Monday's Hydro

Had a good time at the pool today.  I feel good after the session and I hope to be the same way tomorrow.  We cut out a few of the abductor exercises which I think has made a big difference to how I feel after the session.  I think that might be where I was overdoing it.  With that minor change, I should be able to take a few more steps forward strength wise.  I have three more sessions in the pool (instructed by one of my physios) and maybe another three on my own.  It's amazing to think that in as little as three months time, there is a strong possibility that the abductor exercises that are giving me so much grief now might well be easy.  Ok so, maybe it won't be 'easy' that soon, though they are going to be significantly easier due to a  normal or even near normal range of movement.

Shopping and planning for the week I am admitted....

I spent some time on the weekend looking for the extra bits and pieces that I might need to take into the hospital with me.  Where I'm not sure, I have erred on the side of caution and purchased a couple of options :)  I might have mentioned that my pre-op appointment is on the Monday of the week that I am admitted (I go in on the Friday), so I won't be left with a lot of time to do that much in the last week.  The main question I have is when will I get to wear 'normal' clothes again after surgery?  From some of reading that I have found that the answer varies so, I guess it does vary from person to person based on the incision type and how long drainage tubes are in and generally how fast I heal.  I have selected loosely fitting pants and shirts (not unlike what I wear to pilates now) and dresses that aren't too 'hospital' or 'old lady' looking.   I've elected for soft fabrics that feel good and still breathe.  I've also found myself a pair of flat slip on type shoes with good soles and reasonable foot support so that when I can't bend, I can still have some sense of independence should I want it :)

So far for the last week, I have two physio sessions planned, maybe one pilates and one hydro session as well.  I will be finishing up my medication on the weekend before so the last two will depend on my overall wellbeing given that I haven't been off the anti-inflammatories for that long for quite some time.  I am currently taking Voltaren (aka Diclofenac Sodium) 50mg twice daily and will need to stop that in the week before.  I will be allowed to take Panadol Osteo and Panadeine Extra which hasn't been as effective when trialled in the past.  It's only a week, and I will be fine, though I want to be careful not to set anything off in that week before going in.  I have been working closely with my physios and know that they will make sure that I am in the best physical condition that I am physically capable of being in, so it's left to me to follow their expert advice in that field and focus on other aspects, like eating well and maintaining a positive attitude.

In between the physio and exercise, I have the non-critical tasks like getting my hair cut and coloured and getting my eyebrows waxed and any last minute shopping things that need to be done :)  I figure that if I'm not feeling 100% when I first wake up from the surgery, I probably won't want to look in the mirror and see regrowth :)  Though this may seem to be the least of my problems, I think that everything that I can do to go in feeling positive and good about myself, will help on the other end, even if it is as cosmetic as getting my hair done.

Discussion Board worth looking at

I have come across a website with a discussion board that is definitely worthwhile having a look at:  http://www.surfacehippy.info/

Took me ages to find this out there and am glad that I did as there are a lot of other personal stories there and the owner of the board comments often.   Everyone has different experiences and there doesn't seem to be too many bilaterals (at my age), though the general information has been interesting and helpful to the process of getting ready mentally.  Not everything is stellar and completely positive, though I do believe it is a reasonably fair representation of a good cross section of people across continents, with different histories, different procedures and different 'spare parts'.

In the beginning when I was searching for information, I wasn't overly successful.  Now I'm searching for the obscure: like bmhr images, I end up with more reading material at: http://www.hipresurfacingsite.com/Other-Patients/Other-Patients/menu-id-41.html
This one doesn't seem to be as interactive as the other site, though still useful information.

Wonder why I was looking for bmhr images?  I saw a shirt on the surface hippy link that had a stylised image of the prosthesis (resurfacing not mid-head) which was kinda cute in a geeky kind of way.  So I thought maybe my own tee or maybe an iphone case with little bmhr's on the back would be cool :)

Getting my life in order

Much of the last week was spent on tasks not directly related to the surgery.  Once I had made the decision to proceed, there were a lot of housekeeping items that I have decided needed to be taken care of before the 'big day'.  This will be the start of a new phase of my life and the 'old' needs to be finished and left behind as well.  This is the really boring stuff, like going to the accountant and getting the taxes up to date, checking into all our insurances to make sure we have the best options for us at this point in our lives, unpacking a few more boxes that have been sitting in our new house since we moved in twelve months ago and other such 'fun' tasks I am sure most people are familiar with.  It is highly unlikely that I will be inspired to work on these tasks whilst focusing on recovery since I have done so well in putting them off over the last few years, so maybe it's about time that I get my whole life in order and start fresh, not weighted down by the 'old stuff'.

In the decision making process, there were a lot of things to consider about what I want from my future and I think that in part, the things that held off moving towards making these things happen is the 'old stuff' that hangs around and becomes an excuse to stay in the same place (metaphorically).  I'm not quite sure of there was a single catalyst was to start down this path or if it was a number of reasons that I have collected over the last few years that I am sure that when I figure it out, it will be a good story to tell.  At that point though I hope to have all of the boxes unpacked and well on the way down the bright and shiny path.

Rehab Equipment

I went out to look at rehab equipment to see what I might need for when I come home from the hospital.  I will find out a lot more about this when I have my pre-op appointment on the Monday of surgery week, though I'd like to be a little more prepared, so I thought that I would see how knowledgeable the sales staff were in a rehab equipment store coupled with the information that I've found online.  The first place I found when I looked online was only about twenty minutes away in Algester, so I decided to head out and see what I could find.  I was helped out by a really helpful guy called Darren who was able to answer all of the questions that I had about all of the different things that I need to consider.

Some things to help me out will be arranged by the hospital.  As far as I can gather this will be the walker thing (like one of these or maybe just a frame like this - whatever they decide).  The extra bits and pieces to make the house a bit more friendly for me.  One of the important things will relate to making sure that in the early days (until I am cleared by the rehab physio or doctor), that my knee doesn't end up higher than the level of my hip.  Until the musculature strengthens around the joint and recovers from the damage caused by the surgery there is a risk of dislocation if I do.  Apparently this isn't as a significant risk with anterior incision but from what I can gather, this doesn't apply to me.  So, I have been looking at day chairs with adjustable legs (because my tv chair is way too low and I'd never get out of it), a seat raiser for the toilet, bars for stability and a chair for the shower.  I looked at a reacher and I'm not convinced I'll need one of those.  I haven't been easily able to pick things up for years and wonder if I could get away from not picking up anything off the floor for 6 - 8 weeks if I have help at home.  I don't particularly want to become reliant on aids, so it is a bit of a balancing act with those as well.  Obviously I need to take care with some things - like where I sit, chair in the shower etc, I do wonder just how many more of these things that I will need.

Hydro

I started the day off at hydrotherapy with one of my physios.  This is only one part of the whole 'plan' to be in the best possible condition for surgery. (There is also another physio appointment, two pilates sessions and other bits and pieces that I will cover in other posts as it requires more detail and will get me off onto another track all together).

I started this last week in addition to my other activities and exercises that are starting to add up.  In the water I can do more than on land, so hopefully there will be some additional strength or length gained.  It might not be a great deal as I am adding it in so late but every little bit helps and it isn't going to hurt me to be doing that little bit extra.  The main focus in the pool are the muscles around the hip, legs and core.  There is some arm work, though that is secondary and the focus of other parts of my preparation (Some of the exercises I have from physio as well as in pilates).

I was in the pool for about half an hour today which seems to be enough at the moment with everything else.  Last week, I went by myself on Thursday and overdid it a bit and ended up sore for a few days.  It's a fine line between doing as much as possible to benefit me and pushing to the point where I couldn't do anything for the next few days.  I'm willing to push the boundaries at the moment, though in the coming weeks I'll have to be more careful so that I can get as much done as possible.  I think that it might be something that I need to keep an eye on after the surgery as well.  I haven't really read too many experiences online as to whether it is possible to push to hard afterwards and end up delaying the recovery process.  It stands to reason.  I guess I will find out more about that when I actually meet the rehab team.  

Spare Parts

When you need a spare part for an electrical or mechanical appliance there is generally a model number or some type of manufacturers description that requires some form of measurement to make sure that the right one is selected.  

Given that human beings are all different sizes, how do they work out what size 'parts' to order before the op?

Questions that I don't have the answers for yet.

This post will be updated as I find out the answers to these questions and as I think of more questions to ask.  There are a number of them that I will be able to ask when I have my pre-op appointment on 4 April.  I could make an appointment sooner - though these things will not change my decision and can wait until then. (There is a good chance that I have been given this information in earlier appointments but with the amount of information that I have received and researched, it could very well be that I have confused myself and can't remember which applies to me!!)

Where will the incision be? I hadn't thought about this until I was reading this page that I found from a google search.  I hadn't considered the various cutting locations and had assumed that it would be on the side.  I think I saw the start of a surgery video on a site recommended by the surgeon for information and assumed that is how he will cut...  (I say beginning as I couldn't watch it all - squeamish!)  What I do remember about the cut is that it isn't a micro-incision and the reasons why this isn't used by my surgeon...  just not where the cut will be. [edit:  I do know now :)  it will be down the side]

The Birmingham Mid Head Resection (BMHR)

The goal is to have a left and right Birmingham Mid Head Resection (BMHR) completed on the 8th April.

After the right hip is completed, the surgeon and anaesthetist will chat and make sure that all is good to proceed with the left.  The right is where I experience most of the pain and it will be a great relief to be without this, though I will be very disappointed if I wake up with just one done.  Obviously the doctors will make the decision based on what is best for me and I would rather wake up disappointed than take unnecessary risk.

Depending on the bone quality and the degree that the protrusio affects the procedure, the surgeon may elect to complete a total hip replacement instead.  This again is not ideal as the BMHR is preferred for younger more active patients. The surgeon has suggested that I take a look at the McMinn Centre website for more information and I have found the site a wealth of information.  An update in recent months includes a lot more video testimonials which are interesting to watch.  I would like some more from some less active people (ie. not highly sporting).

Preparing for Surgery

I booked the surgery in a couple of weeks ago after having a lot of long conversations with my husband.   There was a lot to consider for us when looking at our plans for the next three - five years.  The decision process is for another post.

Once the decision was made and the surgery was booked in, there was a lot more research for me to actually find out more about what I could expect and to see what I could do to improve my overall health and strength to hopefully reduce the length and difficulty of rehabilitation.  I know that rehab isn't going to be easy especially getting both hips done at the same time so I figure that anything that I can do to improve my chances has to be worth the effort.

What this has meant as spending time talking and planning with the health professionals that I already work with on a regular basis and finding new people to answer the questions that I still have.  This has meant more physio, an extra session of pilates, blood work at the GP to see where all the vitamins and minerals are at, a nutritionist to look at my eating habits and generally clean up my act.  

I have to mention that I am currently only working part time.  This was all part of the planning process for the next few years for me.  I finished up with a full time job, one that engulfed my life for a decade, in September of last year.  The company went into liquidation and another short term contract took me up until Christmas.  My options at this point were to find another full-time job straight away or use the opportunity to get my hips fixed.  There were a lot more considerations to the decision than that, though this is the bit that is relevant now.  I don't think that I could devote the time that I am at the moment 'looking after myself' if I was working in a full time capacity.  My ability to maintain work-life balance has been questionable at times, though a large wake up in September of last year has really prompted a lot of thinking time about what I want out of life and when.  That said, the point of me mentioning the part time is the schedule I am keeping at the moment, making sure that I am preparing and eating fresh food and spending time each morning either at physio, pilates (two days), hydrotherapy (all three with instructors) and the final week day back in the pool or doing the other exercises that I have on my list from one of my physios.  This morning it was pool time doing as many of the exercises that I could remember from my Monday's hydro session.  

Some super humans manage to do these things while working full time.  I'm not quite sure how they achieve that.  Maybe their definition of full time is less hours, maybe they are just more motivated.  I'm not sure.  I just mention it in case you think I am one of those super humans.  I can assure you that I am not.  A number of the testimonials that I have seen online for hip replacement surgery seem to be either super humans or super sporting people.  It makes it a little difficult for me to relate to as I don't fit into either category.  I get tired easily, take a long time to recover from over exertion, I don't look after myself as well as I could.  Making sure I eat breakfast every day was probably one of the more difficult hurdles to overcome after many years of taking the extra half hour sleep instead.  

The count down to surgery is 36 days.