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 :-)

Almost There - but not quite yet

Its Thursday and the physio has just called around. In preparation for her visit I had a go on the elbow crutches for a few minutes before she arrived. I have felt better balanced recently with more control over the otherwise jelly like behaviour of my filleted right leg so thought I would experiment.

When she arrived we reviewed the email advice on the amount of weight bearing that should be aimed for, and what this meant for me. She was not too keen on me using crutches - not because of the weight bearing issue but concern over upper body strength. When I said I had experimented and was no stranger to using crutches - having spent about 4 years of the last 27 getting around on them - she thought it worth seeing for herself.

I manoeuvred out into the corridor and demonstrated my ability to balance for a count of 3 on the 2 crutches with both feet off the ground. I then proceeded up and down the corridor without my right foot touching down at all. The physio agreed that using crutches on the level was no problem at all. We both realised that coping with a step or two would be a different matter.

We discussed what exercises I had been doing and when I was still not able to push my foot forward when on the ground she decided it was time to demonstrate another exercise I could do. This meant both of us getting onto the double bed. This is something I can do with relative ease now and the physio was forced to admit admiration for my bedroom gymnastics!

The new exercise involves lying flat with my right knee bent and pressing down on a pillow folded in half. By pressing the back of my knee into the folded pillow (which acts as a fulcrum) my right heel should lift off the bed. That's the theory - try as I might - even when I felt there was some gap it was probably a couple of millimetres and not that visible. So definitely something to work on.

I asked if we could see what I might be able to do about getting out of the house. I demonstrated with the zimmer frame the limited extent to which I could move between the 2 front doors. We both realised that while I might be able to manage to get out of the 2 doors on crutches and manage the 2 steps down that would be involved I would not necessarily manage the return journey and certainly not at this stage unaided. So we looked at getting out though the conservatory into the back garden. We tried with zimmer frame and with crutches and even with the shower stool to see if it could be used on a small step as a half way house for the return "leg". But neither of us felt confident enough without a 2nd helper on hand.

As a result of these first attempts at fleeing the nest - with all the trepidation of a reluctant fledgling bird - we agreed to try again in a week's time provided the physio was accompanied by a colleague. In the meantime no doubt my confidence and control will improve still more so hopefully I shall manage to cross the final frontier then.

Comings & Goings

After a disturbed night where I finally managed to get off to sleep around 4:30 a.m, today has been one of comings and goings.

The Health Care Assistant arrived to collect some more blood. I had earlier in the week been asked by the anaemia team at hospital if I could ask for serum ferritin and iron profile tests to be carried out at the same time. I rang the local surgery yesterday and a note was made of this request. In the event the message got through and the Health Care Assistant turned up with the necessary "Green Form" for these tests. This is noteworthy because collaborative sharing of information and willingness to be flexible has been allowed to lapse in recent years.

We talked briefly about gardening and computers and because she had not been able to make use of her notebook computer since her son had upgraded it from XP to Vista I showed her Ubuntu and Open Office and gave her an installation CD for both, which would get her back to being able to produce the odd invoice in Word and to use the Internet and email again.

When the she was about to draw blood the phone rang and it was the community physiotherapist calling to arrange a home visit for Monday.

Shortly after the Health Care Assistant left the door bell rang again. I was expecting the local hairdresser to call in on her way to opening up her shop. By the time I transferred from office chair to power chair the visitor had turned to leave.

On her way back to her car she spoke to a neighbour who confirmed that the man who has just had an operation lives where she had already rung the door bell. My neighbour had himself the previous day been to the local hospital for a hernia operation on a day patient basis but he was on the ball enough to realise that she meant me.

By the time she got the door a 2nd time I was waiting to gesture her to make her way in.

After making a cup of coffee I positioned my chair in the middle of the kitchen and she placed her bag of tricks on the breakfast bar and started to trim my hair.

When it was cut I found a soft broom and like a knight with a lance on horseback I proceeded to chase the fallen grey hair into a neat pile ready to dispose of (probably by feeding to the worms in our organic composting kit).
Before she left the hairdresser brought the post in and I saw that my imminent out patient appointment with the renal team had been pushed back by 6 weeks. Unfortunately as she left my son's cat who we had been looking after for the last 6 months decided to sneak out.

After having soup for lunch I settled back into the study and a few minutes later my neighbour let himself in and we compared operating notes for a couple of hours. As he left I asked if he could see if the cat was nearby and if so to leave the door open for him to return if he wanted. The cat was patiently waiting right outside.

No sooner has the cat settled down to a bite to eat than the front door has just opened - its my wife returning from work.

So now , before I have even published this posting I can tell her all about the comings and goings of this day as well.