I have touched on the issue of pain management in some of my other posts though the issue really does need a bit more attention as it really is a major issue in my history, decision making process, post operatively and even now as I am on the recovery path. Since I've been asked recently about my current pain levels, I'll start with the present and work my way backwards.
Today, I'm taking Panadol Osteo at night before bed. It's nothing really. I've gone without it for a couple of nights in the last week or so as well. Since I've been home, I've been choosing the level of medication that I require on a day to day basis. After two decades of managing pain I get it right most of the time. Throughout the rehabilitation process they tell you it's important to stay ahead of the pain as it's more difficult to fix the problem after it's gotten too bad. Bad pain also restricts the amount of exercise that you are doing which can delay recovery times so it makes sense to manage the medication carefully. On the flip side of this, I want to be off medication. Being off anti-inflammatories was one of the hopeful outcomes for the surgery which I have now met so I've moved the goal posts a little. It won't be the end of the earth though if I need to take two panadol at night for the rest of my life. It certainly is better than the other meds that barely managed the pain pre-op.
The pain I have now is only muscular. The joints don't hurt. They move freely and don't grind or stop me from moving. I'd say that the pain that is left is probably similar to work-out pain (without straining anything). If the worst pain I had pre-op was a ten, I'd say today was only one or at most a one and a half. (I'm sure that there are things more painful that my worst flare but for the sake of the scale, I'm putting the worst one up the top end and working down from there) I'm completely worn out and everything feels fatigued but it isn't real pain. There is the friendly muscle ache going on letting me know that I did work hard today and my body really has had enough for the day. Every now and then it's a little sharp if I sit too long and stretching and moving will help release it out.
A lot of the exercises that I am doing are to build the hip flexors and hip stabilisors. To work these a lot of other muscles are getting a work out as well. Pretty much everything around that area needs to be stretched out as it gets tight. The adductors are some of the worst offenders. Gluteals, quads and hamstrings are pretty close behind. The muscles that are above the top of the pelvic bone on the right side are getting a bit of a look in at the moment too as I am practicing walking on one crutch. Knees ache and are swollen a bit more than normal. They are getting a work out too given my gait has changed as I'm straightening up and not compensating as I used to pre-op. As the muscles strengthen, I'm able to do more before things get worn out.
Over the years of working with Paul at Body Leadership, I have learnt a lot of skills to help relieve muscle pain. Squeeze, Stretch, Trigger, Move are the four tenets of body maintenance and when applied make a massive difference to how my whole body feels. I probably won't explain this anywhere near as well as either Paul or Reese would but I know what I'm supposed to do and they check in regularly to make sure that I'm doing everything properly and add in extra stretches and exercises to my program. Trigger pointing myself isn't anywhere near as effective as when either of those guys are doing it either, though it does make a huge difference. Pain is more easily managed with the help of these guys. I can't wait until I can comfortably lie on both sides on the beds at the clinic so that I can get all my connective tissue released. The thought of all the muscles all loose and nice feels like floating which would be awesome right now!
When I'm in bed I can lie on the wound on either side. The time limit before I have to move is a couple of hours so I am waking to move still and as time goes on, I can stay mostly asleep to move so my sleep feels less interrupted and I wake feeling like I have actually slept. It's probably close now as I can comfortably rub a moisturiser into it and put quite a bit of pressure into it. Apparently this is good thing to do while the scar tissue is still pliable to try and minimise it. I've only really just started this in the last week or so as I've been pretty tentative with it until I was sure it wouldn't hurt. I don't think I'm going to end up with a really big scar anyway as it looks like the surgeon has done an awesome job putting me all back together again. The line is quite a fine line and a lot less than I would have expected when you consider how deep the incision would have been to get down to the femur.
When I arrived home from hospital, I was taking the maximum dose of ibrupofen and panamax. The dose of codeine that I was taking had been cut down to 60mg at night and three lots of 30mg through the day. 30mg is what is in a single Panadeine forte tablet. Codeine is an opiate and it isn't one of the common ones they use for pain management for this surgery apparently. The narcotics usually prescribed are oxycontin and endone which I couldn't take as I had a bad reaction to them.
I hadn't really thought of Panadeine Forte as a stong pain killer. I guess that's because if I had used them pre-op to handle pain and I thought that post-op the pain would be so much worse and I'd need something so much stronger. Surprisingly I didn't. The surgical pain really wasn't that bad. Don't get me wrong, I wouldn't have wanted to put too much pressure on the wounds in the early days but mostly the site was numb around the wound. It isn't completely back to normal yet but it isn't numb like it was then.
Every now and then there was a quick sharpness but it didn't last. I like to think of it as the point where the nerves that were healing were first taking the electrical impulses through them and that first sharp pain is the first one as it pushes through the damaged piece the first time to forge the new pathway. I'm not sure how it really works but the visual of that made the whole thing a bit more positive in my mind.
The most pain I ever had was the second night in the ortho ward and it wasn't in my hips or legs. It ended up being my back from being in one place for so long without moving. The first night I still had the PCA to help out but the second night it was gone (I think the PCA is the name for it. It is the button that you can press to self administer drugs straight into your drip.) The night it was gone things weren't as comfortable. I'd also lost the air mattress thing that I had in ICU and they don't roll you in the ward to help relieve the pressure. The next day I managed to get the air mattress back and that made all of the difference. Over the next few days I could move a bit more, they got my haemoglobin under control and sorted out meds that worked and I was starting to sleep for a couple of hours at a time which helped. I think this is the main reason that the goal is to get you up and moving the day after surgery. Unfortunately when that doesn't happen, muscles start to tighten up and within two days muscles start to weaken. So I guess the moral of the story is to at least try to get up the first time the physios come in. If it works out, you'll be so much better off.
When I moved to the rehab ward, the back pain moved to further up the back. I'd lost the air mattress topper again but the pain was likely from poor posture while using the rollator. The muscles across the middle were really tight and difficult to stretch out. I found that the solution was a rolled up towel that I lay on as it ran down the length of my spine and my shoulders could fall back over it and get a good stretch.
Tuesday, May 31, 2011
Sunday, May 29, 2011
Unscheduled Daily Activities
Some days I wake up and everything feels good. It feels like I could get out of bed and things will just work like they are supposed to. It certainly feels like it. There is no pain anymore. It isn't until I start to get myself out of bed and the sleepy haze wears off and I realise that things aren't quite there yet. There are still a lot of exercises to get through and a lot of strength to still build. I started of the day in quite a positive mood. Last night while doing a few extra exercises, I found I was able to balance on my right leg without any support meaning that strength is returning to my hip stabilisors. These are an important part of actually being able to walk without the crutches. The left is still far to shaky to take the support away yet but hey, one out of two aint bad.
Daily activities are a huge part of building strength. Incorporating activity into the day, even to add an extra trip up and down the stairs all makes a difference. A piece of advice that I was given before I had the op was to do just one more than was on the list of prescribed exercises (without overdoing it - so I have to listen to my body pretty carefully so that I am pushing myself without hurting something that would stop me from doing my exercises the next day). Using that theory, I have been trying to add more into each day. Sometimes circumstances make this happen without me actually having to try. Life often throws unscheduled curve balls just to keep things interesting.
Today, it was attempting to wash the car. For those that know me, this really will seem like a very strange thing for me to get up and do. I had a pretty good reason for it and the process was somewhat of an effort that I really hadn't considered being the 'activity' to add to today. There was bird poo (or possible bat poo - it was brown and stuck like glue) on almost every single panel on my beautiful black car. There was splatter absolutely everywhere. I'm really not sure how it was entirely possible for this to happen without a flock of awful little animals deciding to specifically seek out and target my car. I noticed the big splotches when I went out the front to sit in the sunlight to drink my coffee this morning. A couple of weeks ago, I probably would have resigned to the fact that it would have to stay on there until someone else was around to take care of it as it slowly ate into the paintwork. Today, I thought that I had the energy to give it a go.
I went downstairs and started to soak the large splotches with the car cleaner, I notice more on every single panel. I probably spent about an hour shuffling around the car cleaning it as best as I could while my crutches were leant up against the bin beside the car. I needed both hands, one for the car cleaning spray and one for the cleaning cloth. I did ok as I moved around the car, though they aren't really real step yet, still more of a cross between a shuffle and a waddle. After I had completely trashed three cleaning cloths, I called it a day and had another shower to clean the smell off me. I don't think the smell really was on me but my brain seemed to think that it was and I needed to be clean again. The cloths also needed to be cleaned and that required two trips up and down the inside stairs. The stairs are slowly becoming a little easier. The inside ones are narrower than outside but they seem to be not quite as high, so stepping up without vaulting isn't quite as difficult (still not easy, just not as difficult). Overall this little unscheduled activity added a fair amount of incidental exercise today.
I am pretty worn out tonight which is a good sign that I have expended sufficient energy today. Another day has passed on my trip to recovery and hopefully tomorrow morning I will wake again feeling good and it will be just that little bit easier to get out of bed. I hope that my unscheduled activities that unexpectedly get added to my day tomorrow aren't quite as smelly as they were today.
Daily activities are a huge part of building strength. Incorporating activity into the day, even to add an extra trip up and down the stairs all makes a difference. A piece of advice that I was given before I had the op was to do just one more than was on the list of prescribed exercises (without overdoing it - so I have to listen to my body pretty carefully so that I am pushing myself without hurting something that would stop me from doing my exercises the next day). Using that theory, I have been trying to add more into each day. Sometimes circumstances make this happen without me actually having to try. Life often throws unscheduled curve balls just to keep things interesting.
Today, it was attempting to wash the car. For those that know me, this really will seem like a very strange thing for me to get up and do. I had a pretty good reason for it and the process was somewhat of an effort that I really hadn't considered being the 'activity' to add to today. There was bird poo (or possible bat poo - it was brown and stuck like glue) on almost every single panel on my beautiful black car. There was splatter absolutely everywhere. I'm really not sure how it was entirely possible for this to happen without a flock of awful little animals deciding to specifically seek out and target my car. I noticed the big splotches when I went out the front to sit in the sunlight to drink my coffee this morning. A couple of weeks ago, I probably would have resigned to the fact that it would have to stay on there until someone else was around to take care of it as it slowly ate into the paintwork. Today, I thought that I had the energy to give it a go.
I went downstairs and started to soak the large splotches with the car cleaner, I notice more on every single panel. I probably spent about an hour shuffling around the car cleaning it as best as I could while my crutches were leant up against the bin beside the car. I needed both hands, one for the car cleaning spray and one for the cleaning cloth. I did ok as I moved around the car, though they aren't really real step yet, still more of a cross between a shuffle and a waddle. After I had completely trashed three cleaning cloths, I called it a day and had another shower to clean the smell off me. I don't think the smell really was on me but my brain seemed to think that it was and I needed to be clean again. The cloths also needed to be cleaned and that required two trips up and down the inside stairs. The stairs are slowly becoming a little easier. The inside ones are narrower than outside but they seem to be not quite as high, so stepping up without vaulting isn't quite as difficult (still not easy, just not as difficult). Overall this little unscheduled activity added a fair amount of incidental exercise today.
I am pretty worn out tonight which is a good sign that I have expended sufficient energy today. Another day has passed on my trip to recovery and hopefully tomorrow morning I will wake again feeling good and it will be just that little bit easier to get out of bed. I hope that my unscheduled activities that unexpectedly get added to my day tomorrow aren't quite as smelly as they were today.
Saturday, May 28, 2011
Mr McMinn comments on ABC's Four Corners bash up of hip resurfacing
There was a recent Four Corners program that was rather negative about hip resurfacing and metal on metal prostheses. It focuses on the ASR device that has been recalled and applies these statistics across a field of other devices that have had significant success. (Like the side note of the post 'Six Week Surgical Review', the negative effects of metal ions are overstated compared with research based evidence using larger sample sizes)
Mr McMinn responds to the program with an article on his website: http://www.mcminncentre.co.uk/response-abc-corners-program.html
(McMinn invented the BMHR that I have and has had great successes with his previous invention the BHR resurfacing device. He is regarded as an expert in the field by many and above average survivorship rates clearly support this)
The key statements that resonated with me are:
"It would be unfortunate if the adverse results from a few ill-designed, poorly implanted devices are allowed to throw this excellent treatment option into disrepute."
"It must be remembered however that component malposition is a cause of failure and should be avoided. Choose your device and your surgeon carefully."
Well designed, well implanted devices have changed so many lives for the better. I hope that people looking at resurfacing consider all the research out there and not just the sensational media reports.
Mr McMinn responds to the program with an article on his website: http://www.mcminncentre.co.uk/response-abc-corners-program.html
(McMinn invented the BMHR that I have and has had great successes with his previous invention the BHR resurfacing device. He is regarded as an expert in the field by many and above average survivorship rates clearly support this)
The key statements that resonated with me are:
"It would be unfortunate if the adverse results from a few ill-designed, poorly implanted devices are allowed to throw this excellent treatment option into disrepute."
"It must be remembered however that component malposition is a cause of failure and should be avoided. Choose your device and your surgeon carefully."
Well designed, well implanted devices have changed so many lives for the better. I hope that people looking at resurfacing consider all the research out there and not just the sensational media reports.
Thursday, May 26, 2011
The Essay: To JRA kids
I was eleven when I was diagnosed with JRA. Soon after I heard about a summer camp being held in Perth for kids like me. It amazed me to think that there were enough kids out there going through this horrible process to have a camp full of them. The only other kid I knew with JRA was Bradley and he was a lot younger than me so we really didn't talk too much. I felt alone at that point in my life and a camp sounded like an awesome idea.
The problem was we couldn't afford for me to go. To get a sponsored place I needed to apply for a scholarship and that involved writing an essay about how JRA had affected my life. I'm sure at this point the blood drained from my face as contemplated exactly what they wanted. In my twelve year old brain, JRA hadn't just affected my life, it had completely ruined it and I knew that they didn't want to hear that. I was sure that they wanted some fluff piece about I had overcome adversity and beaten the odds to become this stronger, wiser, somehow better version of myself. Even with the imagination of a child, I couldn't do that. I couldn't comprehend the idea of a world where my life would be OK with JRA. Then I would doubt myself. What if I was wrong and they wanted the truth, that I couldn't see how it was possible to have the same opportunities as my friends, that life wouldn't be the same and I would alone... forever.... What if the sob story sold and I got my place out of pity? The same pity that was on the faces of the adults that surrounded me. I didn't want it if it came with that condition.
Worse still, what if I told my story whether it was the truth or the fluffy version of it and they didn't want me there. What if I found out that I wasn't good enough? I was probably different than most of those kids too. Kids that could still actually walk without help. Kids who's lives weren't quite as broken as mine. Those that had figured out a way to write the essay about the happy times and how much stronger and better they were than me.
The truth was, I couldn't deal with my condition. I couldn't control it. I couldn't control anything in my life. I tried once. To control it. To take my medication or not to take it. It didn't make me feel better. It just made me sore and I got in trouble. Why would I do that? Why wouldn't I do what I was told? Do I think that I'm the only one going through a difficult time? Why didn't they understand?
I couldn't see a way of growing up and being anything but that sick child that needed so much help from people that tried so hard to understand but just didn't. I didn't know what I wanted or what I needed. I know now that all I really needed was to feel like I had value and a belief in myself and that I could work it all out.
This is one of the few distinct event memories that I have of that first year after my diagnosis. The rest is a blur of pain and helplessness, of anger and grief for a life that I thought I had lost. It seemed never ending as time drew past the twelve month mark where 'for most JRA kids it burns itself out' and it didn't. I could walk again but the pain was still there. I still needed medication. I knew that there would be a lot of things that I might never do again or be able to do for the first time.
Somewhere along the way I realised that there were still a lot of things that I could do. I found things that I enjoyed, found ways to cope and found ways to live. It wasn't always easy and I still have days where I think that life isn't fair where I wonder why I was given this faulty body to work with. I still don't like to talk much about when I got JRA except in the fluff pieces where I exclaim that it had made be a stronger, better and wiser version of myself. It's easier that way. Easier to put it behind me and take each new day as it comes.
Some days the pain is still there and I've had to fix a few joints on the way but I've done OK. I've done a lot of things that I never thought I'd do. I survived my JRA childhood and became the regular kind of troubled teen. Ok, I needed to make some adjustments and compensations along the way but I managed. I had fun.
I went to uni and rebelled.
I worked and learnt to support myself and take care of me.
I've had good jobs and bad jobs and still don't know what I want to be when I grow up and that's ok! (If you're a teen - I'm OLD. 34 this year!)
I went to Las Vegas and partied like a rockstar. I went to London and saw a play. I went to Thailand and relaxed. I travelled when I thought I never would.
I've had good friends and just for time friends who I've lived it up with, who I've shared life's ups and downs with. Some know and some don't.
I've been accepted by others.
I've been accepted by me.
I'm married to someone who loves me, who accepts that my body is a little bit broken and still accepts me anyway. He accepts me for who I am and not just the shell that I want the world to see.
We own a house and are all grown up, making our own choices for our lives.
One day I'll have kids of my own and though I've got a good life, I hope and pray that they won't need to take this road because I wouldn't wish it on them. Just as I don't wish it on you. If there were a magic wand, I would take it away from you because I know.
There is still lots of life to live and though I might not be jumping back in the mosh pit anytime soon, life is good.
So on your darkest days, where no one understands you and you question why you were punished with this horrible disease, please know that even if you don't think that camp full of kids understands, there are more people like us who do understand and have been through this and had great lives. It is horrible and it is hard to talk about. It might not go away but you will be ok.
This is your life and JRA is a part of it. Just a little part. It isn't who you are. You are in charge of making the best life you can for you. That life you create can be great!
The problem was we couldn't afford for me to go. To get a sponsored place I needed to apply for a scholarship and that involved writing an essay about how JRA had affected my life. I'm sure at this point the blood drained from my face as contemplated exactly what they wanted. In my twelve year old brain, JRA hadn't just affected my life, it had completely ruined it and I knew that they didn't want to hear that. I was sure that they wanted some fluff piece about I had overcome adversity and beaten the odds to become this stronger, wiser, somehow better version of myself. Even with the imagination of a child, I couldn't do that. I couldn't comprehend the idea of a world where my life would be OK with JRA. Then I would doubt myself. What if I was wrong and they wanted the truth, that I couldn't see how it was possible to have the same opportunities as my friends, that life wouldn't be the same and I would alone... forever.... What if the sob story sold and I got my place out of pity? The same pity that was on the faces of the adults that surrounded me. I didn't want it if it came with that condition.
Worse still, what if I told my story whether it was the truth or the fluffy version of it and they didn't want me there. What if I found out that I wasn't good enough? I was probably different than most of those kids too. Kids that could still actually walk without help. Kids who's lives weren't quite as broken as mine. Those that had figured out a way to write the essay about the happy times and how much stronger and better they were than me.
The truth was, I couldn't deal with my condition. I couldn't control it. I couldn't control anything in my life. I tried once. To control it. To take my medication or not to take it. It didn't make me feel better. It just made me sore and I got in trouble. Why would I do that? Why wouldn't I do what I was told? Do I think that I'm the only one going through a difficult time? Why didn't they understand?
I couldn't see a way of growing up and being anything but that sick child that needed so much help from people that tried so hard to understand but just didn't. I didn't know what I wanted or what I needed. I know now that all I really needed was to feel like I had value and a belief in myself and that I could work it all out.
This is one of the few distinct event memories that I have of that first year after my diagnosis. The rest is a blur of pain and helplessness, of anger and grief for a life that I thought I had lost. It seemed never ending as time drew past the twelve month mark where 'for most JRA kids it burns itself out' and it didn't. I could walk again but the pain was still there. I still needed medication. I knew that there would be a lot of things that I might never do again or be able to do for the first time.
Somewhere along the way I realised that there were still a lot of things that I could do. I found things that I enjoyed, found ways to cope and found ways to live. It wasn't always easy and I still have days where I think that life isn't fair where I wonder why I was given this faulty body to work with. I still don't like to talk much about when I got JRA except in the fluff pieces where I exclaim that it had made be a stronger, better and wiser version of myself. It's easier that way. Easier to put it behind me and take each new day as it comes.
Some days the pain is still there and I've had to fix a few joints on the way but I've done OK. I've done a lot of things that I never thought I'd do. I survived my JRA childhood and became the regular kind of troubled teen. Ok, I needed to make some adjustments and compensations along the way but I managed. I had fun.
I went to uni and rebelled.
I worked and learnt to support myself and take care of me.
I've had good jobs and bad jobs and still don't know what I want to be when I grow up and that's ok! (If you're a teen - I'm OLD. 34 this year!)
I went to Las Vegas and partied like a rockstar. I went to London and saw a play. I went to Thailand and relaxed. I travelled when I thought I never would.
I've had good friends and just for time friends who I've lived it up with, who I've shared life's ups and downs with. Some know and some don't.
I've been accepted by others.
I've been accepted by me.
I'm married to someone who loves me, who accepts that my body is a little bit broken and still accepts me anyway. He accepts me for who I am and not just the shell that I want the world to see.
We own a house and are all grown up, making our own choices for our lives.
One day I'll have kids of my own and though I've got a good life, I hope and pray that they won't need to take this road because I wouldn't wish it on them. Just as I don't wish it on you. If there were a magic wand, I would take it away from you because I know.
There is still lots of life to live and though I might not be jumping back in the mosh pit anytime soon, life is good.
So on your darkest days, where no one understands you and you question why you were punished with this horrible disease, please know that even if you don't think that camp full of kids understands, there are more people like us who do understand and have been through this and had great lives. It is horrible and it is hard to talk about. It might not go away but you will be ok.
This is your life and JRA is a part of it. Just a little part. It isn't who you are. You are in charge of making the best life you can for you. That life you create can be great!
Tuesday, May 24, 2011
Six Week Surgical Review
I went to visit the surgeon on Monday for my six week post-op review. I was a little nervous the night before and while driving back into the hospital. Realistically, I know I've done well and my progress has been steady, so there was no real reason to be nervous. I'm not quite sure what started up the butterflies but they were quickly squashed.
On the way in, we were a little early and managed to get a 15 minute parking spot just in front of the coffee shop so the day was starting off well.
When we arrived in the surgeon's office, we were sent upstairs for new x-rays. Q-Scan uses the new digital machines so I have a nice little CD with the three views showing the perfect placement of my two BMHRs. I had to download a view for the Mac (it came with a windows viewer - the one I downloaded is free and pretty cool. It's a DICOM viewer called Osirix) and now when I have a few minutes I will be able to upload some clearer images. It still amazes me that they are in there. The joints don't feel anything but natural. I guess after so many years of crunching and ROM limitations my idea of normal is a joint with smooth, fluid movement. I know that my limiting factors at the moment as far as mobility goes are to do with muscle strength and tightness not the actual joints themselves.
We headed back to the surgeon's office and saw him pretty quickly. He's pretty happy with my progress and gave me the all clear to lift the hip restrictions. We had a quick chat about my progress, the improvement of the left side foot drop (all better now) and other bits and pieces. The Four Corners piece was raised, which I commented that I hadn't seen though I had heard that it was quite biased and that kind of led into a general conversation about acetabular cup placement (mine is perfect, having an awesome experienced surgeon is crucial), the number of resurfacings he has done (700+) and the success he has had with the BHR (The BMHR is still new though the data is much like the BHR's early data and is promising).
I asked about metal testing and pregnancy for when we get to that point in a couple of years. I was asked if I would supply test results when we go down that path and I said I would happily volunteer results for data for a study on the MOM devices.
[Side Note: I really believe that they are the best option for a lot of people, not just people like me. Some articles still suggest the MOM devices are not suitable for women of child bearing age as there is some evidence that the metal-ions pass through the blood barrier, however, there is no evidence that it will cause any problems. This may get a lot of negative comments and I challenge the naysayers to find hard data before name calling. I am open to an open dialogue of the issue, however, comments with rude remarks will not be accepted. I trust my surgeon and the data that he has researched as an expert in this field. The research I have done supports my belief in him. The decision to have the procedure was not one made without great consideration of a lot of factors. I will eventually write more on the topic of making this decision, so at some point the label 'Decision' will have more posts. Just like this part of our lives, we will do due diligence to any big decisions that we make. Anyway, back to the topic at hand.]
I enjoyed the appointment. I think I'm an interesting topic to talk about! Actually it's the shiny new hips that are interesting as well as the progress that's been made and will be made and all things relating to the new parts that the surgeon knows that I don't. The summary of the appointment is that all is good and I am due for review again in September.
In the meantime, HIP RESTRICTIONS ARE LIFTED! Not that I can really exceed 90 degree hip flexion, but that isn't the point. The point is that the risk of dislocation has reduced and I have passed that first hurdle. (There are other things that I don't have to be as concerned about either - though the seat height is probably the one that functionally is the most difficult to deal with.) It's nice to be able to be able to stretch a bit more, to reach down to at least try and touch my toes - still a few inches off and my hamstrings are squealing! They need a lot of stretching out just like pretty much everything else. I can't reach as far as I could pre-op yet, though it has been almost seven weeks since I've done that stretch so I guess it isn't too surprising that it isn't the easiest thing to do.
So the plan for the coming week is as much stretching as possible and keep on top of the exercises. I have a little bit of work to do tomorrow so I'm going to have to figure that into my day as well to make sure everything gets done. I feel like I should be doing more by now but I am still tiring easily. It's getting better as each day passes though there is still a little way to go yet.
With that in mind, I really need some sleep. It's way past the bed time I have gotten used to. Even though I've always loved sleep, I need even more these days. I guess that's an indicator that my body is still investing a lot of energy into the healing process.
Til next time!
On the way in, we were a little early and managed to get a 15 minute parking spot just in front of the coffee shop so the day was starting off well.
When we arrived in the surgeon's office, we were sent upstairs for new x-rays. Q-Scan uses the new digital machines so I have a nice little CD with the three views showing the perfect placement of my two BMHRs. I had to download a view for the Mac (it came with a windows viewer - the one I downloaded is free and pretty cool. It's a DICOM viewer called Osirix) and now when I have a few minutes I will be able to upload some clearer images. It still amazes me that they are in there. The joints don't feel anything but natural. I guess after so many years of crunching and ROM limitations my idea of normal is a joint with smooth, fluid movement. I know that my limiting factors at the moment as far as mobility goes are to do with muscle strength and tightness not the actual joints themselves.
We headed back to the surgeon's office and saw him pretty quickly. He's pretty happy with my progress and gave me the all clear to lift the hip restrictions. We had a quick chat about my progress, the improvement of the left side foot drop (all better now) and other bits and pieces. The Four Corners piece was raised, which I commented that I hadn't seen though I had heard that it was quite biased and that kind of led into a general conversation about acetabular cup placement (mine is perfect, having an awesome experienced surgeon is crucial), the number of resurfacings he has done (700+) and the success he has had with the BHR (The BMHR is still new though the data is much like the BHR's early data and is promising).
I asked about metal testing and pregnancy for when we get to that point in a couple of years. I was asked if I would supply test results when we go down that path and I said I would happily volunteer results for data for a study on the MOM devices.
[Side Note: I really believe that they are the best option for a lot of people, not just people like me. Some articles still suggest the MOM devices are not suitable for women of child bearing age as there is some evidence that the metal-ions pass through the blood barrier, however, there is no evidence that it will cause any problems. This may get a lot of negative comments and I challenge the naysayers to find hard data before name calling. I am open to an open dialogue of the issue, however, comments with rude remarks will not be accepted. I trust my surgeon and the data that he has researched as an expert in this field. The research I have done supports my belief in him. The decision to have the procedure was not one made without great consideration of a lot of factors. I will eventually write more on the topic of making this decision, so at some point the label 'Decision' will have more posts. Just like this part of our lives, we will do due diligence to any big decisions that we make. Anyway, back to the topic at hand.]
I enjoyed the appointment. I think I'm an interesting topic to talk about! Actually it's the shiny new hips that are interesting as well as the progress that's been made and will be made and all things relating to the new parts that the surgeon knows that I don't. The summary of the appointment is that all is good and I am due for review again in September.
In the meantime, HIP RESTRICTIONS ARE LIFTED! Not that I can really exceed 90 degree hip flexion, but that isn't the point. The point is that the risk of dislocation has reduced and I have passed that first hurdle. (There are other things that I don't have to be as concerned about either - though the seat height is probably the one that functionally is the most difficult to deal with.) It's nice to be able to be able to stretch a bit more, to reach down to at least try and touch my toes - still a few inches off and my hamstrings are squealing! They need a lot of stretching out just like pretty much everything else. I can't reach as far as I could pre-op yet, though it has been almost seven weeks since I've done that stretch so I guess it isn't too surprising that it isn't the easiest thing to do.
So the plan for the coming week is as much stretching as possible and keep on top of the exercises. I have a little bit of work to do tomorrow so I'm going to have to figure that into my day as well to make sure everything gets done. I feel like I should be doing more by now but I am still tiring easily. It's getting better as each day passes though there is still a little way to go yet.
With that in mind, I really need some sleep. It's way past the bed time I have gotten used to. Even though I've always loved sleep, I need even more these days. I guess that's an indicator that my body is still investing a lot of energy into the healing process.
Til next time!
Saturday, May 21, 2011
Coffee Break and The Week in Review
Last night my husband got home from being away for a few days for work. No matter how much he wanted to be at home, there is work to be done that cannot be delayed forever no matter the desire to do so. The deciding factor was more to do with how I was going and whether I could confidently do what I needed to do on a day to day basis.
I am pretty self sufficient now with the only thing that I really need help with being getting the compression socks on for day and TEDs for night. These special socks are knee high and not the nicest things to get on and off. They are used as a blood clot preventative recommended by the rehab doctor for at least six weeks post-op until my mobility increases and is a little closer to normal. There are differing opinions as to the duration required, the time that it will take for mobility to return to normal and what activity level will prevent the development of clots. The time frame recommended is at least the six weeks while I am on the clexane injections (aka lovenox, a blood thinner, daily self-administered injections). My GP suggests that after the six weeks are up that this is a decision that I need to make based on how mobile I think I am as to whether I continue wearing them. At this stage, it really doesn't hurt to be cautious, though a little time off from them each day since that the clexane finishes today will be most welcome.
I had some awesome sock helpers come and stay through the week to help me out with this and keep me company through the week. Special thanks for the help and the company! Even though I know I would be fine home alone, it is nice to have someone around to chat to (and overdose on chocolate or apple crumble with as it really is no fun to moan to yourself that you ate too much and can't move!)
Physio this week was great and there were increases to the measurements that we made for the range of movements last week. I'm expecting another change when we measure again next week. Amazingly it is the hip flexion that is lacking over abduction. The reason I find this a little odd is that it was very much the reverse pre-op and I had really expected them to return and strengthen in the reverse order. Hip flexion equates to more of my functional goals at the moment. Stairs without compensation vaulting being the big one. Once the hip precautions are removed, it will be an important part of building the strength to drive again as well. The exercises to strengthen these muscles are becoming more manageable since I have been able to start leg lifts using my own strength.
Today was a big sleep in day. It was awesome to have no where to be and nothing to prepare for this morning. Coupled with a late night last night chatting with my husband and a big week, the extra sleep was welcome. I can sleep on either side now quite comfortably so even though I wake to move, I am able to move into different sleeping positions safely (ie not breaking hip precautions) and getting a reasonably good sleep each night.
After a lazy start, we headed out to have coffee with friends of ours. This time when we arrived, I used the stairs and not the elevator. I wouldn't have contemplated that week. I'm not sure if the stairs weren't even and smaller than normal but I was able to step up without compensation on just over half of them. When I arrived at the top of the stairs, I walked the long way around to the front of the restaurant and arrived at the same time as our friends.
This afternoon has been rest, catching up on email and reading some of the blogs that I frequent. The feet on the recliner are up, the tv is on in the background and as I think of it, there are foot pumps or muscle contractions or little leg lifts, just something to keep moving while I kick back.
I am pretty self sufficient now with the only thing that I really need help with being getting the compression socks on for day and TEDs for night. These special socks are knee high and not the nicest things to get on and off. They are used as a blood clot preventative recommended by the rehab doctor for at least six weeks post-op until my mobility increases and is a little closer to normal. There are differing opinions as to the duration required, the time that it will take for mobility to return to normal and what activity level will prevent the development of clots. The time frame recommended is at least the six weeks while I am on the clexane injections (aka lovenox, a blood thinner, daily self-administered injections). My GP suggests that after the six weeks are up that this is a decision that I need to make based on how mobile I think I am as to whether I continue wearing them. At this stage, it really doesn't hurt to be cautious, though a little time off from them each day since that the clexane finishes today will be most welcome.
I had some awesome sock helpers come and stay through the week to help me out with this and keep me company through the week. Special thanks for the help and the company! Even though I know I would be fine home alone, it is nice to have someone around to chat to (and overdose on chocolate or apple crumble with as it really is no fun to moan to yourself that you ate too much and can't move!)
Physio this week was great and there were increases to the measurements that we made for the range of movements last week. I'm expecting another change when we measure again next week. Amazingly it is the hip flexion that is lacking over abduction. The reason I find this a little odd is that it was very much the reverse pre-op and I had really expected them to return and strengthen in the reverse order. Hip flexion equates to more of my functional goals at the moment. Stairs without compensation vaulting being the big one. Once the hip precautions are removed, it will be an important part of building the strength to drive again as well. The exercises to strengthen these muscles are becoming more manageable since I have been able to start leg lifts using my own strength.
Today was a big sleep in day. It was awesome to have no where to be and nothing to prepare for this morning. Coupled with a late night last night chatting with my husband and a big week, the extra sleep was welcome. I can sleep on either side now quite comfortably so even though I wake to move, I am able to move into different sleeping positions safely (ie not breaking hip precautions) and getting a reasonably good sleep each night.
After a lazy start, we headed out to have coffee with friends of ours. This time when we arrived, I used the stairs and not the elevator. I wouldn't have contemplated that week. I'm not sure if the stairs weren't even and smaller than normal but I was able to step up without compensation on just over half of them. When I arrived at the top of the stairs, I walked the long way around to the front of the restaurant and arrived at the same time as our friends.
This afternoon has been rest, catching up on email and reading some of the blogs that I frequent. The feet on the recliner are up, the tv is on in the background and as I think of it, there are foot pumps or muscle contractions or little leg lifts, just something to keep moving while I kick back.
Wednesday, May 18, 2011
Second Week at Home: The New Routine and Progress
Life is getting into a routine at home with regular exercise, walking laps around the house, regular good food and restful sleep. I am ambling around on crutches with significantly more confidence. The next walking goals are to increase the distance that I am regularly walking and get down to one crutch around the week of my surgical review. Review is next Monday and I am moving towards having enough strength in my hip stabilisors to achieve this later in the week. It's likely that my right side will be the stronger one as it has been throughout this process. There is still work to do and a lot can be achieved in a week, so I am hopeful.
The major change that I have seen physically in the last couple of days is the ability to lift each leg up from the bed into the air while laying down. So far it's only about six inches from the bed though it is a good start and a massive difference as I haven't had the strength in my hip flexors to lift much more than half an inch until Monday of this week.
The other functional goals that we have as part of the first phase of Project Awesome are to increase the amount of stairs that I practice daily and to eliminate compensation vaulting on stairs. The compensation occurs as I don't have the hip flexor strength to easily lift my leading leg to place it on the upper stair and have been compensating by lifting the heel of the grounded foot to gain the additional height to clear the step. Though I have the strength and balance to do this reasonably safely, it isn't the best way to climb stairs. I have to practice lifting each leg higher while activating all of the required muscles. It requires concentration and a huge amount of energy to clear each step when leading with the right. The left is still about an inch off and I am still practicing as I don't want the progress to stop on the weaker leg.
I also need to increase the amount of outings that I do each week to improve my confidence and stamina. I am still wary of being out in public and the only way that will change is by getting out there. I need a bit more practice so that I am soon at the point where I am comfortable going to the pool and starting hydro. I'm probably still a few more weeks off that.
The major change that I have seen physically in the last couple of days is the ability to lift each leg up from the bed into the air while laying down. So far it's only about six inches from the bed though it is a good start and a massive difference as I haven't had the strength in my hip flexors to lift much more than half an inch until Monday of this week.
The other functional goals that we have as part of the first phase of Project Awesome are to increase the amount of stairs that I practice daily and to eliminate compensation vaulting on stairs. The compensation occurs as I don't have the hip flexor strength to easily lift my leading leg to place it on the upper stair and have been compensating by lifting the heel of the grounded foot to gain the additional height to clear the step. Though I have the strength and balance to do this reasonably safely, it isn't the best way to climb stairs. I have to practice lifting each leg higher while activating all of the required muscles. It requires concentration and a huge amount of energy to clear each step when leading with the right. The left is still about an inch off and I am still practicing as I don't want the progress to stop on the weaker leg.
I also need to increase the amount of outings that I do each week to improve my confidence and stamina. I am still wary of being out in public and the only way that will change is by getting out there. I need a bit more practice so that I am soon at the point where I am comfortable going to the pool and starting hydro. I'm probably still a few more weeks off that.
Sunday, May 15, 2011
Grocery Shopping
Fuelled with the enthusiasm from the successful outing yesterday, we went out for coffee (so we could buy coffee beans) and grocery shopping today. We started out at Merlo as we really needed beans and didn't have enough for another day. I was a little scared to get out of the car into the crowd as it was pretty busy in there. My husband convinced me to give it a go and again it worked out fine. We had coffee and decided to give grocery shopping a go. I figured that I wouldn't be able to walk down every aisle but I figured that I would go as far as I could go and then rest a while before continuing the process.
I didn't go into all of the aisles and required quick rests on the wheelie walker from time to time but I did make it back to the car! I really need to get a pedometer so I can at least try to get some idea of the distances that I am working before I am completely worn out. I was pretty wrecked after that effort and did very little for the rest of the day.
I've exceeded my outings target for this week on the Project Awesome goals and am pretty pleased with myself.
I didn't go into all of the aisles and required quick rests on the wheelie walker from time to time but I did make it back to the car! I really need to get a pedometer so I can at least try to get some idea of the distances that I am working before I am completely worn out. I was pretty wrecked after that effort and did very little for the rest of the day.
I've exceeded my outings target for this week on the Project Awesome goals and am pretty pleased with myself.
Saturday, May 14, 2011
First Real Post-Op Outing
Today was the first real outing and my husband and I went for coffee and brunch at La Dolce Vita at Park Road, Milton with friends. (I know I went to the hospital to see the social worker on Tuesday but that really wasn't a 'real' outing after being there for four weeks)
The trip was part of the 'Project Awesome' goals that I worked out with Paul from Body Leadership for my recovery process. Reintegration into the real world is a little scary when you have been in safe places since a major operation. I'm also very comfortable in my own space and am not getting cabin fever, so there it is easy for me to let time pass making the prospect of going out a bigger issue than it actually is.
The main reason that I had been a little scared about going out in public are all of the falls hazards that are outside of my control. I also worried about available seating and whether toilets were going to be available that were accessible and the right heights. (The toilets for some reason were a really big deal which is strange considering that when they weren't a problem - at the hospital - I didn't even need to use them and we were out for about two hours that day. Surely I could manage a quick outing without having to go?) I also worried about being stranded somewhere without being able to sit and not able to walk any further (highly irrational considering that was a) unlikely to happen and b) I wasn't going to be left alone). All of these things were probably becoming bigger deals in my own head as I put off facing them.
I got to chose where to go out to and the conditions of my 'release' to help make me more comfortable about what we were going to do today. I chose La Dolce Vita Restaurant because I am comfortable there. I have spent a lot of time there and I know the staff well and also know the terrain well. I knew how we could get in there without having difficulties getting me out of the car even though my disabled permit hadn't arrived yet. About the only thing that I wasn't sure of was toilets. I knew that the ones upstairs were a no go as there was a massive step to get into them that I had little chance of clearing on my own and the height of the toilets was probably too low especially without bars to assist in correct positioning to maintain the hip precautions. I knew there were some downstairs (accessible by lift) as well, but I wasn't sure what they were like either. Google for once, let me down. I didn't find what I was looking for. It may not have been google's fault as the resource just might not be available. How do people who have permanent conditions find out this kind of information? Trial and error? That seems absurd. Is it even possible that one of the most popular coffee/dining areas in Brisbane doesn't have disabled toilets? Surely they do somewhere? I figured that they must and if they didn't, there was always McDonald's across Milton Road (After all of that worry, I didn't even use them and stupidly I didn't even check to find out exactly what was available).
We made it there around the time that we said that we would be there. It takes me a lot longer to get organised at the moment. Part of the problem is that it is easy to sit in the shower for long periods of time rather than have a quick shower to get ready. The second issue are the Venosan socks that I still need to wear during the day. I should have organised a 'sock helper' before now to assist the assistant helping me get these things on. It's on my list to do over the weekend so that I can hopefully get something delivered early next week. As they are heavy duty compression socks, they aren't the easiest things to get on. With hip restrictions, they are even more difficult. They are for a very good reason though, to reduce the likelihood of blood clots and for that reason we persist with them. The third issue is trying to figure out all of the things that we needed to take with us that may or may not be required. I reasoned that this was somewhat similar to trying to get a child out of the house and all of the things that they require. It might not be as bad, though there were still a lot to consider. We needed a pillow and a towel to try and adjust seating height so that I could sit and not break hip precautions, the wheelie walker in case this solution didn't end up being viable, another set of shoes in case the ones I decided to wear but haven't worn since the op didn't work out, tissues (yep I have managed somehow to get a freaking cold), medications, jumper and then the regular day to day items that you don't leave the house without. In the end we made it and we had everything that we needed.
I had a mild case of anxiety as we were crossing the Captain Cook bridge and arriving at our destination. As I got out of the car, someone I knew was walking through the car park and was a nice reminder that I was in a safe place. I felt a little calmer as I got out of the lift and started to walk around the front past Alegria and saw more people that I knew having brunch. The friends we were meeting with had already arrived and seating wasn't an issue once we had topped it up with the pillow and towel. Quite comfortable actually! There was no requirement to bring the wheelie walker out so I just used crutches which are not only more comfortable for me to use, but I feel better using them. I know that there is no shame using a walker and if I had to I would, I just wanted to look like I was more well than that.
Brunch consisted of real coffee and a bacon and egg panino for me and was awesome. Meds were taken with a sparkling mineral water chaser. We were out for a few hours and then headed home.
On the way home I spoke to my sister who was in the city and asked her to go into the pharmacy for me. She called while she was there so I could talk to the pharmacist to confirm what I could take to get rid of this cold. Thankfully the blood thinners weren't an issue and hopefully I can stop suffering with the congestion and associated tiredness and step it up a little in the rehab. She picked up some things for me and I had some cold tablets still at home that had the all clear so I had one of those and pretty much feel asleep straight away. A few hours later, I woke up and felt a million times better. I even did another round of step ups on the single stair outside (10 each side no vaulting) and feel pretty proud of that at the end of a big day. My walking distance will be a bit lower today even with the outing as I haven't done as many laps around the house. It probably balances out as far as energy usage goes and each day I do get a little more stamina to do more.
The trip was part of the 'Project Awesome' goals that I worked out with Paul from Body Leadership for my recovery process. Reintegration into the real world is a little scary when you have been in safe places since a major operation. I'm also very comfortable in my own space and am not getting cabin fever, so there it is easy for me to let time pass making the prospect of going out a bigger issue than it actually is.
The main reason that I had been a little scared about going out in public are all of the falls hazards that are outside of my control. I also worried about available seating and whether toilets were going to be available that were accessible and the right heights. (The toilets for some reason were a really big deal which is strange considering that when they weren't a problem - at the hospital - I didn't even need to use them and we were out for about two hours that day. Surely I could manage a quick outing without having to go?) I also worried about being stranded somewhere without being able to sit and not able to walk any further (highly irrational considering that was a) unlikely to happen and b) I wasn't going to be left alone). All of these things were probably becoming bigger deals in my own head as I put off facing them.
I got to chose where to go out to and the conditions of my 'release' to help make me more comfortable about what we were going to do today. I chose La Dolce Vita Restaurant because I am comfortable there. I have spent a lot of time there and I know the staff well and also know the terrain well. I knew how we could get in there without having difficulties getting me out of the car even though my disabled permit hadn't arrived yet. About the only thing that I wasn't sure of was toilets. I knew that the ones upstairs were a no go as there was a massive step to get into them that I had little chance of clearing on my own and the height of the toilets was probably too low especially without bars to assist in correct positioning to maintain the hip precautions. I knew there were some downstairs (accessible by lift) as well, but I wasn't sure what they were like either. Google for once, let me down. I didn't find what I was looking for. It may not have been google's fault as the resource just might not be available. How do people who have permanent conditions find out this kind of information? Trial and error? That seems absurd. Is it even possible that one of the most popular coffee/dining areas in Brisbane doesn't have disabled toilets? Surely they do somewhere? I figured that they must and if they didn't, there was always McDonald's across Milton Road (After all of that worry, I didn't even use them and stupidly I didn't even check to find out exactly what was available).
We made it there around the time that we said that we would be there. It takes me a lot longer to get organised at the moment. Part of the problem is that it is easy to sit in the shower for long periods of time rather than have a quick shower to get ready. The second issue are the Venosan socks that I still need to wear during the day. I should have organised a 'sock helper' before now to assist the assistant helping me get these things on. It's on my list to do over the weekend so that I can hopefully get something delivered early next week. As they are heavy duty compression socks, they aren't the easiest things to get on. With hip restrictions, they are even more difficult. They are for a very good reason though, to reduce the likelihood of blood clots and for that reason we persist with them. The third issue is trying to figure out all of the things that we needed to take with us that may or may not be required. I reasoned that this was somewhat similar to trying to get a child out of the house and all of the things that they require. It might not be as bad, though there were still a lot to consider. We needed a pillow and a towel to try and adjust seating height so that I could sit and not break hip precautions, the wheelie walker in case this solution didn't end up being viable, another set of shoes in case the ones I decided to wear but haven't worn since the op didn't work out, tissues (yep I have managed somehow to get a freaking cold), medications, jumper and then the regular day to day items that you don't leave the house without. In the end we made it and we had everything that we needed.
I had a mild case of anxiety as we were crossing the Captain Cook bridge and arriving at our destination. As I got out of the car, someone I knew was walking through the car park and was a nice reminder that I was in a safe place. I felt a little calmer as I got out of the lift and started to walk around the front past Alegria and saw more people that I knew having brunch. The friends we were meeting with had already arrived and seating wasn't an issue once we had topped it up with the pillow and towel. Quite comfortable actually! There was no requirement to bring the wheelie walker out so I just used crutches which are not only more comfortable for me to use, but I feel better using them. I know that there is no shame using a walker and if I had to I would, I just wanted to look like I was more well than that.
Brunch consisted of real coffee and a bacon and egg panino for me and was awesome. Meds were taken with a sparkling mineral water chaser. We were out for a few hours and then headed home.
On the way home I spoke to my sister who was in the city and asked her to go into the pharmacy for me. She called while she was there so I could talk to the pharmacist to confirm what I could take to get rid of this cold. Thankfully the blood thinners weren't an issue and hopefully I can stop suffering with the congestion and associated tiredness and step it up a little in the rehab. She picked up some things for me and I had some cold tablets still at home that had the all clear so I had one of those and pretty much feel asleep straight away. A few hours later, I woke up and felt a million times better. I even did another round of step ups on the single stair outside (10 each side no vaulting) and feel pretty proud of that at the end of a big day. My walking distance will be a bit lower today even with the outing as I haven't done as many laps around the house. It probably balances out as far as energy usage goes and each day I do get a little more stamina to do more.
Tuesday, May 10, 2011
I just want to get back to my regular life
Only Better.
And Yesterday.
Slightly unreasonable expectations.
No matter how much the hippies on http://surfacehippy.info/hiptalk prepared me for those days where everything is all to hard that they had when they first came home, I wasn't quite ready for what it might feel like. I pretty much lost it last night and for most of this morning. I had some dark moments in the hospital but I managed to work through those a little bit better than I was last night and this morning. I knew it was going downhill and I had already booked an appointment to talk to someone on Thursday but I didn't think that I could deal with this for that long. I then tried to get a hold of my GP and couldn't get in until Friday, so I rang the hospital looking for the Occupational Therapist who I liked to give me a referral to someone who I could talk to. She wasn't available but it turned out that the lady that answered the phone is the social worker at the rehab unit and she was able to see me today.
Things started to come together during my first physio session at home. I was working with someone that I have worked with before that has a similar philosophy as I normally do. I say normally given that I haven't quite been myself lately. When I am in that mode and am talking about it - I am positive. When I'm left to my own devices things don't always stay on that path. Apparently I got a good report card which is nice to hear after the 'you are all wrong' physio that I have been seeing for the last week. I lost a bit of momentum without the mini goals that I had in the first two weeks, like trying exercises that I knew I was a way off perfecting to see how close I could get and then trying again the next day and the next. There wasn't any negativity associated with the process. I wasn't failing, I was getting closer. This is the positive attitude that I am looking forward to having back. It might seem a little 'me me me' requiring positive reinforcement all of the time and that isn't entirely wrong. It's not entirely right either. I need to be the one to start with the positive 'hey look see what I can do now' and have a positive response back like 'we'll need to set you some new targets' or 'we are almost ready to fine tune that one and move up' not 'you are doing it all wrong'. I do still need correction and assistance, I just don't need it like that.
Now that I have been assessed and started off with some new exercises, the mini-goals plan will start to be worked upon. We are going to start on this tomorrow and I am hoping that this will help get my mind back into a more positive state. I've been lost over the last week and it's time to get back on track.
Even though the session gave me a bit of a pep, I still needed more and I think that the trip to the social worker helped. She really didn't say anything that I didn't know or hadn't been told before. I also saw the OT as well before hand and that was helpful too especially since I already knew her and respected her. I have heard so many times that this is a massive operation and such a big deal to undertake and the emotion that goes along with it is completely understandable especially since I have such high expectations of myself but I guess it still hasn't sunk in. I got sent home with a book on panic attacks and how to deal with them and maybe a little more confidence that I can deal with this.
I got home and read the panic attack book. It didn't help. Instead I think it almost set one off. I couldn't relate to the examples and though some of the things I was fearing were irrational (like my husband dying or any number of bad things happening to my favourite people) some I think were fair enough (like not going back to work when I should be and the financial implications of that). I made a phone call to the person I was booked to talk to on Thursday and apologised and asked for five minutes on the phone now and it made a difference. It was very similar to some of the things discussed with the social worker but I guess it sunk in a little more this time. Again the effects of the general anaesthetic were raised (that's three times today) which surprised me as I would have thought they'd be long gone by now. I guess this is part of the being hard on myself thing to disregard anything that I might deem an excuse. I don't want to be making excuses. I do need to differentiate the difference between excuses and possible reasons though. It isn't weakness to see that there is a justifiable reason for me feeling this way sometimes. I still need to be held accountable for how I react to it though and this might take a little bit of work yet.
At that point I spoke more with my husband about the things that I feared and could do so a little more calmly and without completely losing it. I think this is the indicator of a big shift from my morning anxiety to a little bit more peace. I hope I can hold it out and get a good night's sleep and that things look just a little brighter again in the morning.
And Yesterday.
Slightly unreasonable expectations.
No matter how much the hippies on http://surfacehippy.info/hiptalk prepared me for those days where everything is all to hard that they had when they first came home, I wasn't quite ready for what it might feel like. I pretty much lost it last night and for most of this morning. I had some dark moments in the hospital but I managed to work through those a little bit better than I was last night and this morning. I knew it was going downhill and I had already booked an appointment to talk to someone on Thursday but I didn't think that I could deal with this for that long. I then tried to get a hold of my GP and couldn't get in until Friday, so I rang the hospital looking for the Occupational Therapist who I liked to give me a referral to someone who I could talk to. She wasn't available but it turned out that the lady that answered the phone is the social worker at the rehab unit and she was able to see me today.
Things started to come together during my first physio session at home. I was working with someone that I have worked with before that has a similar philosophy as I normally do. I say normally given that I haven't quite been myself lately. When I am in that mode and am talking about it - I am positive. When I'm left to my own devices things don't always stay on that path. Apparently I got a good report card which is nice to hear after the 'you are all wrong' physio that I have been seeing for the last week. I lost a bit of momentum without the mini goals that I had in the first two weeks, like trying exercises that I knew I was a way off perfecting to see how close I could get and then trying again the next day and the next. There wasn't any negativity associated with the process. I wasn't failing, I was getting closer. This is the positive attitude that I am looking forward to having back. It might seem a little 'me me me' requiring positive reinforcement all of the time and that isn't entirely wrong. It's not entirely right either. I need to be the one to start with the positive 'hey look see what I can do now' and have a positive response back like 'we'll need to set you some new targets' or 'we are almost ready to fine tune that one and move up' not 'you are doing it all wrong'. I do still need correction and assistance, I just don't need it like that.
Now that I have been assessed and started off with some new exercises, the mini-goals plan will start to be worked upon. We are going to start on this tomorrow and I am hoping that this will help get my mind back into a more positive state. I've been lost over the last week and it's time to get back on track.
Even though the session gave me a bit of a pep, I still needed more and I think that the trip to the social worker helped. She really didn't say anything that I didn't know or hadn't been told before. I also saw the OT as well before hand and that was helpful too especially since I already knew her and respected her. I have heard so many times that this is a massive operation and such a big deal to undertake and the emotion that goes along with it is completely understandable especially since I have such high expectations of myself but I guess it still hasn't sunk in. I got sent home with a book on panic attacks and how to deal with them and maybe a little more confidence that I can deal with this.
I got home and read the panic attack book. It didn't help. Instead I think it almost set one off. I couldn't relate to the examples and though some of the things I was fearing were irrational (like my husband dying or any number of bad things happening to my favourite people) some I think were fair enough (like not going back to work when I should be and the financial implications of that). I made a phone call to the person I was booked to talk to on Thursday and apologised and asked for five minutes on the phone now and it made a difference. It was very similar to some of the things discussed with the social worker but I guess it sunk in a little more this time. Again the effects of the general anaesthetic were raised (that's three times today) which surprised me as I would have thought they'd be long gone by now. I guess this is part of the being hard on myself thing to disregard anything that I might deem an excuse. I don't want to be making excuses. I do need to differentiate the difference between excuses and possible reasons though. It isn't weakness to see that there is a justifiable reason for me feeling this way sometimes. I still need to be held accountable for how I react to it though and this might take a little bit of work yet.
At that point I spoke more with my husband about the things that I feared and could do so a little more calmly and without completely losing it. I think this is the indicator of a big shift from my morning anxiety to a little bit more peace. I hope I can hold it out and get a good night's sleep and that things look just a little brighter again in the morning.
Sunday, May 8, 2011
One Month Post Op: Home for two days
Wow, what a relief to actually be here. I'm tired and it's still difficult to do day to day activities but I am finding ways to do what I need to do. I'm finding that these activities are achievable and slowly getting easier for me.
This morning I sorted out my cereal for breakfast, a cup of water and the pills that I would need to eat after and sat down in the sitting room to eat it - all on my own. It may seem like such a little thing to some but there is an effort and thought required to put all the pieces of the process together. The first thing that needs to be done is to find somewhere near the wheelie walker to put the crutches where I can reach both and they won't fall over. The reason I need the wheelie walker is that when you are using two crutches you can't use your hands to carry anything which is required if you don't want to eat at the kitchen bench. Then it's a case of getting everything you need: a bowl, a cup, the cereal, the milk, the pills. You need to be able to sort out obstacles, like moving the stool that you left in front of the pantry door last night so that you can actually get the cereal out. Set it all up and then put the cereal and milk away again. Then it's get the wheelie walker carefully over the little tiled lip between the kitchen and the sitting room without spilling anything. Getting into the chair getting close enough with the walker so you can still reach everything once you have sit down and then doing the reverse and getting things all away again.
Real food is such a wonderful thing. Even if it is just my choice of cereal. It has been so much more than that since I've been home though! My husband cooked my favourite risotto the day I came home (chorizo, mushroom and baby spinach). I got to be a helper and instructor. I think that my husband will soon weary of the instructor component and will be more comfortable with me navigating the kitchen and preparing meals again. I've also had real salads, grainy bread and cereals and even toasted hot cross buns (they were frozen for my return home since I missed out on easter - and frankly missed out on hot toasted bakery/bread items in hospital). There are real green beans in the fridge (not icky overcooked frozen ones) and other fresh vegetables that I'm looking forward to in the next couple of days. My tummy is so much happier. I am so in love with real food! (I am a little curious as to whether I came home with any vitamin deficiencies. I didn't get any final bloods taken and I'm not that curious I want to brave a trip to the doctors just yet, so I will just have to wonder)
Day to day at home is more exercise than in the hospital. Activities like breakfast take time and energy to co-ordinate and our house is larger than the hospital room and immediate area that I used regularly while I was in hospital. Even going to the bathroom is more exercise as it's a far longer walk from anywhere I am likely to be inside the house. I've also tried to add the exercises that I have to do into my day to day activities so that I am getting more in. This means that when I'm on my way back from the bathroom, I might do leg lifts at the basin (it's on a solid base and fixed - I'm not going anywhere hanging onto that) or maybe squats. The trip back to where ever I was in the house has to be the long way - past each end of the house, even if I don't need anything from there. I figure that the more that I add in, the more activity I'll have and the quicker recovery will be. I'm ready to be fixed already. I really have had enough of being so reliant on others, though realistically I know I have a little while to go before I'm going to be completely independent.
I am going to have my PT come in twice a week to start off with and we will see how I go in adding to my program as I progress further. I'm hoping to be confident enough to go to the hydro pool in a couple of weeks as well. I've been cleared by the rehab doctor for this but I'm not quite ready for public yet as the walk to the pool from the entrance is reasonably long compared with the distances that I have been walking in one go at the moment. I have a fear of being pushed over and there are always millions of kids at this pool that you need to pass to get to the ramp to get in - I'm sure that as I get stronger this will pass and in the meantime I'll find creative ways to maximise the exercise. My PT is gong to check out some other pools in the area to see if any of the others have a set up which will be a little easier/safer for me until I have a bit more confidence.
It's almost time to start to figure out dinner again. One thing hospital has done to me is make me hungry for dinner much earlier than normal. Not sure what it will be for dinner yet but I can assure you it will be awesome!
This morning I sorted out my cereal for breakfast, a cup of water and the pills that I would need to eat after and sat down in the sitting room to eat it - all on my own. It may seem like such a little thing to some but there is an effort and thought required to put all the pieces of the process together. The first thing that needs to be done is to find somewhere near the wheelie walker to put the crutches where I can reach both and they won't fall over. The reason I need the wheelie walker is that when you are using two crutches you can't use your hands to carry anything which is required if you don't want to eat at the kitchen bench. Then it's a case of getting everything you need: a bowl, a cup, the cereal, the milk, the pills. You need to be able to sort out obstacles, like moving the stool that you left in front of the pantry door last night so that you can actually get the cereal out. Set it all up and then put the cereal and milk away again. Then it's get the wheelie walker carefully over the little tiled lip between the kitchen and the sitting room without spilling anything. Getting into the chair getting close enough with the walker so you can still reach everything once you have sit down and then doing the reverse and getting things all away again.
Real food is such a wonderful thing. Even if it is just my choice of cereal. It has been so much more than that since I've been home though! My husband cooked my favourite risotto the day I came home (chorizo, mushroom and baby spinach). I got to be a helper and instructor. I think that my husband will soon weary of the instructor component and will be more comfortable with me navigating the kitchen and preparing meals again. I've also had real salads, grainy bread and cereals and even toasted hot cross buns (they were frozen for my return home since I missed out on easter - and frankly missed out on hot toasted bakery/bread items in hospital). There are real green beans in the fridge (not icky overcooked frozen ones) and other fresh vegetables that I'm looking forward to in the next couple of days. My tummy is so much happier. I am so in love with real food! (I am a little curious as to whether I came home with any vitamin deficiencies. I didn't get any final bloods taken and I'm not that curious I want to brave a trip to the doctors just yet, so I will just have to wonder)
Day to day at home is more exercise than in the hospital. Activities like breakfast take time and energy to co-ordinate and our house is larger than the hospital room and immediate area that I used regularly while I was in hospital. Even going to the bathroom is more exercise as it's a far longer walk from anywhere I am likely to be inside the house. I've also tried to add the exercises that I have to do into my day to day activities so that I am getting more in. This means that when I'm on my way back from the bathroom, I might do leg lifts at the basin (it's on a solid base and fixed - I'm not going anywhere hanging onto that) or maybe squats. The trip back to where ever I was in the house has to be the long way - past each end of the house, even if I don't need anything from there. I figure that the more that I add in, the more activity I'll have and the quicker recovery will be. I'm ready to be fixed already. I really have had enough of being so reliant on others, though realistically I know I have a little while to go before I'm going to be completely independent.
I am going to have my PT come in twice a week to start off with and we will see how I go in adding to my program as I progress further. I'm hoping to be confident enough to go to the hydro pool in a couple of weeks as well. I've been cleared by the rehab doctor for this but I'm not quite ready for public yet as the walk to the pool from the entrance is reasonably long compared with the distances that I have been walking in one go at the moment. I have a fear of being pushed over and there are always millions of kids at this pool that you need to pass to get to the ramp to get in - I'm sure that as I get stronger this will pass and in the meantime I'll find creative ways to maximise the exercise. My PT is gong to check out some other pools in the area to see if any of the others have a set up which will be a little easier/safer for me until I have a bit more confidence.
It's almost time to start to figure out dinner again. One thing hospital has done to me is make me hungry for dinner much earlier than normal. Not sure what it will be for dinner yet but I can assure you it will be awesome!
Friday, May 6, 2011
28 Days Post Op: Going Home Day
Today was the last day that I would be woken at 6:00am, 6:15am, 6:30am, 6:45am, 7:00am and 7:15am at which point I would usually be kicked out of bed. Hospitals are like alarm clocks set by some evil person for an ungodly hour with a snooze button that keeps going until you are forced out of bed. Going home day is exciting as well as a little bit daunting. I was pretty confident that I was ready for it, though it is hard to know how I'll be able to handle everything until I got here and settled into a routine again. I think it might take a few days to get to that point.
Prior to leaving the rehab doctor came passed to ask about the drama that we had last weekend. Since I was actually at the point of getting out of there, I didn't see the harm in talking about the issues that we had. I didn't really want to get into it while I was still there as I didn't want to have to deal with people that I have had issues with if they knew that I had made a complaint about them. The doctor wants to address issues like these when they happen so that they can be fixed. I understand what he was saying and had I been at a fully fit and independent state, I might have done so but having to still have to stay there and be reliant on these people, I really didn't want to rock the boat. They were still able to identify the bad advice nurse since I knew what day I blogged about it. I also told them about the 'good chance to be normal' comment and the other things that happened during the infamous physio session. I'm not sure if there will be further training or what the repercussions will be but thankfully I won't suffer any consequences for it. The doctor asked us to speak to the head of nursing about the issues as well, and she said that many people feel the same in relation to 'retribution' and fail to comment which doesn't help them improve the level of service provided. Apparently it doesn't happen but I can't see how it wouldn't change the way that the spoken to person would react the next time that they had to deal with me. Anyway it is all done now and I'm home!
On the way home we stopped past the mobility place and got the last couple of things that we needed for me at home. I am now equipped with a granny wheely walker so that I can carry things around the house, specifically the kitchen and have a perch stool to sit in while I'm in the kitchen. The main issue in the kitchen was that I am physically able to cook or make a cup of coffee or whatever it was, but I couldn't actually carry something out of the cupboard or the fridge as I am using both hands to use crutches. The wheely walker means that I have a tray to put things on and both hands are still on the walker while I am walking. Problem solved.
Stopping on the way home meant that I was in and out of the car twice which was an achievement. Getting home seemed like an even bigger one.
Prior to leaving the rehab doctor came passed to ask about the drama that we had last weekend. Since I was actually at the point of getting out of there, I didn't see the harm in talking about the issues that we had. I didn't really want to get into it while I was still there as I didn't want to have to deal with people that I have had issues with if they knew that I had made a complaint about them. The doctor wants to address issues like these when they happen so that they can be fixed. I understand what he was saying and had I been at a fully fit and independent state, I might have done so but having to still have to stay there and be reliant on these people, I really didn't want to rock the boat. They were still able to identify the bad advice nurse since I knew what day I blogged about it. I also told them about the 'good chance to be normal' comment and the other things that happened during the infamous physio session. I'm not sure if there will be further training or what the repercussions will be but thankfully I won't suffer any consequences for it. The doctor asked us to speak to the head of nursing about the issues as well, and she said that many people feel the same in relation to 'retribution' and fail to comment which doesn't help them improve the level of service provided. Apparently it doesn't happen but I can't see how it wouldn't change the way that the spoken to person would react the next time that they had to deal with me. Anyway it is all done now and I'm home!
On the way home we stopped past the mobility place and got the last couple of things that we needed for me at home. I am now equipped with a granny wheely walker so that I can carry things around the house, specifically the kitchen and have a perch stool to sit in while I'm in the kitchen. The main issue in the kitchen was that I am physically able to cook or make a cup of coffee or whatever it was, but I couldn't actually carry something out of the cupboard or the fridge as I am using both hands to use crutches. The wheely walker means that I have a tray to put things on and both hands are still on the walker while I am walking. Problem solved.
Stopping on the way home meant that I was in and out of the car twice which was an achievement. Getting home seemed like an even bigger one.
Thursday, May 5, 2011
27 Days Post Op: I am so outta here in the morning
Tomorrow is going home day and I have finished my in patient rehab program. The goals have been met and I will be able to cope with being at home. There is still work to be done to get where I want to be and that will be under the care of the fantastic people at Body Leadership Australia. I don't mean to sound like an advertisement, I just miss them and this change over point really marks achievement (as in I've learnt the things I need to learn to cope on the outside) and a change in philosophy for my rehabilitation program to one that I am more comfortable with and positive about.
The things that I have learnt / reinforced from this hospital stay are:
Private cover is worth every penny: I think that if I was in a shared room I would have gone absolutely crazy. I also think that public might have discharged me sooner than now when I wouldn't have been completely prepared to go home. (This is based on some of the horror stories that I heard over morning tea in the rehab gym - absolutely crazy - they weren't about Mater Public but even so)
Don't book in for major surgery a couple of weeks before Easter or other holiday period: Even if you think you are going to be out before the holiday period, don't risk it. Not as many services are available during holidays even in hospitals. I hadn't really thought that I would be in here this long though if I had of been asked before hand, I would have expected something like rehab in a rehab unit to be an essential service. Apparently it is not. Even in a Private Hospital. Disappointing huh?
People who complain about TEDs have never had to wear Venosans: TEDs are a walk in the park in comparison. The policy of my rehab doctor is TEDs for night, Venosans for day. I'm sure they are excellent at doing the job of keeping clots at bay and are no where near as much difficulty as a clot but it doesn't mean that I have to like them. I certainly don't like them being put on me. (Hip restrictions means I can't do it for myself either so there have been times where I've been flicked or there has been a part that is overlapped and digging in during the process of struggling to get them up my leg.
If the nurses have reason to ask you if you want a movicol, it's probably a good idea to take it. If you don't know what I am talking about, don't ask. I just hope that one day if you are asked you remember this piece of advice. Especially if you are being fed codeine.
If someone offers to bring you breakfast/lunch/dinner accept: Don't be a martyr. Too much hospital food has to kill you. It can't possibly be good for you. I have been told that this hospital has better food than the others in Brisbane. While this may be true, four weeks of it is far too much of it.
Stand up for yourself: You have to know what your medication is, what your treatment process is going to be and anything you are supposed to or not supposed to do and if anyone tells you otherwise, correct them. It could be dangerous not to know. People make mistakes. Don't be the one to suffer from them.
Accept that you can't do it all and accept help graciously: This is a hard lesson to learn for the independent and stubborn like me. I'm in hospital for a reason and that reason is stopping me from being the independent person that I am. I hate being reliant on others however that being said, I am grateful for those that helped me and didn't make me feel like I was a burden to them. I am especially grateful to my husband who helped me at least maintain some dignity and the little sanity that I have left. I could have done this without him and survived but I would have been somehow less me at the end of the process and very probably on anti-depressants and in worse physical shape. I don't know how people do things like this without the kind of support that I have and I hope that I never have to find out.
I'm probably still a little close to the situation since I'm still here so I may not have figured out yet all of the things that I have learnt out of this experience.
The things that I have learnt / reinforced from this hospital stay are:
Private cover is worth every penny: I think that if I was in a shared room I would have gone absolutely crazy. I also think that public might have discharged me sooner than now when I wouldn't have been completely prepared to go home. (This is based on some of the horror stories that I heard over morning tea in the rehab gym - absolutely crazy - they weren't about Mater Public but even so)
Don't book in for major surgery a couple of weeks before Easter or other holiday period: Even if you think you are going to be out before the holiday period, don't risk it. Not as many services are available during holidays even in hospitals. I hadn't really thought that I would be in here this long though if I had of been asked before hand, I would have expected something like rehab in a rehab unit to be an essential service. Apparently it is not. Even in a Private Hospital. Disappointing huh?
People who complain about TEDs have never had to wear Venosans: TEDs are a walk in the park in comparison. The policy of my rehab doctor is TEDs for night, Venosans for day. I'm sure they are excellent at doing the job of keeping clots at bay and are no where near as much difficulty as a clot but it doesn't mean that I have to like them. I certainly don't like them being put on me. (Hip restrictions means I can't do it for myself either so there have been times where I've been flicked or there has been a part that is overlapped and digging in during the process of struggling to get them up my leg.
If the nurses have reason to ask you if you want a movicol, it's probably a good idea to take it. If you don't know what I am talking about, don't ask. I just hope that one day if you are asked you remember this piece of advice. Especially if you are being fed codeine.
If someone offers to bring you breakfast/lunch/dinner accept: Don't be a martyr. Too much hospital food has to kill you. It can't possibly be good for you. I have been told that this hospital has better food than the others in Brisbane. While this may be true, four weeks of it is far too much of it.
Stand up for yourself: You have to know what your medication is, what your treatment process is going to be and anything you are supposed to or not supposed to do and if anyone tells you otherwise, correct them. It could be dangerous not to know. People make mistakes. Don't be the one to suffer from them.
Accept that you can't do it all and accept help graciously: This is a hard lesson to learn for the independent and stubborn like me. I'm in hospital for a reason and that reason is stopping me from being the independent person that I am. I hate being reliant on others however that being said, I am grateful for those that helped me and didn't make me feel like I was a burden to them. I am especially grateful to my husband who helped me at least maintain some dignity and the little sanity that I have left. I could have done this without him and survived but I would have been somehow less me at the end of the process and very probably on anti-depressants and in worse physical shape. I don't know how people do things like this without the kind of support that I have and I hope that I never have to find out.
I'm probably still a little close to the situation since I'm still here so I may not have figured out yet all of the things that I have learnt out of this experience.
Wednesday, May 4, 2011
26 Days Post Op: I'm Boring
I've got nothing.
Today was just a day.
I woke up, went to rehab, had lunch, went back to rehab, rested, had dinner and now I'm online for a while before I go to sleep.
I'm pretty worn out from a big day and I guess there will be a few more days like this until I am back on top of things.
One more full day to go tomorrow and then the next day I go home.
Today was just a day.
I woke up, went to rehab, had lunch, went back to rehab, rested, had dinner and now I'm online for a while before I go to sleep.
I'm pretty worn out from a big day and I guess there will be a few more days like this until I am back on top of things.
One more full day to go tomorrow and then the next day I go home.
Tuesday, May 3, 2011
25 Days Post Op: The Home Visit
Today I got to go home for the first time in almost four weeks. I went for about an hour with an occupational therapist to check things out in anticipation of me getting out of here on Friday. My big achievements that were made today were getting in and out of a car twice, getting up my front stairs at home and getting up the inside stairs and out of the house twice. (We really were only going to do it once as the point of the exercise wasn't to practice multiple times, just to check out how to handle things - but nothing ever goes smoothly and there were of course issues with the alarm that had to be sorted out before we could leave - typical)
We have sorted out the shower chair and I have figured out a place to put the crutches so I can get them to get out and we also sorted out the raised toilet seat as the toilet was too low and I would have violated hip restrictions without the higher seat above it. These are the main two things that needed to be sorted out so that I can actually survive at home. Good news was that our bed is also the right height and the only thing we really need to sort out is another comfortable chair to sit in when I am up. We are going to look at one of those recliners that tips you out but I think we will need to go and actually look at some and see what is comfortable and high enough that doesn't dip back to much at the back of the seat. We'll get home first and worry about that one early next week.
I am becoming more confident on crutches and though it is tiring to walk around, my stamina is increasing and I think that is making the other hurdles a little easier to overcome. As my mobility is increasing, my hip flexors seem to be getting a little stronger as I am starting to see that there is a slight difference in the amount that I can lift my feet off the ground. Today I spoke with the Physio that will be in charge of managing operation awesome (bugger normal!) also known as my home program and once targets are met the ongoing maintenance program. It isn't going to be any problem at all to be re-assessed and an appropriate program written to strengthen up these stubborn little muscles that haven't yet joined the party. I am looking forward to working with the Body Leadership Team again as I really have missed working with those guys! Speaking of people I miss working with, I miss Pilates too - though that might be a little while before I am back to my usual schedule. I can at least do bridges now (pelvic curls) and they are slowly getting better even if I am a little way of my pre-surgery capability. It's unlikely that I will be using the bosu or a fit ball for a little while yet! It's a step at a time at the moment and I know that once I'm home and under expert guidance that I will be making those steps at the right time and maximising the benefits that I will receive from the new joints in the long term.
Pain meds were reduced today and so far I am going ok. The nights are the big test and those haven't been reduced yet so I am pretty confident that we are on the right path. Today was a big day and so far there isn't much pain. There is some muscle fatigue and aching though this is to be expected and isn't anything that is going to keep me awake. I am hoping that what I feel now continues to be the worst of it as it certainly is manageable at this level and the level of activity I can do before it gets to this level is significant enough to see progress.
After the excitement of this morning I had a quiet gym session this afternoon with the regular drills. We didn't do steps again today as there were probably as many today as the amount we did in practice yesterday. I'm sure we will be back on them tomorrow and in the 'fine tuning' mode to work on not using the grounded leg to provide the extra clearance space required by pushing up on the toes slightly. I'd guess and say I'm probably about an inch off that and I would expect to see that amount picked up in the next week.
All in all a good day with the slight exception of the possible cold germs that I may be carrying. It might just be the really dry air-conditioning that is drying my throat out and causing me to start to lose my voice. At least I hope that is all that it is and as soon as I am back in my regular environment everything will go back to normal.
It is time for sleep now. It has been a really long day. I hope I'm worn out enough to sleep in more than two hour blocks like last night. Fingers crossed!
I just figured out that since I don't have to stay here all Friday and today is already gone, the countdown was actually wrong. I only have two whole days left, Wednesday and Thursday!!
We have sorted out the shower chair and I have figured out a place to put the crutches so I can get them to get out and we also sorted out the raised toilet seat as the toilet was too low and I would have violated hip restrictions without the higher seat above it. These are the main two things that needed to be sorted out so that I can actually survive at home. Good news was that our bed is also the right height and the only thing we really need to sort out is another comfortable chair to sit in when I am up. We are going to look at one of those recliners that tips you out but I think we will need to go and actually look at some and see what is comfortable and high enough that doesn't dip back to much at the back of the seat. We'll get home first and worry about that one early next week.
I am becoming more confident on crutches and though it is tiring to walk around, my stamina is increasing and I think that is making the other hurdles a little easier to overcome. As my mobility is increasing, my hip flexors seem to be getting a little stronger as I am starting to see that there is a slight difference in the amount that I can lift my feet off the ground. Today I spoke with the Physio that will be in charge of managing operation awesome (bugger normal!) also known as my home program and once targets are met the ongoing maintenance program. It isn't going to be any problem at all to be re-assessed and an appropriate program written to strengthen up these stubborn little muscles that haven't yet joined the party. I am looking forward to working with the Body Leadership Team again as I really have missed working with those guys! Speaking of people I miss working with, I miss Pilates too - though that might be a little while before I am back to my usual schedule. I can at least do bridges now (pelvic curls) and they are slowly getting better even if I am a little way of my pre-surgery capability. It's unlikely that I will be using the bosu or a fit ball for a little while yet! It's a step at a time at the moment and I know that once I'm home and under expert guidance that I will be making those steps at the right time and maximising the benefits that I will receive from the new joints in the long term.
Pain meds were reduced today and so far I am going ok. The nights are the big test and those haven't been reduced yet so I am pretty confident that we are on the right path. Today was a big day and so far there isn't much pain. There is some muscle fatigue and aching though this is to be expected and isn't anything that is going to keep me awake. I am hoping that what I feel now continues to be the worst of it as it certainly is manageable at this level and the level of activity I can do before it gets to this level is significant enough to see progress.
After the excitement of this morning I had a quiet gym session this afternoon with the regular drills. We didn't do steps again today as there were probably as many today as the amount we did in practice yesterday. I'm sure we will be back on them tomorrow and in the 'fine tuning' mode to work on not using the grounded leg to provide the extra clearance space required by pushing up on the toes slightly. I'd guess and say I'm probably about an inch off that and I would expect to see that amount picked up in the next week.
All in all a good day with the slight exception of the possible cold germs that I may be carrying. It might just be the really dry air-conditioning that is drying my throat out and causing me to start to lose my voice. At least I hope that is all that it is and as soon as I am back in my regular environment everything will go back to normal.
It is time for sleep now. It has been a really long day. I hope I'm worn out enough to sleep in more than two hour blocks like last night. Fingers crossed!
I just figured out that since I don't have to stay here all Friday and today is already gone, the countdown was actually wrong. I only have two whole days left, Wednesday and Thursday!!
Monday, May 2, 2011
24 Days Post Op: 4 Days to go in Rehab
Today is the first day that I have been able to consistently get my feet in and out of bed. Last night I didn't have to buzz for help to get out of bed which was completely awesome. I also had too many chances to practice last night as I was pretty restless and was up four or five times. Part of being able to do this is down to the fact that they forgot to lock me in for the night by putting the side rails up on my bed (they got two late transfers from another ward and were rushed of their feet - so I smiled and nodded and didn't remind them!). Even though I had mastered the in and out of bed thing, I would have still required assistance as you can't actually put the rails down when you are in the bed unless you are able to contort yourself over the side and lift a latch to do so which I really can't as to get to where it is placed would violate my hip precautions.
This really was the last thing on my absolutely must do goals list before I can go home. The extra couple of days is going to be good to solidify the progress and start to put a new plan in place as to what I want to achieve next. I'll need to talk to my real Physio about that one and put a proper home plan in place so that I am maximising the results that I achieve.
I also had real food smuggled in for me today again. It was awesome. I miss real food and am counting down the hours until I can have it all of the time. I'm not sure what my nutrition has been like while I've been here but do doubt that the meals are nutritionally balanced and designed for optimum health. If they are, they certainly don't taste like it. Having said that, dinner just arrived and actually looks ok. The broccoli and carrots look real. I might just eat those! I still need a few more vitamins and minerals to help with the healing.
The rehab assistant turned up as we were finishing eating to take me for a walk which I politely declined opting to walk with my guests today. It still surprises me that they have asked considering that I haven't received that level of attention on holidays before today with them expecting my husband to assist. I wonder what has prompted the changes. It is a little bit too late really given that I am going home in just a few days.
I had an interesting talk to a registrar today that will be presenting my case as a case study for his physician's exams. It seems that emotional responses to chronic illness now feature as part of a patient assessment. I'm not sure when this cropped up in the medical process but I am glad that it did and I hope that it filters throughout the medical profession as this seems to be where a big void was when I was diagnosed. There seems to be more information sharing these days as well, making patients more informed about the medical process and what is going to happen. It isn't completely there yet, google still helps (and probably hinders in a number of occasions) and the number of reputable medical resources online are growing. Take Mr McMinn's site as an example of valuable medical information in relation to the procedure that I have had done. My surgeon pointed me in this direction to find out more about the process and the prostheses which is something that couldn't and wouldn't have been done a decade ago.
Tomorrow is my home visit and I'm a little nervous about getting in and out of the car. It's not something that I have done before and I'm not sure how I'll go. It's something that I wish we could have tried before the actual day though there is no real way to do this without them actually organising a car and bringing it to the front of the building where the patient transfer vans pull up. I have to decide tomorrow whether or not I should organise an ambulance to get me home or whether we should go in the car. I'm leaning towards patient transport to get in the first time. It also means that even though I can get up the front steps, I won't need to be able to get up them that day as I will be stretchered in and will actually be able to do some more work on building strength and mobility and be both physically and mentally prepared before we go out into the real world. I'm a little bit worried about going out too early and not being strong enough to hold my own. At the moment my pace is more than slow and the idea of being pushed around scares the living daylights out of me. I'm sure like my progress so far, things will come together and I will know when it is going to be ok and until then, I'll at least be in the comfort of my own home.
I suppose it isn't surprising that I have new anxieties as the next change to my situation changes. I have to keep reminding myself that it was a massive surgery and progress isn't going to be immediate. Apparently the mood swings are quite a normal part of the whole process. For some reason it came up when I was talking to the rehab doctor today and he wasn't overly concerned and reminded me that I have had a major surgery and there will be emotional ups and downs as I get through the rehabilitation process. I have been reasonably even the last 48 hours and I'm hoping to at least get through until I get home before something else sets me off. The disparity between what the appropriate emotional response is to a catalyst to what actually happens is lessening but there is still a way to go yet. I'm not sure I made the right decision in not following up my request to speak to a social worker or not. I'm sure that I will work through these issues, just not sure if I should have sought more help to get there. I guess I will see how I cope when I'm in my own environment again and just keep an eye on the mood swings and enlist the help of friends to give me the heads up if I start to head too far into a slump. It's important that I keep a positive attitude to speed up the recovery process.
I'm still hoping that I will meet my end of June goals though right now I can't imagine walking without a mobility aid. It's crazy that I can't because only a few days ago I couldn't imagine getting my feet into bed. I really shouldn't have these hangups as my progress should be proving to me that I am on the right path. I guess that's really why the physio upset me on Saturday. Even though I really didn't have doubts that I would get there eventually, I still can't imagine progressing that far and I didn't like being told that I just had a 'good chance' as it's made me actively think about the little things that are niggling at the corners of my mind as the main part tries to stay positive and focused on what needs to be done.
This really was the last thing on my absolutely must do goals list before I can go home. The extra couple of days is going to be good to solidify the progress and start to put a new plan in place as to what I want to achieve next. I'll need to talk to my real Physio about that one and put a proper home plan in place so that I am maximising the results that I achieve.
I also had real food smuggled in for me today again. It was awesome. I miss real food and am counting down the hours until I can have it all of the time. I'm not sure what my nutrition has been like while I've been here but do doubt that the meals are nutritionally balanced and designed for optimum health. If they are, they certainly don't taste like it. Having said that, dinner just arrived and actually looks ok. The broccoli and carrots look real. I might just eat those! I still need a few more vitamins and minerals to help with the healing.
The rehab assistant turned up as we were finishing eating to take me for a walk which I politely declined opting to walk with my guests today. It still surprises me that they have asked considering that I haven't received that level of attention on holidays before today with them expecting my husband to assist. I wonder what has prompted the changes. It is a little bit too late really given that I am going home in just a few days.
I had an interesting talk to a registrar today that will be presenting my case as a case study for his physician's exams. It seems that emotional responses to chronic illness now feature as part of a patient assessment. I'm not sure when this cropped up in the medical process but I am glad that it did and I hope that it filters throughout the medical profession as this seems to be where a big void was when I was diagnosed. There seems to be more information sharing these days as well, making patients more informed about the medical process and what is going to happen. It isn't completely there yet, google still helps (and probably hinders in a number of occasions) and the number of reputable medical resources online are growing. Take Mr McMinn's site as an example of valuable medical information in relation to the procedure that I have had done. My surgeon pointed me in this direction to find out more about the process and the prostheses which is something that couldn't and wouldn't have been done a decade ago.
Tomorrow is my home visit and I'm a little nervous about getting in and out of the car. It's not something that I have done before and I'm not sure how I'll go. It's something that I wish we could have tried before the actual day though there is no real way to do this without them actually organising a car and bringing it to the front of the building where the patient transfer vans pull up. I have to decide tomorrow whether or not I should organise an ambulance to get me home or whether we should go in the car. I'm leaning towards patient transport to get in the first time. It also means that even though I can get up the front steps, I won't need to be able to get up them that day as I will be stretchered in and will actually be able to do some more work on building strength and mobility and be both physically and mentally prepared before we go out into the real world. I'm a little bit worried about going out too early and not being strong enough to hold my own. At the moment my pace is more than slow and the idea of being pushed around scares the living daylights out of me. I'm sure like my progress so far, things will come together and I will know when it is going to be ok and until then, I'll at least be in the comfort of my own home.
I suppose it isn't surprising that I have new anxieties as the next change to my situation changes. I have to keep reminding myself that it was a massive surgery and progress isn't going to be immediate. Apparently the mood swings are quite a normal part of the whole process. For some reason it came up when I was talking to the rehab doctor today and he wasn't overly concerned and reminded me that I have had a major surgery and there will be emotional ups and downs as I get through the rehabilitation process. I have been reasonably even the last 48 hours and I'm hoping to at least get through until I get home before something else sets me off. The disparity between what the appropriate emotional response is to a catalyst to what actually happens is lessening but there is still a way to go yet. I'm not sure I made the right decision in not following up my request to speak to a social worker or not. I'm sure that I will work through these issues, just not sure if I should have sought more help to get there. I guess I will see how I cope when I'm in my own environment again and just keep an eye on the mood swings and enlist the help of friends to give me the heads up if I start to head too far into a slump. It's important that I keep a positive attitude to speed up the recovery process.
I'm still hoping that I will meet my end of June goals though right now I can't imagine walking without a mobility aid. It's crazy that I can't because only a few days ago I couldn't imagine getting my feet into bed. I really shouldn't have these hangups as my progress should be proving to me that I am on the right path. I guess that's really why the physio upset me on Saturday. Even though I really didn't have doubts that I would get there eventually, I still can't imagine progressing that far and I didn't like being told that I just had a 'good chance' as it's made me actively think about the little things that are niggling at the corners of my mind as the main part tries to stay positive and focused on what needs to be done.
Sunday, May 1, 2011
23 Days Post Op: 5 Days to go in Rehab
I am pretty wrecked this afternoon. I did a big session at the gym this morning back onto my terms and with my goals. There seemed to be a little bit of back tracking which might be because I was more forceful about what needed to be achieved today or maybe she realised the normal comment was out of line. I'm not sure but the positive side of things was that it went better and I achieved what I needed to achieve. The next time I will be in the gym is Tuesday afternoon as the morning will be my home visit with my OT. Tomorrow is yet another public holiday and I will be doing my exercises on the ward and going for walks. I have friends coming in with real food and they can take me for a walk (like a puppy *smirk*).
The big 'I did it moment' today was getting my feet into bed twice today. I'm not quite sure I could manage it now as everything is ready to fall asleep but I got them in - twice. Out is pretty easy now provided the rails are down. I'm not quite sure why they want the rails up still when I go to bed as I'm not rolling anywhere yet. I guess it might just be one of those safety requirements that they need to follow for certain patients. It just means that I still need to buzz the nurses when I wake up between 3 and 5am for a bathroom break so I can get out bed.
I am allowed to get a pass out of here now to go across the street for lunch or a coffee or whatever provided that I go in the wheelchair. My husband suggested we do this for lunch today but I wasn't keen as I think it is already going to be hard enough to come back on Tuesday after actually going to the house. It's probably a little backward, but I figure that if I just stick to my routine here, the days go quickly and the five days left will be over before I know it. As it stands it's not quite even five really as I should be kicked out in the morning. That will probably depend a lot on whether we still go for patient transport or not. That is going to be decided on Tuesday as the getting in and out of the car thing hasn't been attempted yet. I don't care if I have to go home in an ambulance so long as I get there and get there this Friday coming.
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