Game Day

The countdown is over and we are here checked in to Mater Private in the 'Welcome Lounge' which seems to be the private hospital version of a waiting room.  Pretty cool really.  Internet access, tv, proper lounges, no overcrowding.  You can even borrow an ipod stocked with movies and music.   It's a little like an airport lounge just without the beer.

I am remarkably calm.  The day has started out well.  We got up at six to get the pre-op breakfast and coffee in before seven (at Two Cups) and then went home for a nap until about 9:30.  I didn't really sleep but it was nice to curl up under the covers (on my side - which will be out for a little while after today) while it rains away outside.  We were up, showered and out by about 10:15 and are now checked in and waiting.  I'm not scheduled until 2pm this afternoon and before then I will be meeting with the nurse, anaesthesiologist and the surgeon.  I think they might just keep you in here to make sure you don't eat.

Hahahaha...  I was just commenting (ok bitching) that it wasn't fair that someone just brought coffee in here. I thought it was food and drink free.  Apparently it is, it didn't take too long for the nurse to descend and tell her to get out as you can't eat and drink in here.

Not much more to tell at the moment.  Will post again when I am out of surgery and allowed back online. I go to ICU tonight so not likely to be allowed to have access until tomorrow - probably going to be pretty druggy until tomorrow anyway so I shouldn't suffer too much with communication withdrawals!

About two hours to go!

Game Day Eve

Almost ready to go.  I have less than 12 eating hours left and I really should get some sleep for some of those.  Today wasn't quite as relaxed as yesterday though that is probably more psychological than actually being too busy for the day.  It may also have a little to do with the 7am phone call from the hospital this morning checking the spelling of my name.  (It was a little more than this - but not much!)  I haven't quite figured out the urgency of this as I'm sure they will have plenty of time tomorrow after I arrive and before I go in for me to check all of my paperwork.  I was supposed to start the day with sleep until about 8:45 which is the absolute latest that I figured out that I could get up, have breakfast, shower and still be at Physio on time.  I got back to sleep not too long before the alarm went off.  Missing almost two hours of sleep isn't nice.  I didn't quite make it on time but I wasn't too late :)

I had two appointments today at Physio.  One to get all my muscles and tissue ready for tomorrow and one to go through everything that I need to know and take range measurements to compare to.  I really wanted baseline measurements to compare to after and I wasn't sure that the hospital physio would look after this.  I know it's going to be better but I want to know just how much better as it well could be a good tool to get through any low points that I have when the rehab isn't going as quickly as I want it to.

I thought I was done with work, though there were few things that came in today that I had to look at.  Some were passed my way which really didn't have to.  I guess its probably a bit easier to focus on things like this at the moment than actually doing the final processing of tomorrow.  From a logical point of view, it will all be fine, everything is organised, there isn't anything to worry about but I can help but feel a little anxious.  At least I'm done now and don't have to deal with any of it for at least three weeks.  After that, I'll see how I am and if I want to take some of it back on that I can do from home.

Not sure I'll get a chance to post tomorrow.  Maybe when we are at the welcome lounge waiting for all the final prep to be done before they take me in at around 2pm.

Wish me luck :)  If I'm not online tomorrow, I'll have a lot to share in a few days when I'm out of ICU.

Two days to go

I woke up sore and tired again this morning after a restless night.   I think that it may well be a conspiracy to take you off medication before an op like this.  Maybe it has nothing to do with blood thinning properties, more that they want you to remember how bad it can possibly get before they put you in and fix it up.  Kind of like under promising and over delivering.

At least I woke up mentally positive.  There are two days to go and then the physical stuff will at least be on the mend, permanently and I'll have much better pain management meds too :)  A little nervous about how much I might need them but overall positive.  I'm hoping that the visible improvements that I will see and knowing that there is an actual end date for the surgical pain will be enough to help overcome the pain hurdles.  I've been told that you shouldn't be a hero with pain meds and don't let it get to the point where you can't handle it anymore as it takes time then to get it under control.  It's very different from the 'tough it out' attitude that many of us learn and live with.  The other tip that I got was to use pain meds about twenty minutes before the physio arrives.

I had hydro this morning and that helped loosen things up a bit and I felt a bit better after that.  It was the last session before surgery and was a little bit slower than what we were doing last week.  I'm generally just a little bit slower at the moment.  Thankfully there isn't really a need to speed it up - so it isn't too much of an issue.  Not sure that I could have handled another full work day today so it's just as well that I finished things yesterday.   Being finished and not completely up to my regular activities on Wednesday, I had changed the hydro until today from Monday and am skipping the last pilates slot as I really didn't think I'd be up to it today.  Unfortunately I was right, though at least I was prepared and got to make the most of the time and feel better for it.

Instead of pilates, I went visiting and took cake with me.  It's nice to be free to do things like that when the mood strikes you.  I got a chocolate cake from the bakery down the street that I haven't been before and it was truly awesome.  I haven't had a huge amount of sugar lately so the sugar rush was a little weird but also awesome.  (I must admit after my long haul work day yesterday I did have a Coca Cola in a glass bottle which was freaking amazing - though I think that it may well have unlocked the sweet tooth as I also had a little hallow easter egg tonight too which hubby brought back with him from Melbourne - it was awesome too.  There are still five left which I am trying to stay away from so I can have some later but they looooook at me saying eat meeeeee!  We did have lots of veges for dinner and I'll need to make sure I eat lots of good nutrients tomorrow to prepare for fast healing and healthy red blood but chocolate today is all good since I've been getting all the good nutrients for a while now when I started the prep about a few weeks before the blog :)

The day didn't step up a notch at all.  It stayed at the same cruisey pace and culminated in an afternoon nap which was awesome.  Think I managed to be completely out for about an hour and a half which is probably a longer stretch than I managed all night last night so I was pretty happy with that.

The evening was pretty low stress too.  Visit from my sister and her fiance and I got presents :)  Not sure what is in there, they are special ones marked with different times during my hospital visit to keep me occupied .  Very sweet and very cool (and oddly heavy so I am quite curious) :)  I'll keep you posted on that one.

The big decision of the day is whether or not to upgrade from my beloved kobo to the kindle for my hospital reading.  The reason that I am seriously considering it is the fact that the books that I want to read while I'm recovering are twice the price in the format for the kobo than the kindle and the kindle has access to more books and it has the wireless and 3G access so doesn't need to connect to a computer to get new books to read.  The new kobo does the wireless thing (but not 3G so probably just as useless as not having it in hospital) so it really comes down to the cost of books.  With the Aussie dollar as strong as it is at the moment it's even better for me as a consumer.  (Apparently its not that great for our economy as predictions have us getting to $1.10 USD, though there is always something that isn't good for our economy, mostly lately it has been natural disasters but I digress)  I do have some books to read while I make the final decision on this one.

Pretty much ready to attempt sleep again.  Hopefully I'm exhausted enough to just pass out regardless if I'm comfortable or not.  Wish me luck :)

[edit:  The kindle is on its way! 7 April, 2011]

Spilled Milk

There is no use crying over it, right?

Even if there is coffee in the milk?

Probably not.

But that's where I was at this morning when I managed just that when I arrived at Physio today (all over towels and pillows....  sorry!)

Now, it was good coffee, but probably not quite good enough for a cry, it wasn't like the last cup of coffee that I would ever drink again and it really wasn't the problem.  The day just didn't start off well.  I woke up tired and sore having not been able to sleep that well.  Panadol Osteo really doesn't cut it to replace the anti-inflamatories that I was on until last Friday.   This is probably the longest I've ever gone without something stronger and sleep is hard to come by at the moment.  I think that naps may be in order when I feel that I might actually be able to sleep for a little while.  There were a few other little things that managed to fray the nerves before I actually got to the point where the coffee was a really big issue but even so, really not a proportionate emotional response.  It's probably just as well I was somewhere where people know me well, as it really was quite an episode, one that I really wouldn't want to have out in the real public.

The day turned around and I got over the weepies and felt a lot better after an hour of Physio and another cup of coffee.

I caught up with an old friend for that second cup of coffee and got a chance for a bit of a sit down and breather to keep the physio calm and relaxed mood going on.  The pain subsided for a bit and I got a chance to get stuck into the last few work tasks so that I can handover to the person taking over.  I pushed through til about 10:30 tonight to get everything done so I won't have to work again before the op.  I finished up about the time that my husband arrived back home after being away for a while.  He wasn't definitely coming home today as he was still in exile but after my little episode this morning.  

I need nap time and relax time now that my husband is home and we are this close to game day.

Post Pre-Op Appointment

All went well with the pre-op appointment so I can relax a bit now.  Maybe I should have a nap this afternoon :)

Some of the questions that I had left had been answered and I have been given reassurance that I am definitely booked in for bilateral, I will be going to ICU for at least one night post surgery and all is good.  I have had my pre-op blood work done (results still to come in though there shouldn't be any issues based on the blood work I had done about three weeks ago) and had an ECG which apparently looks normal.

I also filled out some surveys relating to pain and mobility and signed a consent form for a tiny little bit of my tissue near the bone to be taken for research.  I asked what happens to the bone that they cut out too and it gets sent off somewhere to maybe be used for something too.

Side Note:  Speaking of research, I have recently been involved as a participant in the Motherhood Choices Survey being run by the University of Western Sydney to develop a decision aid to assist women with rheumatoid arthritis aged 20 - 45 who are considering having children.  If you've come here and meet that criteria, please consider participating as they are still looking for people.  I'm not sure how they will collate the information collected though I hope that it is the start of further research into issues affecting people with arthritis and result in the development of resources, knowledge and communities.

Early for Pre-op Appointment

I am in the Fourth Floor Surgery at Mater Private clinic waiting for the nurse to finish with her previous patient so that I can have my pre-op appointment.  I have my list of questions, though am still a little nervous as I'm really not sure what the answers will be (though I've done heaps of research I should have a fair idea - just not exact).  My big questions relate to getting bumped.  There shouldn't be any reason why I would get bumped, though there is still that fear that I might be.  I'm ready now and just want to get it over and done with.  I may change my mind in the few hours before or maybe as I'm trying to get to sleep the night before and have a few moments of uncertainty but I am sure that I won't cancel now.  I've been three days without meds as well as spent a lot of time prepping so I can't let that all go to waste.  I've still got twenty minutes to go so I might catch up on some reading on the discussion boards.

Husband in Exile

My husband was supposed to come home from Melbourne today but I didn't let him (at some level his exile is self imposed as he does share the sentiment that it is a good idea - neither of us have to like the good idea - but unfortunately it is).  He has germs.  Somehow he has managed to catch a cold and is busy resting and hopefully kicking it in the next 24 hours so he can actually come home.  

I sound like a completely crazy woman.  I very well may be completely crazy woman - not just 'sounding like one' but I do need to tell a story that backs me up.  A friend of a friend was due to have surgery on his knees last week (I don't know the guy - this is just a story that I have heard second hand) and he got food poisoning two days before and he got bumped!! Poor guy was in public and has been bumped for a year!

Ok, that won't happen to me in private - a bump might only be a month but even so, I'm not sure my remaining sanity could survive a month delay.  More accurately I don't think that the sanity of my husband or close friends could survive.

Last day for arthritis meds

Today is the last day that I am allowed to take my arthritis meds.  At the moment I am just on the anti-inflammatories, Voltaren (Diclofenac).  I have been on these for over twenty years now.  Throughout that period I have been prescribed other drugs in addition to, or to try instead.  When I've tried other things, there hasn't been any great success and management has primarily been with the Voltaren and Prednisone.  I don't recall everything that I was trialled on when I was a child as other things didn't last very long (I'll go through what I can remember another time).  

Side Note:  Over the last decade, I've never really needed anything other than the Voltaren.  Disease modifying drugs aren't suitable for me, the pain comes from the damage that was caused in the early days and a slow degradation as the bone grinds on the bone and the associated inflammation caused by this.  (My CRP and ESR are on the high limit of normal - which are one of the diagnostic tools used to indicate that it is still something alot more than that.  In the old days - there was no such thing as single digits - I really should try to get a hold of my children's hospital records to document all of that).  Though I have damage in other joints (fingers, ankles, knees, tmj and probably shoulders and elbows but they haven't been xray'd so I don't really know), none of the rest of them really give me too much difficulty.  There are range limitations, though no pain.

Back on track:  The reason that anti-inflammatories need to be stopped a week out is that they can act as a blood thinner and result in excessive bleeding (which is something that you definitely don't want during surgery.)  I am allowed to take Panadol Osteo which is going to be *fun*.  I've tried this before when I had a minor procedure last September, and it was only three days then and that really was enough for me.  So it's not likely to be a fun week but it should see the end of needing meds to manage pain (well once the surgical pain heals).

Seven sleeps to go.

Pre-admission phone call from Mater Private

I just received a phone call from a lovely nurse at Mater Private in relation to my 'check in' next week to run through the process of what is going to happen next week.  I am the last surgery of the day and need to be in at reception at 11am.  I will then be taken to a welcome lounge where the anaesthetist and a theatre nurse will speak to me.  When they are ready for me, I will get changed and off I will go.  The afterwards process was also discussed.  I'll get more detail from Dr Journeaux's nurse on Monday afternoon about this.  I may go into recovery and then to a ward, or to ICU depending on what risk they assess me to be at the end of the operation.  I was expecting ICU based on my last appointment with the doctor talking about what happens.  ICU is apparently bright and loud and not as nice as a regular room but you have one on one nursing.  I guess I'll leave it up to the experts to decide where I should go.  If I am in ICU, I shouldn't panic if I wake up with a tube down my throat and shouldn't try to speak because I won't be able to.  Apparently this isn't completely uncommon for long late afternoon surgeries if at the end my body temperature is low.  It is just another precautionary measure.  It was something that I hadn't considered though and is taking a little while to process.

Another thing that I hadn't considered is: That dressing gowns aren't necessarily the most comfortable thing to sit up in bed and watch tv in if it is a bit cool and maybe bring a wrap or cardigan.  I'll need to process the whole 'cardigan' thing too....  :)