Sleep In Saturday

I didn't really get out of bed this morning.  It was after twelve by the time I decided that I was too hungry to nap anymore and needed some breakfast.  I wasn't home too late last night and there was only one glass of red wine but I have been paying for it all day!  It has been a full week and there were a few nights there where I didn't sleep well, so it isn't too surprising that I needed to catch up on some snooze time.

Last night I went out with some of the people that I used to work with.  As I was getting ready to go out, I figured that I might give boots a go.  Last winter I couldn't wear them unless I had some help to do the zippers up.  The zipper runs down the inside of the leg right to the sole of the shoe near the arch.  Pre-op I couldn't reach that.  I managed to get tights on and my boots which I was pretty pleased by.  I did joke to my sister that I might need her to come around this morning if I couldn't get them off when I got home last night.  As I headed out, I really wasn't sure if would be able to get them off when I got home but I wasn't too concerned about that.  I've slept in my shoes before after a night out and overdone it.  Things can only get better from here on in so it was worth a try.

It was good to catch up.  Everyone has gone on to do different things and has new stories about the things they are doing.  It would be awesome if there was a project in the future that we could all work on again.  We had a really good team there.  It really is a shame that it all ended.  Sitting around talking about the good old days is surely a sign that I'm getting older.  This was a very quiet night for this crowd.  Likely another sign that we are getting old.  It was a good night.  We should do this more often.  Life just gets busy and moves on to different things.  I'm not quite sure what mine is moving on to.

Progress Update

This morning I got out of the pool using the steps.  This wasn't something that I could do pre-op so it's a pretty big step (literally and figuratively!).  I led with the left which is the side with the greater range.  I did need to pull up a little with my arms until my right foot was about 30 cm from the pool floor.  From that point on, there was more weight through the left leg to bring the right side up.  I went up step at a time with the same side so the next goal will be to alternate and then to start with the right leg up.

Next week I'm going to start pilates again.  I was cleared by my physio to do this a couple of weeks ago but I wasn't quite ready for the getting up and down off the floor.  The actual exercises I was and am looking forward to.   It means that I'll probably miss out on hydro for a week or two while I realign all my appointment times to fit everything in.  I'll still go to the pool on its new day - it will just be on my own until everything fits together properly.

Cooking Dinner

About six weeks pre-op, I increased the amount of vegetables that I was eating in an effort to make sure that I was getting all of the vitamins and minerals that my body would need going into surgery.  I got bloods taken about a month before to confirm that everything was looking good.  Even though this wasn't a big concern to anyone but me, making sure that my body was as healthy as it could be just made sense.  I've always been a big fan of fresh food and I made the time to make sure that I was eating well every day.

I didn't eat this well while I was in hospital as they don't really cook with a large selection of anything fresh.  It was something that I really looked forward to coming home for.  Since I've been home, I'm getting back to my pre-op eating habits.  My favourite at the moment is a lot of stir fried vegetables with bean thread noodles.

One of the things that I missed out on yesterday was the stir fry that I had planned for dinner.  Since last week's market run wasn't very successful, I was craving a good fresh mix of vegetables and when I missed them on Friday night, they moved to Saturday.  That's actually a lot of days for me not to have a fix.   Now that it is winter, the selection is less and the quality isn't as good.  This week's shopping expedition was actually quite successful and I managed to get a good selection.



The interesting thing that I found when I was out shopping were purple carrots. I thought that I would give them a go as apparently they are the new super food.  I'm not sure where I heard that and even if it isn't completely true, I'm a big fan of using as many colours of vegetables as I can when I'm making stir fry.  They feature front and centre in the veges that I pulled out to cook dinner with tonight.   I was a little surprised when I cut them to see the white rings.  I'm not quite sure what I expected.  They taste like orange carrots.  More like baby carrots than the larger ones.  They are a quite sweet.

I used the cutter that I normally do when I add carrot to stir fry.  It kinds of cuts them like little noodles.  I added some regular carrot in as well just to see how different that they tasted after they had been cooked.  I used chilli, garlic, ginger, soy and oyster sauce as I often do at the moment.  I'm a huge fan of bean vermicelli as well which I added in.  The weird thing is that the carrots released more liquid than orange carrots do and it turned the sauce a bit purple.  My noodles also ended up a bit purple too.  

The whole thing was just a little bit too sweet.  I'm not sure if I overcooked them, used too much or just needed more chilli and soy to balance the flavour.  I have leftovers for tomorrow that I might try to fix as I don't think that I want it again as it is.   It will be interesting to see how the flavours come through overnight.  It might be even sweeter tomorrow.  I hope not!  If it doesn't work out this time, I have two more still in the fridge so I can try again from scratch later in the week.

[Edit:  I recooked with extra chilli and garlic and it took away enough of the sweetness.  Noodles and mushrooms were very purple today]

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.

Unified Healthcare

The RA Guy

I read an awesome blog post on the RA Guy's blog called: Rheumatoid Arthritis Healing Center.    It's an old post definitely worth revisiting.  The key idea I love about in this post is that all your health professionals are in one place and work together to help you have the best possible life all in a spa like setting combining the traditional medical appointment with your rheumatologist  with everything else that can make a difference; yoga, acupuncture, Physio, hydro, support groups, psychologists, doctors in other specialties and more.  The list was pretty comprehensive and the only thing I can think of to add is Pilates as it's something that has made a big difference for me.

I think that bringing all of the health professionals together like this would be awesome.  The people that would choose to work in this kind of environment would be ones that I would want to see.  People who understand that it isn't going to be just the medicine that is going to help.  Healthcare is slowly changing and the professionals that I have found to work with have been great.  For a long time and for a lot of doctors that I have seen anything out of the ordinary is seen as 'new fangled hippy rubbish' that doesn't do anything.  I once had a rheumatologist remark that the physio treatment I was receiving probably wasn't doing anything for me.  I was pretty upset by that as I when I came to him I was so happy with the increases to the range of movement that I was seeing and the improvement in my overall health and wellbeing, I couldn't believe that he would discount the effectiveness of the treatment.  Seriously, even if it was all in my head, what was the harm?  Why criticise? He went on to tell me that I couldn't afford to put on any weight and I pretty well had no options to improve my quality of life.  I found another specialist.  Thankfully, not all doctors are in the stone age. The team that I eventually found is one that I would expect to fit in to this concept quite well.

Attitudes are changing and it isn't just health professionals that need to come to the party.  We do too.  Having a community centre like feel will help visitors to maybe explore other services that will help them reach their full potential.  All aspects of life and body maintenance in one place is an awesome way to kick start the process.  The alternative is to spend years finding them which is something many don't have the confidence or resources to do.

The RA Guy has since updated his concept and posted it on his blog at: Autoimmune Wellness Center.  There is even a picture of what it might look like.  Check it out.  I'm sure you'll like it as much as I do.

Do you think that I could jog 5K?

Not now - that would be a pretty daft idea.  I can't even walk properly yet and my femurs aren't up to the impact of running.  It's off the list for at least a year.  Some argue that femurs are finished healing six months but I don't think it is worth the risk.

So maybe, September next year?
Bridge to Brisbane
I've never done anything like that before.  I'm not even sure I like running.  There is a possibility I could though.  I don't think I'll get into marathon running or anything like that.  Every now and then I hear of some activity that one of my friends is going to do and I think, maybe I could do that.

This is a very new experience for me.  I'm not quite sure what to make of it.

Bilateral Hip Replacement Recovery Time and Answers to this Week's Search Terms

So you came here looking to find out just how long it takes?

The answer is:   well it all depends...  not really what you were looking for?  Probably not!
 I'm not completely there yet but I am back at work part time and a lot of my day to day activities are at a similar level to what they were pre-op.  The limiting factor now is fatigue rather than pain and as time progresses the fatigue is reducing.

The big thing that I have learnt through this process is that everyone is different.  People heal at different rates dependent on so many different factors.  I've read so many stories of single hip recoveries and the variances in those are incredible.  Some people are off and walking without a cane in a week, while others are in excess of eight weeks.  Bilateral just makes the variables in the process increase as there are two hips to consider.  I've heard stories of bilateral resurfacing that are better than ever within a month.  I think that a lot of it depends on how fit / strong / healthy you are pre-op as to how quickly you bounce back.

Not everyone is offered the opportunity to get both hips done at once.  This option is at the surgeon's discretion and will be based on how he/she determines you well you do.  Some surgeon's don't do them.  Their reasons for not doing both?  I don't know.  I could guess, though that's all it would be, a guess.  It is a longer surgery and would have more risk associated with it.   Some might weigh this against the risk of going under twice.

As you would have read in some of my earlier posts, I really do believe that the more you can do to 'train' for the procedure, the better your post-op results will be and how rehabilitation will go.  I've referred to it as prehab and pre-op preparation and for me this included diet, physio, exercise and mental preparedness.

Things didn't go exactly to plan for me but things could have been a whole lot worse if I hadn't made changes in my life to prepare for this surgery.

Another term that I've seen pop up in the search terms today is "hip replacement game".  I'm not exactly sure what that is and wouldn't think that it would be a very fun game to play.

"physiofirst", well yes I did but I'm not sure whether that was the point of the search.  If you are looking for Physios who can help you pre-op and post-op to get the best possible outcomes, I'd suggest the team at Body Leadership.  The bias I have for them has been earned through years of helping have the best life I can possibly have.  I'll keep plugging them because I believe in them and the difference that they can make in your life as well as mine.

This leads into "planning bilateral hip replacement".  The most important things that you can do is find a great physio who can help you create a pre-op program to help you get the best outcomes possible.   A healthy diet should also be a part of your pre-op planning to make sure that all your vitamins and minerals are in healthy ranges.

Getting all of the 'housekeeping' type things out of the way before you go into hospital is usually a good idea.  You aren't going to feel like sorting out your taxes when you get home.  I also got all of my insurances in order and made sure everything was up to date.  This was more me being having an irrational desire to have everything in its place.  I think it was something to focus on instead of what was going to happen.

I'm still getting queries about the four corners piece on MOM implants.  I have commented on this before but recently I have expanded on the earlier thoughts and posted the following on a website after someone referred to this 'terrifying documentary on BHRs' lumping in the Birmingham device with others that are not in that league.

I have MOM devices, specifically the BMHR. I discussed the MOM issues with my surgeon and did a lot of research before finalising this as an option for me. The program focused on the ASR recall, and this should not be used as a basis for all MOM implants as there are many that have been highly successful.

I would suggest reading Mr McMinn's response to the ABC Four Corners program at: http://www.mcminncentre.co.uk/response-abc-corners-program.html as well as the other information on his site that shows his successes with a well placed, well designed MOM implant. There are many reasons to consider this as an alternative to THR if you are a suitable candidate, for example these devices are far more bone conserving and will make later revision easier for younger patients who are likely to require revision as some point down the track. As an example, I am 34 and even if I do get 20 - 30 years out of my BMHR's, I'm still looking at revision at 54 - 64.

Even for THRs, MOM implants allow less restriction to patients activities post operatively which is a huge benefit to active people.

Rumour has it that McMinn has started working with ceramic BMHR's for patients with metal allergies. If you are in the UK, I would seriously consider checking this out as even though they are new, McMinn's stats on his other devices are exceptional, including those that were done many years ago when they were new.

Cup placement is a huge factor in the success of MOM implants and research shows that those with a steep angle have a higher instance of edge loading and wear. It is imperative to seek out a highly skilled surgeon in this process. The site http://surfacehippy.info has a list of surgeons with 500+ surgeries with excellent statistics to consider talking to if you want more information on this procedure. There aren't too many listed for Australia. If you are in Brisbane, I can highly recommend Dr Simon Journeaux at Mater. He practices both publicly and privately. I went private so I'm not sure of what the wait times are like to see him publicly.

I really want a bath!

I'm just not sure that it would be the best idea.  I don't have anyone here to help fish me out if I get stuck at the moment.  I'm not even sure if I could sit in it at the moment.  It's a bit shorter than I'd like - so it's probably not worth the hassle even if I could get out.

I saw one of these walk-in bath tubs in the TV guide when I was in the hospital and am dreaming about it right now. Amazon has them and they aren't cheap:  American Standard 2848.100.WRW 28-Inch by 48-Inch Walk-In Bath Whirlpool System, Right Side Drain, White


I think I could find a pretty awesome jacuzzi for that.  It's not really in the budget but I can dream!



I'm going to the pool tomorrow so that will have to do.  It's not the same though.

[Edit] I realised about 3 hours after I posted this that it was actually the 100th post of this blog.  The 100th post really should have been reserved for something insightful, thought provoking and just awesome.  Oh well...  Maybe for the 1000th post?  Maybe I can get one in a little earlier and make 250 the next big milestone!

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!

Things I can and can't do

Things that I can do, that are getting easier but are still difficult:

• Reaching down to pick up anything off the floor.  It all depends on the height of the item.  Paper is still out.  So is the lid for the butter that always seems to land face down.  It seems like I drop a lot more things than I used to or is it just that I notice it more?
• Lifting my legs in and out of the car.  Still feels like it should belong to part of a workout.
• Holding my legs in the air....  Why would anyone need to do this?  The only reason that I can think of is because it is on a list of exercises to do.  I can't really think of how this might fit into day to day life on a G rated blog!
• Getting socks on.  Requires the use of the reacher still.  Once the toes are in though, it is heaps easier to get them over my heels.
• Getting up of a low seat.  I am still using the toilet seat raiser in the toilet at home, not because I have to, more because it's still a pain to get up and down, especially at night when I'm half asleep.  Given that I am out a fair bit now and using regular height toilets quite frequently, I'm not in a huge hurry to get rid of it completely.
• Getting to the pool from the car park...  this still feels like a really big walk.  I've been using two crutches but tomorrow, I think I'm going to have a crack at using the cane.  I'll keep the crutches in the car, where they have been for the last couple of weeks, just in case I need them.  
• Getting onto the elliptical.  That step up still seems huge. The step to get into the ladies toilets at work is still a bigger effort...  a much bigger but required effort!
• Putting on pants.  For the benefit of others this is something that I practice every day!
• Working all day.  I'm getting closer to doing that but I'm still capping out at about 6 hours before I'm totally wrecked.  
• Carrying things.  I still ask for my coffee to be in a takeaway cup when I'm at work as I couldn't carry a cup on a saucer up the stairs to the office.  I am limited to using one hand when I walking outside of the house as I rely on a crutch or cane.  At home, I will walk short distances without and can use both hands to carry light items.

Things that I can't do yet that I'm looking forward to:

• Use the step ladder at the pool.  I couldn't do that pre-op so it's a good range tester
• Wear shoes with laces and tie them myself.  Again, no go pre-op.
• Walking long distances without pain and mobility aids.  By long distance, I mean an entire morning or afternoon shopping without a cane or crutch.  
• Walking without a limp and without a mobility aid

I can't think of too much else to add to the list at the moment.  If anyone has any ideas of day to day activities that I really should comment on, please let me know!