THR AussieMike returns

[AussieMike]

CURRENT DATE: Wednesday 3rd October
Procedure: LTHR
Post Op: 9 days
Location: Rehabilitation Hospital
Current Weight: 77kg / 172Ib
Target Weight: 70kg / 154bIb

CURRENT ISSUES:
Moderate swelling around incision
Ache in middle glute.
Annoying TED socks

ACHIEVEMENTS TO DATE:
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. Walked down and up 2 flights of stairs (total 60 stairs)
15. Hip Flexion 90 degrees
16. Hip Abduction 28.5 degrees
17. Supporting my roomie and new friend David on his journey
18. Making people happy and positive
19. Walking with two walking sticks


CURRENT PAIN MANAGEMENT:

Targin every 12 hours
10mg Endone every 3-4 hours upon request
Gabapentin every 12 hours
Panadol every 6 hours
Aspirin 150mg per day
Ice packs as required

TODAY'S FOOD PLAN:

Breakfast
Apple juice, sultana bran, milk, compote of fruit, poached eggs (2), black tea.
Lunch
assorted sandwiches, fruit plate, orange juice
Dinner
stir-fry chicken, rice, spinach, carrot, fruit plate, apple juice


TODAY'S FOCUS:
1. Physiotherapy sessions (2)
2. Use the stairs not the lift - 50% of the time
3. Redress incision
4. Doctors appointment re Hydrotherapy

NOTES:

08.05 Its been a tough night with no more than one hour sleep at a time. Well intentioned nurses are taking my blood pressure, issuing medications, pulling off my TED socks, delivering the breakfast tray and I just want more sleep. Its hard to find the off switch when the appliance is a hospital...

08:54 I had a visit from the OT who did the standard interview about my home environment and how it might need to be adapted for my continued rehabilitation at home. My set-up might be referred to as an OT's nightmare. It has 32 stairs from the car park to the front door with a single rail that changes sides twice. My apartment is two-storey with a 15 step staircase which starts with a 90 degree turn. She gave me advice on the additional equipment I would need to hire which included a toilet seat raiser, a standard chair with armrests and a wedge seat for the car.

More importantly she gave me her smile, her optimism and her genuine care. Its a beautiful thing about the young people of today - they are so caring. She help me feel happy and optimistic about the day. Thanks Kylie.

11:13 Had a great PT session this morning. I found the same exercises I did yesterday just that little bit easier today. A couple of more challenging exercises were introduced including the plank, half squats and straight leg raises.

My operated leg flexion increased from 62 degrees to 90 degrees with the assistance of a towel. My walking aid was reduced from two walking sticks to one walking stick.

12.54 I had a visit from the rehabilitation specialist Dr Prendergast today. He inspected my incision and ordered a redressing. He approved me for use of the hydrotherapy pool from tomorrow. He watched me walk and said the my gait was very good.

13.10 Went to the second rehab class today which focuses on a series of strengthening exercises for the calf, quadricep, hamstring and glute muscles as well as the supporting abdominal muscles. I find some of these exercises extremely difficult.

I have yet to be able to complete the whole 25 mins of exercises. My glute muscle becomes exhausted and I am unable to do any more. Following this session I am in pain and need to rest for at least 90 mins. Today was a little better than yesterday and that is all we, as rehab patients, can hope for.

15.15 I had my incision recovered in a waterproof dressing in preparation for tomorrow's hydrotherapy session.

17.00 Had another couple of hours sleep and iced my swollen areas from the afternoon physio session.

18.00 Went for a walk around the streets with my lady. It was useful to practice on an uneven footpath (sidewalk). The walk uphill is certainly a lot harder than the flat or downhill.

19.58 For those who are interested I have posted a pic of my incision in the relevant thread. Its not a really clear image as the incision has yet to be cleaned. I am pleased that the incision is only 12.7cm or 5cm in length. (I am not very tall).

 

[Jaycey]

Hi Mike, the situation about not being covered is the case in the UK. Until you are officially released to drive by your surgeon you can not drive. Well - you could drive I guess but if you had an accident you would not be covered. In any case it's very wise to wait. You need to be able to perform an emergency stop.

Keep up the great work Mike. You are an inspiration to many!

 

[AussieMike]

Thanks Jaycey for clarifying how a clearance to drive works. That makes perfect sense to me. So if a person is driving an automatic car and the operated leg is not required to use the brake or accelerator, the OS may at their discretion provide a clearance to drive earlier than for the patient whose operated leg is required to make the emergency stop or for the patient who has some complications in their recovery.

So in my case, my OS books his patient's post op appointment at 6 weeks as a matter of routine before surgery. In doing so he is really saying that he will first consider a driving clearance at 6 weeks post op.

 

[lncrwley]

When I discussed with my surgeon about driving, he said that I could drive anytime I wanted HOWEVER I was not to drive while taking the drugs! I was able to operate the gas and brake with my right foot because the surgery was on my left. He said that if I got a DUI, I would be on my own. So here I give a word of caution to those who drive while taking their meds. Be sure you know how the meds will react with you before you get behind the wheel!

 

[AussieMike]

Hi Lynne

Thanks for adding your knowledge to this thread. So we all agree that we need our OS clearance to drive in the first instance. I am not sure how DUI laws work in your US state, but in Australia the testing is done for recreational drugs as distinct from prescribed drugs. If a driver is stopped by the police and found to have drugs in their system which effect performance, the driver would need to have that clearance from their doctor for its use whilst driving to avoid further action.

Cheers

Mike

 

[lncrwley]

Really? Wow...here in Arizona, it doesn't matter if the drug was prescribed or bought on the streets. Having the drug in your system when an accident happens, will result in you getting a DUI. The police will run a drug test to see what is in your system by taking a blood sample. Any drug, legal or illegal, will result in fines or worse. I find the laws here in Az just totally nuts! If I am in an accident after having ONE SIP of beer, I will be prosecuted for being under the influence to the least degree. They do the same for drugs. Each state in the US has their own DUI laws so I don't know how the laws are in other states.

 

[AussieMike]

OMG Lynne

Yep, I find your state's approach to the use of drug's and driving nuts too. So what do you guys do if you want to go out to a restaurant, a night at the baseball (go the Padres), or a friend's 50th birthday party? It sounds to me like the kind of laws you pass when you have run out of ideas of how to deal with an out of control situation.

Cheers


Mike

 

[lncrwley]

Either you don't drink, stay home or cross your fingers that you don't get stopped. I love living in this state but the DUI laws are totally nuts. My son got a DUI because he got stopped and he had smoked a joint of weed a few days before. Just because he had it in his system, they arrested him. These laws need changing.

 

[Jaycey]

Hey Mike, I notice in your reports your weight is steadily dropping. Some of it is all the fluids they pumped into you pre and post op. But I am sure alot of it is all that healthy eating. Great stuff!

 

[AussieMike]

Hi Jaycey

I am so lucky. At both the operating hospital and here in rehab, they offer healthy food alternatives. They mark them with a little symbol and all I have to do is pick them. I know that consistent exercise and sound diet is all that it takes to achieve the weight loss I want. Right now it couldn't be easier.

Mike

 

[AussieMike]

CURRENT DATE: Thursday 4th October
Procedure: LTHR
Post Op: 10 days
Location: Rehabilitation Hospital
Current Weight: 77kg / 170Ib
Target Weight: 70kg / 154bIb

CURRENT ISSUES:
Moderate swelling around incision
Muscle weakness in left glute
Muscle weakness in left calf
Constipation

ACHIEVEMENTS TO DATE:
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. Walked down and up 2 flights of stairs (total 60 stairs)
15. Hip Flexion 90 degrees
16. Hip Abduction 28.5 degrees
17. Supporting my roomie and new friend David on his journey
18. Making people happy and positive
19. Walking with two walking sticks
20. Walking with one walking stick
21. Commenced hydrotherapy program

CURRENT PAIN MANAGEMENT:

Targin every 12 hours
10mg Endone every 3-4 hours upon request
Gabapentin every 12 hours
Panadol every 6 hours
Aspirin 150mg per day
Ice packs as required

TODAY'S FOOD PLAN:

Breakfast
porridge, baked beans on toast, orange juice, black tea.
Lunch
assorted sandwiches, fresh fruit, black tea
Dinner
beef stroganoff with lite cream sauce, rice, green beans, sweet potato, apple juice, creme caramel


TODAY'S FOCUS:
1. Physio session @ 9am
2. Hydrotherapy session @ 10am
3. Physio session @ 1pm
4. Use the stairs not the lift - 50% of the time


NOTES:

01.03 Took 10mg Endone to relieve hip pain and referred pain in my lower leg. Its the normal pattern these past few days. This should allow me 2 or 3 hours of peaceful sleep through the early hours of the morning.

08.33 Took additional medicine to combat constipation this morning. Its about finding the right balance here. Hopefully this does the trick.

12.30 Had my first hydrotherapy session this morning. It was great to challenge my leg strength against the hydrojets and experience the increased range of motion that water provides for all the exercises. Can't wait for the next session, but it made me really tired.

13.37 I completed the stretching and strengthening session today with a little more strength and proficiency. I got to the second last exercise before I had to stop with glute pain. Certainly an improvement on the first few times I have done this but still with a lot of room for improvement. Every day I have a new admiration for classical and ballet dancers.

16.35 Attended the weekly social event here at the rehab centre where 'mocktails' were served and the problems of the world were all solved inside 60 mins. I now know all there is to know about funeral insurance, public transport, foreign policy and classical music.

20.08 At the end of 1pm physio session, I was given 10mg Endone. Since that time I have been very drowsy and over medicated. I have attempted to speak with the nurse when she arrived with my evening medications but she was quite dismissive and told me not to ask for Endone so much. Gggrr

 

[bottomshollow]

What a fabulous report, Aussie Mike! You'll be running circles around all of us in no time at all. Keep up the great work! You're an inspiration to your fellow hippies.

 

[AussieMike]

Hi Bottomshollow

I am pleased you think the report is useful. I file it each day in the hope that it helps those who walk a similar path in the future. It's the least I can do to support the army of Bonesmart angels like you.

I would encourage others who have the time to keep a diary to do so also. On days when things are difficult, its very useful to be able to look back over the diary entries and recognise that the big picture is still positive even if the current situation is difficult. I can attest that it gives you a strong sense of achievement and motivates you to continue.

Mike

 

[tashia]

Mike, You sound that you are doing so good. I was reading your daily active and I did notice a lot of walking and remember you saying you are swelling. I think you are right about over doing it a little. Balance is so hard to do because if you feel better you go for a walk. Take care and keep going in the direction you are going. Tashia

 

[AussieMike]

Hi Tashia

I am not sure if the walking I am doing is causing much swelling but would be happy to explore that angle. So yesterday I did a walk of perhaps 300 meters. The physio sessions I did were about 60 minutes and 30 minutes in duration. The second physio session is the one I find very difficult as it focuses on balance and range of motion for the leg muscles. Immediately following this session I feel the fatigue and I swell. The other time I swell is around 3am (early morning) after about 6 hours in bed.

Your thoughts?

Mike

 

[Poppet]

Good morning Mike

Just caught up on your journal, what a wonderful job you are doing with it, so much good information and inspiration for not only members recovering, but also the myriad of guest we have you are searching for information.

Regarding the swelling, yes, it is related to the exercise. Although in saying that, moving around helps to reduce it. The traumatized tissue just complains when it thinks it has had enough.

However, you are doing everything right! Guidance with your Physio and rehab taking pain meds as prescribed and when needed and resting, elevating and icing in between.

Perfect !

Some folk find the swelling travels and can move down the leg even into the foot and ankle. It can last for quite some weeks and even has been known to last for months with some folk. I wrote a lengthy post on someone else's thread regarding swelling, but cant recall which one.. I will try and find it..

Enjoy the hydro therapy.. I did that and it is wonderful. Just remember with zero gravity in the water it is easy to overdo it though (not that I think you will )Getting out of the pool also is a wake up call with heavy muscles feeling heavier..

Have fun and a great day...

 

[AussieMike]

Good Morning Poppet!!

Well I am showered, dressed, fed and ready for that hydrotherapy pool this morning. Just because I am ready 1 hour before I need to be, is no indication that I am keen (much).

My swelling is not excessive. I expected it and as you point out expect it to last for up to three months. It does not worry me. I think of it as my body ensuring I don't overdo things by adding swelling as a protection.

I do have another question which you or someone else might have knowledge about.

As I have mentioned earlier I have famial hypercholestrolemia. This genetic condition causes the liver to product crazy volumes of cholesterol. My uncontrolled cholesterol is 13.2 compared to the normal of around 4 to 5. In my youth this was largely untreated and that excess cholesterol deposited into the joints. In my case it deposited behind the elbows and into the achilles tendons in both ankles. As I did the normal range of sporting activities, I experienced partial ruptures to both achilles - twice in the left ankle and three times in the right ankles. Since those days I have worn orthodics.

I think that the muscle aches and pain I am experiencing in my left glute and hamstring are in part attributable to the fact I have been wearing slippers without orthodics. Should I reintroduce the orthodics to my slippers at this stage? Do you agree that I should be working to resolve the muscle imbalances with the corrected posture the orthodics provide?

 

[AussieMike]

Help please Angels,

I need some advice here. I am feeling over medicated, drowsy and not in control for the past six hours. I attempted to discuss this with the nurse who brought my evening medication who was quite dismissive. She stated that I should not order Endone during the night in a tone that suggested I had done something wrong. I have done nothing different since I was brought here five days ago. What are my rights in this situation?

Thanks

Mike

 

[Poppet]

Don't know what happened there my answer got caught up in your quote.. I will delete that and start again so that no one gets confused!

As far as I am concerned you have every right to discuss your meds with the nursing staff, and it is important that they listen to you and don't dismiss you.

Did she think because you mentioned that you felt over medicated and drowsy that this could be the reason for you not taking or requesting Endone during the night?

I would ring the bell, get her back and ask if you could discuss the way you are feeling.

You are on a few pain meds and if you are feeling strange then they need to explain why... Not dismiss you!

Just noticed Jo is online, I will tag her to give her expert opinion Josephine;

 

[AussieMike]

Thanks Poppet

One can only assume that she was advising me to not order Endone during the night so that I don't feel the way I do right now. A junior nurse came around about 10 mins later and she was careful not to contradict her colleague but she did suggest that I should discuss my meds with the doctor who will be in tomorrow. I had waited for 2 hours to have that conversation with the nurse and was dismissed in less than 30 secs whose only question was do you want me to close your door. I felt like saying, no I want you to listen, answer my questions and understand what I am saying here.

I realise the drugs will probably magnify my emotions but the whole incident was quite upsetting.

Mike