Onwards and Upwards - Talking the talk if not yet Walking the walk

Today is Thursday and I've just returned to the study after 3 trips outside of the house and a further trip up to the converted loft. I also managed to transfer into and out of the passenger seat of my car.

The reason for such rapid progress all in the one day was the presence of the community physiotherapist (accompanied by colleague). I reported that I had managed the initial crossing of the front door threshold and also made it up the stairs to the converted loft - under supervision and with the assistance of my wife. I stressed that I had not yet repeated either of these accomplishments.

I was able to talk and eventually hop through the process (note I carefully avoided using the word "walk" - I may talk the talk but I'm a long way yet literally from walking the walk!).

In the process of demonstrating how I managed to negotiate the change in levels on the way through the inner and outer doors and then again out into the front patio I referred to the concern I had about the wheels on the front of the zimmer frame moving away from me when I was shifting my centre of gravity forward of centre. The answer proved simple - to swap the front wheel components for static feet. Fortunately the colleague of the regular community physiotherapist had 2 in his car. So with those in place and using the more straightforward route we had worked out before, getting out was really no problem. I made my way over to the small round table we have outside and sat on one of the 2 chairs in the afternoon sun and thought I can now return to sitting out on the "front decking" like the retired cotton pickers of old with a cup of fortified coffee and a good book to read.

Having got this far we then made our way back. I would like to have said "headed" back but this would be misleading. I find it easier to negotiate the steps to get back inside if I approach them in reverse. Because I had only made this journey once before in my current state I forgot that one of the manoeuvres required a single long stride backwards and subsequent second or two supported in mid air with both feet off the ground. I initially tried this particular manoeuvre in 2 stages and it felt wrong. Both physios recognised that this would be better as a single step backwards and so it worked out. It was good to have a second (and third) opinion and gave me more confidence.

Once back inside safely we then discussed the progress I had made with "climbing" the stairs to the converted loft. I demonstrated this and asked one of them to be behind me at the top of the stairs ready to steady the shower stool. Having got up to the converted loft I was asked why I wanted to get there - was it to sleep? So I pointed out the ceiling mounted projector, sky box, sound system and Nintendo wii and explained that with friends from Germany coming in a few days it would be good to be able to set up a game or two on the wii. (I realised this went down as an example of "boys toys" so stopped there) This seemed an acceptable reason all round but especially to the colleague who wished to do something similar in his house - provided of course he could persuade the wife!

After returning to the ground floor without any mishap the three of us discussed the risks involved in trying to get into the car. If I had a full hip replacement there would be special considerations regarding the angle that my leg could be bent so as to avoid the hip joint dislocating. As this did not really apply in my circumstances and because I had demonstrated that I could manage to lever my way up and down stairs it was agreed that I could attempt to get into the car under supervision.

So another trip outside was required. In preparation for this "journey" to the car - which was either by steps ( definitely ruled out) or slope - we agreed that I should use the mobility scooter to travel from front door to the car below. As it happens my son was visiting and in the process of loading up a hire van with some furniture. A shout to him resulted in the mobility scooter appearing at the front door before I got there. 2 minutes later I was sitting in the passenger seat of my car - having ratcheted the car seat up to its highest extent, pushed the seat back as far as it would go and reclined the back to 30 degrees. Past experience of managing with newly replaced hips came back to me as I laid back as far as I could and positioned myself over the handbrake before swivelling round and lifting my filleted leg over the car door sill. Getting out was easier and I got back on the mobility scooter made my way back (again under supervision) to the front door and once again reversed my way back with the zimmer frame into the house.

Later that afternoon my son wished me to advise him on stuff to keep or dispose of in the garage and as my wife had by then returned the three of us repeated the careful egress from the house one more time.

About 40 minutes later after acting both as gaffer (barking out instructions) and labourer (moving a few items around the garden on the mobility scooter ) I returned to the house a final time.

All in all an afternoon of moving both onwards and upwards and if not quite yet walking the walk I was at least talking the talk :-)

Daily Living - Progress Report (3)

Its 4 weeks since my discharge from hospital and about 5 1/2 weeks since the operation.

I am able to manouvre with a greater degree of flexibility as each week passes. My right leg still twists around 45 degrees from straight ahead when left to dangle. I experience much less popping of ligaments and only have a muscle spasm about twice a week and then only when I move too quickly. I am able to use the crutches to reach areas inaccessible to my powerchair and hardly ever use the zimmer frame now. I am able to stand up directly from the chair on one leg with relative ease and this is now my preferred method of relieving myself when the need arises - no more use of an improvised urine bottle. I still wash over the sink while seated in the chair but have managed one steam shower.

I think all sutures have now either dissolved or been removed (it took 3 attempts on different days - probably due to the tight stitches being covered by swollen tissue which gradually resolved and caused their reappearance.) En-route one stubborn clear suture seems to have caused superficial infection which was worrying given the possibility of a return of the sepsis that has troubled me for the last 4 1/4 years. That all now seems under control and the District Nurses finally "discharged" me from their care on Friday evening.

Having crossed the final threshold on Saturday, and managed to scooter my way around our front and back gardens, I returned to the attempt to "climb" the stairs leading up to our converted loft area yesterday evening.

A little like NASA's careful attempts to land a man on the moon my approach was to test each step on the way before committing to the final attempt. So with my wife ready at the top of the stairs I made my way up by sitting down and levering my way up one step at a time. As I approached the top we faced the problem of how I would stand up without taking any weight through my filleted right leg.

In the event the adjustable height shower stool bought 4 years earlier came to the rescue.

I could not manage to lever my way up to the seat at its usual (highest) setting but by reducing it to its lowest height I could just manage to haul my way up backwards to sit on it. Then by twisting slightly I was able to move through 90 degrees and stand up. At this stage that was all I wanted to prove so after a brief rest we attempted the "re-entry".

I was able to stand at the top of the stairs and experimented with which step I should aim my right foot at ready for my left to join it after a brief transfer of weight. I was able to stand with my weight on the banister to my left which was horizontal and some of my weight on the right hand (sloping banister). I needed to feel confident that my right hand on the 30 degree sloping banister would not give way and once I did I was able to support my weight and hop through with my left leg onto the 3rd step down. I could then resume a seated position and begin bumping my way back down to the ground floor.

I am still not able to do these things unaided but it is quite an achievement nonetheless to have resumed a greater degree of normality.

The next goal will be to sit in my car as a passenger and escape briefly into the nearby Peak District. If I can manage this then I might be in a position to cancel the ambulance that is booked to take me to the follow up out patient clinic in just over 2 weeks time.