2014 in Review and What Comes Next?

A lot has changed in my life in 2014.

There has been an overwhelming sense of accomplishment as well as the associated 'well what now' that inevitably follows completing something that you never thought would ever be possible.  This was the theme of my homework set by Julie for the Christmas holidays.

I'm in Bangkok at the moment on my annual break.  This is something that is only relatively new in my life, taking holidays!  The first year that we came here was in 2010, just before I met with the surgeon for the first time.

Travel was never really that high on my wish list - it was uncomfortable, I suffered for days after the flight with pain and stiffness, I could never do as much as I wanted to and it was just easier not to think too much about it.  I also worked a lot...  like a crazy person in fact.  Work was something I could do, something that I could achieve with.   I'm not entirely sure that I had time from the start of 2000 until 2010 that I could have actually gone on holidays overseas for too long.  This isn't to say I never travelled.  I did a few trips with work in the privilege of business class and no time to do too much that was physically demanding.  (There was that one trip to Vegas...  but that's for a whole other post)

So the last year pre-op I went to a city that I knew people and they knew what I could and couldn't do.  They also didn't feel the need to do too much that was touristy and required too much walking.  Taxis were in abundance and were extremely affordable and I had a holiday that fit in with what I could do.

We now return and the holiday has changed a little - we do walk more.  I still don't go to the gym or the local pilates studio as I promise myself each year as I pack my gym gear but my life is substantially more active than it ever has been before.

So the homework....  to figure out what my 2015 goals are going to be.  In trying to come up with something, I spent a fair bit of time reflecting on the year and what I had actually achieved and what had changed.

The highlights:

• I can get up and down off the floor without leaning on anything above ground level
• I can walk 15km and pull up fine in the morning (I could possibly do more - but it's at that point where I'm kind of bored with being in my own head and just want to do something else)
• I walk and people don't know that I've had hips replaced
• My posture has improved substantially 
• I can wear heels (Hey, I know bad for the body and I've always claimed flats are the way to go but it is nice to dress up some times and slide into a pair of Ferragamo peep-toe heels.  My physio says it's ok on occasion too - so I'm in the clear!)
• I sleep better than I ever have before.  I can exist on substantially less sleep than I ever have before.  I prefer to get more hours and quite often do but I can now wake up in the morning before the alarm and be where I need to be without the 
• I can easily do up my own shoelaces.  I could earlier post-op but it still had it's challenges.  It's now just part of real life these days.
• Getting in and out of car - completely changed - it's so much easier to not slide in like a lady and then bring legs in.  
• General flexibility.  It amazes me sometimes that I don't think twice about picking things up off the ground.  That I can bend and reach.  That my balance has improved.
• I actually like physical activity.  It turns out that my old belief that I didn't was really just a function of what I was physically capable of - not actually what was real.  It surprised me.  

The things I've learned:

• To accept that these great accomplishments just aren't as impressive to others.  The things that I get excited about and have shared with friends have often been met with the blank oh great stares.
• To accept that the most important thing to the outside world is the weight that I've lost.  About 14kg.  I know this is awesome and it's been fun buying a new wardrobe and fitting into things that I haven't worn for years, but to me this is just a nice little positive side effect.  I never did any of this to lose weight.  That was never a factor in any of the decisions I've made.  The strength and new found freedom, the blank stare stuff is just so much more important.

My world has changed.  I'm finding myself.  The person that I never thought that I was.  The person that I never even thought about being because it was so far removed from what my reality was.

I didn't quite make it to figuring out what the goals were.   I started by looking at the suggestion of Kokoda Trail - but it didn't jump out at me.  It's not the distance.  This is a pretty great challenge that meets the criteria of a suitable challenge in that I would require a fair bit of training to be able to achieve the goal, and yet still it's just not quite right.

The Bhutan Trek to Happiness walk as a fundraiser for the Black Dog Institute interested me more - but it wasn't really challenging enough to be a goal for the next stage of my development.  I think I might still do this one day - but it won't be a goal, just something that I'll do for fun.  The fund-raising side to this event would be the biggest challenge.

I'm still looking.  I'm sure it will come to me soon and in the meantime, the search is fun.  I've thought of and found a lot of activities that require another look at now that I have this new found freedom.

Things like:

• Going to an all day music festival and be in the mosh pit at least once.  
• Indoor rock climbing
• Abseiling

If you can think of anymore - please post!!

I'm looking forward to spending more time on this little homework project in the coming weeks.

Off the Floor

For the first time for as long as I can remember, I got off the floor without leaning on a chair and using my arms to assist.  I was on one of those thick squishy mats so I kind of wrote it off to the matt and maybe just a fluke.

So today I tried again at pilates on a regular mat.   I did it.

I haven't tried a regular hard floor yet but I did it.  Twice.

That's huge.  It's so huge that I can't even tell you.

Some people get it.

Some don't.

I'm grateful for those that do.

Range Update

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

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

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

I can drive again!

Today my sister came and picked me up in my car and we went to the ring road on the Griffith Uni campus which is pretty flat and very quiet on non-uni days (it's a public holiday here today).  I wanted to get behind the wheel on a flat road with little traffic to see if I could drive.  I figured that the low speed limit and the speed bumps would give me a chance to change gears quite a few times if I did a few laps.

When I got behind the wheel and started to drive, it felt normal and I didn't even do a lap, we just left the campus and headed out for lunch.

After we got home, I called a friend and headed out again.  This trip I went on the freeway with the music up loud.  It felt like freedom.  It felt like life was pretty much normal again.  Ok, so I still need at least a single crutch (and two if out in public) but for those few moments when I'm driving, I'm in control of my life again and its starting to seep into my general mood.

This could be the start of the next step of the rehabilitation process.

Going out for Lunch

Today and yesterday, I went out for lunch.  It was good to be out, even in the cold.  A change of scenery for a little while has been good for my mental health.  I'm becoming a little too comfortable staying at home and need a little nudge in the direction of living life on the 'outside' every now and again.

Today was a bigger day with a lot more walking.  We headed to Garden City for lunch and after eating, we went for a walk for the length of the centre and back.  I'm not quite sure what the distance that I walked was but it was pretty decent amount for a single trip. I was tiring about two-thirds the way back to the car but we had planned a stop for cake and coffee on the way back and it was just about at the right time.   I think that I could have done another trip about the same distance after a bit of a longer break.

I also had a go at an elliptical machine and a recumbent bike to see what was possible at this stage of the rehab process.  The bike is out for the time being as the flexion range isn't comfortable and it is difficult to get my feet in the pedals without assistance.  The elliptical was really good.  It is a little difficult to get on to, though possible and no more difficult that getting in and out of the car.  The movement is smooth and could be a good way to increase my activity levels.  Walking is cheaper and just as good an option, though I'm not really confident enough to go out walking on my own especially with how hilly it is and how few pathways there are around here.   I have been thinking about it for a little while and still not sure which way is the best way to go from here.  I need to up the activity a bit more but I don't think that I can walk around the house anymore than I already do.  It takes a lot of loops around a house to do the distance that I did today and I'm not sure I can do that around the house.

Tomorrow I'm going to try to drive.  My sister is coming to take me to a parking lot so that I can learn to drive again.  I'm not too keen to try and take the car out of my driveway here.  I'm just a little bit concerned that if I'm not ready, I might end up rolling into the garage door or maybe the house at the end of the street.  I'm sure that it won't be that difficult, I think that I have the range, reflexes and strength to use the pedals and once again it's just confidence.  It seems to be that's what is lacking at the moment to take things to the next level.  I'm just not quite sure how to get that back.  As the weather cools, I seem to becoming even more comfortable staying at home which really isn't a good thing.  Everyone is busy getting on with life, it's just seems easier for me to stay here.  This really isn't the right attitude to move forward but right now that's just how it is.  There needs to be some change or catalyst to get me out of this slump.  I'm just not sure what it should be.

Six Week Surgical Review

I went to visit the surgeon on Monday for my six week post-op review. I was a little nervous the night before and while driving back into the hospital. Realistically, I know I've done well and my progress has been steady, so there was no real reason to be nervous. I'm not quite sure what started up the butterflies but they were quickly squashed.

On the way in, we were a little early and managed to get a 15 minute parking spot just in front of the coffee shop so the day was starting off well.

When we arrived in the surgeon's office, we were sent upstairs for new x-rays. Q-Scan uses the new digital machines so I have a nice little CD with the three views showing the perfect placement of my two BMHRs. I had to download a view for the Mac (it came with a windows viewer - the one I downloaded is free and pretty cool. It's a DICOM viewer called Osirix) and now when I have a few minutes I will be able to upload some clearer images. It still amazes me that they are in there. The joints don't feel anything but natural. I guess after so many years of crunching and ROM limitations my idea of normal is a joint with smooth, fluid movement. I know that my limiting factors at the moment as far as mobility goes are to do with muscle strength and tightness not the actual joints themselves.

We headed back to the surgeon's office and saw him pretty quickly. He's pretty happy with my progress and gave me the all clear to lift the hip restrictions. We had a quick chat about my progress, the improvement of the left side foot drop (all better now) and other bits and pieces. The Four Corners piece was raised, which I commented that I hadn't seen though I had heard that it was quite biased and that kind of led into a general conversation about acetabular cup placement (mine is perfect, having an awesome experienced surgeon is crucial), the number of resurfacings he has done (700+) and the success he has had with the BHR (The BMHR is still new though the data is much like the BHR's early data and is promising).

I asked about metal testing and pregnancy for when we get to that point in a couple of years. I was asked if I would supply test results when we go down that path and I said I would happily volunteer results for data for a study on the MOM devices.

[Side Note: I really believe that they are the best option for a lot of people, not just people like me. Some articles still suggest the MOM devices are not suitable for women of child bearing age as there is some evidence that the metal-ions pass through the blood barrier, however, there is no evidence that it will cause any problems. This may get a lot of negative comments and I challenge the naysayers to find hard data before name calling. I am open to an open dialogue of the issue, however, comments with rude remarks will not be accepted. I trust my surgeon and the data that he has researched as an expert in this field. The research I have done supports my belief in him. The decision to have the procedure was not one made without great consideration of a lot of factors. I will eventually write more on the topic of making this decision, so at some point the label 'Decision' will have more posts. Just like this part of our lives, we will do due diligence to any big decisions that we make. Anyway, back to the topic at hand.]

I enjoyed the appointment. I think I'm an interesting topic to talk about! Actually it's the shiny new hips that are interesting as well as the progress that's been made and will be made and all things relating to the new parts that the surgeon knows that I don't. The summary of the appointment is that all is good and I am due for review again in September.

In the meantime, HIP RESTRICTIONS ARE LIFTED! Not that I can really exceed 90 degree hip flexion, but that isn't the point. The point is that the risk of dislocation has reduced and I have passed that first hurdle. (There are other things that I don't have to be as concerned about either - though the seat height is probably the one that functionally is the most difficult to deal with.) It's nice to be able to be able to stretch a bit more, to reach down to at least try and touch my toes - still a few inches off and my hamstrings are squealing! They need a lot of stretching out just like pretty much everything else. I can't reach as far as I could pre-op yet, though it has been almost seven weeks since I've done that stretch so I guess it isn't too surprising that it isn't the easiest thing to do.

So the plan for the coming week is as much stretching as possible and keep on top of the exercises. I have a little bit of work to do tomorrow so I'm going to have to figure that into my day as well to make sure everything gets done. I feel like I should be doing more by now but I am still tiring easily. It's getting better as each day passes though there is still a little way to go yet.

With that in mind, I really need some sleep. It's way past the bed time I have gotten used to. Even though I've always loved sleep, I need even more these days. I guess that's an indicator that my body is still investing a lot of energy into the healing process.

Til next time!

First Real Post-Op Outing

Today was the first real outing and my husband and I went for coffee and brunch at La Dolce Vita at Park Road, Milton with friends.  (I know I went to the hospital to see the social worker on Tuesday but that really wasn't a 'real' outing after being there for four weeks)

The trip was part of the 'Project Awesome' goals that I worked out with Paul from Body Leadership for my recovery process.  Reintegration into the real world is a little scary when you have been in safe places since a major operation.  I'm also very comfortable in my own space and am not getting cabin fever, so there it is easy for me to let time pass making the prospect of going out a bigger issue than it actually is.

The main reason that I had been a little scared about going out in public are all of the falls hazards that are outside of my control.  I also worried about available seating and whether toilets were going to be available that were accessible and the right heights.  (The toilets for some reason were a really big deal which is strange considering that when they weren't a problem - at the hospital - I didn't even need to use them and we were out for about two hours that day.  Surely I could manage a quick outing without having to go?)  I also worried about being stranded somewhere without being able to sit and not able to walk any further (highly irrational considering that was a) unlikely to happen and b) I wasn't going to be left alone).  All of these things were probably becoming bigger deals in my own head as I put off facing them.

I got to chose where to go out to and the conditions of my 'release' to help make me more comfortable about what we were going to do today.  I chose La Dolce Vita Restaurant because I am comfortable there.  I have spent a lot of time there and I know the staff well and also know the terrain well.  I knew how we could get in there without having difficulties getting me out of the car even though my disabled permit hadn't arrived yet.  About the only thing that I wasn't sure of was toilets.  I knew that the ones upstairs were a no go as there was a massive step to get into them that I had little chance of clearing on my own and the height of the toilets was probably too low especially without bars to assist in correct positioning to maintain the hip precautions.  I knew there were some downstairs (accessible by lift)  as well, but I wasn't sure what they were like either.  Google for once, let me down.  I didn't find what I was looking for.  It may not have been google's fault as the resource just might not be available.  How do people who have permanent conditions find out this kind of information?  Trial and error?  That seems absurd.  Is it even possible that one of the most popular coffee/dining areas in Brisbane doesn't have disabled toilets?  Surely they do somewhere?  I figured that they must and if they didn't, there was always McDonald's across Milton Road (After all of that worry, I didn't even use them and stupidly I didn't even check to find out exactly what was available).

We made it there around the time that we said that we would be there.  It takes me a lot longer to get organised at the moment.  Part of the problem is that it is easy to sit in the shower for long periods of time rather than have a quick shower to get ready.  The second issue are the Venosan socks that I still need to wear during the day.   I should have organised a 'sock helper' before now to assist the assistant helping me get these things on.  It's on my list to do over the weekend so that I can hopefully get something delivered early next week.  As they are heavy duty compression socks, they aren't the easiest things to get on.  With hip restrictions, they are even more difficult.  They are for a very good reason though, to reduce the likelihood of blood clots and for that reason we persist with them.  The third issue is trying to figure out all of the things that we needed to take with us that may or may not be required.  I reasoned that this was somewhat similar to trying to get a child out of the house and all of the things that they require.  It might not be as bad, though there were still a lot to consider.  We needed a pillow and a towel to try and adjust seating height so that I could sit and not break hip precautions, the wheelie walker in case this solution didn't end up being viable, another set of shoes in case the ones I decided to wear but haven't worn since the op didn't work out, tissues (yep I have managed somehow to get a freaking cold), medications, jumper and then the regular day to day items that you don't leave the house without.  In the end we made it and we had everything that we needed.

I had a mild case of anxiety as we were crossing the Captain Cook bridge and arriving at our destination.  As I got out of the car, someone I knew was walking through the car park and was a nice reminder that I was in a safe place.  I felt a little calmer as I got out of the lift and started to walk around the front past Alegria and saw more people that I knew having brunch.  The friends we were meeting with had already arrived and seating wasn't an issue once we had topped it up with the pillow and towel.  Quite comfortable actually!  There was no requirement to bring the wheelie walker out so I just used crutches which are not only more comfortable for me to use, but I feel better using them.  I know that there is no shame using a walker and if I had to I would, I just wanted to look like I was more well than that.

Brunch consisted of real coffee and a bacon and egg panino for me and was awesome.  Meds were taken with a sparkling mineral water chaser.  We were out for a few hours and then headed home.

On the way home I spoke to my sister who was in the city and asked her to go into the pharmacy for me.  She called while she was there so I could talk to the pharmacist to confirm what I could take to get rid of this cold.  Thankfully the blood thinners weren't an issue and hopefully I can stop suffering with the congestion and associated tiredness and step it up a little in the rehab.  She picked up some things for me and I had some cold tablets still at home that had the all clear so I had one of those and pretty much feel asleep straight away.  A few hours later, I woke up and felt a million times better.  I even did another round of step ups on the single stair outside (10 each side no vaulting) and feel pretty proud of that at the end of a big day.  My walking distance will be a bit lower today even with the outing as I haven't done as many laps around the house.  It probably balances out as far as energy usage goes and each day I do get a little more stamina to do more.