Arx Hereticus

Welcome to the ramblings of a merry heretic, an ex-pat (Tex-pat?) American living in Maryland after having spent six years in Germany. Arx Hereticus is part travelogue, part cooking, part budo, part socio-political commentary and mostly just me BSing.

Thursday, August 09, 2007

He's good to go

I just wanted to say how proud I am of this guy and his motivation to return to normal life after a really steep degradation and drastic measures to return him to something resembling normal.

It's no small thing, to decide to get your greater trochanter sawed off, your acetabulum bored out and replaced with high-impact plastic, all your hip rotators and your tensor fascia latae cut through, ESPECIALLY if you are a budoka and this is, literally, where you live.

I still suffer fits of paranoia and regret on his behalf, something I know AH/cg doesn't do, thinking there was something else we could have done. But when my teacher Peter Schwind suggested we get an Xray of the joint because he suspected something serious was going on, we didn't delay.

I literally did everything I physically could to prevent the surgery. But when my mate kept sliding back into pain after the manipulations, I realized it was out of my hands.

After the pre-op treatment with Peter S, CG was "himself" for barely two days before sliding back down into the black well of pain. I realized that my heart was going to break if we didn't go through with the surgery and find CG some hope. Seeing him so bright-eyed again, after the Peter's treatment, just broke my heart.
I realized how far CG has slipped into pain, and missed the vital, powerful, warm, totally giving and brilliant man I fell in love with.

Now, I see him again, now that we've gone through the (gruesome but well-medicated and well-managed) surgery to replace the greater trochanter with chromium steel alloy, and the acetabulum with carefully angled (to allow further budo training) plastic.

We were told that ceramic was great, but hard to replace and, well.. squeaky.

It's a bloody miracle, with emphasis on the "bloody".
I'm a holistic health practitioner, but this experience, especially my 5 days in the hospital directly post-op with my mate, have reinforced my faith in "a damn good knife when you need one".

We bodyworkers can't do everything. It's a mistake for us to think so. We need our "partners of the knife" close at hand, for when our hands can't do it all.

Meanwhile, I'm doing my best to work up a challenging rehab..

HW

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I yam (almost ) OUTTA here!

Finally. Had my final doc appointment, all's well (albeit with a slight low red blood cell count -- more red wine for me!) and I'm done as soon as I finish my appointments and self-driected activities tomorrow afternoon.

Saw the chief doc for the rehab center and he basically said, "You're going home! Hurrah! Good luck."

Here's the PT schedule I'm planning for the next couple of weeks, I'll be consulting my family and ortho docs and the PT crew at Eschenbach next week:

Self-administered PT

Self-Krankengymnastik
(Massage table or bed, daily, mix and match any combo for 20-30 minutes)

1. Po-presses
Point toes up, press knees down, tighten thighs, po and tumy, hold 10 seconds
Relax, repeat 5x

2. Toe twirls
Circle toes inward x 30 sec., rest, reverse, repeat

3. Pedal pumpers
Toes up and down to full extension/contraction for 30 sec.
Relax, repeat

4. Knee raises
Heel stays on top of table, raise knees, alternate L-R for 30 sec.
Relax, repeat

5. Leg lifts
Knees up, keep knee bent, raise leg off bed, alternate L-R 30 sec
Relax, repeat

6. Hippy shimmy
Lie flat, wiggle hips, pressing heels down (like belly dancing), 30 sec.
Relax, repeat

7. Leg spreader
Lie flat, toes up, knees down, alternate L-R leg spread for 30 sec.
Relax, repeat

8. Pelvic arch
Lie flat, knees bent, toes off table, arch back off tabletop, hold 10 seconds
Relax, repeat 2x (for a total of 3 arches)

9. Arched belly boogie
Lie flat, knees bent, toes off table, arch back off tabletop
Tilt pelvis up and down for 30 seconds
Relax, repeat

10. Mule kicks
Lean across table, feet on floor, knees bent
Raise heel, keeping knee bent, alternating L-R for 30 seconds
Relax, repeat

10. Seated leg lifts
Sit on edge of table, legs dangling, not touching floor
Lift foot, straightening knee, alternate L-R, 30 seconds
Relax, repeat

12. Seated belly boogie
Sit on edge of table or chair, tilt pelvis forward and back for 30 sec
Relax, repeat

Assisted krankengymnastik
(Massage table or bed, any combo for 20 min, 3x per week)

1. Po presses
Patient does po presses as above
Tech applies positive resistance to toes
30 seconds, rest, repeat

2. Knee raises
Patient does knee raises as above
Tech applies positive resistance to knees
30 seconds, rest, repeat

3. Leg lifts
Patient does leg lifts as above
Tech applies positive resistance to knees
30 seconds, rest, repeat

4. Leg spreader
Patient does leg spreader as above (O/P side only)
Tech applies positive resistance to leg (at ankle)
30 seconds, rest, repeat

5. Pelvic arch
Patient does pelvic arch as above
Tech applies positive resistance to try to push knees together, then apart
30 seconds, rest, repeat

6. Mule kicks
Patient does mule kicks as above
Tech supports o/p/ side knee, and at apex provides lift to go slightly higher
30 seconds, rest, repeat

Physio ball exercises
(20 min, 2-3x per week)

1. Bouncy bouncy
Sit and bounce, 30 seconds-1 minute
Relax, repeat 2x (total of 3 sets)

2. Rolly rolly
Sit on physio ball
Roll back and forth for 30 seconds
Rest, repeat 2x (total of 3 sets)

3. Leg lifts
As in seated leg lifts above, but on physio ball

4. Catch
Sitting on physio ball, left one foot
Play catch! Alternate feet
Start at one toss per foot for 3-5 tosses
Increase to 2 per, then 3 per, etc, up to 5 tosses per foot

5. Egg rolls
Lie on mat or table, O/P foot on top of small physio ball or similar
Roll ball toward and away from body, 10x
Rest, repeat 2x (total of 3 sets)

Water exercises (bewegungsbad)
(20 min., 2-3x per week)

1. Walking in water
Walk in chest-deep water, 1-2 minutes clockwise, 1-2 min, counter

2. Big slow kicks
Stand in chest-deep water, holding side rail/edge
Raise and lower legs slowly front and back, alternate L-R, 10x per side
Rest, repeat

3. Little fast kicks
Stand in chest-deep water, holding side rail/edge
Kick back and forth in small arcs, front to back, alternate L-R, 10x per side
Rest, repeat

4. Side kicks
Stand in chest-deep water, holding side rail/edge
Raise leg laterally, lower, 10x per side
Rest, repeat

5. Flutters
Stand in chest-deep water, back to side rail/edge, holding on
Let legs float, flutter kick, 30 seconds
Rest, repeat

6. Bicycle
Stand in chest-deep water, holding side rail/edge
Let legs float, pedal like a bicycle, 30 seconds
Rest, repeat

MTT
(3x per week)

1. Reclining bike
30 minutes, increase time as endurance allows

2. Butterfly, arms
5-7 Kg, 15 reps, 3 sets

3. Butterfly, thighs
17-22 Kg, 15 reps, 3 sets

4. Leg presses
OP leg: 20-30 Kg
Both legs: 50-60 Kg
15 reps, 3 sets each, O/P and both, alternating

5. Lat pull-downs
15-30 kg, 15 reps, 3 sets

(Increase weight as endurance/strength allow)

Other:

1. Lymph drainage massage, 20 minutes, 3x per week

2. Ice packs, 2-3x daily or as needed for muskelkater (muscle aches)

3. Massage scar, surrounding tissue, 1-2x daily

I'm not supposed to put more than 20kg on the o/p leg until about the end of August. At that time, I'll get another x-ray and my local doc will make the call. I found out today, that SOME hospitals and docs allow much more weight, but Hr. Dr. Prof. Grifka is kind of conservative and prefers to err on the lighter side.

Eh. Whatever. The crutches are great for stability, primarily, and I'll continue to use them until Fr. Dr. Eisner says to put them aside.

I have to keep up the anti-thrombosis shots and wear the luverly support stockings till then, too. Fashionable AND functional!