Total Hip Replacement #2 – Day 1

I had a good night’s sleep, despite waking up a couple of times with the blood pressure monitor and the compression boots. I was awake properly from about 7am and started on my bed-bound exercises.

These exercises are extremely important, especially the butt clenches. For the other hip replacement, I should have been doing them from the start, so I’m not making that mistake again.

The bed exercises consist of flexing your quadriceps (front thigh muscles) and then pressing your knee down onto the mattress (still flexing the quads) for about 10 seconds per leg. Butt clenches are simple: contract and squeeze your glute (bum) muscles. I also did a few lying knee raises, where you keep the sole of your foot on the bed and slide it up to your bum, raising your knee in the process.

I think I was briefly seen by the surgeon or it may have been yesterday, but was told everything went fine, leg length is fine, same sort / type of replacement on both sides (I love symmetry), hip capsulotomy done (Dremel-ing out hip socket)…

I spent the day dozing and at some point was taken to x-ray to check placement of the, er, replacement which was all fine and dandy.

Later in the evening I was seen by another surgeon and I mentioned the knee pain. He mentioned that they used it for a fulcrum to dislocate my hip, and that my left foot was up by my head, so he wasn’t surprised it was a bit sore :-)

I then had a last shot of morphine for the knee pain, watched Citizenfour and dozed off :-)


Total Hip Replacement #2 – Day 0

Jacky dropped me off at Nuffield Derby at 7am and we had a quick chat before she headed back. I was shown into my room (not ward) and before I could unpack, lots of people came through, checking and double-checking my details.

“Yes, it’s my left hip” x 4
“Yes, I’m allergic to penicillin” x 4
“Yes, I do want the the sedative before the epidural because I’m a big baby” x 8

After the necessary barrage of questions, I finished unpacking and before I knew it, I was heading into surgery at 9am. I asked whether I could keep the removed hip bone and make a hip cane or paperweight, but was told no due to the risk of infection. Shame :-(

I was wheeled through into the anaesthetist’s room, given half the sedative and then the epidural, which I remember more about this time, and then I was gone.

[slicey dicey cut hack chop hammer stitch]

I came to in the “step down” room, which is where you’re monitored after surgery. This basically means you’re hooked up to lots of machines that make lots of noises, multiplied by the number of people in the room. It certainly makes peeing in a bottle lying down more complicated than usual :-s

This time, I had quite a bit of pain in my left knee, which was odd. I mentioned it and was quickly given morphine to shut me up – maybe work could start doing that? I basically snoozed throughout the day, really lost track of time. Jacky and Alex visited briefly in the evening, was great to see them but unfortunately there was nowhere for them to sit so it was a quick visit :-(

As luck would have it, I was able to go back to my room early, which meant privacy, which meant peeing, finally. I then had another dose of morphine (it really is quite moreish) and watched 10,000BC and dozed again.

After a late-night sandwich, I had some oxycontin and went to sleep. I was disturbed a couple of times through the night by the automated blood pressure check and a nurse, but it was a good night’s sleep :-)


Total Hip Replacement – catch up

Well, the visit with the consultant went very well, they were happy with the progress I’d made. So much so, that I was placed on the waiting list to have my left hip replaced – this always needed doing as well, but I wasn’t expecting to go on the list so soon.

A few weeks after that, I received a call asking me if I minded having the surgery at a private hospital (Nuffield, Derby) by the same team as Derby Royal couldn’t see me for a while. They also asked if there were any dates in February I couldn’t make; long story short, I was booked in for the replacement on the 24th February.

My excellent employer, Peppermint Technology Ltd, were very understanding and arranged upcoming development work around my holiday, er, hip replacement :-)

I had a pre-op assessment at Nuffield the week before the surgery, usual stuff, questions about health, allergies etc. and then just waited until the 24th :-)


Total Hip Replacement – 8 weeks on

You know, I honestly thought I had posted a six week update, but I guess Christmas preparations got in the way, and then Christmas, and then New Year, and now here we are :-)

So, 8 weeks on. I am almost totally back to normal – for me, anyway. I can walk just under a mile without crutches, but the left leg (the un-operated one) is suffering a bit but I guess that’s down to working more to compensate.

My operated leg has atrophied to about 2/3rds usual size, which is a bit of a shock. I have started doing some free weight leg extensions to counter that, unfortunately squats and lunges are still out as I’m still stiff / sore, but easy does it. I’ve also started doing some simple leg stretches, again, nice and easy.

To be honest, I am not doing the side extensions, knees up, hamstring tighteners and butt clenches as much as I should, but I am walking a lot more which is A Good Thing, apparently. It sounds silly, but you really have to concentrate on walking, to make sure you’re not limping for whatever reason. I plan to get on the treadmill when I’m back at the gym, and just spend 30 minutes really concentrating on my walking.

I am seeing the hip surgeon this Thursday, so we’ll see what he has to say. I am now itching to get the other leg done :-)


Total Hip Replacement – 5 weeks on

Well, pretty much continuing as week 4 did, but more so: more exercises, more walking with and without the crutch, etc.

That said, walking with the crutch is rather tiring, my cardio (never that good) must be even worse now :-( I am looking forward to getting back to the gym and improving my cardio :-)

Nancy Jones on Twitter contacted me, a fellow hip replacement patient, and we’ve been exchanging our experiences, and Nancy pointed me to this interesting article about pre- and post-operation experiences, all good stuff.

After next week, the deep vein thrombosis socks come off, so I’m looking forward to that. Until then, more walking, more exercises, a Christmas fuddle at work – all good stuff :-)


Total Hip Replacement – 4 weeks on

Recovery is certainly improving, and the speed of recovery is increasing as well. I am now scooting around the house on one crutch, and few steps between kitchen cabinets and island :-)

I think one of the key things that has increased my recovery is these things called “glute sets”, where basically you squeeze your bum cheeks together. I found the exercise on YouTube, courtesy of HomeHealthPT. I recommend you have a look and add them to your exercise routine:

Glute Sets – A Must After Hip Replacement Surgery

I also found some more exercise routines, which I have incorporated into my exercise routine:

More hip exercises!!!

If this seems like a lot of exercises – buck up. They will definitely aid in your recovery, but definitely start slow and listen to your body. I have the benefit of several years of weight training, so I know how far to push myself, what is a “good” pain vs. “bad” pain – a dull, contented ache in the muscles vs. sharp pains. Again, start slowly and add in more exercises, sets and repetitions when you are able to, but at least do something.

On Friday evening, I went to my work’s Christmas do, and despite them imploring me to use the wheelchair, I went on both crutches, walked for about a mile and a bit on them, and felt fine.

I think next week I will start walking unaided, but will return to my crutches if that’s a problem – there is no point jeopardising my recovery by going too fast :-)


Total Hip Replacement – 3 Weeks On

A quick update after my right leg total hip replacement three weeks ago, split out by weeks, with some graphic explanations.

Week 1

This week was mostly taken up by sleeping and dozing (thanks, Tramadol!), interspersed with exercises and brief walks around the house. A few items of information which you may find interesting:

If you don’t sleep on your back, start practising now. I absolutely hate it. Good thing for the Tramadol as it knocked me out quite well :-) The DVT socks had to taken off each day for an hour, which my wife did, which is much appreciated.

You may be given laxatives to counteract the effects of certain drugs. TAKE THEM. And prunes, lots of prunes. Six days on, I went to the loo, and frankly felt like I shat a brick. It was extremely unpleasant and painful, and took half an hour. Look up “digital impacted fecal removal” for er, shits and giggles. Seriously, take the laxatives.

You probably will be given lots of drugs, make sure you take all those too, they’re to aid in your recovery.

Week 2

Slow progress, and I got a bit down, frankly. The recovery time seemed to be a long way off, my days were filled with daytime TV (Bargain Hunt!), the nights were filled with constant bloody trips to the loo, very annoying.

I felt a lot better when my mother came to visit for a few days, albeit still housebound. I was pleased when my mother and my wife got out of the house for a few hours, as I felt I was cooping them up. My mother then told me about her hip replacement, and how she borrowed a wheelchair from the Red Cross. The next day, we made enquiries and picked on up on the next day so we could get out a lot more. It was good news :-)

My mother left, we had a day to recover, and my sister and niece came to visit for the weekend, which was great as well. Lots of chatting, watched films, ate well, chatted some more :-)

The swelling from the operation was, by now, pretty much all gone and the scar was healing well. The Tramadol, gabapentin et al were finished in this week, so it was just painkillers and stomach settlers to take.

Week 3

Movement on both crutches had been improving very well over week 2, and continued to improve. There were occasions where I could walk with one crutch, but not for long.

The malaise of week 2 had passed, and passing the halfway mark of recovery certainly felt good. I was out a lot more thanks to the wheelchair, and the powerful engine that was my wife – apparently, it provides a very good cardio and arm workout :-)

Near to the end of week 3, I stopped taking the painkillers as well, as my pain level was no more than a 1, plus some discomfort, but nothing bad.

Another tip: when you have your DVT socks off, rub some (manly) moisturiser into your feet, shins, ankles, etc., they’ll probably be a bit dry.

More next week :-)


Total Hip Replacement – Recovery Day 2

I awoke early, about 6am, due to no morphine the night before. Weirdly enough, my left knee (on the un-operated leg) was rather sore. I asked the nurse what time the drug trolley came around, was told it was 8am, so I could wait until then.

After another Rice Krispies breakfast and a top-up on the painkillers, two physioterrorists (ha ha) came round and asked to see me stumble around on my zimmer frame. They were happy, and gave me some adjustable crutches and watched me on those.

I was then taken by them to a stairway and taught how to negotiate stairs on crutches, or more accurately, crutch. Again, they were happy with my progress; “you can go”, they said. I was a bit surprised – “what, *go* go?”, I asked. “Yep,” they said.

As it was close to lunch, it was decided that I would leave after that. I can’t remember what I had, but I do remember that all the food in the hospital was very good :-)

After lunch, I was checked by a couple of nurses (I think one was actually a ward sister) to make sure I could get in and out of bed, get to the loo OK, and traverse stairs safely. They also had to check that I could poo alright, but I hadn’t been for a few days thanks to the drugs :-( I said I’d probably be OK at home, and they were fine with that.

I then called my lovely wife to give her the good news that I was being discharged, and she was rather surprised (as was I, really). I was taken to the discharge ward to wait, saw Michael again (another Michael) as he was also being discharged. We had a chat, he was collected, and then so was I, but not before being given a great big bag of drugs and painkillers. These were omeprazole, aspirin, paracetamol, tramadol, ibuprofen, gabapentin, and laxatives. I was also given a sheet with instructions of what to take and when, all very thorough.

After a short drive home, I hopped up the stairs, into bed and began my recovery :-)


Total Hip Replacement – Recovery Day 1

I awoke from a morphine-induced sleep – they are only 12-hour slow-release doses after all – to the clinking of a tea trolley, which was gratefully received. The sleep through the night was a bit broken as my blood pressure was being taken automatically every half-hour by a machine, and a nurse came by every three hours to check the figures. I also had these lovely inflating boots on, which inflated / deflated on each foot every 15 seconds or so. That said, I did manage to sleep.

After a pleasant breakfast of Rice Krispies and toast (and more tea), I spent at least an hour chatting to Sean, Gerald and Malcolm about various things, and we were told by a nurse we sounded like old soldiers comparing war wounds :-)

I decided to spend some time out of the bed and in the chair. Once again, being upright didn’t agree with me as I felt woozy, sick and faint within five minutes and asked for a sick bowl but got hustled back into bed quickly and felt much better.

About 11am, a couple of physios came around to check on me on the zimmer frame, said I was fine and they would be back later with some crutches. I was then taken to x-ray so that the position of the replacement could be checked. It was fine and dandy, so I was returned to the ward just in time for lunch.

After lunch, time passed, Sean and Gerald were moved to a different ward to receive a couple of new chaps, David and Michael, who were operated on that day. I had the inflating boots removed (relief), along with the blood pressure machine, as it seemed to be back to normal. I was no longer being measured for, er, output so I could go to the loo normally again.

After dinner, my wife and son came visiting again, we had a good long chat and after they left, I napped and read a bit until lights out again.

It was only then I realised that the physios hadn’t come back to see me, but I wasn’t going anywhere :-)


Total Hip Replacement Day 0 – Surgery

On the 8th of November, 2014 I arrived at the Derby Royal Hospital at 7am, driven in by my wife. I had with me nightwear for two nights, a book or two and most importantly, my admission letter.

I gave the letter to the receptionist on the day admission ward, was told I was second on the list (result) and went through to the waiting room. There I met a fellow patient I’d already seen a couple of times at the advanced recovery class and the pre-op assessment, so we had a chat before he was called in, as he was first.

After a bit of wait, about an hour, things started moving for me. I was taken to a ward, had my blood pressure tested and some blood taken. The anaesthetist came to see me to explain what was going to happen: I would be having a sedative followed by an epidural. I said i was concerned by the epidural and he said it was like being stung by a bee. For ten seconds. Then he double-triple-checked that I was having a total hip replacement on my right leg, drew an arrow on it, and then I got changed into one of those lovely gowns. I’m pretty sure I signed some more paperwork as well.

After another short wait, I was taken into the anaesthetist’s room (whatever that’s called) and the anaesthetist put a cannula into my left hand for easy administering of lots of drugs. I still don’t like needles, incidentally. I then had the the sedative injected into the cannula, which the anaesthetist called gin and tonic, and it had pretty much the same effect as 10 of them in about 5 seconds :-) I vaguely recall being put onto my side for the epidural…

Time passed.

I woke up in the recovery room, very sleepy, and had a few sips of water three times thanks to a helpful nurse.

More time passed.

I awoke on the ward, in a bay of three with some other patients; Gerald, Sean and Malcolm, who was just a disembodied voice as I couldn’t see him. I then had lunch and a cup of tea, and dozed for a bit. I had my cannula still attached with some fluids going in for hydration, a blood pressure monitor on my right arm along with a heart rate monitor on my finger. I was not in a great deal of pain *at all*, which was very surprising, but then again, I couldn’t feel my legs due to the epidural. I was asked to keep trying to wiggle my toes, which I eventually did about an hour and a half later.

At some point in the same afternoon, the occupational therapists / physiotherapists assisted me out of the bed and into a chair via a zimmer frame, as they are keen to get you up as soon as possible under the advanced recovery program. It was in the chair that things started to go South. It appears that when the epidural wears off, your blood pressure plummets. I started feeling sick, sweating and almost passed out – I asked for a sick bowl from the nurse, but they put me back into bed, put some oxygen on me and I felt better in a few minutes.

I was told by the nurses that my wife, mother and sister all enquired about me and were told that I was fine and dandy.

After a nap and some tea, I placed my dinner order (lamb curry, turned out very nice) and then it was pee time. I managed to zimmer to the loo quite easily; again, not much pain at all. I couldn’t go in the bed lying down, hence the trip to the loo.

Visiting time rolled around, and my wife and son came around and we chatted for a bit. It was great to see them :-) After more tea and painkillers (morphine is great ), it was lights out at about quarter to eleven.


Full right hip replacement – eep

My last post showed how bad my hips were, and mentioned that I was on a waiting list for my right leg full hip replacement.

Well, my wait was less than two months, as I go in for surgery this Saturday :s

I am having the surgery at the Royal Derby hospital (guess where that is?), and they have been excellent up to the operation. They are very keen on getting you mobile as quickly as possible, so I’ve attended an Advanced Recovery class, wherein they tell you what’s going to happen before, during and after surgery, and then a pre-operation assessment where the consultant etc. saw me, blood tests, blood pressure tests, urine test, the whole thing.

Apparently I’m having a titanium stem with a ceramic end, which goes into a ceramic cup, so it’s a ceramic on ceramic joint, the latest and greatest approach, which is nice. The life span is 10 – 20 years, which is pretty decent. The six weeks recovery time will be interesting, I think, but as my close personal friend Bill Wallace (*) said to me, “The one they put in is a lot better than the one they take out”.

Being a martial artist, it’s been asked of me whether all the years of training caused the problem. The honest answer is I don’t know, and the doctors can’t seem to tell me either. One said that it appeared that I’m pre-disposed to osteo-arthritis (“It’s got you early”), and adding in osteo neo phytosis (bony growths at the head of the femur), which grate against the hip socket causing more arthritis, makes for very uncomfortable legs. That said, I’ve never really been that flexible out to the sides, so I could have been born slightly off, and it’s certainly got a lot worse (unbearable) in the last five years.

It has taught me that no amount of flexibility training and stretching will overcome a physical block – Rachel Burr worked with me for a long time on mobility and pain relief, and it worked for a time, but it soon became apparent that the issue was bone, not tissue. I’m just surprised that a) I’m having them done at 43, and b) I’m being seen so quickly.

I’ll be blogging my experience as I go along, as it may help others :-)

(*) Bill Wallace isn’t actually my close personal friend, but I have attended a couple of his seminars, he is a top chap (spoke to me at length about his hips) and legend.


How bad are my hips?

As part of my hip problems, I had an ant/post x-ray taken a couple of months ago – I should have had a lateral too, but the radiologist flat-out refused to do so, despite a clear request from my GP. Never mind, they got done eventually, and I snapped this pic when I saw the consultant at Royal Derby.

SLightly buggered hips...

Long story short, my hips are “buggered” (technical term) and I’m on the waiting list for two new titanium, ceramic on ceramic hip replacements. Which is nice.


Oblivion, 9/10

Just got back from seeing Oblivion, starring Tom Cruise, Olga Kurylenko, et al. I’ve seen written that it heralds the start of a new age of cinema sci-fi, and being somewhat of a cinema sci-fi buff, I have to agree.

The films starts by getting the viewer up to speed by Tom Cruise’s character Jack Harper (not Reacher). A long time ago, Earth was invaded by aliens, they were nuked and the war was won, but at the expense of the planet. Harper’s mission is to look after drones which in turn look after huge hydro-reactors that generate power for the remaining humans on Titan. He’s aided in this by his partner Victoria, who communicates with him and a mahoosive orbiting satellite called the Tet(rahedron), who are basically mission control.

Harper, who lives and dreams among the clouds, flies around in a *really* cool craft and repairs drones that have crashed. Well, not really crashed, more like shot down, by some of the remaining aliens called Skavs. They seem to be fairly intelligent, as they are taking the drones apart for their own reasons. Early in the film, Harper has a run-in with some Skavs, and that when we are introduced to the drones proper. Basically, they’re just giant balls of death, making mincemeat out of the Skavs and doing a fine job of protecting Harper.

They don’t do such a good job of protecting the hydro-reactors however, and after one gets destroyed in a (very large) explosion and some humans turn up unexpectedly, the film really gets going and that’s all I’m going to say on the plot.

I found the acting, unsurprisingly, to be top-notch. A lot of people put Tom Cruise down (ha ha), but he does this role very well, he seems to be all over the place at the moment. The rest of the cast are also excellent, especially Andrea Riseborough in the role of Victoria. Olga Kurylenko also does very well, despite being a smaller character initially. The film packs a bit of an emotional punch as well, almost to Silent Running levels ;-)

But good god, the design of the film is incredible. Earth looks ruined, but in a way not seen before. It is truly desolate, with only some recognisable features left (half the Pentagon, Lady Liberty’s torch, etc). Juxtaposing this is the achingly cool sci-fi tech. It looks advanced, but believably so, i.e. there’s no magic sci-fi thingy to help our hero out. The flying craft holds a myriad of devices to help Harper in his job, and even a fold-out motorbike – but again, it’s realistically done. The drones look fantastic, Harper’s house in the clouds looks like something Frank LLoyd Wright would design if he was alive in 2077, it’s all just stunning.

I was going to link to a featurette about the look of the film, but it really is worth going into it blind, and just enjoy the spectacle. The score is also fantastic, will probably end up buying it.

All in all, a very worthy 9/10 for Oblivion. To explain why it’s not 10/10, my reasons (referencing other sci-fi films) may lead to deductions of spoilers, and I wouldn’t want to do that. It’s a crackers of a film, and you’d be mad to miss it. It deserves to be seen on the big screen, but not necessarily IMAX big…


Blog Off / press freedom

Although I am not a news blog by any stretch of the imagination, I do enjoy being able to post my opinions on the news on here and on Twitter. The recent mish-mash of press regulation put forward at 2am when no representatives of journalism were present is a serious attack on the UK’s long-standing press freedoms.

A free press is essential, to hold the government of the day to account, to expose shady goings-on (e.g. Nick Boles telling property developers the planning laws will be liberalised, MP’s expenses, etc.), to report on politicians meeting on Russian oligarchs’ yachts, etc. It is the measure of developed, civilised, first-world country, and the coalition government’s restriction of it (even a little bit of it) is extremely wrong.

As Old Holborn said, it only took 24 hours for Max Mosley to call for web content to be prohibited, merely 24 hours after the Leveson cobble was voted on. What a Nazi… ;)

Fraser Nelson of The Spectator (and others) have said they won’t sign up to the new body, exposing themselves to “exemplary” (punitive?) fines if found guilty by a kangaroo court, er, the regulator. With this in mind, I’ve signed the Blog Off petition, and encourage you do the same:

Keep the UK’s press free!


Windows 8 App Store Development, Day 2

Right, following on from Day 1, the next lesson was to Manage app lifecycle and state. Apps are a little bit different to good old Windows Forms (a la Visual Basic 4, up to XAML apps) and ASP.Net web sites: your app can be suspended on the device (Surface, phone, etc.) when the user switches away from it or the device enters a lower power state. For bonus points, your suspended app can be terminated at any time if the device deems it necessary.

Coming back from suspension isn’t so bad (as many a premiership football player will tell you), as Windows lets you know it’s suspending the app. However, you get no warning about termination so saving state (e.g. what’s in use by the application) needs to be done on suspension. As per the article, there are two different types of data that can be used to hold state, app data and session data.

From the lesson: “App data is persistent across sessions and must always be accessible to the user”. This could be viewed as settings (username, favourite colour, birth date) but also as items displayed in controls on the app’s “frame”. Session data “is temporary data that is relevant to the user’s current session in your app”, and the session ends when the user closes the app, logs off or reboots the computer.

When it comes to saving the app data, it is advised to “save important app data incrementally throughout the life of your app”. I’m not sure if I agree with the use incrementally, because what they’re saying here is save your changes to the app data when they happen. Since using the Android OS, I’ve noticed a lack of “OK” and “Apply” buttons for settings, because the changes are applied as soon as they are made, e.g. checking a checkbox. The lesson details how to save the contents of a textbox on the TextChanged event, which seems a bit of overkill to me as it would save it down each keystroke (I believe).

Saving app data is done to an ApplicationDataContainer; the lesson uses a type of one called RoamingSettings which ensures the data saved in it is available to the same user across multiple machines. You can use the LocalSettings ApplicationDataContainer to save machine-specific settings. Basically, when the application data changes, update the value stored in the ApplicationDataContainer, and when your app comes back to life, restore it from the same container, after checking for its presence.

Saving session data is a little more involved, as it reacts to the Application.Suspending event in the main App.xaml.cs class. However, because Lesson 1 made me use a Basic Page template, a particularly helpful class called SuspensionManager is added to the project in the Common folder. This takes lots of grunt work out of saving the navigation state, session state, etc. and the lesson tells you where to stick it in various files, and how to use it. Suffice to say, it’s a bit of a doddle (I’m writing too much detail from the lesson, instead of my dealings with the lesson!).

It’s worth noting that the output from the ‘Say Hello’ button goes to a label, e.g. “Hello Mike”. This content is actually saved into session state on suspension so that it can be re-displayed when the app is brought back. So what? Sooooo, you need to keep track of what is displayed to the user and make sure it’s re-displayed, or at least gets refreshed (e.g. a news ticker).

Restoring the app and session data is basically done in reverse, with some app data (navigation, for instance) being restored via the SuspensionManager.RestoreAsync method, but only if the app was previously terminated – smart thinking ;) Then, for the rest of the relevant app and session data, it’s pulled from the RoamingSettings ApplicationDataContainer and the pageState thingy respectively, after checking for data presence.

There’s a nice piece at the end of the lesson about how to simulate a suspend and shutdown so the suspension code will fire / be debuggable.

So, what did I learn? Save app data often, as there’s no longer a “Save” / “OK” / “Apply” button. Session data, maybe all the crappy output data, also needs saving and re-displaying. However, the SuspensionManager class makes this very easy, and there’s the goodness that is the RoamingSettings ApplicationDataContainer class for app data – I think interesting times lie ahead :-) The next lesson is on Navigation, Layout and Views, stay tuned.