Caffeine Sensitivity

WHAT?!?  How did that happen??

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

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

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

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

Baking up a storm

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

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

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

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

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

Down for the count and a week of updates

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

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

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

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

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

Hydro and the sniffles

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

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

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

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

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

Fear of Falling

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

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

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

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

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

The week in review

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

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

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

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

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

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

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

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

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

Derek McMinn addresses Metal on Metal AZ May 2011

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

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

RPA: A bilateral hip replacement on TV!

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

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

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

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

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

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

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

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

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

Back to Pilates

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

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

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

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

Range Update

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

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

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

Changes

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

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

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

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

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