Wednesday, February 29, 2012

Happy Leap Day

It's Leap Day -- the day that occurs once every four years.
Every time this day rolls around, I'm reminded of my twin cousins who were born on this date back in 1956.
They were quite the celebrities when they were young, often photographed by the local newspaper along with whoever was the eldest living Leap Baby in the region.
Now, as they celebrate their 14th birthday, the joke material is endless of course.  They both have wives and families (now adult children).  They're grandfathers, for heavens sakes.
Yet, they need only wait sixteen more years to become officially old enough to drink. (They will actually have been on this earth for 74 years by then!)
But, on a brighter note, in only eight more years they can get their drivers' licences.
Go figure!
Anyway, happy birthday, L and L!

Tuesday, February 28, 2012

Four weeks post-op

Here I am, four weeks post-op and my progress continues to amaze my physiotherapist.
She tells me that I am exactly where I'm supposed to be for this point in the recovery phase.  Which surprises her, given the fibromyalgia and all.
She's aware of the set-backs I'm having because of the fatigue issues so she marvels that I'm doing as well as I am.  But I'm clearly demonstrating progress each week.
I had to fess up to a bit of an "accident" last week and we kind of had a good giggle about it, although it could have had much more serious repercussions.
A friend had come over to have me help him with a project and in doing so I went to retrieve a piece of plastic protector sheet for the document.  The protector sheets just happen to be in a box on the floor of the storage closet.  Without even thinking, I crouched down to get it.
Oops!  And I mean big time oops!
I had to have him come and grab me gently by the armpits to lift me up.
He said he wondered what I was doing when I so quickly bent down like that.
Truth is, I forgot that I couldn't do it!
I paid the price on Saturday and Sunday as no amount of icing would relieve the pain in the muscle that I had pulled.
By yesterday, it was still giving me a little trouble but had let up considerably.
My physiotherapist told me I was lucky -- said that I obviously had a very good surgeon who tied everything up very well.  But yes, it would hurt for a while.
In any event, in spite of having done that, she is still pleased with my progress so I guess I didn't do any permanent damage.
We discussed the phenomenon that occurs at this point in recovery:  patient is feeling so much better, more confident, that she believes she can do lots more and she forgets her restrictions.  This is the phase during which serious accidents can occur because the patient feels overly confident.  It's imperative to respect the restrictions until those restrictions are lifted by the physiotherapist! 
Anyway, she tells me that she will probably start weaning me from the walker to the cane between weeks five and six (next week).  She wants to go extra slowly with me because of the fibromyalgia.  If she goes too quickly, we'll just have a set-back and not be able to make any progress at all.  And we don't want that to happen.
I have to agree with her approach.
There is an unexpected benefit to using this damned walker though.  It really does take a lot of work to use a walker.  It's burning the weight off me at a phenomenal rate.  I might be sorry to see it go before I reach my goal weight!

Sunday, February 26, 2012

Three steps forward ...

... and one step back.
I don't know what's going on but it seems every time I make a bit of progress, up jumps fibro rearing its ugly head.
Then I have to take an enforced day of doing nothing ... and I mean doing nothing!
It's so very frustrating.
This recovery phase has me doing little enough. And I'm sure that is exactly why fibro keeps making its presence known -- too little activity.
So once the fibro flares up, I am prevented from doing even the minimal exercises that I'm supposed to be doing every day.  I just can't manage them.
But if I could do more in a day than just those minimal exercises, fibro wouldn't feel it necessary to appear.
Vicious cycle it seems.
What came first -- the chicken or the egg?
Obviously, it's difficult to find the balance my body needs during this recovery phase.
Fortunately, I see my physiotherapist tomorrow and I'll discuss this conundrum with her.

Friday, February 24, 2012

Improvement continues

I know that I'm improving because each night's sleep gets better.
Last night, my dreams were filled with long walks in the streets of down town Ottawa.  I was plunged back to the neighbourhood where I used to live more than 35 years ago, but the situations were in the setting of 25 years ago (ie my little chickadee was in my life as an 11 year old).
I would go out for these long walks, which is something I used to do often before my hips got bad.
But then I'd wake up, with hips burning in pain, a reminder that I can't do that kind of walking -- yet!
It was weird, to say the least.
And even weirder still was, I kept going back to sleep and going out for yet another walk!
Then I'd wake up with the same burning hip pain!
I take from these dreams that I am very much looking forward to being able to go for long walks again -- but without the consequence of burning hips for having had the pleasure.
Sure hope the dreams aren't telling me that I won't be able to enjoy long walks even after this recovery period is finished.
Say it ain't so!

Thursday, February 23, 2012

I'm definitely getting better

Improvement is definitely evident.
How does one know?
I am soooooooooooo frustrated with the physical limitations being imposed on me.
I just so want to be able to hop in the car and go for groceries, or run errands, or meet a friend for breakfast ... it seems like forever since I've been able to do that.
And it's only been three plus weeks!
Unbelievable really.
The physiotherapist will tell me when I can graduate from the walker to a cane.  And for safety's sake I get that.
I can walk around the house using furniture to support me, but I definitely still need substantial assistance.
And it seems that I can easily walk sideways -- it's the forward motion that is difficult to execute.  I guess that's the consequence of having had the anterior approach -- the muscles in the front of my leg are what have more healing to do.
So I'll just keep on trucking, as the saying goes.
I've managed to sleep on my right side now, but can only tolerate that for just under two hours at a time because my right hip is still "bad."  But at least it gives me temporary relief from sleeping on my back.
I also quit taking the pain killers on Tuesday (took the last one Monday night).  And I'm feeling much better for having stopped them.  I'm taking the occasional XS Tylenol now, but that's it.
My weight loss effort is right back in place too, without my doing anything in particular in that regard.  I'm assuming that it is because I'm burning mucho calories using the walker.  It really does take a lot out of me.  It's exhausting really.  I suppose I'd burn more if I were not using the walker, given the effort it takes to walk at this point in the recovery.
My physiotherapist told me the other day that all those people who claimed to have had no problem after their hip replacements -- that they were up and about right away, doing everything they wanted to do in no time -- they had forgotten what the first six to eight weeks were like.  Because the first six to eight weeks are hell!
Hell is putting it mildly.  It is damned hard work.  And my muscles were readied for this by all the work I did on the stationary bicycle in the six months leading up to the surgery.  I'm one of the luckier ones.  If it weren't for the fact that I have fibromyalgia, there's no telling how far along I might be in the recovery process.
Damned fibro anyway!

Monday, February 20, 2012

Bed rest does help

Turns out that bed rest really does help -- when fibro is the problem.
I've been keeping a low profile for the past couple of days, not out of choice but out of need.  I simply had to stay down because I couldn't be up (and it was a major challenge to do my exercises even once).
Today, I'm much better for having taken those days of extra rest.
Fibro is funny that way.  If you don't listen to its subtle hints, it jumps up and hits you in the face, forcing you to pay attention.
I continue to wake frequently throughout the night, acutely aware of the need to move but unable to do so.  I have to sleep on my back and when I waken, my lower back is aching and my legs are numb and I hate the sensation.
It's not like I can turn to one side or the other yet either.
I can't sleep on my left side because that's the new hip side and it's still too soon.
And I can't sleep on my right side because I have to ensure that my left leg stays aligned with the centre of my body (tricky business that, if you go to sleep on your side ...)
I know that this too will end, eventually.  In the interim, I'm becoming seriously sleep deprived.
That doesn't help much with my ability to tolerate the pain.
But I now know that the pain I was having in my left calf was in fact due to fibro.  How do I know?  Because today that pain is in my right ankle.
That's the beauty of fibro -- a new location every day.  Just to keep life interesting.
Obviously, this damned fibro will delay my recovery because I have to go so much slower than most people.
But recover I will.
When is the unknown.

Sunday, February 19, 2012

It's been a tough couple of days

Where to begin?
My leg has been giving me old what-for since Thursday.
I don't know what's going on but it sure isn't happy.
And what confuses me is it's the lower part of my leg that's giving me grief.
How does one explain that?  I just had my hip replaced so why is my leg giving me fits below the knee?
Walking is difficult because pressure hurts on the lower part of my leg.
My hip is just fine.  No pain whatsoever in the hip or in the upper portion of my leg.
I just don't get it.
To add insult to injury, I received a call on Friday telling me that a very special lady had passed away the day before.  She went very suddenly, as it should be.  She had sounded so feisty when she called me in the hospital, pleased as punch with herself for so thoroughly surprising me with her call.  She will be missed, to be sure.
On a happier note, my nephew's wife gave birth to their second daughter on Friday.  Annabel Lyn weighed in at 9.3 lbs and she arrived without benefit of any drugs (now there's a trooper of a Mom!).  She is joining a wonderful circle of family and friends and won't be without the love and attention that every child deserves.
Today, my little chickadee, Pauple and my striking young man came to visit.  I've been on bed rest for the past several days so it was nice to see them -- I needed the diversion.
Tomorrow I have physiotherapy so I'm hoping the therapist will be able to shed some light on this matter of the pain I'm having.  Last week, both she and the doctor felt that the pain was due to fibro rearing its ugly head but I'm not so sure any more.
I don't know what to think about this pain.  I sure hope the therapist has some plausible explanations.

Thursday, February 16, 2012

A bit of a setback ...

I'm having more pain now than I've had since the surgery.
It's bizarre, really.
My left leg is aching like a bad toothache.
And it's taking everything I've got to manage my exercises.
The painkillers don't seem to be having any beneficial effect.
 I know I have to get through this, and get through it I will.
Just yesterday, my physiotherapist and I were discussing the phenomenon of physical setbacks that surgical patients experience during the third week following their surgery.  She couldn't explain it.  She just knows from years of treating patients that they all seem to go through it.
So I can't say that I wasn't warned.

Wednesday, February 15, 2012

I am progressing well

I saw my physiotherapist again this morning.
She continues to be impressed with my progress.
I had a few questions for her.
Before the surgery, several people had told me that during recovery, I must be content with doing only what my physiotherapist told me to do ... nothing more.  The only thing she told me to do was my set of exercises at least twice a day.  So, my question was, what the hell am I supposed to be doing with the rest of my day.
She laughed because she understood exactly where I was going with the question.  And the answer was:  I should do exactly as I am doing.  Move about the house to whatever extent I could comfortably, and when I was tired, I should rest.  Obviously, I should not be a couch potato because that causes muscle atrophy but at the same time I can't overdo it because that will cause damage.  Bottom line is:  listen to your body.
She assured me that based on my progress, I was doing an excellent job of listening to my body.  But it's been her experience that most fibromyalgia sufferers are very good at that.
My other question concerned the amount of pain I'm having in my left leg, pain that seems to be increasing as the swelling is subsiding (at least that's the way my brain is perceiving it).  She, just as the Doctor had assessed on Monday, checked my leg for the amount of swelling and felt that the pain is a localized fibro flare-up.  That leg was "attacked" and has to heal from the assault. 
She was some impressed as I went through the exercises and she saw how far I can flex my leg (and then even more impressed when she saw how well I can extend my leg flat).
Of course, I have nothing with which to compare this progress so I have to accept that I am doing well.  Her reactions seem to be truly genuine.
My next question I knew what the answer would be before I asked:  "When could I start on my stationary bike again?"  The answer:  "Not for quite some time," which was just as I expected.
But I had to ask!
She added two new exercises (both are done while standing) and told me to keep up the good work.
I see her again next Monday.  We'll see if my progress continues to amaze her.

Tuesday, February 14, 2012

Happy Valentine's Day

OK, so I love my husband in a romantic way suitable for Valentine's Day-like sentiments.
But nothing can compare to the love I have for the first person who came into my life and taught me what it really means to love and be loved unconditionally.
Perhaps the fact that I raised her on my own (and when I say that I raised her on my own, I mean I raised her on my own) helped develop a stronger bond between us than some mothers and daughters have, I don't know.  Not having an abundance of other mother/daughter relationships to which I can compare ours, I don't think I can fairly make a blanket statement about ours vs all others. 
But my little chickadee and of course now my striking young man are undoubtedly the two people in my life who can bring out my "Mama Bear" instinct still.
 My little Chickadee with her Mom, 1980

My Little Chickadee with her new Stepfather and her Mom, 1997

My Little Chickadee meets Her Son (My Striking Young Man), 2001

Who could resist this most beautiful of smiles???? 

My Little Chickadee with her Mom and Son, 2009


Monday, February 13, 2012

Staples are gone

The staples were removed this morning.  And it didn't hurt.  There was a bit of a pinch with some of them, not unlike the pinch of having stitches removed.  But for the most part, it didn't hurt.
The doctor said, of the incision, "Beautiful!"  And once all the staples were removed, she again commented on the nice work by the surgeon.  I guess it's nice work!  (She's not the first to have made such comments.)
I've noticed that with each day as the swelling subsides (it's not completely gone yet), the pain in my leg increases.  My leg just feels like it's one big bruise.
When I mentioned the swelling/pain, the doctor checked my leg and agreed that there is still some swelling.  Then she poked around to see where the pain was (it was everywhere she touched, of course).  She declared the pain to be more from fibro than anything else.
Fibromyalgia -- the pain that just keeps on giving!

Sunday, February 12, 2012

Improving still ...

Each morning, I wake aware that I am improved from the day before.
Although I'm still waking several times during the night (for reasons I can't yet explain), I'm having no difficulty going right back to sleep.  And I seem to be sleeping to a later time each morning.  That's quite a change for me, who used to start every day around 4:30-5:00am.
I've already grown quite tired of the "rehab" phase of this journey.
I know I'm supposed to be patient and take it slowly.
And I'm doing that.  Because I know I have to if I want this surgery to be a success.
But I don't have to like it.
I am by nature a "do it my ownself" kind of person.  So I knew that this phase would be difficult for me.
I'm trying, really I am ...

Saturday, February 11, 2012

Wanna see my incision?

OK, all you queasy readers out there, if you don't like seeing surgical sites, I suggest you read no further and close this page now.
On Monday, I'll go to John's doctor to have my staples removed.  She graciously agreed to do the deed to save my having to make the trip into Ottawa to have either the surgeon or my own family doctor remove them.
The hospital gave me the staple remover instrument and some steri-strips which I guess are to be applied over the incision after the staples have been removed.  I would have thought that all family doctors would have the instruments for removing surgical staples.  Apparently that is not the case, so every patient is given a remover on discharge from hospital.

There are only twenty-five staples to be taken out.
Bonnie's Incision - 10 days post-op
I'm assured that it doesn't hurt to have these suckers removed but I'm not so sure I'm convinced.
I guess I'll find out on Monday if people have been feeding me a line.

Friday, February 10, 2012

Wow, everyone should go this route!

As I've posted here before, I did extensive research before having my hip replaced.
And that research pointed me in the direction of seeking out a surgeon who would perform the "anterior approach."
Now, my reasons for making that choice were based on my history of fibromyalgia.  Since the bursa are trigger points for fibro, I felt that the incision should stay away from that part of my body. (As one doctor put it -- why fix one problem and give me another?)
The more I looked into it, the more I was convinced that I should stick to my decision.  My gut just told me I was on the right track (as did my physiotherapist and my massage therapist -- based on my history).
And of course, since I have fibromyalgia and the surgery would be an assault anyway, I figured we should try to minimize the damage as much as we could.   As it was, the flare-up I suffered was minimal, in the scheme of things, only delaying my rehab by a couple of days.
If it weren't for my insistence that my surgery be done by anterior approach, my hip would have been replaced last July.  But I chose to wait. (There are only two doctors in Ottawa who are trained in the procedure.)
Turns out I was righter than I realized!
This morning, I was poking around trying to see if I could find an indication of just how long I have to be a couch potato (haven't found it yet -- I got side tracked), and I came across the following information:
"An increase has occurred in the number of hip replacements performed through the anterior surgical approach.  Among the advantages of this procedure is the fact that it is minimally invasive, preserving the hip musculature; the posterior approach, in contrast, involves the detachment of the posterior hip rotator muscles and the mobilization of the gluteus medius muscle.  With the anterior approach, the risk for hip dislocation is reduced.  The patient has almost no restriction of physical activity during the postoperative period.  Less tissue injury and, subsequently, less pain occur. In addition, recovery is faster." (WebMD Professional)
So, this brings to mind one burning question.
Why doesn't everyone who needs this surgery have it done using the anterior approach?
If more people insist on the procedure, more surgeons will train for it.

Thursday, February 9, 2012

I continue to improve

With each day, I see marked improvement.
Getting into and out of bed is easier each time I do it.
This morning, I woke feeling less stiff than I have been.
The swelling in my leg is reducing nicely (although not nearly fast enough to suit me).
And I'm guessing that having had this left hip done will in fact prove to delay the need for having the right hip done.
On what do I base that expectation?  Already, the ever-present inflammation in my right hip is gone.  Not just reduced.  Gone!
The physiotherapist yesterday had me walk between the parallel bars so she could judge my gait.  She said that I am walking perfectly normally.
I haven't walked with a normal gait in well over ten years.  Here I am, ten days after surgery, and already I'm seeing the benefits.
And that perennial pain that I had in my hip joint?
The new hip causes me no discomfort whatsoever.
Yes, there is pain associated with the surgical site.  But even that lessens with each day.  And we know that eventually, it will be completed healed.
So as long as I follow instructions and don't do anything to violate the rules of movement (and I only have three restrictions), I should be good to go in no time.
Well, OK, in six weeks.
Well, in another four weeks and a few days (since it's already been ten days).
Am I anxious for recovery to be over?
You bet I am.
I truly don't make a very good patient when I'm not sick!

Wednesday, February 8, 2012

I'm doing "remarkably well"

So says the physiotherapist at the Almonte Hospital.
I had my first session with her this morning.
It was really a "get to know you" session, more than a work-out visit.
She wanted to see how much I could do, what exercises I had been given by the rehab centre crew, etc.
And she was extremely impressed with my progress.
She said that I am doing "remarkably well for one week post op."
So, I guess I'm doing really well.

Tuesday, February 7, 2012

I'm at home now

Twenty-four hours at home and I can assure you, it was the right decision to leave the rehab centre.
I mean, it served its purpose.  I needed to be there, initially.
But by Saturday or Sunday, I clearly needed to be home more.
The "living arrangements" leave much to be desired in the hospital setting and I am simply not cut out for sharing my quarters with strangers.  Especially strangers who are totally inconsiderate of the fact that they are sharing tight quarters with someone else in less than ideal circumstances.  One simply has to accept that one is not at home and one must therefore take others into consideration.
Like, perhaps flushing the toilet one shares with another patient.
Like allowing the other patient at least half the room for movement of equipment.
Like maybe making some effort to cover one's butt (literally) when walking about in those horrific hospital gowns (everyone knows they don't cover anything!).
Like using the supplied headphones when watching television -- goes without saying in a hospital, I think.
Like, like, like ...
I could go on.  But I think you get my point.
My roommate was less than polite.  Which added tremendously to my stress level.
The sooner I got out of there the better.
I needed to get out of there to get some rest.  Peace and quiet.
Now that I'm home, we're settling into the routine that will be ours for the next several weeks as I learn that the limitations put on my movement will severely restrict me.
I knew I had to accept this.
And I knew I wouldn't like it.
But believe me, it is so much better than where I was.
This is like heaven!

Sunday, February 5, 2012

I need to go home now

Really I do. I am sooooooo ready.
Yesterday, the physiotherapist upgraded me to independent, which means that I no longer require assistance or supervision for most day-to-day activity.
Obviously, I can go home now.
So I cornered the occupational therapist and asked her to show me how to use the tub transfer bench because I need to know that before I go home. She will do that today.
I made it abundantly clear that I was asking because I want out of here ASAP.
This morning I showered, on my own, and I have been getting in and out of bed without assistance since Friday.
Clearly, I'm ready for the big times!

Saturday, February 4, 2012

So close ...

How fleeting that much needed private room has become.
Yesterday the occupational therapist assessed me as a priority need for private accommodation in this esteemed establishment.
The request was quickly approved and I was assigned to the next available room (coming due today, Saturday). 
I was told that I would be moving but I had to understand that should someone arrive who had isolation needs, I would be moved again until another private room surfaced. I accepted the move on that condition.
Not fifteen minutes later, I was told that an admission had arrived who needed the room.
So I lost my private room before I even got there!
But, the next one is mine!

Friday, February 3, 2012

Obviously I can plan on having good nights

Again last night, I slept without disturbance.
OK, I was wakenened at 11:00pm by the respirologist who wanted to know if I wanted the CPAP machine hooked up. Of course I said yes to help ensure that I had a good night.
And I made it then until 3:00am. So that's four hours with the machine -- wonder if I'll feel better rested today as a result.
I desperately need to be put into a private room though.
This business of sharing accommodation simply isn't working for me. But it will serve to motivate me to get out of here quickly, if nothing else.

Thursday, February 2, 2012

Another good night

I slept well again last night.
Perhaps this is indicative of that to which I can look forward -- nights of sleeping without pain!
My rehab is a little slower than it should be (damned fibro reared it's ugly head) so I am being moved to the short term rehab wing at the hospital, probably some time today.
There I will stay for three to fourteen days but not likely the max. Once there, the physiotherapists will work with me until I can function independently, which will lessen the load on John when I get home.
Today is the day that I would normally be sent home (actually yesterday was that day) but I failed to meet the required milestones.
That's it in a nutshell so far.

Wednesday, February 1, 2012

I slept well

Slept very well last.
From 6:00pm 'til 5:00am this morning! Now that is some kind of record for me.
I did wake up periodically, and I was wakened regularly but each time I drifted right back to sleep with no problem whatsoever.
My physio didn't go very far yesterday. They got me sitting on the edge of the bed and I felt like I was going to pass out so we'll try again today.
The doctor said if I continue to be slow they will look at moving me to rehab before sending me home. That's not a bad idea -- it's actually what my regular physiotherapist had recommended for me (but of course it's not her call).
I'll try to keep you posted here.