Stepping out

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November sky, Roundhay Park.

Nearly two weeks since my last blog, and just over halfway through the 6 weeks healing period after my new hip was installed.

Not much has happened and a great deal has happened, at the same time.  I can barely remember the acute phase- vulnerability, shocked body, drugs, anxiety about swollen legs, spectacular bruising, dodgy bowels, seeping wound sites, pain….  The post-op amnesia is very powerful.  I’m struggling to remember even now, and people who’ve had hip replacements longer ago mostly say they can’t remember things, but the experience is so vivid at the time.

So, all of the above anxieties have receded.  The swelling and bruising has almost gone, even though I was warned it could take months for the leg to get back to normal size (I’ve been sleeping with my leg elevated).  Have stopped most of the drugs- just have to take the anti-coagulant for another week or two.  Don’t even need paracetamol for pain relief now, having been on it for the arthritis pain for a year or more.  The wound has healed really well and I’m walking without crutches, easily.  I’m building up the length of walks outside with a bit of care (and a stick for stability- I don’t want to fall over).  The picture above is from yesterday’s outing to beautiful, cold, bright Roundhay Park.  I’m more confident about managing the hip precautions out and about- seat and toilet heights etc….

Freedom and walking, walking, walking beckons.  I’m a little bit impatient so need to be careful.  I can tell I am recovering still because I’m tired, mentally drained.  I wonder how long it takes to recover from blood loss.  My appetite is still poor and I have lost weight (I need to!).  I’m starting to reinstate activities but want to be careful about it.  I would like to be less busy and have more of the time and space I have appreciated over the past weeks- I LOVE reading and thinking.  But I’m seeing friends, getting down to the coffee shop, my book group and singing group met here last week and more regular things are getting slotted in.  Alison from Kendal was here overnight last week and Mary from Bristol is coming for a couple of nights this week.  I might try going to the pictures soon.  Have managed to visit Mum throughout, as well as participate in her birthday weekend, a week ago.  The list of stuff to do is re-emerging- things for Mum, art projects, planning meals, nights out, social things, putting my nice life back together again.

So that’s all good then, as they say on W1A.

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Halloween

Pic of the Spanish chestnut tree in Walsall Arboretum planted in memory of my friend Charo Rivera.

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A few years ago I was in France in the autumn and observed their ‘Halloween’ traditions.  As you’d expect (being France) it’s a day off work and school, families gather and everyone takes pots of chrysanthemums to place at the graves of their ancestors.  So, first the shop frontages, and then the graveyards, are a sea of spicy autumn colours- gold through to red and purple.  Everyone is out and about and there is an air of warm and respectful celebration. Very different from the gaudy, gory, commercialised American version, or the macabre and riotous Mexican Day of the Dead.

Halloween descends from our Celtic festival Samhain which recognises the turning of the year. On its eve the boundaries between the worlds of the living and the dead were thought to break down.  So, when there was a power cut between 4.30 and 5.15 last night, it felt appropriate to remember my Dad who died 28 years ago and was, for all his working life, an employee of the Central Electricity Generating Board.  I gave him a little wave in the wee small hours this morning.  The family will all be gathering this weekend for my Mum’s 90th birthday so he will be with us then too.  Mum has spent these past 28 years as a widow, most of them coping with ill-health and impairment from Parkinson’s Disease, which she has borne with resilience and good cheer (most of the time anyway).

I’ve just finished Volume 2 of the Jane Smiley Hundred Years American family saga so am immersed in the looping dramas of successive generations framed by swirling history (1919-2019) and no less intense interpersonal dynamics.  It’s a satisfyingly long perspective on the human condition and I keep playing with slotting me and my family into the structure- the story of a complex and expanding family told in 100 chapters of about 20 pages, one for each year.  I saw Jane Smiley speak (about these books and US politics) at last year’s Ilkley Literature Festival.  She is formidable and funny, around the same age as me and with similar attitudes, values, doubts and confusions.

It’s been marvellous to have time for these books and for Thinking. Highly underrated these days- increasingly squeezed out (for me anyway) by electronic chatter. Also, I’ve had no alcohol for a couple of weeks now and think that has helped with the thinking.  Apart from greater clarity I can see how my depressive turn of mind before the op twisted so many of my thoughts, memories and ideas seemed to twist into something negative and mournful, disturbing.  Now I’m lying here chewing over the same material, the mental landscape of stories, coincidences, connections that make up ‘me’.  And, overwhelmingly, they make me feel happy and grateful.

So this has brought to mind another beautiful person who died 17 years ago, my dear friend Charo, who used to describe my expansive and interesting life, as she saw it, as my ‘web’, another nice echo of Halloween. I miss her still.  And all the others- Pete, Barry, Mary, Daisy, Ken, Phyll, Fred, Ruth, Tommy, Edna, Lily, Pearson, Molly, Norman, lots more.  Good to bring them back in remembering.

I hope this isn’t maudlin.  It doesn’t feel it.

In terms of the hip, healing and recovery, I’m much better.  Had a scare about my leg swelling up but checked it out and it’s OK- uncomfortable but just one of those things, apparently.  Everything else is still improving.  I keep setting off to walk around the house forgetting my crutches- it’s a miracle.

 

Eleven days later

Emily’s flowers which have opened up and lasted beautifully.

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Sustained progress in terms of pain and mobility but slight setback because my leg has swelled up, mostly below the knee.  It’s uncomfortable and unpleasant and a reminder that it’s not all ‘onwards and upwards’.  I can’t tell if I’m doing too much or too little.  I rang the hospital on Sunday morning and got straight through to one of the physios for a good chat about do’s and don’ts and overall reassurance that it’s OK and normal.  Excellent and wonderfully accessible support, again.

I think I was sitting still too much on Saturday night (the curse of Strictly?) and also standing a bit too much cooking our tea.  So I had a relatively easy day yesterday, with two exciting ‘firsts’- washing my hair leaning over the bath, with Pete’s help, and going for a walk down the street, in the autumn sunshine.  Hoping to make it as far as the coffee shop by the end of the week.  The post-operative pain is definitely resolving and walking is much easier.  Thinking about cutting back on the pain killers.

I’m still relaxed and happy- mostly in bed, watching the leaves on the trees turning gold, rattling through the brilliant Jane Smiley trilogy- over halfway now with only another 1,000 pages to go (!), watching stuff on the laptop, listening to the radio, chatting to friends on the phone, enjoying the occasional visitor, doing my exercises, planning each day with Pete (what we’re going to eat mostly), and generally healing.  If ever I needed evidence that the operation has had a major impact it is that I am OFF MY FOOD!  Things taste too strong, and I can’t eat very much.  A quite new experience.

My bowels are almost normal now.  Had a great chat on the subject of bowel function with a friend who loves a good ‘guts’ chat- nice to be able to share.

The weather is a great aid to recovery.  I love the autumn blue skies and honey light.  I’ll go out again today and walk a little further.

I’m definitely up for visits and phone calls now.  Only connect!

Feeling better

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Pic is of a late autumn Chapel Allerton tree.

It is surprising how good I feel. Happy and just a little bit high.  Still very emotional and opened-up.  Partly, I’m sure, because of the di-hydrocodeine, but not just that.

Perhaps I had been ‘down’ and irritable before the op because of the impairment from the arthritic hip.  All the objective facts of my life are the same but I remember often feeling unhappy and wondering why, considering all the good things.  Now it’s easier to see and appreciate it all- my comfortable home, enough resources to do everything I want to do, loads of lovely family and friends, my Mum still being here, happy and well looked-after, the delightful new babies, and the good man who is looking after me.  Looking at that list I see that the order needs to be exactly reversed to accurately identify what is most important.  Oddly, I often think in reverse like that when I’m writing.

I am so very grateful for the NHS, the wonderful staff and their expertise in delivering this great operation.  I’m so lucky and am grateful to have plenty of time for the gratitude!

Everything is getting better day by day.  This morning I managed to get up, washed, dressed, dry shampoo my hair and do my usual extensive beauty regime (a splash of cold water, a dab of moisturiser and a swipe of eyeliner) all by myself. A little triumph.

I wrote my first post-operative list this morning (anyone who knows me will appreciate how significant this is).  It was very modest and I have ticked half of it off already.  I wrote a couple of ‘fan’ messages, to the comedian Josie Long, and to the Young ‘Uns (folk singers).  Over the last week these people have provided me with chest-swelling amounts of inspiration and laughter. I thanked Josie for a stand-up set on BBC i-Player about politics and optimism, which included her pulling out and describing very beautifully one of my favourite books, Hope in the Dark, by one of my favourite writers, Rebecca Solnit.  I wrote to the Young ‘Uns on similar lines, about their new album Strangers, which is made up of lovely songs about ordinary everyday heroism, flying in the face of the cruel and divisive worldview currently being promoted by our ignorant and misguided ‘leaders’. That’s what I call a tonic.

I’m spending lots of time in bed because it’s so comfortable and nice here and I think it’s what I need to do during this acute healing phase.  I’m still moving about quite a lot- doing my exercises and going back and forth to the loo about every 2-3 hours (including at night).  I have been dressed and up every day, starting to make meals with Pete, watching the telly, etc, but I’m uncomfortable sitting in a chair at the moment- happier to be horizontal or propped up in bed, looking at the sky, the birds and squirrels and the autumn trees.

Bowels are working, pain is easing, really enjoying THINKING.  Great progress in a week and a day.

Blog is posted, third item ticked off the list.

Home again

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Recreational resources which are not dependent on broad band connectivity.

It’s Wednesday now so I have been home since Saturday evening and tomorrow it will be a week since I had the op.  Best news is that bowels are working again, which makes me very happy.  Have all the meds arranged in a routine, though I’ve come off the anti-coagulants for a bit since there was a bit of leakage around the wound site.  This is all a bit earthy isn’t it?  Apologies but I think writing this is mostly for me to help process what’s going on.  Humour me?

I’ve not been up and dressed much. I do get up every day to eat, and watch telly in the evenings for a bit- I sorted out the edge pieces of one of the jigsaw puzzles yesterday (big achievement).  But at the moment sitting for any length of time isn’t comfortable.  I really prefer being in bed, with the radio, Some Luck by Jane Smiley to read, the laptop for music, radio playback and writing, Pete bringing me food, drinks, the Guardian and cards and flowers as they arrive in the post. The bedroom is full of flowers and the whole top floor of the house is fragrant.  I am very tired and happily napping when I please.  Managing the exercises, including lying down ones recommended by my cousin’s wife Rita, who had her hip done 2 days before me.  It’s great chatting to people about their experience, the more recent the better- we all forget stuff like this, especially the nasty things.  Rita actually went out with ‘the girls’ last night- only for a little while but I’m well impressed.

I talked to my Mum on the phone yesterday.  I see her about every other day at the moment and am missing her, feeling that ancient thing about wanting your Mum when you are in trouble or distress. She finds communication so difficult these days that I wasn’t sure about asking the nursing home staff to put me on to her, but we managed.  After one of the inevitable silences I said, “Well, I’ll go now”, and she said “No, don’t go yet”.  It’s really amazing how important and touching such a small fragment of conversation can be.  I’m going to see her today.

I went out for a shower at an elderly friend’s house on Monday, since we don’t have a walk-in one at home.  It. Was. Fantastic.  I washed my hair and everything.

There’s a difficult balancing act to negotiate between being active vs overdoing it.  Mostly this is to do with communicating with or seeing friends (or not), doing things vs resting, and staying away from the screen vs reading etc. I need to keep reminding myself that it was a major operation and that the recovery takes time. It’s not about bravery so much as accepting vulnerability and weakness, which seems rather the opposite of bravery.  This world drives us all so hard, it’s a good lesson.

 

 

 

Coming round

Pic is of my drugs!

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After the op I was wheeled into a small post-op ward and there was lots going on, most of which I can’t remember.  Recall that I had an oxygen mask on throughout the op and for some time after?

Still blissed out from the sedative mix, I couldn’t feel or move below the waist, for a few more hours.  As the feeling slowly returned I felt something in my legs, tingling, pressure? My calves felt as if they were inflating and deflating- strange.  Eventually I looked down and sure enough the blankets were shifting up and down.  What weird effect of spinal anaesthesia was this?  So I called someone and they lifted the blanket to show me that the inflation/deflation was not my legs but some pressure cuffs which stayed with me for the next couple of days (preventing DVTs).  We laughed!  I got used the feeling and quite liked it, especially when I was half awake and it made me think one of our cats was snuggling up to me.  Comforting.

I was straight on to some heavy-duty opiates to help with the post-op pain.  They made me feel sick so they gave me little magic minty papery squares to melt on my tongue.  Started to realise that, as well as the operation, I’ll be on lots of drugs for a while.  Constipation here I come.

Can’t remember much about the day of the op.  My blood pressure was really low, heart rate was high, and I didn’t wee until the early hours of the next day.  It was, quite literally, a shock to my system. Several cups of tea really helped- good tea as well, greatly appreciated.

The staff were all really good again but I did start to feel that the service is a bit pared down the bone (pun intended).  Although the time the doctors spent with me was quality time, it was not enough really- to make a human connection and open up space for questions and conversation.  Now I won’t see a surgeon for three months, and so far I have seen three different people- one for the initial consultation in July, the Prof on the morning of the op, and another one after the op (who did the surgery, under supervision from the Prof, for which I gave my permission).  All the surgeons are extremely experienced and skilled, so that’s fine, but the human connection was a bit lacking.

There was a lot of pressure on beds so I didn’t get moved onto the rehab ward for a couple of days, with a detour one night into a rather unsuitable pre-op room where I was isolated from the ward staff.  That night and morning I had to use my mobile phone to call the ward telephone when I needed assistance, and I didn’t get any breakfast.  One member of staff was clearly put out that I was in one of ‘her’ beds and was insensitive to say the least, I had to remind them what to do and felt really cut off.  There were lots of apologies but still.

The dreaded physio visits- to get you out of bed and supervise you through essential things so that you can go home (asap)- went well.  And the occupational therapist came by to do her bit.  Again they were all very skilled and nice but there wasn’t much time for human connection.  Everyone kept saying (apologetically) that they were really busy.  Perhaps that’s the downside of them being a ‘centre of excellence’ and having to meet various targets. I think I’d have preferred to wait a few weeks if it meant a more relaxed, personal service.  Hey ho, it’s probably not that simple.

I did well on the physio tasks, and finally got onto the rehab ward where everyone was much more attentive and nice.  Then came the most unpleasant part of all.  Which I won’t describe in any detail but was to do with my bowels and something getting STUCK!  It was sorted eventually but, oh dear, very painful.  Not the best time for a visitor, my dear friend Kath who is a nurse and works at the hospital.  Luckily she completely understood and we managed to laugh about it.

I was very keen to get home (in retrospect I could probably have done with another day in hospital) so Pete came to get me on Saturday night.  Again, it’s all a bit of a blur. Of which more in tomorrow’s blog post.

My bedroom is full of flowers and cards.  Very grateful for love and friendship when I feel so vulnerable.

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I’ve been home for two nights now and still in that post-operative hazy state, not sure which way is up and trying to adjust to a whole new situation and a significant process of change.

For a week or so before I went in to hospital I was unusually weepy and emotional.  I had some dreams about the hospital, the first two were a take on ‘The Secret Garden’- wandering around Chapel Allerton Hospital and its grounds and finding beautiful laid-out gardens populated by kind and funny people- the usual dreamy quirks and weirdnesses.  The last one was a nightmare, with bodies marked up for various forms of unpleasantness (this is the gentlest description possible, no need for detail!)  I felt tired too, closing down pre-op, preparing for post-op, life (new bed, chair, aids, a freezer full of nice food).

The operation is a watershed.  The pain and impairment of the arthritic hip eclipsed by the acute effects of a major operation, a big ‘insult’ to my body.  My hip was dislocated and the top of my femur removed, replaced by a metal sphere attached to a pin hammered into my thigh bone.  The socket part of the joint was ground down and re-lined with a ceramic replacement.  Lots of muscle and other tissues were cut away then everything sewn back together.  Blood is lost, lots of drugs administered- for sedation, anaesthesia, pain relief, prevention of blood clots, and drugs to treat the side effects of other drugs- and I was attached to various drips and monitors.  This is all quite amazing and marvellous, and it has quite an impact!  The operation site all needs to heal and the joint start to work again.  I just watched a video of the procedure.  It feels useful to describe it back to myself, to own it as something that happened to me, to my bones and muscles and skin.  So much autonomy is lost in hospital, the vulnerability is very raw and real.  There’s a lot to process and to heal.

So how did it go, looking back nearly 4 days on?  My main concern that morning was a horrible caffeine withdrawal headache and several hours (7am-midday) longing for a cup of tea.  During that time I met the doctors, who were absolutely lovely, a big bloke, the surgeon, from India, and a petite woman, the anaesthetist, Arabic name, Dublin accent.  They talked it all through with me and I was marked up on the correct thigh, with an up arrow in case they thought it was my knee that needed doing.  I got into bed and drifted back and forth listening to music and the radio via my phone- hard to remember it now.  Then when they finally came for me, a wave of apprehension and backed-up fear.

Being wheeled into the ante-room for anaesthesia is when control is surrendered.  It seems to be the job of the anaesthetist and the technician job to make you feel comfortable, both physically and emotionally, which they did beautifully.  We talked about the vulnerability thing and the technician (another lovely big bloke) told a story about how he had been shaking like a leaf before an op at the hospital where he was working, carried out by people he knew and trusted.  So.. cannula in for an excellent cocktail of happy drugs, then the spinal block in my back.  It was chilly (because the bugs don’t like the cold apparently) so they wrapped my top half (the only half which could feel anything) up warm and I got the phone set up to listen to music.  A first listen to the Young ‘Uns new album purchased specially and saved up for the occasion and some of Emily Portman’s beautiful ‘Coracle’ album.  Inspiring and moving, a great distraction from the hammering and grinding going on down below.  Then it was done and I was off to the post-op ward.

Next instalment tomorrow- this takes up quite lot of energy!