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.

Trigger Pointing Day

Just a quick note about my knotted glutes (ok I'm being a little more eloquent the other day) and the  adductors that were also *really* bad.    Trigger pointing at physio today hurt like hell but it was worth every single little moment where I wished that I had a leather strap to bite down on.  I felt l the most amazing kind of awesome walking out of there and the nice feeling has stayed with me throughout the day.  

I don't think that my husband could have handled inflicting that much pain to release those pesky muscles.  Only a true professional can do that!  (I know comments like that seem like an open invitation for comment but I'm tired, so please read only read it in the manner to which I mostly intended!)

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).

Pain Relief

I put up with the pain for over a day before I realised that I could take some pain relief.  I took an ibruprofen before bed and it seemed to help enough that I got to sleep and slept well.  I don't know why I didn't consider pain relief as an option.  The pain that I had wasn't one that I was used to or can ever recall having.  It wasn't that sharp pain that I was used to but it was still able to stop me from doing things - like full weight bearing.  It wasn't as bad as the old pain, even though it did hurt a fair bit, I'd describe it more as irritating and limiting than bad pain.   It was irritating enough that I wasn't able to get comfortable enough to sleep on Friday night and I woke on Saturday morning feeling pretty rough.  As the day progressed, things were a little better but by the end of the day I was pretty much back where I started.  

As I contemplated doing this all over again today, I was a little upset that I had taken what seemed like two big jumps backwards when I had been doing so well.  Now that it's been so long, I don't get much feedback to help me determine the improvements that I don't see for myself either, so the little that I do see seemed to be stripped away which is ridiculous since it was solved with nothing more than a single ibruprofen.  I'm someone that has dealt with far more pain than this for a very long time and yet this little episode threw me for quite a while.  It was just a bit of a reminder of what was and how uncertain the future is.  It's representative of change that I don't quite understand and don't quite know how to deal with yet.  I'll get there in my own time and until I get there people are just going to have to wait.

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.

What the BMHR's look like / Where they are now

I have digital copies of xrays that were taken on the day of my surgical review.  I can open them in a piece of free software called OsiriX and export them into a format that I can open in photoshop to remove the pieces that I don't particularly want to show everyone.  I've also rotated the image so that the left is on the left (which probably doesn't make sense - but hey I'm new to this and am having fun playing!).  When I have a bit more time I'll have another go at getting some clearer copies up that haven't been cropped so tightly (that was to hide the outline of my body, which I'm sure can be removed with a little bit more work.  This process also had the side effect of darkening the detail of the femurs, so I need to go about the process a little bit differently).  In the meantime, I thought I'd upload something so you can see my new parts in place!

Back to work planning

Today I went into my old office to plan going back.  This is a little bit more complicated than just going back to work since I don't really have a full time job to go back to.  This was one of the reasons that we decided to have the operation now.  There may be some opportunities to increase my work load but it really will be a case of wait and see.  To start off with I am increasing my one day to three days a week and starting a new project.  In a lot of ways it's good because I can go back sooner than I would had I been trying to go back to a full time position.  I'm not sure I have the energy yet for a full time job as well as the rehabilitation exercises that I still need to do.  The positive side of this arrangement is that I have all week to get everything done.  About 25% of it needs to be done by Wednesday and ideally I would have it all finished by then but I do have some room to juggle things around a bit.  The juggling room will let me make sure that I get all of my exercises done.  I know that I have more activity on the days that I go out but this doesn't cover all of the muscles that really need to be worked each day.  I've heard stories of people that don't continue with the rehab and are limited because of it.

I'm at 10 weeks post op tomorrow.  Statistically 80% of the improvements happen within the first 12 weeks, so I really need to make sure that I follow the program and stretch it out.  I guess it is all averages out though and there are a lot of people's stories that I have read who are up an walking a few miles within a month.  Surely that has to sway things the other way a bit and I'm just on the other side right?  The ones that still see steady improvement over a longer period of time in the beginning.

I'm not sure if it is my imagination or whether there are some real changes in the last few days.  I'll ask Reese when I see him at hydro in the morning.  Today I felt good so I know that I can push a little bit more in the session tomorrow.  The knot in my shoulder has almost worked it's way out and my burn doesn't hurt anymore so it's been a good day.

Back to Hydro

Now that I am back driving, I've started hydrotherapy again.
The weather is cold but the pool is inside and the water is heated.

The session was awesome.  The feeling of walking in the water is amazing.  The movement is fluid, there is no joint pain and it really does give me an idea of what things will be like on land very soon.  I'm due to go back again on Friday.  I'm going to have a break from the pool tomorrow and head into my office and organise when I'm going back to work a few more hours each week.  I'm hoping to soon be strong enough to go to the pool each morning for an hour and then head into the office for a few hours each day.  

I think that the pool exercise will help get to the next level of strength and ability pretty quickly.   We started off pretty slow with marching laps forward, backwards, sideways.  There was also bicycle like exercises and heaps of stretching.  I also got to jump which was pretty cool.  I was in the water for an hour today and felt really good when I got out.  I'm not sure if the muscles will be a bit tired still tomorrow but they are doing pretty well at the moment.

I have managed to get a knot in my shoulder which I am trying to work out using a trigger point ball.  That's pretty much the only thing that hurts and I have absolutely no idea how I've done it.  Between that knot and a burn on my finger (stupid cooking accident) it really does look like things are getting back to normal!