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.
Showing posts with label muscle spasm. Show all posts
Showing posts with label muscle spasm. Show all posts
Monday, 28 April 2008
Thursday, 3 April 2008
Tweaks, Pings, Pops Snaps and other Painful Sounds
Almost immediately I was transferred from POSU ready for return to the orthopaedic ward I realised that I would have to get used to ligaments being stretched, tendons cracking and other connecting tissue around my knee reacting to the slightest movement. Unfortunately all of these twinges were accompanied by peculiar feelings as things dropped into place for a while and announced the fact with the strangest of noises. Added to this was the readiness with which such muscle as remained would go into spasm at the slightest provocation.
Over the next 9 days I would gradually regain some muscle tone and as the swelling reduced was able to extend my limited range of movement. For most of that time however I had to support my right leg under the thigh as the dead weight of the leg being pulled down by gravity was a painful reminder of the extent of damage, to the soft tissue of my right leg, both before and during the operation.
Any transition from bed to chair or back again and standing up to plod short distances behind a zimmer frame with front mounted (alloy?) wheels was difficult for most of the time that I spent back in the orthopaedic ward.
Given time I could manage but unfortunately although there were a few exceptions most of the nursing staff had insufficient time to let me move at my own pace. As a result I would be pulled and dragged or encouraged to "get it over quickly". On one occasion the nurse who came to assist getting me out of bed came complaining that unlike her colleagues she had not had a cup of tea yet and that although one was waiting for her it was getting cold. I suggested she return after she had her tea, but she would not have it. This was even more galling because the morning before the hospital's coordinator for patient lifting and handling was attached to the ward and both skilfully and patiently assisted me getting out of bed. She adopted positions that allowed her to support the dead weight while I controlled the pace of movement from straight leg to bent and to from the middle to the end of the bed.
Movement around the hospital bed was difficult as the contact points (buttocks, elbows, heels, knuckles etc) sunk into the mattress and had to overcome the inertia of the less than slippery sheets. Perhaps this is why I was given a slippery red tube when I left POSU. ( I later discovered at home that when placed under the dead weight of my contorted right leg it could slide around with barely any effort. - so that's how it works , what a good idea, just a pity that advise about using this simple solution had not percolated down to the ward staff - no doubt in a few months it will have done).
Knowledge of appropriate patient lifting and handling techniques among nursing staff was very random. Sometimes without me needing to ask a nurse would automatically provide support without trying to force the pace of movement. I was very grateful for this whenever it happened. At times a nurse would need to be reminded to take it slowly and would oblige but this was not the hoped for and ideal automatic empathy that I just described. These nurses were sympathetic. Then there were the nurses who have seen it all before and believed in tough love. Funny whenever they "helped" I seemed to have more problems with involuntary muscle spasms as well as having to endure all those tweaks, pings, pops snaps and other painful sounds.
One day I came across an empathetic male radiographer who not only seemed to instinctively realise what a wimp I was but patiently and skillfully took the weight of my right leg while together we manoeuvred my body onto the x-ray table. During the process I experienced various twinges and popping sensations and what is more the radiographer felt them too! At last someone who was not only empathetic but could also experience the feelings even if only in a vicarious manner.
Despite my previous experience of 4 hip replacements I had not realised until I became a "one hip wonder" the importance of both skilful and empathetic handling and lifting by nursing and other staff. In the light of my recent experience I have therefore come to the conclusion that aditional attention needs to be given to patient handling and lifting during basic nurse training and updating courses.
Over the next 9 days I would gradually regain some muscle tone and as the swelling reduced was able to extend my limited range of movement. For most of that time however I had to support my right leg under the thigh as the dead weight of the leg being pulled down by gravity was a painful reminder of the extent of damage, to the soft tissue of my right leg, both before and during the operation.
Any transition from bed to chair or back again and standing up to plod short distances behind a zimmer frame with front mounted (alloy?) wheels was difficult for most of the time that I spent back in the orthopaedic ward.
Given time I could manage but unfortunately although there were a few exceptions most of the nursing staff had insufficient time to let me move at my own pace. As a result I would be pulled and dragged or encouraged to "get it over quickly". On one occasion the nurse who came to assist getting me out of bed came complaining that unlike her colleagues she had not had a cup of tea yet and that although one was waiting for her it was getting cold. I suggested she return after she had her tea, but she would not have it. This was even more galling because the morning before the hospital's coordinator for patient lifting and handling was attached to the ward and both skilfully and patiently assisted me getting out of bed. She adopted positions that allowed her to support the dead weight while I controlled the pace of movement from straight leg to bent and to from the middle to the end of the bed.
Movement around the hospital bed was difficult as the contact points (buttocks, elbows, heels, knuckles etc) sunk into the mattress and had to overcome the inertia of the less than slippery sheets. Perhaps this is why I was given a slippery red tube when I left POSU. ( I later discovered at home that when placed under the dead weight of my contorted right leg it could slide around with barely any effort. - so that's how it works , what a good idea, just a pity that advise about using this simple solution had not percolated down to the ward staff - no doubt in a few months it will have done).
Knowledge of appropriate patient lifting and handling techniques among nursing staff was very random. Sometimes without me needing to ask a nurse would automatically provide support without trying to force the pace of movement. I was very grateful for this whenever it happened. At times a nurse would need to be reminded to take it slowly and would oblige but this was not the hoped for and ideal automatic empathy that I just described. These nurses were sympathetic. Then there were the nurses who have seen it all before and believed in tough love. Funny whenever they "helped" I seemed to have more problems with involuntary muscle spasms as well as having to endure all those tweaks, pings, pops snaps and other painful sounds.
One day I came across an empathetic male radiographer who not only seemed to instinctively realise what a wimp I was but patiently and skillfully took the weight of my right leg while together we manoeuvred my body onto the x-ray table. During the process I experienced various twinges and popping sensations and what is more the radiographer felt them too! At last someone who was not only empathetic but could also experience the feelings even if only in a vicarious manner.
Despite my previous experience of 4 hip replacements I had not realised until I became a "one hip wonder" the importance of both skilful and empathetic handling and lifting by nursing and other staff. In the light of my recent experience I have therefore come to the conclusion that aditional attention needs to be given to patient handling and lifting during basic nurse training and updating courses.
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