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THR AussieMike returns

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Hi Jaycey

Yes it nice to be home in one sense but a bit lonely in another. There is no backup here. As they say - if its to be, its up to me. I am returning to work on Monday and I too have strong reservations about it. I plan to start each day and do what I am capable of and go home. After a few days of meetings I will be able to do less work in the office and more from home.Its not ideal but recent staff turnover has made this unavoidable.

I certainly don't want to cause a setback. After all - I have a cruise to go on next month!!

Mike
 
Good evening Mike

Good to hear you are settled at home. You have such a positive attitude, I am sure you are going to be ok.

You have your game plan well and truly thought out.. Have a good nights sleep..

Hugs
 
CURRENT DATE: Sunday 21st October 2012
Procedure: LTHR - 24th September 2012
Post Op: 27 days
Location: My apartment
Entry Weight: 78kg / 172lb
Current Weight: 74.5kg / 164Ib
Target Weight: 70kg / 154bIb

CURRENT ISSUES:
Muscle imbalances in left leg

OPERATING HOSPITAL ACHIEVEMENTS (5 days):
1. Got out of bed independently
2. Stood in place with walking frame
3. Walked 6 meters to bathroom
4. Used bathroom independently
5. Took shower seated with assistance
6. Dressed with assistance
7. Walked 30 meters with a walking frame
8. Walked 10 meters with 2 crutches
9. Walked up and down 1 step repeatedly
10. Showered standing independently
11. Dressed independently (except TED socks)
12. Walked 100 meters with 2 crutches
13. Walked up and down the 6 step mini-stairs
14. Supporting my roomie and new friend David on his journey

REHABILITATION HOSPITAL ACHIEVEMENTS (14 days):
15. Walked down and up 2 flights of stairs (total 60 stairs)
16. Hip Flexion 90 degrees
17. Hip Abduction 30 degrees
18. Making people happy and positive
19. Walking with two walking sticks
20. Walking with one walking stick
21. Commenced hydrotherapy program
22. 30 seconds of continuous kicking against the Hydrojets
23. 60 second Plank
24. Breaststroke / Backstroke in the pool
25. Slept through the night without pain relief
26. Walking leg over leg down stairs
27. Walking leg over leg up stairs
28. 6 x 60 secs Planks with 30 secs rest between reps
29. Walking leg over leg up 10 flights of stairs
30. Lost 2.5kg / 5.5lb in bodyweight in rehab - none of it muscle

POST HOSPITAL ACHIEVEMENTS:
31. Completed 800 meters / 875 yards footpath (pavement) walk in 7.5 mins
32. Completed 800 meters / 875 yards footpath (pavement) walk in 6 mins
33. Completed 910 meters / 995 yard walk around local park.
34. Completed 1,350 meters /1,476 yard walk around local park.
35. Lost a total of 3.5kg / 7.7lb in bodyweight since my THR.
36. Completed 2.34 km / 1.45 mile walk around local park.

CURRENT PAIN MANAGEMENT:
5mg Targin every 24 hours
5 mg Endone as required (max 2 per day)
2 Panadol every 12 hours
Aspirin 150mg per day
Ice packs as required

TODAY'S FOOD PLAN:
Breakfast
Scrambled eggs, tomato, mushroom, toasted turkish bread, mandarin juice and black tea.
Lunch

Dinner
Salmon cakes, steamed vegetables

TODAY'S FOCUS:
1. Recumbent exercise bike (15 - 30 mins)
2. Hydrotherapy session
3. Afternoon walk

NOTES:

03.45 Sleeping in my own bed for the first time. Its really no better or worse than any other bed I have used in the post op period. Pain remains just beneath the surface of my consciousness thanks to the medication. When the medication starts to wear off it isn't long before pain wakes me again.

Fortunately I have a very soft Italian leather recliner in the corner of my bedroom from which I am writing this note. Hopefully I can drift off to sleep again from here.

Today's pain management regime is slightly different. From this day forward for the next 14 days I have a single dose of Targin (slow release pain killer) Previously I was taking one tablet each 12 hours. With my mind on my return to work, I will try to take this tablet around 8am each day.

04.31 I am still awake but resting comfortably in my favourite recliner chair. I am thinking about my day ahead and how I will choose to spend it. I think I will try my recumbent exercise bike before breakfast. I am thinking that I will aim for 15 minute and if I am feeling good roll on to 30 minutes. No resistance and no speed in mind. Just rolling it over at whatever speed is very easy.

Next I want to go to my local pool with my noodle in hand to do some hydrotherapy exercises. Some rest, some cooking and a late afternoon stroll. That sounds pretty nice to me.

I want to stock my fridge with delicious food that will assist in my weight loss quest. So today I will use my slow cooker to prepare a chicken and vegetable soup, some sweet chilli chicken tenderloins for sandwiches and some red salmon cakes for dinner.

04.49 My 22 year old son Ben will arrive home this morning. He has been staying in my apartment in my absence as he completes a four week internship with an international media agency in the CBD of Sydney. He has just had word that they will be offering him a permanent role in a couple of weeks. So I will have him back with me after four years away at university. Nice.

07.55 I woke again around 7.20am and took 5mg Targin tablet for pain relief. Waiting for the effects to kick in at this time.

15.10 My first full day at home has been good. I have done a walk and some cooking which always gives me pleasure. This hip of mine demands lots of exercise. If I don't walk it tightens up. If I walk too much it swells up and needs ice and elevation. Clearly I have to aim to walk short distances more often.
 
Poppet said:
Good evening Mike

Good to hear you are settled at home. You have such a positive attitude, I am sure you are going to be ok.

You have your game plan well and truly thought out.. Have a good nights sleep..

Hugs
Click to expand...

Hi Poppet

Thanks for your vote of confidence. It helps at this time. I am realistic enough to know that this will not be perfect or easy but my health and recovery will come first.

Hugs

Mike
 
Mike, You are doing so well, and I think its because you stay postive by writing down the things you can do, not focusing on just the things you cann't do. Staying postive is so healty and eating well is also good. Keep it up. Tashia
 
Thanks Tashia,

I appreciate you stopping by. As I have mentioned before, in my view, I am responsible for my recovery. That is to say, I am able to chose my response. I chose to be positive and committed to finding a way every day to move forward. How far doesn't matter. Just move one thing forward.

cheers

Mike
 
Energy levels are very curious things. Its really hard to work out what makes them change. For the past three days my energy levels have been very low. I have tried to roll with that and not worry about the fact that I feel tired and lethargic most of the day. I wish I knew the secret. Sleep is part of the answer as if food but I have done as well in these departments as at any other time, yet the result is so different. I am hoping for a burst of energy for my return to work tomorrow.
 
Hi there Mike, have you read this article from the library on energy drain... if not, here it is :)

Energy drain for THRs

I found the energy drain to be one of the most significant issues returning to work at 7 weeks on a phased return. It kicked in around 3pm for me, so I made sure I took a couple of Paracetamol around 2:30pm, that way I stayed ahead of the pain that set in immediately with the energy drain..

Good luck for tomorrow, I am sure if your plan of shorter days will help.

Nice to have your son home :)
 
Hi Poppet,

Yes I had read the energy drain article before, but it never hurts to revisit this material. I am having trouble seeing a pattern in my energy drain. It doesn't seem to follow a 24 hour cycle. I would be thrilled if my energy levels were maintained until 3pm each day. I don't expect I will last that long.

Cheers

Mike
 
Still early days Mike. I am afraid that energy level may take awhile to settle into a routine - especially if you are still having sleep problems. Be sure you are not under medicating. Rest when you can - naps are your best friend.
 
Jaycey

I think you have hit the nail on the head - I think I am under medicating. My mind is really not clear on what I should be taking and when at this stage of my recovery. When I left the rehabilitation hospital I was given prescriptions for Targin 5mg and Endone 5mg as well as Panadol regular strength. The Targin prescription stated that I should take 2 tablets per day for the first seven days and then one tablet per day thereafter until the packet was empty. The Endone was to be taken as required but at that time I was using just one tablet per day and therefore the packet would last me 3 weeks approximately. The Panadol was to be taken four hourly during waking hours.

So in my mind I had this clear picture of having enough pain medication to last through to the end of week 4 post op. From there I began to reverse engineer the process. Targin at 6am and 6pm daily and only one Endone per day when the pain kicked in. If I got pain at other times just use Panadol.

Well its not working. I was in pain at 7.30pm and went to bed. I fell asleep but now at 10.45 I am awake again and have taken 2 Panadol for the pain but am not confident it will get me through the night. What should I do?

thanks

Mike
 
This is a very common problem Mike. Typically you are discharged from hospital with medication to keep you going until such time as you contact your GP.

We all heal differently but as you are experiencing you still need those meds at a steady rate. Can you contact your GP tomorrow (Monday) and either visit or have a discussion? You still need to stay ahead of that pain and not be limiting the doses so the supply lates you longer.
 
Thanks Jaycey, I so appreciate your advice. I do recall that they said that I should see my GP in week four and they gave me a copy of my discharge papers in an envelope marked GP. I remember thinking at the time that that was a bid odd. After all, I was due to see my OS in week six. No one made the point that this would be about my pain management. I wish they had but I suppose they are concerned about patients who overuse these powerful drugs as well.

Anyway I will attempt to see my GP tomorrow and meantime use my medication as it is needed.

Thanks again for always being there.

Mike
 
CURRENT DATE: Monday 22nd October 2012
Procedure: LTHR - 24th September 2012
Post Op: 28 days
Location: My apartment
Entry Weight: 78kg / 172lb
Current Weight: 74.5kg / 164Ib
Target Weight: 70kg / 154bIb

CURRENT ISSUES:
Muscle imbalances in left leg

OPERATING HOSPITAL ACHIEVEMENTS (5 days):
1. Got out of bed independently
2. Stood in place with walking frame
3. Walked 6 meters to bathroom
4. Used bathroom independently
5. Took shower seated with assistance
6. Dressed with assistance
7. Walked 30 meters with a walking frame
8. Walked 10 meters with 2 crutches
9. Walked up and down 1 step repeatedly
10. Showered standing independently
11. Dressed independently (except TED socks)
12. Walked 100 meters with 2 crutches
13. Walked up and down the 6 step mini-stairs
14. Supporting my roomie and new friend David on his journey

REHABILITATION HOSPITAL ACHIEVEMENTS (14 days):
15. Walked down and up 2 flights of stairs (total 60 stairs)
16. Hip Flexion 90 degrees
17. Hip Abduction 30 degrees
18. Making people happy and positive
19. Walking with two walking sticks
20. Walking with one walking stick
21. Commenced hydrotherapy program
22. 30 seconds of continuous kicking against the Hydrojets
23. 60 second Plank
24. Breaststroke / Backstroke in the pool
25. Slept through the night without pain relief
26. Walking leg over leg down stairs
27. Walking leg over leg up stairs
28. 6 x 60 secs Planks with 30 secs rest between reps
29. Walking leg over leg up 10 flights of stairs
30. Lost 2.5kg / 5.5lb in bodyweight in rehab - none of it muscle

POST HOSPITAL ACHIEVEMENTS:
31. Completed 800 meters / 875 yards footpath (pavement) walk in 7.5 mins
32. Completed 800 meters / 875 yards footpath (pavement) walk in 6 mins
33. Completed 910 meters / 995 yard walk around local park.
34. Completed 1,350 meters /1,476 yard walk around local park.
35. Lost a total of 3.5kg / 7.7lb in bodyweight since my THR.
36. Completed 2.34 km / 1.45 mile walk around local park.

CURRENT PAIN MANAGEMENT:
5mg Targin every 24 hours
5 mg Endone as required (max 2 per day)
2 Panadol every 12 hours
Aspirin 150mg per day
Ice packs as required


TODAY'S FOCUS:
1. Return to work
2. Appointment with GP re pain management
3. Pain management

NOTES:

04.38 I have been able to get some better sleep by increasing my pain medication. I feel a little more drugged than I have for the past three days. I little less sharp in my thinking. I hope I am able to function today in the office.

06.21 Well its time to get ready for work and I am certainly feeling medicated like I was in the rehab hospital. I did get much better sleep than the past few days.

14.19 I have a spare minute here in my office and thought I would check in with my BoneSmart™ angels. I am pleased to related that the day is going really well. I have not needed pain medication since 8am this morning and have been able to cope with a series of meetings to this time.

I am pleased to relate to you Jaycey that I have a 4pm appointment with my GP to discuss pain management going forward and will ask him to redress my incision to ensure it remains waterproof for the pool tonight.

I suppose it is a good thing when a hippie goes out of the office at lunchtime to buy a sandwich, gets half way there and realizes he forgot to take his walking stick... lol

18.13 Went to see my GP late this afternoon. He was impressed with progress at four weeks post op. We discussed my pain medication and he gave me scripts for both Targin 5mg and Endone 5mg. He also had a very good suggestion for how to use these two drugs now that I am returning to work.

His suggestion was that I should take one Targin 5mg tablet at bedtime as the slow release nature of the drug would give me the best chance of sleeping through the night. He then suggested that I use Endone during the day at the first sign of pain returning. Then depending on what time the pain returned again, use either Endone or if the time until bedtime was short, use Panadol to get me to the next Targin tablet. Sounds like a smart way to go and will minimise the volume of medication I need.

18.19 So I am pleased to report that my first day in the office went better than I dared to hope for. I arrived at 9am and left at 3.50pm to visit my GP.

The day had a lot of project meetings and a strategic planning meeting with the management team. My concentration levels were pretty good and I asked a member of the management team after our meeting about the quality of my input and she stated that is was at my normal standard. Precise, incisive questions and constructive informed comments.
 
Hi there Mike, just popped in to see how you are doing and wow, you're off to work. Hope it goes okay,remember to take it easy and if it gets too much tell them you are outta there :)

Hope GP can sort out your pain meds too

Take care

Ann
 
Mike,

Hope all goes well with your back to work routine. I think sometimes we don't even realize how much was taken care of in rehab. Yes, we worked very hard in PT and OT but could rest afterward with no inkling of having to even think about meals, being alone, someone bringing our meds, etc. Going home is a huge adjustment and you have done well but often we still need pain meds and other "helps" along the way. This is not a straight path so don't get discouraged if you need to go back to previous routines once in a while. If there is one thing I have learned it is respect for my body. It will tell you what you need/don't need along the way. All the best.
 
14.19 I have a spare minute here in my office and thought I would check in with my BoneSmart™ angels. I am pleased to relate that the day is going really well. I have not needed pain medication since 8am this morning and have been able to cope with a series of meetings to this time.

I am pleased to relate to you Jaycey that I have a 4pm appointment with my GP to discuss pain management going forward and will ask him to redress my incision to ensure it remains waterproof for the pool.

I suppose it is a good thing when a hippie goes out of the office at lunchtime to buy a sandwich, gets half way there and realizes he forgot to take his walking stick... lol
 
Sounds like you are coping well Mike. Long may it continue! Leaving your walking stick behind is a good sign. That's usually how it happens. Let us know how the appt with your GP goes.
 
Keep up the good work. I agree walking without the walking stick is a good sign. But if you have a bad day it might be good to have around. Take care and enjoy the rest of the day. Tashia
 
Went to see my GP late this afternoon. He was impressed with progress at four weeks post op. We discussed my pain medication and he gave me scripts for both Targin 5mg and Endone 5mg. He also had a very good suggestion for how to use these two drugs now that I am returning to work. His suggestion was that I should take one Targin 5mg tablet at bedtime as the slow release nature of the drug would give me the best chance of sleeping through the night.

He then suggested that I use Endone during the day at the first sign of pain returning. Then depending on what time the pain returned again, use either Endone or if the time until bedtime was short, use Panadol to get me to the next Targin tablet. Sounds like a smart way to go and will minimise the volume of medication I need.

I asked him to have a look at my incision and to put a fresh waterproof dressing on it so that I can go to the pool. He removed the existing dressing and stated that it has completely closed at this point and did not need a new dressing. He said there are a couple of spots with a bit of blood on them which would wash off in the shower. I check it out myself in the bathroom mirror when I got home. Its closed with no redness or apparent swelling. I am so fortunate.
 
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