Differences in Me

People who haven't seen me in a few weeks are commenting on differences.
I feel different.  I just wasn't sure that translated into something more visible to the outside world.  Something positive.  My pilates / physio team can see the difference and are working with me to push the boundaries even further out.  That's exciting.  I'm not sure if exciting is the right word.  Awe is a little closer.  Maybe wonder?  Or maybe it's just the anticipation.  Kind of like that anticipation that you get before Christmas as a child - wondering what Santa might bring.

I'm starting to notice that I'm just more comfortable in my body.  It feels like it's doing what it's supposed to do.  The getting up and down off the ground is the biggest thing for me.  It's something that I don't remember ever doing - it opens up a whole lot of things that I've never really done before.

Sometimes I catch myself with the realisation that something that I've done for a long time is just that little bit easier.
My knees are coping a little bit better.
Swelling on my knees and ankles is reducing (and I can't recall it ever having done that)
Sometimes I'm just bouncy.

Last Friday, I went to a meditation class.  Something that I never would have done before.  How could I?  I'm sure there are some that would have accommodated my lack of ability to get down to the floor, though that isn't something that I would ever have wanted.  I've never wanted to be seen to be different or require special assistance.  It was always better not to participate - not to let people know - not to be a burden - not to let anyone see weakness - maybe a touch of pride.

There have been a few people that I've spoken to about this big thing.  Some don't see it as such a big thing.  I guess the novelty of knowing someone that has had both hips replaced has worn off and my achievements aren't that exciting for them anymore.  I kind of wonder if they ever were.  It's ok though.  I don't need that external validation.  I feel good.  It can be lonely at times when there isn't someone to talk to about what is going on with me but it's something that I'm ok with.  I'm ok with it because I don't know where this is going to take me but I'm looking forward to finding out.

Ultrasound

I had physio today.  I learnt a lot.  More than just releasing the muscles and feeling that light buzzy feeling afterwards, I learnt what my muscles looked like when they were working efficiently and what they looked like when they weren't quite doing what they were supposed to be doing.

We used a diagnostic ultrasound, the kind they look at babies with, to look at whether my transverse abdominals and the lowest level glute muscles closest to my hip joints.  Looks like the TA's were firing well and the glutes not so much.  It wasn't a great surprise, but it was very worthwhile to see.   I now have an understanding as to what it feels like working properly because I know what it looks like.  Now I can work towards strengthening what needs to be strengthened.

I probably should have taken pictures for comparison....  Maybe next time!

Random Meeting on a Plane

It turned out to be the next opportunity - the open door that I needed to walk through.

Last week I flew to Melbourne for a wedding.

I was going to leave work early and get there around 6pm so that I could meet up with some people for a few drinks.  Flights were ludicrously expensive as I'd left booking so late and I'd decided that I'd be better off to use my frequent flier miles and treat myself to a business class seat.

The week didn't quite go to plan and there was no way that I was going to make a 3pm flight.  It was just as well that I'd gotten the seat that I had, as a reschedule to a later departure was an easy one.  I survived the day of work and made my flight on time.

Settled into business class, my row mate arrived and settled in.  We both read until dinner.  At dinner we started to chat.  He was on his way to a conference in Melbourne for the fitness industry.  He and his family own a gym, not far from where I lived.  We talked about the industry and I commented that I didn't really fit into the traditional member mould and we discussed the difficulties that I had finding the right 'team' for me for this next stage of my progress.

Turns out his sister is in the game too....  apparently a rehab genius - physio and exercise.   Julie works between a clinic and the gym.  I thought about this for a while when I got home.  Figured that it was worth a shot - what did I have to lose.  I was ready to try something new, take that next leap.

I called the gym and got in contact with Julie.  She wasn't taking new patients - but because her brother recommended her, she was going to take me.

Next week I see her.  I'm hopeful, but not expecting too much.

Surgical Review and Physio

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

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

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

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

Body Leader of the Month

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

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

A couple of notes about the article and pics:

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

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

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

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

Caffeine Sensitivity

WHAT?!?  How did that happen??

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

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

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

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

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.

More than 90 Degrees!

Today my right hip flexion got to a passive range of 93 degrees.  This is a large jump up from where I was last week and over the magic 90 degree mark that I have been aiming for.  The left is still below, at 80-something degrees (I was so focused on the 90 number, I can't remember the other one) but thats ok.  There was still improvement on the right side and it would have still been an improvement that I would have been happy with, especially with the plateau of last weeks measurements.

I was so excited that I wanted to jump...  I didn't!  I'll save it for the pool on Friday.

Today was a good day for the elliptical as well.  I've stepped up to 15 minutes from my previous 12.  I completed this in two sessions and I think that I could probably even go a third session but I want to wake up in the morning first and see how I feel.  I am using level 2 on the ramp and resistance for most of the time.  I figure that I can get to 30 minutes and then I can increase the resistance and ramp throughout the period and maybe even use some of the proper programmes rather than manual settings.

Hip Flexion Ranges

I realised something on Friday at hydro that I forgot to mention.  I have been a bit hard on myself about my hip flexion ranges and how slowly they are moving now.  On Friday, I tried to get out of the pool using the step ladder, which I knew I couldn't but I wanted to try anyway.  I was about an inch off.  I remembered that a few weeks before I went into surgery, we had to use the outside pool and it doesn't have a ramp.  Reese had to help me get out of the pool because I couldn't do it then.   This is good news to me.

It will be interesting to see if I'm still on that plateau or whether the ranges have increased again.  I'll try again each week to see if I'm any closer to that bottom step.  I'll have to figure out the range next time so I have a pretty good idea of what I'm aiming towards.

Guarding my thoughts

Today I didn't make it into the office.

I made it as far as Physio and to one of the venues to pick up invoices and then I went home to start work on them.  I wasn't up to going in today.  I'm not sure if it was the thought of the chair and table that I am using until the person using my desk full time moves into their new office or whether it was inevitable questions explaining how the work I was doing actually fits into the grand scheme of the businesses' future plans that kept me away.  Perhaps it was a combination of both.  

I started off the day with a headache and it didn't really ease until later this afternoon.  My range measurements didn't improve this week either, so not only was there pain there was also general grumpiness and a little despair at the plateau that I've reached.

I've been thinking a lot about that plateau today and have started wondering whether I ever had greater hip flexion than that.  I'm currently at a passive range of eighty degrees but I'm not sure when it was ever better than that.  Maybe it hasn't been since I was a child.  In that case, it's going to take a hell of a lot more than three months worth of stretching to bring it back.  I guess because the abduction range came back immediately, I expected the rest to follow suit pretty quickly.  Under the guise of pain, there were a few tears at Physio today.  You can kind of get away with it when you have your head in the hole and it you are involuntarily jumping each time the pain is sharp.  It probably helps that I'm a girl too.  A little more socially acceptable.   Not that anyone would say anything negative, I'm sure that they would be a great support, it's more that I don't really want to share some of these thoughts.  Not until they've been processed and I can decide how I want to deal with them.  The crazy thing is that is probably the place where how I'm feeling would be understood the best.  

I think the abundance of people who ask but don't want to really know have made me a little more guarded about discussing it especially when I am having a bit of a tough day.  I read a blog a while ago about a girl that had a total hip and wrote a blog.  She stopped blogging when someone made a comment about how that was all she ever spoke about.  It feels like that is where people are at now with me but they just haven't said it yet.  The thing is that this thing is still the central point in my life at the moment.  My whole world revolves around my rehabilitation and the distance there is still to go.  I don't have the energy for too much more than that.  It might seem like I'm projecting that all is good but this doesn't mean that I'm ready to take on anything more than I am right now.  As it stands, I think that I might have too much and I'm not making enough time for all my exercises, that somehow I should be doing more of them.  I worry that this could be part of the reason that I've hit the plateau.  These are just more things that people don't want to know.

I don't know why I thought that this would be any different than talking about the arthritis.  I didn't talk about that too often because those who haven't dealt with it before don't understand living with a chronic condition.  This is an extension of that.  Just because I want to talk about this massive change in my life, doesn't mean that others aren't sick of hearing about it.  I'm thankful for those that have been through this process and those spoonies that can understand.  Even when I have finished rehab and life is better than it has ever been, I'll probably still want to talk about them.  I guess I'm going to have to find some new people to talk to.  Ones that are interested in resurfacing, replacements and MOM joints.  I guess there will always be a place for me at Surface Hippy.  I'll also be able to blog.  People can choose to read or not.  If they don't, well they don't need to hear my hip talk and the important changes that are going on in my life. 

In an attempt to feel like I have achieved something today, I've increased the time on the elliptical today to nine and a half minutes and 500 metres.  I'm not sure how that will treat me tomorrow but I really needed to increase and improve something today.  I feel ok so far so hopefully it will be ok.  If I'm doing well tomorrow, I might try to add another minute and a half.  

Aside from exercise and Physio, I had a little bit of work to do today, though nothing was time critical.  It was more getting a bit of a start on the work that needs to be done this week.  Tomorrow is the time critical day which I already have a good start on.  As for the rest of the week, I guess I will work out as it progresses.  

It's so close

I can feel it.  I'm almost there.  It's not going to be today or tomorrow but maybe another month.  I'm not quite sure which is more difficult to deal with, feeling like it will never end or feeling like it's so close but it still so far away.  I still get tired and needed a really quiet day yesterday to recover from the week.

Today I'm going out to lunch when I could probably would be happier staying at home getting ready for tomorrow.  I picked up some work on Thursday so that I wouldn't have such a big day tomorrow but I haven't even looked at it yet and I'm really not sure I feel like looking at it at all.  I suppose that's a pretty normal reaction to real life and weekends.  

When I get home, I'm going to cook for the next couple of days so at least I don't have to worry about that.  I'm not quite sure what I'm going to feel like only that it has lots of vegetables.  I haven't really had my share in the last couple of days with too many other things going on.  

On Friday, I had physio and we practiced with the cane again.  It's starting to look a lot better but the action of walking doesn't feel natural at all.  My arms don't really know what they should do and my left one just likes to stay still.  Apparently this is quite a normal reaction to injury as the body holds the arms in and it is something that you have to learn again.  When I do concentrate on it and get the pattern right, reduce the hitch in my stride as my left leg moves forward in a straighter line instead of coming around.  I'm not sure why I do this or why this incorrect pattern feels more natural than a proper gait pattern.  

I have to go finish getting ready to go and will finish this post when I get home.

I've made it home and back to the couch where I spent a great deal of yesterday.  I'm still worn out, just with a belly full of Grill'd burger and chips now.  I've still got to get up the energy to get some cooking done for tomorrow as I'm unlikely to have the energy.  I've only clocked up 4 minutes on the elliptical today so far and I'm not convinced that I could step back up onto it to finish of the rest of todays minutes.  I might have a go a little later on, maybe after I've had a small nap.

Before I went out to lunch, I started off with the rest of the activities that filled last week and wore me out.  Friday was a pretty long day.  Aside from Physio first up, I also spent a few hours working at the computer and then went out to the movies in the evening.   I still managed to fit in 8 minutes and 400 metres on the elliptical, so it would have been the longest and busiest day that I have had so far.  On the tails of a full week, I deserved my rest day yesterday. On the plus side, I didn't wear myself so much so I that I couldn't walk without the two crutches like the day that I overdid it.

Tomorrow is Physio day and a measuring ranges day.  I haven't decided if I am going into work tomorrow or Wednesday.   I guess I will just see how I feel in the morning.

Trigger Pointing Day

Just a quick note about my knotted glutes (ok I'm being a little more eloquent the other day) and the  adductors that were also *really* bad.    Trigger pointing at physio today hurt like hell but it was worth every single little moment where I wished that I had a leather strap to bite down on.  I felt l the most amazing kind of awesome walking out of there and the nice feeling has stayed with me throughout the day.  

I don't think that my husband could have handled inflicting that much pain to release those pesky muscles.  Only a true professional can do that!  (I know comments like that seem like an open invitation for comment but I'm tired, so please read only read it in the manner to which I mostly intended!)

Improvements and Progress

I had physio this morning and we measured my ranges, as we normally do once a week.  It has been a little over a week this time since we did two hydro sessions last week instead of the usual program.  Today was all about trigger pointing to release some muscles, measurements, review of the land program (as opposed to the water) and practice walking with the cane.

There have been improvements on both sides, with the biggest ones on my right side.  My passive range of hip flexion on the right side has increased 9 degrees to 80 which I am really happy with.  This measurement is made with the left leg straight and assistance to bring the right leg up as to isolate the joint.  If both legs are at table top, the range is greater but it isn't an accurate measurement as it isn't just hip flexion.  The passive range is less as I don't quite have the strength to bring my legs to a tabletop position on both sides which would improve the 'active' measurements.   This is the only way to improve them as my knees are close to becoming the limiting factor measuring from a heel slide.   On one of the measuring days, my knees and muscles surrounding them were really tight and before we used trigger pointing to release the IT band, my active flexion range was about 5 degrees less.

It's the muscles that are limiting the range now, not the actual joints.  My physio program aims to improve strength and flexibility over time.  The ranges that I have in all directions are better than I had pre-op, so the muscles that I am working to grain these ranges haven't been used for quite some time.  The only range we aren't measuring is adduction as I'm not particularly comfortable with that range.  I think this has a lot to do with 6 week restrictions not to cross the mid-line.  I'm not entirely convinced that it is completely muscle discomfort either, I think that my brain learnt during that six weeks that it didn't like that movement as my hip could pop out and it's taking a little while to get over that.  I didn't just learn this because I was told, for at least the first few weeks, if I accidentally moved my leg too close to the mid-line, it hurt and the hurt was a bad pain that was quite clear that it wanted to be avoided.   It still feels like it wants to be avoided though not with the same level of pain feedback so I am taking it slowly with exercises in this range.  I'm ok with that range taking a little bit longer than the rest.

Surprisingly, the muscles on my right side are starting to loosen up a little bit and it's the left side that's playing at being tighter now.  Maybe this has to do with the different muscles used while driving, since that's one big change since the last time we released everything using trigger pointing.  The clutch movement is very different from moving between the accelerator and brake.  It's not really a big deal, it's just interesting to try to figure out what is making differences.  The main reason that I know what side is tighter, is that is the side that hurts the most to release and so by contrast feels more amazing after the muscles are released.

Walking with the cane is a lot more difficult than crutches.  I practiced for quite a while today.  The movement is not natural at all yet and will take a little bit of time before I move to using outside of the house.  The cane shows just how much weight I am still putting through the crutch and at what point the pressure is being put through it.  Even though I can feel where I'm going wrong, I can't quite figure out what muscles aren't firing the way that they should.  To help correct, we are practicing with exaggerated movements and have filmed me walking so I can see what it is that I can feel so that I can try to link the two together and get things working properly.

It feels like I have had another big burst of improvement over the past week and it's spurred me on again.  Things felt like they were plateauing and I was having difficult staying positive and on task with everything that needs to be done.  From what I've read, it seems this is a normal part of the recovery process.  Some days are just harder than others and you need to just push through as some day soon there will be a massive boost which will restore your faith and move you a lot closer to your goals.

This is the first week that I'm going to pick up some more work.  Depending on how worn out I end up for the next few days will influence how many updates there are between now and the weekend.

Back to Hydro

Now that I am back driving, I've started hydrotherapy again.
The weather is cold but the pool is inside and the water is heated.

The session was awesome.  The feeling of walking in the water is amazing.  The movement is fluid, there is no joint pain and it really does give me an idea of what things will be like on land very soon.  I'm due to go back again on Friday.  I'm going to have a break from the pool tomorrow and head into my office and organise when I'm going back to work a few more hours each week.  I'm hoping to soon be strong enough to go to the pool each morning for an hour and then head into the office for a few hours each day.  

I think that the pool exercise will help get to the next level of strength and ability pretty quickly.   We started off pretty slow with marching laps forward, backwards, sideways.  There was also bicycle like exercises and heaps of stretching.  I also got to jump which was pretty cool.  I was in the water for an hour today and felt really good when I got out.  I'm not sure if the muscles will be a bit tired still tomorrow but they are doing pretty well at the moment.

I have managed to get a knot in my shoulder which I am trying to work out using a trigger point ball.  That's pretty much the only thing that hurts and I have absolutely no idea how I've done it.  Between that knot and a burn on my finger (stupid cooking accident) it really does look like things are getting back to normal!

GP Checkup, Bad Seats and Regular Days

The last few days have seemed busy even though I really haven't achieved a whole lot.  I couldn't even tell you when the last time was that I wrote a blog update without checking.  Hey, it was that entry Pain management: in the beginning - that still needs to be finished!  There is so much more to add and it seems like most days I'm just too busy to sit for a few hours and get the details down.  It's a little odd considering that I haven't really been anywhere for ages.  The every day bits and pieces haven't really been covered for a little while either and there are a couple of things that have happened that rate a mention.

Physio on Friday was good.  It wasn't much of an exercise day as we focused on releasing some of the very tight muscles that had been driving me crazy.  Even though I had been trying to release them myself, I hadn't quite gotten to where I needed to be and needed some extra help to get there.  I felt a hundred times better by the end of the session.

When we did the range measurements for hip flexion, it was actually my knees holding me back in the active range.  Once we released these, I ended up with an extra 5 degrees more than the previous measurement.  (If you need a visual on this one to understand what on earth I am talking about:  Laying on your back, slide your heel up towards your bottom making sure that your pelvis stays straight - so other leg straight and level on the bed.  The active hip range is measured in this position.  The passive range is measured by having your leg lifted to table top and moved towards your chest.  For me, there is a few degrees difference between the two)

So while all this was going on, the landline rang in the lounge room which is a fair way from the bed where I was getting measured.  I elected to ignore the phone as the only people that have it are the hospital, the red cross and the alarm company and I could see no reason why any one of those would be calling me since I've been to my post op appointment, spoken to the red cross in the last week and I was in the house so the alarm can't have been going off.  After it stopped ringing, my mobile rang.  It was the alarm company.  They were just checking to make sure that the alarm was still working since it hadn't been armed in such a long time (maybe two weeks).  We had to go outside the house and arm and disarm while I was on the phone so that they could confirm that it was all working properly.  How very embarrassing.  A reminder that I hadn't gone anywhere in two weeks.  Hopefully I'll be driving myself soon and will be a little bit more independent.  Even though I am quite comfortable at home and can fill the days, I think that getting out a bit more would probably do me some good.

I didn't really do anything out of the ordinary on Saturday.  It was a day for sleeping in, getting my exercises done, making sure that I did a few extra trips up and down the stairs and I watched some tv.  My husband was at home but unfortunately he had to work most of the day so I was pretty much left to my own devices.  

Sunday we went out to lunch at my mums place.  It's the longest car trip I've had since pre-op and it went ok.  The seat that I sat on for lunch wasn't really that great though and I came home a little bit tired and tight.  This probably wasn't just a bad seat for me but more that since I went out and it wasn't an activity where I had to walk very far that I didn't have the same level of activity on that day.  I am used to doing a far bit now, even if it is just around the house and a day where the activity levels drop seems to make more of a difference than I thought.  I still only needed a couple of Panadol Osteo to sleep, so I guess it wasn't too bad.  I'll have to make up for the lack of walking today.  

Today I had a GP checkup.  Primarily it was to sign some paperwork so that I can get some extra physio rebates from Medicare as I have a chronic condition (I'm sure you've figured this out by now!). While I was there I checked on my blood work (all good, inflammatory markers a little high but nothing that wasn't expected), got a flu vaccination and went through the changes / improvements since my last visit.  The doctor seemed really happy with my progress.  He has seen some bilaterals before so I guess he has some basis for comparison.  The main changes to report were the lack of medication required, using one crutch most of the time, hip restrictions gone and improvements in ranges.  

Things feel like they are going so very slowly at the moment.  It feels like the improvements are slowing down.  It's hard for me to see the differences between each day as it is taking more than a day for the differences to add up to something substantial.  The last big one was being able to balance on my right leg.  I'm not sure that there has been anything new since then.  

I suppose I could say that sitting on a regular toilet seat and managing to get back off it was an achievement.  I'm not sure if I could have done that a few weeks ago (I wasn't allowed to try until I got off hip restrictions anyway).   I thought I would give it a go on one of my trips downstairs to practice stairs.  Since it has been two months since I sat on a regular low toilet, I really had forgotten just how low they were.  I'm not sure who came up with that idea but it truly is crazy.  The height I have now (with the over toilet height adjustable seat) seems far more reasonable.  I guess I will have to practice and get used to it the more I am gong out in public though.  I wonder if getting on an off the toilet could be classed as adding an exercise to my day?  I suppose it could be if I drank a lot of water, right?  Anyway, it was just as well I had practiced before we went out on Sunday as I was prepared to use a regular height toilet and it all went fine.  Sometimes I really do wonder how it is that everything seems to end up a conversation about toilets these days.  

I fit into my regular size jeans again.  This means that the swelling has gone down and my thighs have returned to their normal size which is positive.  The knees are still swollen and really should be iced but it's too cold! I know I'm a wimp.  Strange really that I get through a massive surgery like this and what I want to complain about is that it is too cold to ice my knees!  Some would also say that it really isn't cold in Brisbane but it is to me as I've lived here for many years and am well adjusted to this climate.  I really should do it in the mornings when I'm sitting out the front in the sunlight drinking my coffee.  It probably wouldn't be too bad then.  Maybe I'll try that one out tomorrow and let you know.

The big exercise for today will be grocery shopping this evening.  We need fresh food.  There is half a lettuce and two carrots left in the fridge and I really feel like a big salad for dinner.  Even though we really only need to go to the fruit and vegetable section, I think I'll need to go down as many of the aisles as I can because I need to know if I can get any further than I did last time.  I think that I'll still take the wheelie walker in case I need a seat.  There are some seats in the centre of the complex, outside of the supermarket, so maybe I could take my crutches.  The crutches are definitely more comfortable to walk with but I'm not sure on this one.  I might have a chat to my husband and see what he thinks.  As in, if we take both and I use my crutches and I think I need the wheelie walker will you go downstairs and get it?  or can we take both and you push the wheelie walker until I need it? Not sure how this will go down.  It's worth a shot though, right?  If I'm not completely wrecked by the time we get home, I'll update this post.

My History and Pain Management: The Beginning

In the beginning, the pain was bad.  In my eleven year old experience, there wasn't anything comparable.  Not even when I needed seven stitches and they had to scrub the gravel out of my knee when I was ten was that bad.  It started off in my right hip and soon after I wasn't able to bear my own weight on my hip joints as it hurt too much.  When I was first hospitalised, I was put on high doses of asprin as even though they had a fair idea of what was wrong with me, there were a number of things that needed to be ruled out before they could treat me with arthritis drugs.  I guess the asprin helped to some degree but it also put trains in my head.  I could hear them above all else choo chooing their way past my ears.  Over time, a diagnosis was made and I was put on prednisone and Voltaren.   Other drugs were trialled in the first year.  I don't remember all of them.  The one that I do remember was something called Intragam that was a blood product that was supposed to help fix whatever was wrong with my immune system.  It was a series of infusions that I had to go back to hospital to have.  I don't think that any improvement was associated with this treatment as I only had one series of them.  My condition was pretty nasty for about a year.  Prednisone and Voltaren were prescribed.  For the first year I relied on a wheelchair.  In the very beginning and for the first six months or so I couldn't bear my own weight.  I could take a few steps but I would need to be supported or learn on walls or other things to help take some of my weight.   After then, things started to get a bit better.  After about a year I had the strength to walk again.  I'd never run any marathons (or any race really) but I could get around.  At about that time,  the meds managed the pain reasonably well.  I had good days and bad days and over time the good ones outweighed the bad.  I don't remember any really bad flares after then.  I didn't miss out on much at school except for sports and I can't say with any certainty that I was disappointed.  It just isn't something that I remember.

I ended up on Voltaren as the longer term solution.  The next decade went pretty smoothly and the meds dropped to 50mg once a day.  I knew when I missed them but otherwise there was nothing to really complain about.  I misbehaved like most 17 - 19 year olds (Actually this probably went on until at least 21 if I am going to be completely honest).  I think that the Voltaren did it's best work with the sore muscles and bruising on my shins from being pushed up against the speakers on the stage on Friday and Saturday nights in the mosh pit at Her Majesty's Bar (only when Blah Blah Blah and Alimony were playing - was almost my whole 18th year out on the town).  I wasn't any worse off the next day than my healthy flatmates.  Sometimes I think I even fared up a little better.

You can't be 18 forever but life really didn't change noticeably until I was about  22.  It was about then that I started to need to increase the Voltaren to 100mg a day every now and then to accommodate for the times when things went wrong and I didn't pick where my limits were.  It only really occurred if I overdid it and mostly I was pretty good at managing my days so that I didn't push it too far and ended up in pain.  My range of movement had started to slowly diminish and the limits that I had were slowly decreasing.  It wasn't anything that caused any huge disruption to my life and the things I wanted to do, I just new that things were changing.

About ten years ago now, a friend of mine had been telling me about this fantastic Physio that I just had to go and see.  He and his wife had fantastic things to say about this guy.  I was skeptical.  I had been to see physios before.  They were there to make sure that things didn't get worse.  There to make sure that my range of movement didn't decrease anymore by doing one boring exercise after another.  Physios meant splints to make sure my joints didn't get anymore deformed. It was the same thing over and over.  It almost seemed like giving up.  I did have some lovely physios when I was in hospital as a child but I didn't see positive results.  Or at least not positive enough to remember when things were so horribly painfully.  Unfortunately, at that time in my life, there probably would have been very little that brought positive relief to me.  Managing my condition at that time was about making sure that the active disease left behind as little disfigurement and damage as possible.

I don't even remember what prompted me to actually get over my preconceived ideas to make the phone call to make that very first appointment.  I guess to some degree I was curious as to what could possibly be different about what this guy did that was any different to make so much of a difference to my friend.  The concept of life being better for my friend was enough of a lure to at least try.  I wasn't completely convinced that anyone could do anything to help me feel any better.  I was living the best life that I could.  There was pain and limitation and I did need to make accommodations but life was good.    Besides, it wasn't my muscles, it was my joints and the damage left behind from it's earlier activity.  What good could more exercise do since I was fairly well adept at managing myself to the limits.  Oh hell, what was the harm in trying.  Even if it didn't work out, at least I'd tried.

I don't even remember that first appointment at all.  Something must have made me trust that this was something worth doing.  Something must have at least dented my preconceptions about what physio was and what more it could possibly do for me.  Over the space of the next ten weeks, Paul worked on releasing the muscles and connective tissue.  I'd walk out feeling like I was floating or walking on pillows.  I didn't realise until then how much of my pain wasn't actually my burnt out joints, but the muscles surrounding them that were so tight, a tight that couldn't really be stretch out due to joint limitations and the limitation of my knowledge of my own body.  By that point, I too referred to him as magic.

After a few weeks, inspired by some pretty amazing improvements in my range of movement, posture and overall positivity and feeling of wellbeing, I decided that it was time to check up on everything and I went in search of a new rheumatologist.  I'd booked an appointment soon after my trip to Melbourne for a conference.

By the time I went to Melbourne, I had been to about six extended sessions with Paul.  Coming back, I happily reported at how much more free I felt, how much further I could walk without pain, how far the 'limits' of my days had been reduced.  In just six weeks of treatment.  I wasn't ever going to get all my range of movement back as the joints were just too damaged but some of it was returning.  The most I could get out of life was so much more than I thought it was.

This really was the beginning of a whole new story.

To be continued....

Pain Management and Healing: Part I

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.

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 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.

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!!