The longest walk...

So far.

Last night I sent out a few messages to people to say hello, to see how they were doing, some who I haven't spoken to in a while.

I woke up quite early and had a few responses, some from people who were online this morning quite early. (Well early for me for a Sunday).  It's been good to catch up with people, to have a life back and some of the interactions have given me a lot to think about.  About my life.  About the changes that I've made for myself.  About the value of being alive, of being healthy and about having the opportunities to do things like, going for a long walk.

So I did.

I started out thinking that I'd go to a little coffee shop near me.  My local is the one thing that I really miss from living in the city.  It was just an elevator ride and maybe 50 meters.  My new local is about 2.2 km away.

What the hell right?  I can do that on the elliptical, so why shouldn't I be able to do this on the ground.  I have walking shoes and need coffee.  So why not.  I can always call a cab if I feel like I can't make it.  There's bus stops all along the way.  I'm not walking through the desert, I can just roam.  I kind of wonder if I hadn't have had all these health issues whether back packing would have been something that I would have enjoyed.  I'm a little spoilt now and like my own shower and bed in a nice clean somewhat upmarket hotel but I think that I could do the adventure a little more.  There's a whole world out there waiting for me to explore.

I started off quite optimistic.  There were some thoughts that it was a little harder than what I thought it would be when I got to the hills...  that's right - plural.   Calves and glutes burning, I made it there.  I took my time to sit, have coffee, some toast with avo and realised, that it wasn't that far.  I did the check around; ankles - good, knees - good, hips - good; and decided that I didn't think I wanted to go back.

There is freedom in just walking.  Time to think.
Time to just wander and be in my own head and be ok with that.

So I kept going.  Stopped at a friend's place another three or so kilometres down the road.  I detoured through a reserve area that has paved paths through the bush land rather than by the busy roadside in one section.  I was the only person out for most of the way so I got to sing out loud and just enjoy being.

It actually amazes me that I enjoyed it.  It's something that I would have always said that I was too lazy to do.  The reality of it is that I couldn't do it and it was just easier to say that I was lazy and didn't want to.

By the time I got there - I needed more water and a seat for a little while but I still checked out.  I kind of think that I could have done another stretch about that distance again.  Maybe not with all of the hills but I still think that I could have kept going.  In the end, I got a lift home.

I'll see how I fare up tomorrow.  I think that the worst of it will be a little sunburn.

Maybe next weekend I should head in another direction.  Split up the trip by 2 - 3 km chunks with a rest break between and just see how far I can get.  Maybe head towards the city this time.  South Bank is about 7 - 8 kilometres.  I can catch a bus home from there.  It's just finding the rest breaks along the way.   I'm sure headed in that direction that there'll be plenty to look at and keep my mind occupied as I meander along.

Recovery Day

The post that was made yesterday was written on Friday morning after I read the RA Guy's post and was scheduled to post.  I was going to check it before it went out but I ended up doing very little yesterday except for sleep for most of day.

Friday was a big day.  I started off with Hydro and stayed in the pool for an extra 45 minutes after the end of my session.  I had to pick up a computer in town and then I headed home to read email, news and blogs and wrote a few comments like my post.  By the afternoon I was out doing grocery shopping.  This time, I went to the supermarket that was a longer walk from the car park to the store and only used the cane.  I was pretty tired by the time that I got home and hadn't expected to go out again.  There was a tentative plan to go to my sister's house to see her wedding dress that had just arrived, though I had expected that it would move to Sunday as when we had spoken about it, that seemed to be the preferred option.  This isn't how it worked out and I was out again very shortly after getting home.

The peak hour traffic south was pretty bad and a trip that would normally take about 20 minutes ended up taking more than twice as long.  The trip was ok and I was fine with the stairs to her apartment.  I had one of my niece-to-be's help carry things up the stairs but I think that I would have done that anyway even if I wasn't still sporting my cane.  The dress is perfect and my sister looks like the perfect bride.  I'd love to post a pic since I'm sure you would all agree that she looks perfect but that would be just wrong.  It's starting to get exciting now.  I just hope that everyone behaves themselves.  Weddings don't always bring out the best in people.  I'm not really up for arguments yet and tell people they are out of line.  I will though, if it that's what needs to be done to keep them in line and behave themselves.

There is still about 8 weeks to go until the wedding by which point I need to be walking without a limp.  I'm pretty sure that it is an achievable goal to halve that.  I've been practicing my walking every day.

Practicing walking is different than actual walking.  Practising means concentrating on everything to get everything right.  Even when I'm concentrating really hard, it's not quite there yet.  I guess that once I get it right, I'll have to practice wedding walking.  I don't want to confuse my brain too much too soon.

I got home by about 8:30pm and was pretty wrecked by then.  I was overtired though and didn't go straight to bed.  It took a while to wind down before I finally passed out.  That led into a whole day of naps as I got back on top of it.

Your Questions Answered!

If you've ever had a question that you wanted to ask, now is the time to ask it.  If I can get enough questions sent to me either as replies to my posts or by email, twitter (lmcia) or any other social media, I might make this a regular event.  There aren't any stupid questions.  I'll try to answer everything I get sent.

How high is the chair you have to sit on at work and how long are you sitting at any one time?
They are height adjustable chairs, so I make sure that I have them adjusted so that my feet sit flat on the floor.  I'm most comfortable when my hip angle is just a little bit less than ninety degrees.  I think this is habit after many years sitting this way so my body feels most comfortable in that position.

I should be getting up and walking around each hour and that would probably be about right when I am in the office as I get a little uncomfortable sitting in one position.  This could be the chairs in the office or  me, I'm not sure.

When I'm at home, I sit with my feet up in a recliner chair with my laptop so I sometimes sit for longer than an hour working away.  I usually have to get up for something every hour or so anyway.  Sometimes it's to get more papers to get some work done, other times it's for a drink or something to snack on.  Sometimes it's just to move around.

Do you have trouble walking after you have been sitting for a long time?
I do limp a little bit more when I first stand up.  It usually takes me a few steps to start to loosen up a bit. It's the same in the mornings.  The elliptical helps get me moving in the mornings.  It's a little bit of change to pre-op.  Too much movement used to be what slowed me down.  It's a positive change.  One I'm not quite sure I've come to terms with yet.

As a woman how did you cope with not getting your hair done for the 6 or 7 weeks :D no serious, I'm a fella and my hair looks like a mad scientist, I can't wait to get a hair cut!
Just before I went into hospital, I had a hair cut, colour, got my eyebrows waxed and tinted and I did ok for a little while.  I had to get my tweezers brought into the hospital as the eyebrows started to bug me before anything else did.  The next thing that bothered me was my legs.  I really should have waxed those too as shaving was out due to hip restrictions.  It was totally gross.  I wore long pants a lot.  The compression socks also helped hide my legs!

When I did get home, I had my hair cut at home.  Even before the op, my hairdresser came to my friend's house and we'd all go there to get our hair cut and coloured.  When I came home, the venue changed to mine, so I didn't have to go anywhere.

When you go to the grocery shopping I assume you need your crutch to get into the shop, how do you deal with the crutch/trolley situation?
In the beginning, I took the walker with me so that I could sit down if I needed it.  I did need to sit down a few times when I first went.  When I was going with the walker, I needed someone with me as I wasn't driving yet.  Even if I had been, I wouldn't have been able to get the walker in and out of the car on my own.  I'm really not sure how the older ladies and men overcome that issue.  It's quite an awkward size and shape to lift in. It might just be that it doesn't fit into our car really well that I have so much of an issue with it.

Now I'm walking a bit better I take my crutch and put it in the trolley.  I noticed another lady doing the same thing when I was there last.  She was a little older than me but it seems to be the common solution to this problem.  Putting pressure on the trolley instead of the cane helps to stop me limping.  Shopping is becoming a little easier as time progresses.


Thanks to Tony for the questions for today!  I look forward to getting more sent through to me!

Shopping Marathon

I followed up hydro today with a pretty big shopping trip. I am looking for a birthday gift for an eight year old girl and having trouble finding something cool and appropriate.  I started in the city but the two stores that I wanted to go to weren't there anymore.  A lot has happened in the few months that I have been out of action.  This was my first trip into the city since the op and I was pretty confident going in that I could handle the crowds.  There were people everywhere and I was almost run over by various people swarming in all different directions without really looking what was right in front of them.  There was also a man in a wheelchair who seemed to target me in his sights at a fair distance.  I moved in front of a sign to get out of the way and he cleared it and me by about two centimetres.  I felt like I was moving against the traffic most of the time I was there and spent a fair bit of time standing still as to brace myself in case the person barrelling in my direction makes contact.  They seemed to move out of the way  at the last second after figuring out that the person that they were walking towards that was making their way quite slowly with crutches wasn't going to be the one to walk around.  I wasn't intentionally trying to get in other people's way and I tried to stick close to walls and railings as to avoid that situation but it didn't help.

I survived the city and having not found anything in the stores near where I was parked, I decided that I needed a break from walking and decided to head out.  By the time I got on the freeway, I figured that I still had enough energy to hit one section of Garden City.  I had about as much luck there and went home without anything.  It wasn't really a marathon by most people's standards but it was for me.  I am quite pleased by how my body handled that amount of walking.  My lower back is a little bit tight, as are my calf muscles but aside from that everything feels pretty good.  I don't think that I will continue to get lower back tightness once I'm no longer using crutches.

The day wasn't a complete write off.  I did get to go to MBF to finalise my claim for the anaesthesiologist, so at least something is checked of the to do list today.

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.

End of Financial Year Craziness

And so it starts.  It is my busy time of year and the craziness has begun.  The next two weeks will really be a test of how rehabilitated I really am.  The extra days of work that I picked up about two weeks ago were to start the setup of a new digital setup for cut over at the start of the new financial year. The work that I started a month or so ago has all of the end of year things to do like payment summaries and the like.  Between the two of them, I'm busier than I have been in a very long time.  I'm trying to keep work on just the three days a week so I have four days to make sure that everything else gets done.  I haven't done so well yet as little things are creeping into other days as I'm capping out at about five - six hours of work in a day and some days I really need a little bit more than that.  Mostly this is because of the amount of data entry that I need to get done at the moment to set up this new system.  I don't think that my brain was working properly when I estimated how long the task would actually take.  My brain is getting back into gear as I get back into things.  It's almost there (the setup and my brain!) and I will be going back in tomorrow to keep working on it.  Tomorrow is expected to be a big day so today was a work day reprieve so that I could get a few other things done.

Today's big activity was grocery shopping, which I managed on my own.  I also got all of the groceries into the house by myself, put them away and then organised dinner.  It wasn't a full shop as it is an in between week, so I've started off a little easier on myself.  The last time I went grocery shopping, I went with my husband and he brought everything in so even though it has been less, I still did it by myself.

I'm still at six minutes on the elliptical today.  I was supposed to go up to seven but by the time I had the groceries away and had cooked dinner, I hit the wall and the second session only went to two and a half.  It doesn't sound like much but it is for me at the moment.  My cardio fitness is pretty disgraceful at the moment and will take a little while to recoup.  I haven't been able to do any real cardio activity for quite some time so I'm not overly surprised at the level that I'm starting from.  On the plus side, even though the muscles are fatiguing quite quickly, they are holding up to a lot faster movement than I expected at this early stage.  I'm not quite sure how the speed equates to walking due to the differences in the stride length but for me I think that averaging between 3 - 5 km/hr is definitely a great start.  If I can maintain this speed and improve my stamina, I think I would increase the resistance and incline as part of the program before trying to speed it up anymore.

I'm not quite sure what my walking speed is like at the moment and can't really think of a great way to measure it.  I had thought about using a pedometer when I go out to get a rough idea but it didn't really work out.   I tried using it around the house to count steps but it looks like I still have too much sway as it is counting too many steps.  I had wanted to record the number of steps each day to see the increase in my activity but it looks like it will have to wait for a little while longer.

Arrival of our Elliptical

This morning our elliptical machine arrived and I have already added it into my rehab program.  I need to start off pretty slow and five minutes a day seems to be enough to begin with today since I was in at work as well.  I've started off at the bottom two levels of resistance without any incline.  To start with, the aim is to use it to increase the walking type of activity that I am doing each day.  Though exaggerated, the elliptical is a more natural walking movement pattern than how I am walking at the moment.  It also seems to help loosen the muscles up to help get through the longer days.  I'm hoping that this is not just a result of the movement but a reflection of how the effects of exercise like this will now affect my overall health and wellbeing.  Pre-op, something like this would have me in pain that lasted for much longer than the amount of time that I had spent on it.  The difference between the grating that my hip joints used to do compared with how fluidly they move now. I still can't help be amazed.  I hope that I don't forget this feeling.

I'm hoping that within a few weeks, I have built to a half hour walk and my gait pattern and strength have improved enough to be using my cane all of the time (well at least for a couple weeks after that and then maybe not at all).

Overdoing It

Last night I needed to use two crutches.  I felt like my right glute was a knot of muscles and it hurt more than I've felt pain in a very long time.  It really hurt when I put more than about 40% weight on it and when there was no weight on it, it just was a regular type of pain.  That's the strong side that I don't normally use a crutch to assist, so I ended up back with two for a while yesterday.

How did I get to this point?
Well, probably a little bit of stupid mixed in with a little bit of stubborn.  After so many years of 'managing', I really thought that I understood my body enough to have a handle on finding where the limits fall on a day to day basis.  I thought that I had learnt the lesson to listen to my body a long time ago.  I was pretty good at working out how many spoons I had each day and figuring out early if I've dropped any throughout the day (Check out the The Spoon Theory if you don't know what I'm talking about!).   With change happening every day, it is difficult for me to work it out with any accuracy at all and because I want to keep pushing forward, we have the ingredients for a 'stop work'.

Today has been a very slow day.  Muscles ache and I'm limping pretty badly.  I have done my stretches today and some of my exercises but now where near the level of activity that I have been doing over the last few weeks.  Slowing down is not really that great for my mood.  I'm going to have days like this where it feels like I'm going backwards when I am still moving forwards and just need a break.  The last few days have been the busiest that I have had since the op and I did ok.

The burst of activity started on Wednesday when I went back to the office for most of the day.  I ended up being in there for about five hours which normally wouldn't seem like a lot.  It's not that I didn't notice before how much activity this new office requires because I did. How far things actually are, how many steps I need to walk up and down, the distance to the bathroom, driving home in traffic and where the car was parked were all part of the considerations to go back.  I was ready and it was a full day.  I didn't really think about how sitting for that long would affect me and I was really tired by the time I was finished for the day.  By the time I got home I was totally exhausted but not sore.

I slept well and started early the next morning.  Life is getting back to normal and I had to do normal things like taking my car in for service.  I could have done with another few hours sleep to recover from the previous day and my muscles were still tired and a little tight from the previous day.  I felt pretty good though and we headed out after dropping the car off.  We ended up walking around a shopping centre and looking at elliptical machines.  The first place that we looked at was a no go.  The girl that was a manager couldn't seem to comprehend that I was looking at the elliptical for rehabilitation purposes not for burning calories.  I'm not quite sure whether there was a subtle underlying dig there or not as she kept going back to increasing the heart rate and a proper work out.  It seemed like she might have been in love with her own voice to, though that impression really could have come from my irritation at being told that I needed to burn some calories more than I need to build up my muscles and get my hips moving.  I'm still on crutches and I made it quite clear what my rehab requirements were and it didn't sink in.  It is possible that she was just a bimbo and meant nothing by it.

We went to another fitness store and tried out quite a few of them out.  The guy there was able to listen to our requirements and help out without being insulting.  He was actually pretty cool and helpful.  I probably spent 4 or 5 minutes on different machines which helped loosen everything up.  I wasn't using any resistance at all and that was enough to start out.  We made the decision to get one and it gets delivered on Monday. The rest of the day included finishing off some more of the work that I'd started the previous day, baking and some more chores around the house.  I was on my feel for most of the day and was really ready for sleep by the end of the day.

Friday started with a hydro session.  It went for about an hour and a half which is the longest that we have had so far.  I felt pretty good when I got out of the pool but by the time that I got home, I was pretty well wrecked.   Hydro can kind of sneak up on you like that.  It doesn't feel like you've done that much until later.  Sometimes it doesn't even hit until the next day.  I thought that I felt somewhat rejuvenated later in the afternoon so I figured that I would start on the to do list again and headed back to the shopping centre to go to medicare and MBF to sort out refunds for the surgery.  This involved a fair amount of walking and where at some point I hit the limit and ran out of spoons.

I'm not sure if it was a cumulative effect of the activity of a few days in a row or just that one day with the extended hydro session.  It could also have been one of those unexplained losses of energy linked in with something completely unrelated to the amount of physical activity that I have been doing.  My body may have just decided that it wants a break, just because.

Regardless of what the reason is for my enforced break, it's where I'm at today.  Using two crutches and going as slow as I was a few weeks ago.  I'm better than I was when I went to sleep last night but the muscles still aren't happy.  My husband was some what amused by my request to massage my ass to try and get the knot out.  Amused but he still assisted.  I would have just about asked almost anyone to massage my ass last night.  There is no dignity when it comes to pain.

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.

My Walking Stick

After my conversation with Reese at Hydro last week about moving to a cane / walking stick, I figured that I would get one of the cool ones that I spoke of way back in March when I saw a girl about the same age as me with one.  She had the one called Poppies.  I liked Bubbles (like the picture here) and called around the retailers to find one in stock.  The company that makes them is called Switch Sticks and you can buy from them but they don't have an e-commerce site, it's the old school print and fax the form.  Besides, I really wanted it today so I could take it to physio with me tomorrow.

In the search I found that there was a little gift store just up the road from where I am doing some work at Milton called Michaela's Gifts and Homewares.  (Couldn't find a website but the link goes to the True Local Listing).  It's a great little place that I will go back to the next time I'm looking for a little gift for someone that is a little bit different from the everyday.  There are a few other gift type stores that stock these canes around the places that I travel, though none had the Bubbles design that I could look at as I was pretty sure that was the one that I wanted.

I have had a go walking with it and it is a lot more difficult than using the crutch and will take some practice and strength.  I can feel that it is the next progression from a single crutch before walking unassisted.

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.

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.

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.

23 Days Post Op: 5 Days to go in Rehab

I am pretty wrecked this afternoon.  I did a big session at the gym this morning back onto my terms and with my goals.  There seemed to be a little bit of back tracking which might be because I was more forceful about what needed to be achieved today or maybe she realised the normal comment was out of line.  I'm not sure but the positive side of things was that it went better and I achieved what I needed to achieve.  The next time I will be in the gym is Tuesday afternoon as the morning will be my home visit with my OT.  Tomorrow is yet another public holiday and I will be doing my exercises on the ward and going for walks. I have friends coming in with real food and they can take me for a walk (like a puppy *smirk*).   

The big 'I did it moment' today was getting my feet into bed twice today.  I'm not quite sure I could manage it now as everything is ready to fall asleep but I got them in - twice.  Out is pretty easy now provided the rails are down.  I'm not quite sure why they want the rails up still when I go to bed as I'm not rolling anywhere yet.  I guess it might just be one of those safety requirements that they need to follow for certain patients.  It just means that I still need to buzz the nurses when I wake up between 3 and 5am for a bathroom break so I can get out bed.   

I am allowed to get a pass out of here now to go across the street for lunch or a coffee or whatever provided that I go in the wheelchair.  My husband suggested we do this for lunch today but I wasn't keen  as I think it is already going to be hard enough to come back on Tuesday after actually going to the house.  It's probably a little backward, but I figure that if I just stick to my routine here, the days go quickly and the five days left will be over before I know it.  As it stands it's not quite even five really as I should be kicked out in the morning.  That will probably depend a lot on whether we still go for patient transport or not.  That is going to be decided on Tuesday as the getting in and out of the car thing hasn't been attempted yet.  I don't care if I have to go home in an ambulance so long as I get there and get there this Friday coming.   

12 Days Post Op: Progressing Well

I am progressing reasonably rapidly at the moment.   I still require some assistance to survive the day, though the amount of effort required from the 'assistant' is reducing as I am starting to be able to use more of my own strength.  I am still a little way off being a superstar of the rehab process but I think I at least deserve a gold star for effort!

The main area where help is required is to get in and out of bed.  My legs are still too heavy to move around from a laying ore reclined position in bed around to the side of the bed without a little help.  It still astounds me as to how much weakness that there actually is.  I understand the concept that I was cut open, bone sawed off, extra pieces put in and all sewn back together again, however, I just can't seem to grasp how this makes all the muscles go to sleep.  I understand that muscles will waste if they aren't used but still it hasn't been that long since they were used properly.  I guess that I have underestimated the amount of activity that I actually did do in a regular day even if there were a few lazy ones back to back sometimes.

It really is a vicious circle that needs to be broken out of as quickly as possible as when you are weak, activity is difficult, slow and you do less of it.  The less you do, the less you can do.  As an example, Pre-surgery simple activities like going to the bathroom aren't a planned and executed event, you just go and think nothing of it.  Post-surgery they are. In addition, middle of the night trips become a major exercise so returning to sleep isn't particularly easy.

I don't think that I started down that path of doing less and less, which is extremely positive.  I was lucky that even though I was ill for the first week post-op, I had the encouragement and assistance that I required to get started on the path to recovery.  (Even when I was high on oxycontin the first time I had it ever and was freaking out and throwing up, I still tried something.)  Each day I get stronger and have both more ability and more endurance to complete the exercises and add new ones in.  I'm hoping that this continues for a while yet as I still have a number of old skills to remaster.

The big one is walking.  I am currently using a rollator/gutter frame that looks like this to walk.  I am using significantly less pressure through my arms and walking is slowly becoming more fluid.  It is more difficult to walk in the rehab gym on the bars, though this too is getting easier as time passes.  The bars are a prelude to crutches which I will need to be an expert on before I am allowed to go home.  My left side is still recovering from a bruised nerve and is weaker than my right side.  There may have also been a pre-existing weakness in this side that I wasn't aware of as it was the side that had the most joint damage.  Thankfully I was still able to have the BMHR on the left and it didn't have to be changed to a total hip.  Surgeon's skill or luck or likely a lot of the former and a little of the latter, I don't know, I am just grateful as it will make revision a little easier.  As I walk without pressure through the arms, I fall into the left side as the hip stabilisers aren't there yet.  I have added in other exercises to start to encourage these guys to fire and work a bit harder.  The residual numbness in the left side is almost gone, so hopefully we will soon see strength returning a little quicker than it has on this side so far.

Sleep is still difficult and is likely to continue to be for a little while yet.  I have started to get into a little bit of a routine in which I am able to get about 3 hours before waking to get up and move around for a bit and then back to sleep again a half hour later for another 3 hour stretch if I am lucky.  There is always further little sleep time depending on waking times, though this can be as little as an hour.  I manage a nap in the afternoons before the afternoon rehab session or in the early evening before my 10pm meds.

I am spending a higher than normal amount in bed and suffering muscle tightness in my mid and lower back.  The periodic muscle pain is pretty much all there is as the actual hips themselves are pretty much pain free.  There is still a lot of swelling left and ice is one of my best friends.  As I understand it, this is pretty normal and will continue to be this way right throughout the rehabilitation process.