Monday 28 May 2012

WEEK 3

So looking back through my blog so far I can see how far I have come in the last three weeks!  Reviewing last week, I have been continuing with my exercises doing them three times a day and finding them very easy to do, so adding to the repetitions required.

I would not recommend this to anyone, but with the weather being so hot, up to 26 degrees for a few days last week, I just could not bear the support socks and have stopped wearing them.  I am checking my calves every day and I am taking the anti blood clot medication and prescribed.  I did some internet research and read a paper on research into the benefits of knee high support to THR patients and it seemed to me that it was not conclusive that it prevented a clot forming if it was going to happen.  This is my decision I stress!  I will however wear them during a two hour car journey to Somerset which we will be going on later in the week, as I think this is the time when problems could occur.  We also intend to have a few stops on the way so I can walk around.  My brother stopped wearing his socks 2 weeks ago and I really told him off, and now I am guilty too.

I have enjoyed taking my R and R on my new recliner which is perfect for the job required!  It is years since I have sunbathed and it is a lovely feeling, and I do like my brown legs!  I have a shower late afternoon and although the first shower ever seemed such a traumatic experience with the crutch going into the shower with me and me worrying about slipping etc, it is now so straightforward and obviously refreshing after an afternoon in the garden.

We have been gardening - by which I mean that Nick has wielded the gardening tools and I have pointed at what is a weed and what needs to be moved, and with my grabber been able to pick up the cuttings and tidy them into the wheelie bin, so I have done my bit!  I am not sure how soon I will be able to garden myself, and along with the need to get down on one's knees, there is the issue of getting back up again afterwards, which was pretty difficult before the operation, and now the 90 degree rule must be observed it does require some thinking about.

Along with that thought came the one that I would actually like to lie on my tummy on a rug.  How does that happen?  So, as usual, I googled getting up from lying down after THR and found discussion threads about this which were a bit helpful but not medical in the advice.  It seems that kneeling comes into it, and having a chair handy to assist in getting back up.  I spoke to my brother this morning and he had actually not done this movement, but thought that strong arms and strength in the non operated leg would be needed.  He suggested rolling over while lying on the recliner (which must be done with cushion or pillow between legs).   He has been sleeping on his non-operated side (which I thought was totally banned) by putting a firm pillow between his knees and rolling on to his side.  I was in bed when we were chatting at 7am , so I decided to try this out for myself and continue over to lie on my front - And I Did It!  What a simple movement that was - no 90 degree infringement obviously, and no crossing leg over either! So that is the first part.  It may be good to try and get to standing while on the bed with Nick standing by to catch me, before I do it outside!  (This is all about wanting a tanned back as well as the front - but my previous posts already would have given an indicaton of my vanities, so I make no apologies!)

We had an early Sunday morning visit to our local car boot sale - we planned our breakfast to be sausage and egg baps from the catering van, washed down with a steaming mug of coffee - which all went as planned.  We were there about 8.30 and chatted to a chap who wheels and deals and sells on eBay,who had arrived at 5am!  Obviously if you are a professional that is what you do!  We bought plants and I bought some beautiful antique linen with crochet trim for my chests of drawers.  Amazingly cheap, so I will return for more.  Also will go back another time and stock up the freezer with whole fillet steak (£15) lamb shanks (6 for a fiver) etc, will take cool box and be prepared.  Managed on one crutch and we were there for two hours.

Have also now started this week walking to shop for papers with Nick each morning before breakfast.  This is about a 15 minute round trip, so I take one crutch and then this morning did it with walking stick for first time which was fine.  Have found myself getting a little breathless keeping up with Nick's pace, which is an indication of my lack of any physical activity for a couple of years now.  So I am determined to improve on this so that in a couple of months we can go for some really long walks together again - we might even get another dog!

I can go up and down stairs now without a crutch, normally,bliss!  It's being able to do something like this, such a simple action, but one which I have not been able to do for 2 years that really brings home how gradually restrictive osteo arthritis is, and the benefits of the new hip!!!!

When I write my next blog we will have been away for a long weekend in the country, hopefully been for a few gentle walks, we may go to Lyme Regis (!) that is an on going amusement for us, in which case maybe my brother might be able to meet me from where he lives in Poole.  At  four weeks I am also going to have a little go at driving.  So watch this space!

DAY 15

Two weeks today since my operation!  I really do feel fantastic!  I am comfortable doing everything I need around the house and have my very efficient grabber for picking up anything from the floor.  It can even pick up paperclips and cotton wool buds it's so precise!  Apart from the tender feeling around the bruising, there is no pain in the joint at all - just a slight dull ache if I do too much.

A colleague from work popped in for coffee and brought flowers cards wine and chocs from everyone, so that was brilliant, and especially hearing all the news and gossip!  The weather is hot and sunny and we sat in the garden.  I have decided I need a recliner, so have found a suitable one from Homebase which is padded and multi position and only 19.99 so we will be going to get it later this week.

I have removed my dressing and inspected the incision with a mirror.  It is very tidy, there are a couple of nylon (?) threads sticking out which I have trimmed off, otherwise the stitches have disappeared and there is just the thin line of the incision with still some bruising towards the front.  Underneath you can feel a lot of tissue, almost cupping my hand around it.  I am amazed that such a short cut can allow all that had to happen, to happen!  I am going to massage Bio Oil into it to help with the healing.  My brother is using E45.  I have just remembered the physio mentioned that some people have found arnica very soothing for the bruises.  In fact I remember my mum taking arnica pills before an operation as she believed it helped the body cope with the stress.  Its probably too late to benefit me now, as my bruising is on the way out: down my leg, to my foot and then away for ever!

Spoke to brother who is on Day 29 and has driven today!  Said he felt very naughty doing it, but had sat in the drive and gone through all the motions including emergency stop and felt confident he would be fine.

I think that now there is not so much daily detail to report that I will add to this blog on a weekly basis and update on my mobility and progress that way!

DAY 14

Appointment with physio this afternoon.  She watched me walk with both crutches and then showed me how to use one, she said I was limping and should take both crutches out for any distance but around the house definitely one was fine.

We went through the exercises I do, which cover all the necessary muscles and she was very happy with how I did them; she added a couple more to try and said increase the repetitions when I felt comfortable.  She said listen to your body as it will tell you when it is ready. She said my consultant does not like squats or exercises done lying face down.  She re-iterated wearing the socks for 6 weeks and sleeping on the back for 6 weeks.  She said all consultants have a different take on the recuperation, and one of them puts no restrictions on his patients at all, where as mine is quite strict.  This explains why when you look at internet chats and sites about THR you see so many different versions of what is allowed.  The things that everyone agrees on however, is the 90 degree rule and the not swivelling on the foot or crossing the legs.  When you consider this there are actually a lot of things you can do without infringing this ruling.

We discussed stairs, which I am finding I can now walk down normally, but walking up normally does not yet feel wholly ok, and I maybe do a couple properly and then revert.  She agreed that that was the best way to do it, every day adding another step or two until I feel comfortable going up and down normally with one crutch.  Then try going down without a crutch, etc.

She did know of a pool where there are physio sessions, but suggested we discuss this after the 6 week check.  She said she saw no benefit to me of seeing her on a weekly basis, as I understood and was obviously doing the exercises necessary, and in my case it was more a question of taking it easy as my personality was obviously one that liked a challenge and could easily overdo it.  Considering I would have been happy to pay for a weekly session I thought that was most impressive.  I asked her if any of the THR patients at the Nuffield needed one to one sessions on a weekly basis and she thought hard and could only think of one lady a while ago who needed a lot of support to get mobile.  So it would seem to me that maybe my brother's physiotherapy is not really needed - he wont agree though! Maybe consultants are friendly with physios and recommend to patients as insurers will pay up and its win win for everyone!

She said there was no reason not to take off my dressing, so I will do that after my shower later.

I lay on her couch to do some of the movements and it was interesting to see how well my new hip behaved and compare that with the limited movement which is now affecting the other hip!  Of course in the usual course of events, if one is not a gym visitor or an exercise class attender, one would not know that the mobility of a joint is affected if all it is asked to do is walk, climb stairs and sit down! So I intend to exercise both sides and hope that when the time comes to have a THR on my left side, the muscles are already as prepared as they can be!  I think this must be a couple of years away though as there is no pain from it yet.

I asked her about driving and she said without  a doubt I would be driving at 6 weeks and that some patients who had recovered quickly, as I was doing, were happily driving after 4 weeks.

Altogether I was very happy with my hour spent with her.  My questions were answered; I felt reassured about my progress; I felt less anxious about exercises.  I will see here again in five weeks time.

DAYS 12 AND 13

This is my second weekend home and quite a contrast to the first!.

My first social outing today with my cousin to a gastro pub, which if I had walked would have been about quarter of an hour, but of course, I didn't, we nipped up in the car!  I was concerned about height of chairs and also the loo side of things, so we arrived early to make sure we secured a table with chairs rather than the sofas with coffee tables or stools, and found the perfect position.  I cannot tell you how lovely it was to be back in the world and away from medical concerns!  I just took one crutch as I am finding that totally comfortable inside and for short distances - I would definitely take both for a walk.

This pub, being newly refurbished, has every disabled person's dream of a loo, with plenty of room, bars to support you, things at the right height, brilliant, so I need not have worried.  I nearly dispatched Nick in advance with a tape measure to check the facilities, I was so concerned.  A normal height loo with no handrails would be totally impossible.  One could get on it but not off it I think!.

After lunch we decided a visit to TKMaxx in search of handbags might be a good idea, and that was a great success, I must have been on my feet for an hour or so in total, with no discomfort at all.

Sunday was a quiet day with a couple of feet up rests - I could tell that I had maybe done a bit too much the day before.

DAY 11

Had a really awful night, got up to the bathroom 3 times, had four sessions of light on and reading (Nick should be really glad I'm in the guest room!) and saw most hours pass on the bedside clock!  Managed to get up and have breakfast at 8, but went back to bed at 10 to catch up on sleep and didnt wake up till 1pm.  I think this is the result of over-exertion - it is my body telling me it is stressed.

Tidied around the kitchen and could 'cruise' around the work tops without a crutch.  Tried a tentative walk across the kitchen space, but I am limping a lot without the one crutch.

DAY 10

We have excitement today! Excursion to Sainsburys!  So I am putting together a list of groceries to last us two weeks, so we dont have to do it again soon!  Also calling into Argos to collect vibrating baby chair for imminent first grandchild, and dropping off tin of biscuits and card to staff on my ward - they were all so brilliant - and I know that people who want to complain are always the noisiest, so it is good to get a 'thank you'! While at hospital, also buying extra long 'grabber' as I think mine is too flimsy and not good for picking up small items from the floor.  I can't believe it is just 7 days since I was in hospital, I would never have believed that I would so quickly be on my feet and doing the usual things.

The shop lasted about an hour and a half and I was glad to get back in the car at the end of it!  I started just pushing the trolley with crutch inside it, and that was perfect until it got too heavy, so then just the one crutch.

Came home and had chat with brother: he reckons he can probably have up to ten sessions of physio paid by his insurer.  He is doing, amongst the other normal exercises, leg squats, and lying on front and curling legs up! - none of which I would even think of doing!  So I am beginning to feel that my little exercise regime is a bit feeble and that my muscles will not be working very hard to support the new joint.  Then that I may be compromising my strength in older age, so I do feel concerned and pleased that I will be seeing the physio after the weekend.  The cost of the initial consultation and 5 subsequent half hour sessions will be in the region of £300 I believe, which I cant really afford, but feel is essential to getting back to work in six weeks time and feeling strong through my hip.

The back of my knee is black and blue with bruising and the whole of my lower leg and round my ankle is bruised and tender, but the swelling is going down now.  Had a lovely shower and feel tempted not to put support socks back on, but I do!

DAY 9

Had an appalling night.  I get this really tense restless sensation of wanting to escape and run off somewhere, it feels impossible just to lie and relax and then sleep, like I need to be somewhere else, not here in the middle of the night, stuck on my back like a beetle, I would do anything to be able to sleep on my side but I am too scared of dislocation now to risk turning.  I keep putting on the light, and reading and piling up the pillows to try for some comfort.  This really is the worst part of the whole thing for me.

Finally morning, and I checked my bag of medecines.  Nothing much left now except senokots, so I will just buy paracetemol and keep taking it as I was told to.  Or not, maybe they assume you know what to do as in (a) keep taking it at regular intervals, or (b) just when you need it.  I don't know, who should I ask.

I suspect this is my body in stress due to over exertion yesterday.  But how would I know.  No-one has told me how much walking I should be doing, how many crutches I should be using.  I like a challenge, I like to know that after a week, this is what you could be doing, 2 weeks, another goal go achieve.  I realise that people of all ages and levels of health will arrive at these stages at different times, but surely some guidelines could be offered!

Bruising is now down on my foot, all around my heel.  The inner thigh bruising is becoming lighter in colour.

Tip - have a notebook and pen in every room, even the bathroom, because thoughts that require action pop up all the time and can easily be lost!

Finally got through to surgery and I can book a telephone conversation with my own nice efficient lady doctor in 2 weeks time, can you believe it, so I said then I would speak to 'anyone' and so some other doctor will call this afternoon at 2.30 and I will ask about physiotherapy.

Well that GP conversation got me precisely nowhere.  I was advised that the hospital had done everything expected of them and that as I had my exercise regime to continue with, all is as expected.  If it was felt I needed any additional physio help, a session could be booked in 6 to 8 weeks, but there was no NHS provision in this area for anything more than what I have had.  I pointed out that I was intending returning to work in 6 weeks and was also aware from my research that there were considerably more elements to the physio side of things than I had been offered.  He was not at all helpful, so then I rang Nuffield Health, which has a private hospital about ten minutes away, and booked to see their senior physio on Monday.