28 Days Post Op: Going Home Day

Today was the last day that I would be woken at 6:00am, 6:15am, 6:30am, 6:45am, 7:00am and 7:15am at which point I would usually be kicked out of bed.  Hospitals are like alarm clocks set by some evil person for an ungodly hour with a snooze button that keeps going until you are forced out of bed.  Going home day is exciting as well as a little bit daunting.  I was pretty confident that I was ready for it, though it is hard to know how I'll be able to handle everything until I got here and settled into a routine again.  I think it might take a few days to get to that point.

Prior to leaving the rehab doctor came passed to ask about the drama that we had last weekend.  Since I was actually at the point of getting out of there, I didn't see the harm in talking about the issues that we had.  I didn't really want to get into it while I was still there as I didn't want to have to deal with people that I have had issues with if they knew that I had made a complaint about them.  The doctor wants to address issues like these when they happen so that they can be fixed.  I understand what he was saying and had I been at a fully fit and independent state, I might have done so but having to still have to stay there and be reliant on these people, I really didn't want to rock the boat.  They were still able to identify the bad advice nurse since I knew what day I blogged about it.  I also told them about the 'good chance to be normal' comment and the other things that happened during the infamous physio session.  I'm not sure if there will be further training or what the repercussions will be but thankfully I won't suffer any consequences for it.  The doctor asked us to speak to the head of nursing about the issues as well, and she said that many people feel the same in relation to 'retribution' and fail to comment which doesn't help them improve the level of service provided.  Apparently it doesn't happen but I can't see how it wouldn't change the way that the spoken to person would react the next time that they had to deal with me.  Anyway it is all done now and I'm home!

On the way home we stopped past the mobility place and got the last couple of things that we needed for me at home.  I am now equipped with a granny wheely walker so that I can carry things around the house, specifically the kitchen and have a perch stool to sit in while I'm in the kitchen.    The main issue in the kitchen was that I am physically able to cook or make a cup of coffee or whatever it was, but I couldn't actually carry something out of the cupboard or the fridge as I am using both hands to use crutches.  The wheely walker means that I have a tray to put things on and both hands are still on the walker while I am walking.  Problem solved.

Stopping on the way home meant that I was in and out of the car twice which was an achievement.  Getting home seemed like an even bigger one.

20 Days Post Op: 8 Days Left in Rehab

Today the target of going home next Friday has been finalised so the countdown is on.  Obviously this requires a couple of targets to be met.  The big one is the stairs.  Both my Physio and Occupational Therapist agree with me in thinking that this really is a reasonable target that I can meet.  

There have been a couple of positive changes today.  The main one that I noticed is that I didn't require assistance to complete some of the bed exercises which I have been getting a little bit of help with.  It wasn't easy and I wasn't working to my full range, though I was still actually getting somewhere with them which wasn't happening yesterday.  Mostly it was the right leg that I was needing light assistance with for the leg bends where you keep your heel on the bed and for the abduction for the left just to get started off.  I got through them today without assistance which was awesome.  Some of the reps didn't quite look as good as the assisted ones but the milestone is actually being able to do them.  I'm hoping this is an indicator that not only am I getting stronger but that my brain is connecting it all together properly so progression will continue along at a speedy rate.

I have started on little steps today, ones that are about half the size of normal steps so at least I am started on the path towards getting out of this place.  I had two sessions down in the gym today that involved a lot more practice on crutches.  I am getting a little more stable and can already see the difference from when I started yesterday.  I'm still a little way off using them unsupervised.  Unfortunately I change Physio's next week as the person that I have been working with for the last two weeks was actually a locum to replace the person who is actually assigned to me.  It is a bit of a shame as I have a good working relationship with my current Physio and I think that he knows what I am capable of and what to push me to do so that we are seeing results.  (It wasn't his fault that the gym was closed and he wasn't scheduled to work!)  I am sure that the other one is good - it just takes time to get into a routine and build a working relationship with a new person and I don't want that time to detract from the benefit from time that I spend with the Physio.

It looks like I will be going on a home visit with the OT next Tuesday where we will go through everything in the house and see what additional aids I might need to purchase or have installed to assist with me living back at home.  I think that we have an idea of most things that will be required, though there may be some little things that I hadn't considered.  We will need to test things out like getting in and out of the shower, moving around the kitchen and even getting in and out of bed.   It's amazing how many little things that you take for granted and it isn't until you do something like this that you realise the full magnitude of what you need to adjust in your life.  I had wrongly assumed that the limitations that I had before and the things that I had learnt to overcome difficulties would be all of the same things and I would be fine.  It turns out that even though I am reasonably well prepared, there is more than that and I am now aware of what I need and will continue to need for the next month or so as I continue to heal.

18 Days Post Op: Bad Advice

I've had a rant in the past about being your own advocate.  I was on that warpath again this morning after a 2:00am argument with a nurse, who told me to do something that clearly violates the 'Bilateral Hip Precautions' sign that sits on top of my bed.  I could have done what she instructed me to do which some people would I guess but I didn't.  It was bad advice and I wasn't going to take any risks with my new hips.

Basically she wasn't fit enough to assist me to get my feet in and out of bed and was trying to get me to put the stronger right foot under the left to move it off the bed. (I really don't require a great deal of assistance, it's down to gentle guiding as I am holding most of my weight now - at best guess from my best helper, when I'm tired it would be lucky to be a kilo and a half of weight).  What she wanted me to do was in clear violation of the hip precautions as I am not to cross either foot past the mid-line.  I have been given at least a dozen worksheets with pictures with large crosses through them that have people with crossed legs just in case I don't quite understand the concept.  This shouldn't be anything new to this woman as this ward is for rehab and there are always hips being done here.  Maybe there is only one bilateral a year, but even so, it's pretty clear as to what I shouldn't be doing. I said I wasn't allowed to do that and was given a bit of a sigh and at three am, I was silently screaming profanities in my head.  If it hadn't of been the middle of the night and had my brain been in gear I might have been a little more eloquent about the issue than 'I'm not allowed' to at least explain, but in the middle of the night when you've just woken up and you need to pee, reason and alertness usually isn't present.

There is a reason for the precautions - it's to reduce the risk of dislocation.  It's not just because I don't want to do it.  I just don't want to end up back in surgery and starting this whole process again.  I don't think my mental health could handle that.

Getting back into bed I had a minor panic and a 'you've pushed them too close together (my feet)' before we'd even got halfway there.  I received a rather stern lecture about how I should do it so that she didn't have to so so much to assist with my feet in future.  The way I have been doing it is fine with other nurses, wards-men and exactly as I was instructed by the physios but apparently that was too freaking difficult for her and I got told how her way was better because I'm too hard on the nurses. (almost a direct quote - it's better for nurses health if I can do it properly - though I have to wonder why the wardies prefer the physios way if it was physically harder - so I'm not sure what the go is other than she was a cranky ass who was physically unfit for the physical requirements of assisting patients)   Not good for my mental health at the moment to be spoken to like that.  I know that I am unreasonably fragile, but come on, she was unreasonably stupid and mean.  I think that I would have been in better condition than her pre-op which really does make me question how she manages to do the job when there are people in this ward that require more assistance than I do.  I guess she doesn't normally get the hard cases and probably wouldn't have answered the buzzer for me last night if my regular nurse hadn't been on her break.  I didn't realise this though and when I awoke again at 5:45am and needed to get up to go again, I tried to fall back asleep until shift change so I could get someone else to help me out.  When you start to think about needing to go though, it really makes it difficult to get back to sleep.  I lasted about ten minutes, by which stage I thought my bladder might explode and I couldn't possibly wait another half hour, I buzzed again.  It wasn't even as though I could even attempt to do it myself as the rails on the side of the bed were up and you can't put those down when you are actually in the bed.   The nice nurse arrived and I nearly cried in relief.  She assisted me out and commented on how much better I was getting and that I was almost doing it all on my own now.  After getting back in bed, I passed out with relief, feeling a bit better about myself and my  progress again.  I had prided myself on becoming low maintenance to the nurses, it was something that showed how much I had progressed.  I don't need that much assistance anymore, just in and out of bed, teds and meds and these things don't really take too long in comparison to higher dependency patients.   Somedays it seems that the better you get at looking after yourself the more you get shafted (it's not just the gym, its now the grumbles at requiring one assist - even though my chart still says two assist).


The whole situation highlights once again how you need to understand what is happening to you and what treatment you require to ensure that the right processes are followed.  Speak up if you think that something is wrong.  People do make mistakes, it isn't always ignorance, stupidity or laziness where errors occur.  If you know what should be going on around you there is an extra person there to pick up an error before it can occur.  Disaster can easily be averted if you know yourself and your treatment and stick up for yourself.

I should note that on the whole, the nursing staff are excellent.  There have been a couple of moments like this with one or two that really change the whole experience.  It's a shame that poor organisation and a few people really unsuited to the job taint a group of truly extraordinary people.