clean today and another item off the checklist.   I spoke to Dr Tom about the surgery and about the report I read in relation to taking an antibiotic an hour before any procedure and apparently these precautions are more commonplace than I thought.  It seems that these precautions are taken by other people with different fixed items aside from joints.  I guess it stands to reason that those with a higher risk of complications due to infection should do what they can to avoid them.  It is just something that I hadn't really considered until now.  Poor dental health is even worse news than not taking antibiotics so making sure that I go for my regular checkups will be important.  I've booked in the next one for six months time (which I did after I got home as the new receptionist forgot to ask if I ever wanted to come back again), by which time I should almost be able to walk there :)  Maybe a little toooo far - a ten minute drive would equate to a pretty long distance, though I could catch the bus which would be a new thing for me.

After I left Dr Tom's office I went up a level to check at my old GP's office to see if all was sorted with the insurance company that was requesting my health information (which it has been so hopefully that will also be something that is checked off the checklist).  The issue was the insurance company not wanting to pay for the time to collate my medical history (which is hardly light reading even though this GP only covers the last four or five years).  I guess this is what happens when you have to search for someone to actually want to insure you.  I would have thought that with the prevalence of arthritis in the community today that it wouldn't be such a big deal, however, it is apparently and there are few insurers that want to touch me (other than the really bad catchall, no medical questions type covers which don't do much for you anyway - don't get me started on that one - just know that I wasn't happy with them).

Next it was coffee at my old coffee shop, Two Cups, which was next door to where I used to live.  That would have to be the big thing that I miss about living in the city - crossing the street for an awesome cup of coffee.  The closest coffee near where I live now is a five minute drive.  I'm not quite sure what the coffee options are when I am in hospital and this might be where I end up in trouble.  Though I've cut back to a cup a day - I make sure it is the best possible cup of coffee that I could possibly have so that I can really enjoy it.  It might be my husband's job to scout coffee before he arrives to visit in the mornings which will be somewhat reflective of what life was like for him on Saturday mornings when we did still live in the city :)

Next it was off to Milton to drop off some paperwork and then out to Coorparoo for physio where I actually arrived early again.  This is highly unusual behaviour for me as things usually don't line up as well as I plan them so today was a bit of a surprise.

I had a bit of a break after physio and caught up with Paul and had a chat about all kinds of stuff.  Ultimately it ended up with the big issue in my life at the moment - surgery - and what I want to eventually write about here that I am going to probably need some help with to make sure that I get it all right.  It's a bit of a pet project that I have to work on when I have some time after the surgery.  I might be crazy to think that I will feel like doing too much in the early days but I do have a lot of little projects planned for those few weeks.  I'm not really starting on a lot of this until after as there is a fair amount that needs to wait until I am going through the rehab process as the work I've been doing to prepare is really to improve the surgical outcomes and reduce the impact of rehab.  These are things that I really can't comment on until I actually am there and going through it.  I'm not going to know what needs to be worked and where I feel weakness until later.  Some of the focus of the pre-op preparation has come from comments made by others on discussion boards as to what things they found difficult in the rehabilitation process while the rest has come from discussions with my physios as to the things that they know that I will need to deal with.

Home again and getting some work done.  There are a few reports that I need to organise and just little bits and pieces that fall due when I am away.  Unfortunately most of them needed March to finish before I could get right into it so the bulk will be done tomorrow on the weekend.

Eight sleeps to go.

Wednesday, March 30, 2011

Lack of Motivation

Today was a day for a complete and utter lack of motivation.  I did manage to get to pilates today though the rest of the afternoon I did very little.  I totally corrupted my good influence :)  This either means that I have accepted that I can't control everything and have finally relaxed or I'm just tired.  Sometimes I over analyse things though today I won't - I'll enjoy the relax I had and take it at face value - I just must have needed it.

I started a course of antibiotics this afternoon and promptly fell asleep.  Hopefully after a few more good nights of sleep I will be able to completely kick the germs well in time for the final countdown until game day.

I've started to have a think about what I want to do that morning before we check in at 11am.  I can eat until seven, so I'll get my morning coffee which is a good start :)

With those happy thoughts of morning coffee, I am going to go back to dreamland.

Nine sleeps to go.

Tuesday, March 29, 2011

No Physio Today :(

Somehow I managed to screw up my scheduling and didn't end up with a physio appointment like I thought I did so I turned up today and wasn't supposed to.  I have been juggling this last couple of weeks around a little bit to fit all kinds of things in, so I guess it's no wonder that something had to go wrong somewhere along the line.  I am rebooked for Thursday at a later time to accommodate for my dentists appointment and all is pretty much the same as any other week. One hydro appointment and one physio appointment, so there should be absolutely no reason to be emotional about it.  Now that I am getting closer to the date, I'm finding myself focusing on the minutiae and getting overly emotionally vested maybe as a coping mechanism for everything else that is going on.  It's disconcerting as I think that I have been really positive about the whole experience.  As the 'most of the time' feeling, it's still positive, it's just that on most days since about mid last week there has been a moment where I have had what I would deem a disproportionate emotional reaction.

In a way it relates a little to the OCD with germs and general control issues over the insignificant that I have discussed in other posts.  I have identified the strange behaviour and yet can't stop it.  Maybe it's because I've not really determined what the exact underlying issue is so that I can deal with it.  I have come up with a number of possible explanations and not too many solutions (other than suck it and see).

On the surface, I suppose it is easier to focus on the little things rather than worry about the unknown.  I'd like to think that I'm ready for the process through finding the right health professionals, research and actual physical preparation but...  I still do worry that I might not have done enough to help avoid any possible complications or that I have done something that I shouldn't have done that may harm my recovery time.  It's mostly because in these situations you just can't control all of the outcomes.  All that you can do is the best you can or make the compromises that you can accept and move forward and deal with what comes next.  So given there are things I can't control, maybe I'm focused on the things that I can or believe that I should be and am affected when these little things end up beyond my control as well.

Stupidly it extends to whether I am going to get everything done before I go into hospital.  The stupid thing is that I am coming out of hospital again so I don't know why that's even a big deal.  It really shouldn't be, though it may just be the last few things that I maybe can control.

So while I'm starting to realise that maybe I don't have control of much in my world and one crutch of control that I have fallen back to many times in the past, I no longer have.  As my health has declined, I have been more reliant on others for lots of different things except for money.  It was an important source of self-esteem, mostly as to me it is still an indicator of being able to look after myself.   My work status has changed very recently and was part of the reason that we chose to do this now (as I have the freedom to focus on preparation and then rehabilitation as I'm not working full time).  Along with not working full-time, this is the first time in my adult life when I haven't been financially independent.  At the moment and for the next few months I will be just about completely financially reliant on someone else.  My husband has no issue with this, it's just me struggling to come to terms with letting go of that portion of control over my life. There are no sick leave benefits or other benefits that were due to be paid to me to fall back on as the company that I was working was destroyed by a selfish director (which given that I am probably still bitter about given the massive time investment that I'd made to this place over the last decade is once again a situation that I have had no control over), so I had the choice of clocking up the leave required somewhere else or making some positive changes now (there were other considerations - though this certainly was a factor).  I guess I didn't think about the emotional impact that the change in work situation would have and it really is extremely likely that it does play at least some part in my current responses to other events where things fall out of my control.   Maybe I was always a control freak, it just wasn't as obvious when there weren't periods of such massive change going on and as such the weird behaviour never really got to raise it's odd little head so often.  This could lead to the conclusion that maybe I just need to get over myself and get my act together :)

Oh crap, I just sneezed.  It's time to go and get a good sleep and hopefully wake up germ free in the morning.. I guess I'll save getting my act together for another day...

Monday, March 28, 2011

Hydro, GP Checkup and Items off the checklist

This morning started out at Hydro and I was a little bit concerned that we weren't starting off the day well when there was no parking, the hydro pool was full of little germy children and the pool outside was cold.  It got progressively better though.  One of the outside pools was relatively unoccupied, though cold for the first few minutes it was ok and best of all there were no children's germs.  I know I have been harping on this recently, though the upset tummy late mid last week and the sore throat of the weekend has put me into a mild panic that I won't be well for next Friday and I might get bumped.  I think that I might just hide away from the public for the next ten days.  Unfortunately I do need to go into the office tomorrow for a while and then maybe again on Thursday for a little bit.  Next Tuesday is the last office day leaving me to be able to kick back and spend some time with my husband before I go into hospital.  Things have been pretty crazy in the lead up, mostly because we both need time off work for more than just a couple of days. A lot of my stuff has been 'housekeeping' type things that I've mentioned earlier (paperwork and the like).

Today's checklist included getting to the GP to get a new referral so that medicare will actually chip in for the operation, renewing a mail redirection, cleaning out some old paperwork and other old junk.  Nothing exciting but things that I am unlikely going to want to do for a little while.  Hell, I haven't wanted to do these tasks for the last year, the next few months is unlikely to be any different.  I'm a little anxious about getting everything done, even though I am sure that some of this stuff really could be put of for a few more months.  I guess I have really gotten into the idea of having a clean slate when I get home from hospital, or very soon after that time, that I am freaking out a little bit on the nearing deadline.   I'm not actually sure if I am misidentifying the cause of the anxiety and it's actually about the op itself and other associated bits and pieces that is causing the anxiety.  I'm not sure.   I know that I am looking forward to being on the other side of the op though a general anxiety would also explain my newly acquired OCD about Germs (which really haven't bothered me too much in the past, anymore than anyone else - I do wash my hands when appropriate and take the appropriate risks) and I do realise that I am becoming a little crazy about it just as I am about the other things that aren't neatly filed away in their happy little boxes.

Back to the GP visit:  the sore throat isn't anything too bad.  I think that the honey, chilli and garlic, lots of water, lots of fresh vegetables and fruit (not all together), have kicked it a bit.  I got the doc to check it today when I was there for the referral just to help put my mind at ease and it isn't too bad.  If it does get worse, I am apparently still allowed to take antibiotics and I have been given a script for that.  I think I would double check with the surgeons office first just in case but I shouldn't need them so it doesn't really matter too much.  The GP visit was pretty sucky as my normal doctor wasn't there and he is way cooler than the one I saw today.  (He's on paternity leave - so I would be an ass to complain too much about his absence).  I've only really just started to go to this clinic, I really do like this new doctor and I'm fussy.  He seems interested in what is going on and is actually knowledgable about it (he does work on some orthopaedic cases though with a different surgeon - so that helps) but I really think that even if he didn't have the ortho background, he would just be one of those doctors that really takes an interest in people so even though I understood the reason why he wasn't there today, I was still a little disappointed that the replacement didn't really live up to expectation (which may well just me not relating to her as well - not a reflection on skills and abilities as a GP).  It is difficult to find these doctors who not only take an interest but you also relate to and feel comfortable with.  If you have been lucky in your life and got an awesome doc first go, you should be very grateful!

I was lucky enough to have one of my best friends to help me stay focused on the clean out and this afternoon post doc's appointment was actually pretty productive.  I am a hoarder and even knowing this about myself, I was still surprised at just how much 'junk' I've collected over the years and carted around from one house to the next.  She'll be back on Wednesday to help relieve the insanity again.  We'll head off to pilates at midday and maybe get coffee on the way back home so it should be a good day.  Thursday is girls night again, so all in all it will be a good week.  Here's to it being a productive and stress free one as well :)

Sunday, March 27, 2011

Sunday Night

It's Sunday night and the end of a pretty lazy weekend.  I'm catching up on my online reading while watching a Tivo recorded episode of The View in the background (ok, I know that is pretty sad but hey it's easy watching and there isn't anything on at the moment).  I've spent a large portion of the last few days napping, trying to kick a cold that is threatening to turn up in full force.  I woke up the other morning with a sore throat (after all my panic and illness paranoia that amounted to nothing a few days before that) and the associated panic hit in as I am within the two week period of the surgery and not supposed to take anything.  The stupid thing is that I can take my normal anti-inflammatory medication until this Friday and I didn't have enough - so I had to go out today to get a prescription filled for six days.  I shouldn't need them after :)    Anyway back to the cold thing, so I have been eating lots of fresh food, drinking lots of water and getting lots of rest.   I have been out of sorts a bit since mid-week and am slowly getting back on top of it which is good news.  I need to kick it quickly so that nothing bumps my surgery date!  About to have tea with lemon and manuka honey and another early night.  Checkup with the GP tomorrow afternoon and to get another referral for the surgeon as my current one runs out before the surgery (stupid rules, the specialist referral that I got to go see the surgeon only lasts three months yet the GP's lasts 12.  How does that work? Wouldn't you think that the specialist referral should have a higher weighting?  It's just weird and a huge waste of time)

This week is going to be a pretty busy one.  It's the last full week and there is still much to be done.  

12 sleeps to go (ignoring any more naps!)

Thursday, March 24, 2011

Cool Walking Sticks

I was at Milton today and I accosted a young woman about where she got her walking stick from.  I hope that she realised that I was being sincere and would be getting my own very soon from Switch Sticks.  I just need to decide which one I want and work out whether I'll need one or two.

Monday, March 21, 2011

It's no big deal, right?

Wrong.

This is a Big F***ing Deal.  Just because everyone ends up getting bits and pieces replaced doesn't make it less of a BFD to me.

The actual op itself - it's not a BFD.  Yes I have considered the risks of {read this bit very fast} going under general anaesthetic, like, hey, not waking up;  or them getting in there and finding out that the BMHR isn't going to work out and it needs to be a total hip; or complications during surgery meaning only one gets done; or the possible post op complications like clots; or the acetabular cup not being placed 'just so' and the metal wear causing pseudo-tumours, having to take antibiotics every time I go to the dentist for the rest of my life, or possibly setting off every metal detector I walk through again and ending up in secondary inspection *deep breath* (and spoken very slowly with finality) Yes - I can not be late to the airport *ever* again.

It's not a BFD for any of these reasons.

It's a BFD because it is going to improve my quality of life.

It might not seem to be a BFD to those who have never struggled with chronic pain (oh how I wish to share, just for a few minutes, just so they know what it feels like to stand still and think about moving in a normal range of movement and to feel the pain the first time - I know that is truly evil - but how else do you gain understanding without experience? *innocent face*)

What's the old saying 'Want to walk a mile in my shoes?'  Apparently then you'll understand...  Hang on a second here - that's not possible?  Who wants to walk a mile anyway right?  You lucky F'er, you get to be lazy.  Maybe I do...  maybe I don't....  maybe I just want the actual choice to walk a mile should I ever want to.

Maybe it's not a BFD to those who think that it isn't a BFD to deal with with what I deal with now.  I guess you could be forgiven for thinking that.  I hide it well.  There are very few that even catch a glimpse of it.  I do the things I need to do to maximise what I can do (Sometimes, I know, I'm not very good at doing *everything* that I could be doing - but that's life.  Sometimes you just do what you can), so most of the time, I just look like the regular stressed worker bee, no different from any other worker bee.  When I'm not, I hibernate, away from the world or find reasons to remain seated, or move when no-one is watching or thousands of other little 'things' I've learnt to protect myself.

The rest of you out in the world just get to think that I'm leaving early because I'm no fun at the party, I'm lazy and catching a cab instead of walking a mile, I'm too busy to go to the event that I'd actually love to go to but there won't be any seating, I look tired all of the time because I don't sleep (and yet I really have but it's never enough).  I bet these same people have never seen me tie my own shoelaces either.  Come to think of it, have you ever seen me wear shoes with laces?  No - probably not - you know why?  I can't do them up.  There's more and it's equally humiliating, but does it really matter?  No.  You know why you don't hear about it? It's not worth complaining about - It Just Is.  There are people worse off.  There are people who can't just go get this fixed.  They aren't looking for sympathy and neither am I.  I live my life to the best I can and now it's time to move past it - management is no longer the solution.

I'm not looking for sympathy, just maybe a little understanding so that you can share my excitement.  (To all you dumb asses that think that understanding is the same as sympathy, please go to last sentence in this post).

This is exciting.  This is going to be a new life for me.  Things that I've not been able to do since I was eleven.  Imagine that.  Wow.  How can you not see my enthusiasm and be excited for me?   Even with all the worst case scenarios, the worst case, is still better than a bad day.
<MorbidHumour> providing that I do wake up from general and get a blood clot - but hey the odds of that are probably lower than getting hit by a bus and hey that hasn't happened yet</MorbidHumour>  The prognosis is excellent.  I've learnt a lot from my journey.  I know I can do this.  I know that I will conquer rehab.  I know that there are new, exciting things happening and they are going to happen this year.

C'mon, who hasn't seen a child take joy in doing something simple for the first time.  How awesome would it be to know what you know now and still get to take the joy in something as simple as tying shoelaces (ok, maybe I'm going a little overboard with the comparison since I still remember how to tie a bow - but come on think about it).  Little things that other people take for granted are a big deal?  Dropped something on the ground and being able to pick it up!!  [Side note:  Believe me, I have walked away from dropped coins before and then other times looked at the dropped item and almost cried, realising that I can't just walk away and I have no fricking idea on how I am going to pick it up while stubbornly swiping and attempt to grasp the offending item.  Sometimes ingeniousness is required when you need another item like a key or something in your handbag for that extra reach to tip it up against something and slowly raise it up against something so it stands a little higher while you silently pray that no one is watching this pathetic attempt. (Please note this can end up horribly - key and credit card on the ground - lol - if you've been here with me at some point in your life, you've got to laugh, otherwise this is the tears moment!)]

Let's step it up a bit.   Want to live without the need for persistent pain medication and miss out on the side order of stomach ulcers?  Want to ride a bike?  Or maybe going swimming in the ocean?  Going to a concert and being in the 'mosh pit'?  Or maybe just being able to walk to school (or work!).  Want to catch a bus or a tram at the end of the day?  Hell, want to get out of a chair at the end of the day? Go on a long walk?  Or just a walk to the corner store?  Sit on the floor and get up again?   [Side note:  It won't happen overnight, but it will happen (haha)] 


Want to have the choice to do any of these things and more?

To those who think that isn't a BFD - well -

Go Jump!

18 Sleeps to go

The countdown is on.  At hydro this morning and we've added in some new exercises and were talking about what things we are going to be doing over the next few weeks.  I realised that I only have two more Mondays left for the big day and the in the last week, I already have most of the day booked out.  I'll be working out when to fit the extra hydro session in when I am at physio on Thursday.

:)  It's getting exciting now :)

Sunday, March 20, 2011

Illness Paranoia

I was actually a little rude today which I'd like to think is out of character.  I caught up with some friends of mine who I haven't seen for such a long time and things were going smashingly until one started to sniffle a little.  At that point, I was pretty much out of there.  I was asked if I could give her a lift home from the event which I normally wouldn't have an issue with at all, but instead responded with, I can't be in enclosed spaces with contagious germy people - I have major surgery in three weeks.  I'm not sure if I am just being overly precious as I really don't want to delay my date because I have a cold or flu.  My chosen surgeon is going on leave for easter, so I'm not sure how long I'd have to delay for if I don't make that April 8 date due to illness.

Saturday, March 19, 2011

The Indoor Pool is Closed

I've never been to the pool on the weekend before as I am normally there in the mornings during the week. It seems that the indoor pool is closed for kids and swimming lessons on the weekends which sucks!  I went over there this morning with hubby to show him what I have been up to and we didn't get to get in the pool.  The outside ones were open - but it was pouring rain, so really not the best plan for the day.  I should have realised that today wasn't the day to be doing this activity when I woke up, it was raining and I couldn't find my swimsuit.  It is just as well that I found this out now as I would have been pretty pissed post-op making the way over there to get in the pool to find out it wasn't open today.

Wonder if I can pretend to be a kid learning to swim?

Friday, March 18, 2011

Late to Pilates

I was late this morning to pilates...  I swear that I set my alarm a whole hour earlier than it went off - someone must have changed it in the middle of the night!!

I did get there, yawning most of the way through the session as I didn't have time for my one cup of coffee a day or breakfast before I took off out of here in a hurry to actually make it before the session ended!  I was only about 10 minutes late and thankfully so was the person after me, so I got most of the program in before I raced of to get coffee.  (There is a new place almost half way home that is awesome - try it out if you are near Holland Park - it's called Stomp Espresso)

My husband was with me today to see what I have been up to (really it was that he needed a good stretch out and tagging along to pilates certainly does that for you).  He does some different exercises than me given that I have range of movement issues that make some pretty impossible.  This prompted me to remember something that I had been meaning to tell my instructor for a few sessions now.  There was finally one thing that I thought 'oh shit' about for after the op.  I would have to use the fitness circle at pilates.  I've never used that thing, but in all the shared studio sessions that I have had with people, no one likes it.  Every one has the exercises that they love and hate and they really do differ from person to person with, it seems the exclusion of the fitness circle, of which I have never personally met anyone that likes it.

The good news that I found out today is that I won't be able to use it for 'a long time' as it puts too much pressure on the femur and/or femoral head (depending on the excercise) - yippee!

As far as the ones I have love and hate relationships with:
So hate:  Reverse Knee Pulls
  I'm not sure why I really hate these.  It could be that I can't really kneel with the front of my knee comfortably on the shoulder rests (hip range in that position) and end up kinda squished or that as I look down to the floor I visualise face planting.  I'd say it's more likely to be the face plant

So Love: Feet in straps exercises like: Hinges (kind of like the first two positions of the long spine, the long spine and basically everything except for the ones I can't do which are pretty much any abduction stuff which upsets the hips
 Long Spine:

The pictures above I found in google, which lead to google books, which actually had an embed link (which is very cool).  I would have thought that would be something frowned upon - but hey if Google wants to let us :)  To give the author kudos, the book that they both come out of is:
Pilates

No, I have never tried that and though it makes for an impressive cover shot, I think that it leads people to believe that they can't do pilates.  I had someone who didn't know me at all (met a few times during a business transaction once when I was on my way to a session) comment that they are not strong or flexible enough for pilates.  I replied that you work to your own level and slowly increase your ability - that I am not flexible at all, in fact I'm going in for two hip replacements in less than a month, so anyone can do it.  Pilates helps lengthen and strengthen, promotes good posture and is exercise that you don't feel sore from the next day.  Sometimes the muscles feel 'worked' the next day and sometimes the day after that, though I've never had the gym type can't walk the next day done too much (and probably incorrectly so ending up putting excess pressure on all of the wrong places) from going to pilates.  There is still the muscle burn when you are there and not everything is easy but there still is visible results when you go regularly.  I always feel good after a session which makes it a lot easier to go.  People who disagree with me just haven't found the right class or instructor.  There is a lot more to pilates than matt classes or watching a DVD.  A good instructor coaches, makes sure that your alignment is correct, the right muscles are being worked and the program is customised to your ability and has a plan for improvement and progression.  If for financial reasons you are going down the class path (yes they are a lot cheaper), try finding one where the instructor also runs studio sessions so that you can go a couple of times on a one-on-one basis and discuss going to the larger classes with them.  This way the instructor can see what level you are at and suggest some alternatives when things come up in class.  You can also become more familiar with the exercises and the techniques so that you get the most out of the class.  If you find the right person, it will certainly help that they know you individually before rocking up with ten other people.  Also if you are one-on-one, be good to your instructor, they'll appreciate it.  If you have a scheduled session, don't cancel late.  Pilates generally isn't something that has a high demand rate for casual sessions so there is a good chance the spot won't easily be able to be filled and will leave them sitting around the studio for the hour waiting for the next session to start.

The extra session a week has made a big difference to abs and core - I actually am starting to have some dints now :)  (Much to the exasperation of a friend of mine who regularly does lots of sit ups - lots more than I ever do - and isn't getting the same dints).  I know that the dints aren't necessarily the goal here but it is kinda cool to have a visual result.

Swollen Knees and Fatigue

My knees are revolting...  as in revolution revolting..  not disgusting revolting (though some might see that the melon like shape is revolting but it really isn't that bad.)  I think they might already be missing the femoral head that is about to disappear and crying in sympathy.  I told them quite sternly that if they didn't start behaving, they would be next on the list to be replaced with a newer, younger and more attractive model!  No not really - not keen on knee replacements, apparently they *really* hurt, rehab is harder, the satisfaction levels are lower (than hips) and I really don't have a need for those.  I do hope that once the hips are done the knees will calm down.

For the last few days I have had mildly sore, majorly swollen knees, likely a result of overdoing it last week, ending up with compensating by rolling in on the femur and putting extra stress on the knees as they weren't being used properly, causing inflammation.  There was no heat (like there was in my right hip last week) so hoping it is just a reaction to the alignment issue rather than the RA flare.  I got an 'it's possible' that this has caused the inflammation from my physio so stuck with that.  Post-treatment I came home with tubigrips that I left on until this morning and like magic my knees are the normal swollen kind not the extra swollen kind.   (Since I was a kid and first had the onset of the JRA, there has been thickening of the synovial fluid. In the beginning there was also inflammation.  Now, my normal range CRP and ESR indicate that it isn't inflamed and causing joint damage which is good!)  I was pretty worn out yesterday and slept a lot longer than normal last night and could still do with a nap this afternoon.  Fatigue is reasonably typical for me when things start to hurt.   I think a lot of it is to do with restless sleep and last night I got to catch up a bit :)

While I was at the physio visit yesterday I followed up the 'what have I done to myself now questions'   with a bunch of alignment questions.  Specifically I am curious as to whether the anterior tilt of the pelvis can be corrected.  As my body has accommodated for the lack of joint spacing in the hip, parts around have moved to give myself more spacing in the joint making it more comfortable to walk.  This was evident pretty early in the piece with a slight lengthening obvious when I started regular physio and regular pilates.  ( I swear I am taller when I come out of physio - and no they don't put me on a stretching rack :)  I don't think that I can get it back to a proper neutral position, though it will be interesting to see how things change once the hip spacing issue is fixed.

Wednesday, March 16, 2011

Pilates Day Today...

I have been doing pilates for a number of years now, with the last three or four with the same instructor. (Who has a really full schedule at the moment and a waiting list, so there is no point trying to steal her from me!)  Over the years, the focus of the sessions changes based on how I am feeling and what I am able to do.  The goals changed a lot earlier this year when I decided to proceed with surgery as I want to be as fit as possible and am prepared to push past what I think my limits are even if there are negative consequences for a couple of days.  I figured that when I started off pushing it, I had more to gain by learning that the limits were a little further away that I thought they were and trying a few new things that I might have previously shied away from.   I need to start to be a little more careful as I get closer to the day as I don't really want to be cut open while the joint is inflamed.  The step up hasn't ignored technique as this really is fundamental to the progress that I feel that I have seen by adding the additional session and pushing a little bit harder.  My change in motivation has probably made a big difference as well.    

My instructor,  knows my main physio really well and they both have similar philosophies on things which is most likely why I get along well with them all and have been going to see them for so long.  The other benefit to them knowing each other and having worked together before is that they have been happy to work together with me to set this whole plan to get me prepared in motion (haha).  Each time I rock up with something new that I have found on the Internet which they are probably a little sick of, though they are all grinning and bearing it and answering my questions about whatever it is that I have found and how it could apply to me.  Today it was about the exercises for both pre-surgery and post-surgery that I mentioned yesterday that I found on Dr Gross's website.  All of these muscle groups are those that are on my regular program, though some a little different as we have the benefit of the reformer and other equipment while I am at the studio.  We have quite a bit more in there and have stepped up some in the old program to push core strength, stability, balance and posture as much as we can through the period of time we had.  I think it was about seven or eight weeks out that I started with the two sessions a week rather than the one that I previously had.    Early after the decision had been made, the physio that runs the hydro sessions for me came along to help with this so we could co-ordinate everyone's efforts.  Seems to be working well :)

Surgeon Advice for Surgery Prep

I found this linked off a discussion board where a number of contributors have great things to say about Dr Gross.    He looks to have done quite a lot of these, having started with the resurfacing procedure in 1989 which seems to be well before it became reasonably commonplace.  [Side note: The first I heard about resurfacing was in 2002 from a rheumatologist who I saw very briefly (as I really didn't like the guy), though he didn't really understand the procedure and its benefits enough to answer any questions or be humble enough to recommend that I speak to a surgeon if I really want my questions answered.  At that time I was pretty much running away from surgery anyway as I'd just started down a new physio path that was making such a huge difference.  (Anyway - based on the conversations with my surgeon, there is no chance I would have been a resurfacing candidate then anyway due to my bone quality)]

Anyway, back to Dr Gross, he actually has some prep advice that was missing from the material that I have brought home about my procedure.  Check it out here: http://www.grossortho.com/hipinfo10.htm
Some of it is pretty common sense and ties in nicely with the program that I have made up myself with the help of the professionals that I have been working with for a while now.

The recovery worksheets are interesting as well.  Though different surgeons recommend slightly different paths, the information is comprehensive and certainly interesting reading.  The exercises that are in the phase two are of more interest to me.  I understand that you need to start out slow and not overdo it and have to follow the instructions given to you by the surgeon.  The fact that you could end up in phase two at six weeks is pretty amazing.  The slower path might drive me crazy and I hope that I am in a rapid path plan.  I guess it will be a wait and see type of thing.

Monday, March 14, 2011

Monday's Hydro

Had a good time at the pool today.  I feel good after the session and I hope to be the same way tomorrow.  We cut out a few of the abductor exercises which I think has made a big difference to how I feel after the session.  I think that might be where I was overdoing it.  With that minor change, I should be able to take a few more steps forward strength wise.  I have three more sessions in the pool (instructed by one of my physios) and maybe another three on my own.  It's amazing to think that in as little as three months time, there is a strong possibility that the abductor exercises that are giving me so much grief now might well be easy.  Ok so, maybe it won't be 'easy' that soon, though they are going to be significantly easier due to a  normal or even near normal range of movement.

Sunday, March 13, 2011

Shopping and planning for the week I am admitted....

I spent some time on the weekend looking for the extra bits and pieces that I might need to take into the hospital with me.  Where I'm not sure, I have erred on the side of caution and purchased a couple of options :)  I might have mentioned that my pre-op appointment is on the Monday of the week that I am admitted (I go in on the Friday), so I won't be left with a lot of time to do that much in the last week.  The main question I have is when will I get to wear 'normal' clothes again after surgery?  From some of reading that I have found that the answer varies so, I guess it does vary from person to person based on the incision type and how long drainage tubes are in and generally how fast I heal.  I have selected loosely fitting pants and shirts (not unlike what I wear to pilates now) and dresses that aren't too 'hospital' or 'old lady' looking.   I've elected for soft fabrics that feel good and still breathe.  I've also found myself a pair of flat slip on type shoes with good soles and reasonable foot support so that when I can't bend, I can still have some sense of independence should I want it :)

So far for the last week, I have two physio sessions planned, maybe one pilates and one hydro session as well.  I will be finishing up my medication on the weekend before so the last two will depend on my overall wellbeing given that I haven't been off the anti-inflammatories for that long for quite some time.  I am currently taking Voltaren (aka Diclofenac Sodium) 50mg twice daily and will need to stop that in the week before.  I will be allowed to take Panadol Osteo and Panadeine Extra which hasn't been as effective when trialled in the past.  It's only a week, and I will be fine, though I want to be careful not to set anything off in that week before going in.  I have been working closely with my physios and know that they will make sure that I am in the best physical condition that I am physically capable of being in, so it's left to me to follow their expert advice in that field and focus on other aspects, like eating well and maintaining a positive attitude.

In between the physio and exercise, I have the non-critical tasks like getting my hair cut and coloured and getting my eyebrows waxed and any last minute shopping things that need to be done :)  I figure that if I'm not feeling 100% when I first wake up from the surgery, I probably won't want to look in the mirror and see regrowth :)  Though this may seem to be the least of my problems, I think that everything that I can do to go in feeling positive and good about myself, will help on the other end, even if it is as cosmetic as getting my hair done.

Saturday, March 12, 2011

Discussion Board worth looking at

I have come across a website with a discussion board that is definitely worthwhile having a look at:  http://www.surfacehippy.info/

Took me ages to find this out there and am glad that I did as there are a lot of other personal stories there and the owner of the board comments often.   Everyone has different experiences and there doesn't seem to be too many bilaterals (at my age), though the general information has been interesting and helpful to the process of getting ready mentally.  Not everything is stellar and completely positive, though I do believe it is a reasonably fair representation of a good cross section of people across continents, with different histories, different procedures and different 'spare parts'.

In the beginning when I was searching for information, I wasn't overly successful.  Now I'm searching for the obscure: like bmhr images, I end up with more reading material at: http://www.hipresurfacingsite.com/Other-Patients/Other-Patients/menu-id-41.html
This one doesn't seem to be as interactive as the other site, though still useful information.

Wonder why I was looking for bmhr images?  I saw a shirt on the surface hippy link that had a stylised image of the prosthesis (resurfacing not mid-head) which was kinda cute in a geeky kind of way.  So I thought maybe my own tee or maybe an iphone case with little bmhr's on the back would be cool :)

Friday, March 11, 2011

Getting my life in order

Much of the last week was spent on tasks not directly related to the surgery.  Once I had made the decision to proceed, there were a lot of housekeeping items that I have decided needed to be taken care of before the 'big day'.  This will be the start of a new phase of my life and the 'old' needs to be finished and left behind as well.  This is the really boring stuff, like going to the accountant and getting the taxes up to date, checking into all our insurances to make sure we have the best options for us at this point in our lives, unpacking a few more boxes that have been sitting in our new house since we moved in twelve months ago and other such 'fun' tasks I am sure most people are familiar with.  It is highly unlikely that I will be inspired to work on these tasks whilst focusing on recovery since I have done so well in putting them off over the last few years, so maybe it's about time that I get my whole life in order and start fresh, not weighted down by the 'old stuff'.

In the decision making process, there were a lot of things to consider about what I want from my future and I think that in part, the things that held off moving towards making these things happen is the 'old stuff' that hangs around and becomes an excuse to stay in the same place (metaphorically).  I'm not quite sure of there was a single catalyst was to start down this path or if it was a number of reasons that I have collected over the last few years that I am sure that when I figure it out, it will be a good story to tell.  At that point though I hope to have all of the boxes unpacked and well on the way down the bright and shiny path.

Monday, March 7, 2011

Rehab Equipment

I went out to look at rehab equipment to see what I might need for when I come home from the hospital.  I will find out a lot more about this when I have my pre-op appointment on the Monday of surgery week, though I'd like to be a little more prepared, so I thought that I would see how knowledgeable the sales staff were in a rehab equipment store coupled with the information that I've found online.  The first place I found when I looked online was only about twenty minutes away in Algester, so I decided to head out and see what I could find.  I was helped out by a really helpful guy called Darren who was able to answer all of the questions that I had about all of the different things that I need to consider.

Some things to help me out will be arranged by the hospital.  As far as I can gather this will be the walker thing (like one of these or maybe just a frame like this - whatever they decide).  The extra bits and pieces to make the house a bit more friendly for me.  One of the important things will relate to making sure that in the early days (until I am cleared by the rehab physio or doctor), that my knee doesn't end up higher than the level of my hip.  Until the musculature strengthens around the joint and recovers from the damage caused by the surgery there is a risk of dislocation if I do.  Apparently this isn't as a significant risk with anterior incision but from what I can gather, this doesn't apply to me.  So, I have been looking at day chairs with adjustable legs (because my tv chair is way too low and I'd never get out of it), a seat raiser for the toilet, bars for stability and a chair for the shower.  I looked at a reacher and I'm not convinced I'll need one of those.  I haven't been easily able to pick things up for years and wonder if I could get away from not picking up anything off the floor for 6 - 8 weeks if I have help at home.  I don't particularly want to become reliant on aids, so it is a bit of a balancing act with those as well.  Obviously I need to take care with some things - like where I sit, chair in the shower etc, I do wonder just how many more of these things that I will need.

Hydro

I started the day off at hydrotherapy with one of my physios.  This is only one part of the whole 'plan' to be in the best possible condition for surgery. (There is also another physio appointment, two pilates sessions and other bits and pieces that I will cover in other posts as it requires more detail and will get me off onto another track all together).

I started this last week in addition to my other activities and exercises that are starting to add up.  In the water I can do more than on land, so hopefully there will be some additional strength or length gained.  It might not be a great deal as I am adding it in so late but every little bit helps and it isn't going to hurt me to be doing that little bit extra.  The main focus in the pool are the muscles around the hip, legs and core.  There is some arm work, though that is secondary and the focus of other parts of my preparation (Some of the exercises I have from physio as well as in pilates).

I was in the pool for about half an hour today which seems to be enough at the moment with everything else.  Last week, I went by myself on Thursday and overdid it a bit and ended up sore for a few days.  It's a fine line between doing as much as possible to benefit me and pushing to the point where I couldn't do anything for the next few days.  I'm willing to push the boundaries at the moment, though in the coming weeks I'll have to be more careful so that I can get as much done as possible.  I think that it might be something that I need to keep an eye on after the surgery as well.  I haven't really read too many experiences online as to whether it is possible to push to hard afterwards and end up delaying the recovery process.  It stands to reason.  I guess I will find out more about that when I actually meet the rehab team.  

Sunday, March 6, 2011

Spare Parts

When you need a spare part for an electrical or mechanical appliance there is generally a model number or some type of manufacturers description that requires some form of measurement to make sure that the right one is selected.  

Given that human beings are all different sizes, how do they work out what size 'parts' to order before the op?

Friday, March 4, 2011

Questions that I don't have the answers for yet.

This post will be updated as I find out the answers to these questions and as I think of more questions to ask.  There are a number of them that I will be able to ask when I have my pre-op appointment on 4 April.  I could make an appointment sooner - though these things will not change my decision and can wait until then. (There is a good chance that I have been given this information in earlier appointments but with the amount of information that I have received and researched, it could very well be that I have confused myself and can't remember which applies to me!!)

Where will the incision be? I hadn't thought about this until I was reading this page that I found from a google search.  I hadn't considered the various cutting locations and had assumed that it would be on the side.  I think I saw the start of a surgery video on a site recommended by the surgeon for information and assumed that is how he will cut...  (I say beginning as I couldn't watch it all - squeamish!)  What I do remember about the cut is that it isn't a micro-incision and the reasons why this isn't used by my surgeon...  just not where the cut will be. [edit:  I do know now :)  it will be down the side]

Thursday, March 3, 2011

The Birmingham Mid Head Resection (BMHR)

The goal is to have a left and right Birmingham Mid Head Resection (BMHR) completed on the 8th April.

After the right hip is completed, the surgeon and anaesthetist will chat and make sure that all is good to proceed with the left.  The right is where I experience most of the pain and it will be a great relief to be without this, though I will be very disappointed if I wake up with just one done.  Obviously the doctors will make the decision based on what is best for me and I would rather wake up disappointed than take unnecessary risk.

Depending on the bone quality and the degree that the protrusio affects the procedure, the surgeon may elect to complete a total hip replacement instead.  This again is not ideal as the BMHR is preferred for younger more active patients. The surgeon has suggested that I take a look at the McMinn Centre website for more information and I have found the site a wealth of information.  An update in recent months includes a lot more video testimonials which are interesting to watch.  I would like some more from some less active people (ie. not highly sporting).

Preparing for Surgery

I booked the surgery in a couple of weeks ago after having a lot of long conversations with my husband.   There was a lot to consider for us when looking at our plans for the next three - five years.  The decision process is for another post.

Once the decision was made and the surgery was booked in, there was a lot more research for me to actually find out more about what I could expect and to see what I could do to improve my overall health and strength to hopefully reduce the length and difficulty of rehabilitation.  I know that rehab isn't going to be easy especially getting both hips done at the same time so I figure that anything that I can do to improve my chances has to be worth the effort.

What this has meant as spending time talking and planning with the health professionals that I already work with on a regular basis and finding new people to answer the questions that I still have.  This has meant more physio, an extra session of pilates, blood work at the GP to see where all the vitamins and minerals are at, a nutritionist to look at my eating habits and generally clean up my act.  

I have to mention that I am currently only working part time.  This was all part of the planning process for the next few years for me.  I finished up with a full time job, one that engulfed my life for a decade, in September of last year.  The company went into liquidation and another short term contract took me up until Christmas.  My options at this point were to find another full-time job straight away or use the opportunity to get my hips fixed.  There were a lot more considerations to the decision than that, though this is the bit that is relevant now.  I don't think that I could devote the time that I am at the moment 'looking after myself' if I was working in a full time capacity.  My ability to maintain work-life balance has been questionable at times, though a large wake up in September of last year has really prompted a lot of thinking time about what I want out of life and when.  That said, the point of me mentioning the part time is the schedule I am keeping at the moment, making sure that I am preparing and eating fresh food and spending time each morning either at physio, pilates (two days), hydrotherapy (all three with instructors) and the final week day back in the pool or doing the other exercises that I have on my list from one of my physios.  This morning it was pool time doing as many of the exercises that I could remember from my Monday's hydro session.  

Some super humans manage to do these things while working full time.  I'm not quite sure how they achieve that.  Maybe their definition of full time is less hours, maybe they are just more motivated.  I'm not sure.  I just mention it in case you think I am one of those super humans.  I can assure you that I am not.  A number of the testimonials that I have seen online for hip replacement surgery seem to be either super humans or super sporting people.  It makes it a little difficult for me to relate to as I don't fit into either category.  I get tired easily, take a long time to recover from over exertion, I don't look after myself as well as I could.  Making sure I eat breakfast every day was probably one of the more difficult hurdles to overcome after many years of taking the extra half hour sleep instead.  

The count down to surgery is 36 days.