Omoplata in Portuguese Does Not Translate To

"A monkey making sweet love to a football."

But it probably should, at least in regards to the Omoplata in Brazilian Jiu Jitsu.

Instead, Omaplata is Portuguese for the scapula, derived from the ancient Greek word for shoulder rather than the Latin word scapula.  The Omoplata in BJJ gets its name as it is a shoulder lock, and a very effective one it is, too, once you actually maneuver in place to lock it in.

Here's a video demonstrating the Omoplata:

 As you can see, there's a fair bit going on.  Once locked in place however, the Omoplata is a pretty surefire way to get your attacker to give up or disable themselves.

With my hip still not being 100%, my finish was more of a pull myself up to the opponent's other side shoulder than the graceful hip flip to upright you see in the video.  The video makes it look easy - for me learning it the first time, not so much.  

In short, me and the monkey were having a romantic time with a football learning this technique. I made it work, but it wasn't pretty getting there.

There are variants, and we learned a few of them.  I found I could get into the Omoplata a lot easier when holding the attacker in 3/4 guard, and it's a great opportunity to do the move if you're in that position and the attacker turns their head the wrong way, thus creating an opening for the move.

We then learned the Go Go Plata, which is the response you use when the attacker tries to sit up and pull away from the Omoplata - you adjust your feet and they get choked out rather quickly from your feet fully choking their neck.   Rather fun, if a tad vicious as it sets in real quick and hard.

You can also shift the opponent into a triangle choke if they try and move their arm to protect it from the Omoplata, and then shift back to the Omoplata when they try and defend the triangle.

BJJ, after all, is all about leading your attacker down a path to worse and worse options to make them regret their bad life choices, with attacking you being one of those bad life choices.

So yep, I need a lot more practice with the Omoplata to make it effective and I'm rather sore from my initial lesson learning it  as my hip is not appreciating moving that much, but will be doing a lot more practice with it later this week.

Diving: Back In The Water

So yesterday, I went diving for the first time in years, and the first time with the new hip.

It was in a pool, so max depth was all of 9 feet, but still, it was diving.

I had assembled all my travel diving (non-drysuit) equipment and still remembered how to assemble it.  

I had earlier taken the dive computer in for a battery replacement and seal service at my local shop so it was ready to go, and I signed up with them for a pool dive and rented a tank from them as my aluminum 80 was out of inspection and hydro. 

I did have to tighten up the mounting screws for the backplate/wing/tank mount.  Hilariously enough, after just sitting around they had backed themselves out. So suitably tightened I headed off to the pool. 

I had forgotten how heavy it is hauling all the gear and tank around.  Nice workout to start.

Bunch of other divers from my friendly local scuba shop were there. There were two classes running and then there was myself and one other guy just getting in some water time.

With a water temperature of 86 degrees it was rather pleasant.

So suitably rigged up, I got in the water and then worked on some basic skills - good trim; dialing in buoyancy so I was hovering a couple inches off the bottom; forward frog kicks; back kicks; helicopter turns; and partner out of air drills (take regulator out extend long hose, put backup regulator in mouth, not lose position while doing so, and then replace).

I then tried to hover and hold on a spot without moving for a few minutes, which is harder than it sounds.   

Did a few charge forward to towards pool wall and then back kick away from it without touching and not loose trim or buoyancy doing so, which required some practice after these years of non-diving.  Need more work on that.

Good practice, and it was fun watching beginners floundering about the pool and sitting on the bottom on their knees. I was remembering my first lessons and how I started out just like that too. 

Overall, I am pretty darn happy with the practice, I certainly looked nice and trimmed out, had good control,  and the new hip gave a better back kick than it ever had before.  The new joint just works better.

I may do another pool dive just to make sure everything is dialed in, as an upcoming travel diving opportunity awaits, which will be blogged about in due time.

That's 70 minutes, 2100 PSI used with 900 remaining, and max depth of 9 feet. Not a bad reentry into the Scuba diving world and a nice bit of exercise.

Back To Jitsu

So yesterday night I finally returned to the mats.

Leg took a lot longer to heal up than I would like, and it's still not even 90%, but I figured if I don't get back now and give it a try, I may never get back.  

Besides, I needed to get some workouts going again.

Overall, I'd say it went quite well. We're doing half guard and today was passing from a three-quarter guard.  Basically the opponent is trying to get back to full guard, but there's an opening as they move into three-quarter guard as they're trying to recover full guard, where you can pass their guard and get to a superior control position.

Rather fun, and it went well.  

Had to switch sides for one of the segments as it involved really putting force on the leg being passed, which was not good at all for my angry quad muscle. So, my partner got to try passing on the left side which is harder than it seems when you're used to doing it on the right side all the time.

Then on to some light rolling.  This also went pretty well.  

I did lose some positions as I had to, on occasion, release one of my hands from an opponent to move it down to shove or adjust an opponent's body or leg off my right leg to relieve the pressure and ouchies thus applied on it, but it was still good.   Did take some breaks from rolling as well.

No major pains and I was careful not to strain the muscles and not go too hard with the leg.  Mainly caused me to be defensive but I need to work defenses too, so still a good workout and got some good rolls in.

A bit more limping around this morning than yesterday morning as a result, but no substantial increase in pain or any mobility loss, so I'll chalk that up as a win.

Yeowch - I Was Not Expecting That

So yesterday I went to do some jitsu.

The lesson was on the overhead sweep from guard.

First time learning it, and it is a very fun sweep.

In short, the attacker stands up in your guard or runs into your guard, and decides while doing so to grab your throat, jacket etc. You basically get your feet in his hips, grab his arms, and basically can get him up in the air with his weight on your feet like a leg press and roll him north above  your head in a somersault-type maneuver, and if you hang on to his arms while doing so you end up on top.

The sweep can be stopped by the attacker if he knows how to shift his body to counter, but it then opens him up for two other sweeps if he persists in standing up.

Much fun, and I did the sweeper but not the sweepee side of things and having people's feet leg pressing into my hips lifting me into the air would be a bad idea. Still not allowed to fall, and the sweepee does do a definite fall onto the hips which is contra-indicated.

So that was good and went well.

Then we did some rolling which went well until . . .

I was in my second  roll of the night with an opponent and had a good opportunity to do a trap and roll maneuver to get him off of on to of me. The problem is as I extended by hips up in a bridge, he in reaction brought his foot down hard right on my right hip to get a hook in to stop me rolling him.

He hit a rather unpleasant spot on the leg, pretty much right on the surgical scar as my hips were fully extended, which unpleasantly triggered a reaction I did not know could happen.

Basically, it felt like 240 volts of electricity coursed through my entire body and I collapsed nicely.

Ow, Ow, Ow.  Basically every nerve in the hip area went absolutely bonkers and I could not move.

After a bit, I discovered I could actually move again, and was able to move the leg and hip.  I was able to get up and move around.  Hip joint seemed ok, but the muscles around the hip were not happy.

I sat out the rest of the rolling and watched, and then helped with cleaning the mats afterward. Got changed, went home, had a hot shower, and took some Tylenol.

Rather sore and a bit limpy this morning, but no serious damage done, still same range of motion as before and no excessive pain. 

So, it turns out I'm not quite as healed up as I thought, which is a bit disconcerting. 

I'm going to need to take it a bit easier, and not do trap and rolls unless I have my training partner know not to try and stop it with the non-rolling side hook, but that was the first time that has happened. All prior rolls to date have only resulted in some soreness, not electric, body-frying pain like that. 

Good to know and certainly a corrective as I thought I was healed up and well past the point that kind of thing happening, but apparently not. Will just carry on, but being a bit more careful as we go here.

Well, Ouch.

Hip had been doing just great up until yesterday.

It had been raining quite hard and my Dad is in town for the Canada Day/Independence Day Weekend and we decided to go to Costco to get his car full of (relatively, and only relatively) cheaper American gas for his trip home, compared to much more expensive Canadian gas he gets at home.

So I go to get in the passenger seat, put my foot on the door-sill to get into the seat.  It was wet and I then did what could be termed a ground loop with a nice sharp rotation of the hip as a result.  Ouch.  Did not actually fall but sure as heck wrenched something in the hip pretty good and I've got a bit of a limp going today as a result.

Great, being active and doing Jitsu with light rolling gives me no hip problems.  

I get messed up by getting into a car of all things.

Well, it's just a reminder that I'm not 100% yet. Recovery takes time so I'll just suck it up and keep at it.

Went To The Dentist T'Other Day

So after the discontinued checkride, I then worked and went to my dentist's office later that afternoon for their last appointment to get my scheduled cleaning in.

Checked in, met with the hygienist and she asked if I had any health changes or dental issues.

I mentioned the teeth were fine but I now had a new hip.

She then asked if I was pre-medicated.

Blink. Huh? 

It turns out that for a year after joint replacement surgery, if you go to your dentist, you need to take some antibiotics before the dental cleaning.

I knew about not going to the dentist for 3 months prior to the hip surgery, but it somehow didn't get mentioned about post-op dental visits.

Apparently, a dental cleaning can release bacteria from your mouth into your bloodstream, and said bacteria tends to not play nicely with joint replacements.

So I quickly downed a 4 horse-pill sized dose of Amoxicillin that they had at the office to get a proper dose on board, and the cleaning began.

Just an interesting quirk that I hadn't realized was an issue. In short, you really don't want the bacteria from your mouth getting into your bloodstream, and that's partially why bites from other humans are nasty (beyond the obvious) - the infections from the bacteria, especially when its not even your own bacteria are rather bad.

Well, learned something new and very good for the hygienist paying attention to things and for catching it.

Hip Report: Back To The Mats: First Full Jitsu Class

After spending a day in trial without getting to finish the hearing and only getting my first witness 90% through after the Plaintiff rested, and having the joy of the trial then being adjourned until mid June, I really needed a workout.

Jiu Jitsu it was then.

So tonight I had a quick bite, packed my bag, and headed to the training center for my first full lesson since the surgery.

This is a review week after the sidemount chapter so it was review then lots of focussed sparring starting in sidemount and then open rolling.

I was glad to be back and good to see and roll with friends again.

Did the review and then did some ficussed sparrign and on to the rolls.

I'm really happy with this new hip,  Flexibility is much better, pain is so much lower it is not even funny, and I can now get up off the mat without looking like something the cat dragged in.

Still no falling, so I did everything from ground level and took care to try and protect the hip during the rolls.

Didn't lose too much skill  during my absence but lots of people sure got better. 

I did however, lose some stamina -- being unable to workout for months and being stuck in a chair or in bed will do that.

Tons of fun rolling with friends and it turns out my pressure is better (probably the unwanted extra weight Ive managed to pickup from all the inactivity) and the new hip actually lets me move a heckuva lot more including maneuvers I couldn't even dream of doing pre-surgery.

I had much fun moving into techniques I could previously not do due tot he hip or could only do them with painful difficulty.  Nice to do them in an almost pain-free manner.

Some aches and such, but nothing major and nothing at all like how bad it felt doing jitsu pre-surgery, and we will see how I feel in the morning.

Real good to be back and I certainly need the workouts.

Hip Report: Back To The Mats

Had a follow up appointment with the doctor a couple Fridays ago.

The not so good news:  Hip was kinda sore and it turns out I have Illotial Band Syndrome, likely due to the muscles and everything getting moved around and re-balancing now that the hip arthritis is now more.  Bit of an ache and I'm doing stretches for it.  Overall things are good and just the Illotial Band and the quad muscle are still angry at  me and everything else is looking great.

The good news:  I have been cleared for all activities except for falling, which is still a no-no.  In short, I was cleared to attend jitsu again once time came that it didn't feel quite so achy.  That time was today.

I decided to take a private lesson with the center's instructor, Heath, to see how much I've forgotten and see what the new hip can and can't do.

It turns out, it can do a lot. A whole lot.

My range of motion is so much better it is remarkable, and we both noticed it right away.

The lack of constant pain while moving was also remarkable.

I can do an elevator sweep without pain!  An elevator sweep is when someone is on top of you and props up to punch you, and then you basically sweep them off and end up on top, which is rather useful and pretty dispiriting for them.  

To do it, you have to get your leg in the right position up and inside their leg (and a few other things), and I could never do that without extreme discomfort and often couldn't even move the hip that way at all.  Now I can.

Ditto for scissor sweeps, and quite a few other maneuvers I used to be completely unable to do.  Other maneuvers I can now do quicker and easier than before, and even getting up off the ground is easier.

We did a half hour trying to figure out what the limits are and there's a few techniques I won't be doing (as in all the takedowns and falling as well as some ground stuff where the hip is kinda vulnerable) and will be telling partners not to do certain techniques on me, but other than that I am good to go, which is very exciting.

This is all very happy-making.  Now I can work on getting back in shape (been an immobile slug for much too long due to the surgery) and work on my jitsu again.

So, I'm a little sore now,  but it's a good kind of sore from a workout, and I'm far less sore than on any normal day with arthritis in the hip, much less a normal day after jitsu.

Next follow up appointment in about 5 weeks may even just clear me for some gentle falls.

It's great to be back in the game again.  Missed it and the people at the center a lot.

Hip Follow Up

A further right hipster report.

Hip is getting better every day.  I can now leg press 90 pounds at PT with no issues, trying to max out their leg press machine at 200 pounds before I'm done, so Monday I'm going to push to have them let me do 100.

Still some aches and pains, tends to still wake me up during the night but things are progressively getting easier including sitting for long periods, walking distances etc.

Had an unnaturally early doctor's appointment this morning.  On the plus side, had just about zero waiting time.

Latest x-ray shows the hip implant has stayed in  position and is really well and truly attached to the bone and the bone has grown in and secured it, which is good.

Muscles are still score due to scar tissue and usage/lack of usage issues from the arthritis and the surgery so still not 100% yet.  I'm to continue PT to try and build up the muscles around the area and try to get the scar tissue to subside.

Restrictions now reduced to: No falling; No inversion tables; and No Ju Jitsu or similar dynamic or explosive movements so Zumba is right out. But then again, Zumba never was a serious consideration.

Next check up in six weeks. 

PT: So, How About Ouch For An Answer?

In addition to flying, I Did a PT session today.

Apparently it's not just my IT Band that is a bit cross with me.

There's a piece of my leg south of the incision where the surface nerves are completely out of whack.  Pressure is felt, but not much other sensation in that spot which is about a palms-width in size.  Feels really strange but it should resolve itself eventually.

 Had a good workout set of the exercises, gave it my all, then got to lie and enjoy some heat on the leg and then the Therapist comes by as it's my turn to get manipulated.

So I'm getting worked on and I mention this dead spot to the physio therapist.

So he starts putting some pressure in the area.

"Does that hurt?"  "No"

"Does that hurt?"  "No"

"Does that hurt?"  "No"

"Does that hurt?"  "N-Yeargh!"

Don't think I caught air on that, but only because he was pushing down into my leg at the time. 

The surface nerves may be fried, but the nerves deeper in the quad muscle are present, still pissed off at being man-handled during the surgery, and absolutely not afraid to let me know that. 

This is part of why I'm having trouble sleeping through the night, as they occasionally fire off to let me know I was a jerk for letting them get moved around, and the muscle tends to be stiff and sore in the morning.

This will apparently all settle down in time, but they're not done messing with me for now.

Hip Update - Cleared For Takeoff!

Went to the Doctor for the second follow-up exam for the hip replacement.

X-Ray shows the hip implant is in a good position and has started mating to the bones nicely, and hasn't shifted.

Pain is now from the muscles being used differently then they were in the past, and some post-surgery soreness and scar tissue.

Overall, I'm apparently recovering nicely and its going great.

Officially allowed to bend now, yay, I'll be able to put my own socks on, but I'm to ease into bending by doing it slowly and not diving for my toes just yet.

I'm still to use the cane outside, and still prevent falls at any cost.

Still no heavy workouts, just to stick to physio for now.  Interestingly enough, lat pull-downs are a big no-no after a hip replacement.

Jiu Jitsu is sadly, but absolutely not unexpectedly, very much off the table, probably until July.

My Next follow up is in another 30 days.

The Big News From The Exam: I'm now cleared to fly again which is great!  

I have all of 2 days though before my passenger currency is kaput.   

My Flight Review is needed by the end of this month, so it's unlikely I'll get the instrument test done in time, but at this point nothing I can do about that, and I'm going to be ok with that. 

Regardless of passenger carrying status,  I will have my first flight will be with an instructor in the right seat for safety.

Getting The PT Talk

Had a PT session today.  

Went well  and I always try to push it as hard as I can and always try to get some extra reps in and try to do better each time on every exercise.

Got all the exercises done and the physio therapist is going to up the difficulty yet again.  Good.

Leg Press weight is going up which is good as 30 pounds is now too easy, and other exercises are apparently going to get more difficult and he has thought of new ways to make me work harder.  Bring it on, and let's get this hip back in shape, I say.

The Therapist did have a talk with me though.

He said he's been noticing that I'm not phoning it in like others doing PT and I'm always putting in the effort to get better. (I do after all have a really good role model for always giving maximum effort in PT).

He then said I'm 6-8 weeks after the Hip Surgery which is apparently the most dangerous time for people like me. 

Apparently, since we're really working the process, we're starting to feel better and stronger at this point in time after surgery and its right about now when we do something stupid thinking we're in better shape than we actually are, and we hurt ourselves and get a major setback.

So, I got strongly advised to maintain all the hip caution protocols, not try and over exert myself, take it easy, and be really careful to avoid falling.

All good advice and I'll take it.  

Overall I am getting better, still hurts but its very manageable pretty much all the time.  Some things do hurt, like lying on either side rather than on my back for example, or sitting or standing in one spot too long. Driving is fine, but getting into the car hurts a bit, and there's now a little limp when walking unless I concentrate on not limping.  Biggest daily hassle is no bending as I can't easily pick things up that fall, that the dogs get into, etc. 

I will be careful as I do want to keep progressing and avoid a stupid setback from having a case of the dumbs.

PT is still going to be done at maximum effort though.

The Weekend Hip Improvement Report

The hip happily continues to improve.  Still rather sore but getting less so as time goes on, which is nice. Still no need for Tylenol and haven't had to ice it at all today.

Made it into the basement and up and down the stairs quite a few times Saturday to do some cleaning and threw out about a garbage bag of accumulated unnecessary stuff and old useless paperwork.  Good exercise, getting steadier, no cane needed, and it made the work area down there look nicer by quite a bit. 

This made Tash happy, as I've taken over her upstairs office so she's going to use my workspace down there until I can bend again and am fully cleared as I can't carry the desktop that I need for some programs back downstairs, nor bend to hook it back up properly once moved at the moment.

I then drove on Thursday home from PT and it wasn't bad. First time driving in 6 weeks. No issues.

Yesterday, I drove for the first time alone in 6 weeks. 

No issues then either.  

There's a little twinge in the hp while getting behind the wheel and I felt it a bit as it rests against the seat itself, and of course from the many potholes on the roads now, but no control problems with the right leg.  So I can drive now which is good.

Putting on socks by myself though is kinda hilarious.

I had to get out and drive yesterday to go pick up the younger daughter at her work as everyone else was out of the house. A little problem was no one had thought this through fully, so I had to get my socks and shoes on by myself with no one else at home.

Putting socks and shoes on solo without bending the hip past 60 degrees is rather difficult.

There is a sock tool:

Basically you stretch the sock over this slippery plastic half cone, place the opening of the sock by your toes and then pull the ropes and the sock is supposed to leave the cone and, as if by magic, appear on your foot and you don't need to bend to do it.

In reality, not quite.

Most of the time the sock goes flying off in the opposite direction of your foot and you have to get up and chase it down before Piper decides to eat it, pick it up with your grabber off the floor as you can't bend,  and try it on the cone again.

Then, it gets on somewhat and you have to pull it up with your grabber or the hook end of you shoe horn.

Takes about 10 minutes to get two socks on. This feels a lot longer and stupider than you might imagine. Even some vocabulary is used.

Then after getting the socks on I got the shoes on using a long handled shoe horn and then the grabber to pull up the tongue of the shoe. The hard part is getting the foot lined up going straight into the shoe, without the shoe moving away, nor the hip hurting from turning it at an angle at all and without the shoe horn slipping out.  But, it worked pretty well and both shoes were on in a few minutes after some finagling.

So finally fully dressed all by myself, I headed out and picked her up, then drove us both to my office and got some things done there and picked up my mail.

Mission accomplished.

Then today Tash and I met up with some friends in Ann Arbor for lunch. 

After lunch, I walked back to the car from the restaurant rather than having her come pick me up. It was across and down the street a ways and was the farthest I've walked outside in 6 weeks.  I did use the cane as a precaution but the streets and sidewalks were mostly clear so I could avoid the snow and ice and it wasn't a problem.

So, I can see lots of improvement and it is getting better. Still a ways to go and at least six more weeks minimum before I can bend and cross my feet or ankles again. I'd also like the rest of the iron collar around the top of my leg to finally leave, but it'll still take more time.

Right Hip Report

So here's the latest on the hip:

As of February 20th,  I've been off all pain killers. 

It still aches a fair bit and does hurt sometimes, but no more Tylenol needed.  

The muscles, as stated by my Physio Therapist are still a tad angry at me but they're beginning to consider settling down and loosening up a bit. Have to not sit in one spot for too long, and I'm still icing it on occasion, but that's it.

The feeling of having an iron collar around the top of my leg is still there, but there's now some breaks in the collar while other areas are still tight which is a weird but welcome feeling.

PT is going well.  I told my Physio Therapist two weeks ago that the exercises were easy to do now and he replied that he was happy I said that.

He then loaded me up for PT Phase 2 - I now do 20 reps instead of 10 of all the exercises I was doing before and to make it more challenging he added weights to them.  

He replaced the smaller step for step-ups that I was using with a much bigger step that's higher than a normal staircase step.  The first time I did that was a little intimidating, but I'm rocking it now.  Get a good sweat going doing all the exercises and I always try to do more than the 20 minimum.

I'm also doing 20 reps of a 30lb leg press, which doesn't sound like much, but it's a good start. Half the fun is getting the right leg into the leg press machine.  Once I can get setup and get both feet in position it's easy, but the first rep to get into position is hard.

I'm now walking around the house 100% without a cane and only using the cane outside to prevent any falls, which is still the main concern/risk for now. 

I've now been cleared to go up and down stairs, so I've now seen the basement again after over a month, and I now daily go up and down them a few times for a little exercise.

Still on the post-surgery hip safety protocol including a no crossing legs or ankles, and the no bending past 60 degrees restriction which makes putting socks and shoes on kinda hilarious. 

It is annoying as heck when I drop something or something falls or the dogs get into something as I can't just immediately bend down to pick it up.   

Still have more PT to go and a follow up appointment with the doctor to come.

Overall it's progressing along nicely, aches less than prior to the replacement, but as my PT said, I'm not done recovering yet.

This Week's Hip Update: March of The Penguin

Last week through this Monday could have been titled: Citizen Cane.

Getting around using the cane for almost 100% of the time that week, only using toe walker for extra support in the shower and in crowded public places to avoid the hip getting bumped.

Per the doc and the PT person - in crowded spots I should still use the walker as people avoid it. Most people in crowded areas apparently ignore or just don't see canes, making the risk of getting your hip bumped pretty high.

This week since my Physio session on Monday late afternoon is more properly titled the March of The Penguin.

About 60% of the time indoors I'm walking without using any cane or walker at all as long as I'm not holding things or the leg doesn't get too sore. 

Mind you, It's more like hobbling than walking but I'll take it.  Looks kinda like this:

Are the kids mercilessly teasing me about this and calling me a penguin? Of course they are! 

I now have a major craving for some herring, dammit.

This morning I unconsciously penguin walked down the two stairs to the kitchen without a cane.  First time doing that.  Made a bit of shock when I realized I had done that and had to get back up the steps without a cane to get to where the cane was, but I did it no problem. Progress!

Certainly better mobility. Using Tylenol instead of the lighter pain control drug 66% of the time and almost done with the lighter pain control drug. Plan is it will be Tylenol only starting Monday. Pain is about a 2+ or so typically.  Heavy PT sessions make it a 3+ sometimes but that's the price of improvement.

Thankfully, the toes have stopped swelling up at night. The ankle seems to be getting better too, so only direct hip pain wakes me up in the middle of the night now. At least it makes sense.

Physio is going well.  Doing good walking around unassisted and doing the exercises.  Some still hurt quite a bit and are hard to do.  Still cannot bring my knee to my chest at all, it locks up well short and is my worst PT exercise right now.

Major swelling and tightness is still around the upper leg hip area as the muscles are still pretty angry about being moved around during the surgery and are making their displeasure still known.  Lying on my side, even my left side for PT treatments hurts like heck, and I'm not about to even try lying on my right side.

Overall, it's steady progress, I can do stuff this week I could not have even tried two weeks ago.

Still no bending at the waist past 80 degrees, or crossing legs or ankles for the next couple months, but may be cleared for driving and going up and down actual flights of stairs next week.

Ow, What The Heck?

So, no ice machine yesterday, much sadness.

As such, I didn't put on the ice gel pack I've bought as a replacement at night, as falling asleep wearing it is not a good idea.  In short, you should ice an area for up to only 30 minutes at a time. Then  you need to give the icing treatment a break.

Swelling does continue to occur in the lower areas.  

Before the guys go "swelling heh, heh, cool" -- Well, it's not so much fun nor is there any swelling in that area, get yer minds outta the gutter. 

Generally, the swelling occurs lower down as the swelling around the quad muscle and hip seems to trap the blood farther down in the leg.

The right ankle again swelled yesterday night to the size of a softball.  Likely the heavy PT had something to do with that. Very productive PT session where I was walking around and doing exercises without a cane or any support or safety belt at all (kinda scary, and wobbly, but I did it)  - quite the workout.

Normally and unfortunately, I'm awoken in the middle of the night because of the right big toe swelling up and feeling like it had been sliced open and bleeding at the top, even though it is not actually doing that.  But it sure feels and hurts like it does.

But last night it wasn't the right big toe that woke me up, this time, it was the  Big Toe on my LEFT LEG.

Seriously left big toe?  Your leg wasn't even involved in this surgery! Knock that off.

Got the gel pack out, iced the right leg at the hip for thirty minutes which felt darn good, and everything settled down.

More outpatient PT today. More icing to come too. Time to go get better.

Ode To An Ice Machine

The ice and compression machine was picked up today as the prescription for it, even as it is not a covered expense, was for only three weeks. It was worth every penny of its uncovered out of pocket rental expense.

To say it was great is an understatement.

No need to constantly freeze ice packs, time their use or have to take either them or compression socks on and off all night.  Instead it pumped water through the black wrap and also would do compressions for it, while the separate calf compression units wrapped around the calf muscles and inflated and deflated at intervals to prevent clotting.

So instead of running to and from the freezer and running a timer. this machine did it all by itself.  The attached remote was also easy to grab and use rather than having to reach the machine.

Only downside was I could not remove those leg wraps by myself and thus needed help taking them off after each use. Also the ice wrap (the black item above) could have been a bit larger to fully cover around the entire leg, and the velcro on it stuck to everything including itself and was generally a pain to use, but overall it worked great.

Kinda noisy, but after awhile it became just some background white noise during rest periods.

Rather sad to see it go, as it really made these first three weeks of recovery much more pleasant. Farewell trusty ice machine, you will be missed.

Now on to using an ice gel pack for occasional relief.

Well That Cleared A Year's Worth Of Deductibles In A Month.

Got the bill in the mail for the surgery, which I have now paid.

Reading the top line I almost passed out.  Bottom line was quite a bit better by comparison, which is likely why they do it.

Our medical system is kinda crazy in terms of billing, but the level of care is rather great. 

A $60k top line, but then there's an insurance reduction of $47k.  Then followed by the  insurance company  payment of $10,842.82 and our deductible of $1,577.18.  So for a $60k charge, they actually got paid $12,420.00.  This is probably what they actually wanted to make from the outset in order to get a decent profit for a few rather intensive and high quality hours of care, so they had to raise the stated price to be able to get to where they wanted to be.

If anybody can make sense of this kind of system where the insurance company's contractual reduction is the majority of the stated charge, good luck with that.

Note that was just the surgery center and didn't include the separate bill from the surgeon, who, just like the surgery center, definitely deserved the money. So, understand that I'm not complaining at all, just remarking on the inanity of how the system works and how the top line price just has nothing to do with the actual final price paid.

Between the two invoices from them alone, we cleared our insurance company's annual High Deductible Health Care Plan out-of-pocket deductible for the entire year and all in the month of January! Ouch. 

We've only cleared that deductible in a year once before - last year when some other serious family health care problems occured and had to be dealt with, but then we hit the max in September, not January. 

Of course, some things aren't covered by insurance at all, such as the ice/compression machine so we paid that out of pocket, but the rental fee  for the 3 weeks for it was really, really worth it. Highly, highly recommended if you get offered it, do it.

Well, the rest of the year now has services without out of pocket deductibles so we've got that going for us, and that's nice.

The New Hip - Now With A Picture!

I'm officially part titanium and part ceramic, now with pictorial proof.

The doctor took off the dressing, examined the incision, and was happy with what he saw. 

The incision looks good, no signs of infection or other issues.  He covered it with a steri-strip and gave some more instructions for caring for it.

The area around the incision is rather raw and has razor burn from them shaving the area.Also still rather swollen, which is to be expected.

X-rays taken shows everything is in the right spot and the surgery was a great success.

The spike into the leg bone is titanium and was press-fit into the bone during the surgery. It has a rough-textured matrix on the outside designed for the bone to grow and attach to the spike, further securing it and cementing the two parts together.

The ball is ceramic.

The cup at the hip bone is titanium with a slippery smooth plastic insert.   The cup, like the spike, has a rough-textured matrix on the outside. It also will have the bone grow and attach itself to the cup and, like the spike, the cup will be cemented to the bone and the screw will become a backup rather than primary attachment point.

Yes, that is a titanium screw at the top securing the cup to my hip bone.

I can now honestly and 100% accurately say I've been screwed.

The titanium is actually stronger than the bones it now holds together.  The worry from falling is dislocating it as everything settles in, or breaking the bones around it. So falling is highly undesirable and contra-indicated at this point.

Theoretically, I can have a normal and full range of movement in all directions as the leg will no longer be impinged by the arthritic hip.  Pretty impressive what modern medicine can do.

Looking forward to making that full range of motion happen.

Got discharged from at-home physio and had my first out-patient PT session today.

Started with a warm up and then we got right to it.  I had walked in with a cane.

They put a belt around my waist for safety, with the therapist holding an end and then had me walk unsupported for the first time since January 13.  

A very strange feeling. I walked essentially unsupported: forward, tip-toe, heel-toe, sideways, and backward and then marching in place.  

Then onto a balance board which was fun.  Then lying down doing all sorts of exercises.  Finally the exercises were done and I got a heat-wrap around the hip, and then a special ultra-sound machine designed to relax the muscles and break up some of the swelling and scar tissue.

A rather intense hour and I'm definitely feeling it now. This is going to be a lot of effort but it's going to be good.

Hip Status Report - Two Weeks After Surgery

Your weekly status report on your newest right hip fellow.

 

I’ve been doing much better quicker than I expected.

 

This is thanks to the excellent home care by the lovely wife, supported by my kids - when they’re not busy saying that I’m now really old because I have a hip replacement (they’re very caring like that).

 

Pain is down to a 3 or less, and is less than pre-surgery. Still taking pain meds, and the icing machine is still the greatest thing ever,  and still rather tired on a daily basis, but that’s getting better too.

 

Physio is going well, now using a cane for 50% of the time moving around with the other 50% using the walker. That was very quick progress.

 

The cane is much more maneuverable, but less support and took a bit of getting used to.

 

Have a lot more mobility this week and the swelling around the hip is lessened, which is nice, but quite a bit is still there.   

 

Can now actually lift the leg to get into bed, which is great so another thing I can do by myself, except for putting on the compression sleeves. 

 

Still under a lot of restrictions movement wise.   

 

Physio Therapists were impressed with the progress I’ve been making, but have warned me not to overdo it.  My right ankle swelled up to the size of a softball due to a bit too much effort, so lesson learned.

 

I can now easily get around the house, minus the basement and I’m really feeling the improvement daily.

 

Post-Op visit with the Doc is set for tomorrow and the bandage will come off, and then we’ll see if chicks really do dig scars.