30 June 2009

Authory stuff (achoo!)

A few developments in Interbet Book Land ... I have a really truly rooly Amazon Author's Page (which involves your publisher verifying that you really are you, and stuff like that).

And I've got a whole page on my web site about the book now, too. My son took the photo - didn't he do a nice job? Points if you can name the two hand-knit items I'm wearing! On this page there's also a free Secret Shape puzzle you can download, print out, and try.

Reviews are slowly coming in (thank you to all the wonderful people who have reviewed it!!). You can read them on Amazon and on Fishpond, as well as various blogs (MadMad, Five Ferns, and Roxie, for starters).

Wiley have recently offered me a second puzzle book, BUT it depends on how their puzzle book sales go over the next few months, so it's on the back burner for the moment. If you were thinking of possibly buying my book one day, doing it sooner rather than later would be really appreciated!! There are links to online shops on my web site, plus it's available in bookshops in the USA and Canada.

Am currently laid up with the worst head cold I've had in years ... it crept up on Friday, I managed to get through friends coming over for lunch on Saturday, and a few cups of tea with friends on Sunday, but by Sunday night there was no denying it. Have been in bed for 2 days now, and still suffering from SFB (Snot For Brains). Blargh.

Cuddles from Petal help a little, when she's not being Psycho Loony Nippy Puppy! Her sister Alexis came over for a Puppy Play Date last week, they barely stopped for 2 hours of dominance 'play', growling, running, tussling, and nipping! She slept all afternoon, afterwards!

25 June 2009

Chihuahua Puppy Jumper

Here's Petal's Cabled Jumper. She's fairly happy wearing it, and it certainly keeps her warm on these chilly Canberra winter days! Chihuahuas are very barrel chested and tiny, which makes it difficult for them to fit standard dog jumper patterns.



This is an adaptation of the Need for Tweed Dog Sweater (Rav link) by Shiri Mor

Size : Chihuahua Puppy - 3 months old (chest measurement ~ 23 cm / 9")

Needle : 3.75 mm / US 5
Bendigo Woollen Mills Classic 8 Ply, 30 metres - machine washable

Back

CO 20 sts

Knit ~7 cm (2.5”), with garter st borders, cables or pattern as desired.

Pattern I did :
RS : k3, p1, k4 (cable twist every 6th row), p4, k4 (cable twist every 6th row), p1, k3
WS : k4, p4, k4, p4, k4

When get to desired length :
Decrease at each end of row, every second row, for 5 rows (k1, k2tog, k to last 3 sts, k2tog, k1).

Bind off loosely.

Belly strap

CO 11 sts
Knit ~3 cm (1”) in garter st
Decrease at sides (k1, k2tog, k to last 3 sts, k2tog, k1) in alt rows until have 3 or 4 sts left. Leave sts on st holder.

Put it together
Sew Belly band to Back piece at sides (see photo). The narrow end of the belly piece should line up with the widest edge of the back piece.

Pick up stitches around the neck section (20 sts from back, cast on 6 new sts, slip the 3 or 4 sts from end of belly band, cast on 6 new sts = 35 sts total).

Knit in the round for 4-6 rows. Knit a few short rows for the chest section to make it deeper, as you go around. This section isn't really wide enough in this first jumper, I'll experiment with the next version and update these instructions accordingly.

Bind off loosely, darn in ends.

The nice big leg holes mean it’s easier to get on, and more comfy for a pup who isn’t used to wearing stuff.

Final step : Get onto squiggly puppy, somehow!

23 June 2009

What the Occupational Therapist Said

On to the last section of the Joint Replacement Information Session I attended earlier this month. This is what Christie, the Occupational Therapist (OT), had to say :

The OT is there to help you learn how to manage daily tasks at home - bathing, toileting, sitting, driving, and so on. They can help with training, equipment, setting up your house, and so on.

Hip precautions are set by your surgeon (they vary depending on whether the incision is done from the front or the back of the thigh). At Canberra Hospital they are prescribed for strictly 3 months, no exceptions. And possibly longer (I know of women with hip dysplasia who were given hip restrictions for as long as a year). 3 months is the minimum time for the ligaments that support the hip joint (and were cut / disrupted during surgery), to restabilise and repair.

My surgeon (and most of the Canberra surgeons) use the posterior approach (closer to the back).

Hip Precautions (posterior THR) :

1. The operated leg must not cross the mid-line of the body - not when sleeping, standing, or sitting. No crossed legs!

2. No internal rotation. Do not let the leg turn in towards the mid-line (ie pigeon-toed) - and no twisting of the upper body towards the operated side.

3. Do not bend the operated hip less than 90ยบ - so you can't bend forward for anything. This one has the biggest impact on daily functioning. I won't be able to sit on anything lower than my knees. There are some diagrams here.

Daily tasks

Showering


  • Have your toiletries in easy reach, on a shower caddy or shelf. Don't leave shampoo on the floor, for example.
  • Use soap on a rope, or liquid soap in a dispenser (tick)
  • Use a long-handled brush &/or sponge (tick, tick)
  • Use a shower stool if you're wobbly! (tick) They can be borrowed from the hospital - I got one from Aldi
  • Not quite sure how to dry my legs yet ... my feet may get very good at grabbing towels for this!
Getting Dressed


  • Use long-handled aids such as a reacher, grabber (tick x 2), long shoe horn (tick), sock putter-on-ers (tick) etc
  • Have the items to put on in easy reach
  • A long-handled shoe horn is extremely useful when away from home, as the curved end can be used to hook and grab things that slip out of reach (like undies when in the loo!)


Toileting

  • Be very careful how far forward you bend
  • Place the toilet paper forward, so you don't have to twist to reach it
  • Use an over-loo chair at home for 3 months (will be lent to me from the hospital)
As for going to the loo when you're out ... this is a problem! Unfortunately all the disabled toilets I've checked so far have low seats - including the ones at the hospital!


After asking around on Hipwomen, several women mentioned using devices that allow women to wee standing up - I decided on the brilliant (Aussie invention!) Whiz Freedom. I know it only takes care of 'Number Ones' - but it's a great start (and great if you're into camping too!).

Cooking

  • Have all equipment at waist height, easy to reach
  • Temporarily store your crockery on the bench, or in some higher location

Cleaning and Gardening

Don't do it. Well, you can possibly do a little, with a great deal of caution. But there's to be no vacuuming, sweeping, mopping, digging, weeding, mowing, or raking. Any excuse to drop the housework, and get the kids and hubby to take over!

Work

Most people need 4-6 weeks off work - the main thing if you go back to work within the 3 months, you still need to do your hip precautions. I should be okay, since I work from home, and just so long as my brain is functioning (debatable at times!), I can work on my laptop in bed, or at my desk.

Driving

Driving after a joint replacement is illegal in Canberra for 6 weeks post-surgery. 3 months of no driving is recommended for THR.

As a car passenger : tilt the back of the seat backwards, so the angle is very wide when sitting down.

Setting up the house
  • Check what steps & stairs you have to deal with.
  • Grab rails in the bathroom can be very helpful. The suction cup sorts are not strong enough!
  • Use a toilet seat raise for 3 months
  • Low lounge chairs are out - look for more suitable seating around the house - they must be knee height or higher
  • Foam wedge cushions are good (tick)
  • Get in and out of bed on the same side as your operated hip
  • Sleep on your back for 4-6 weeks
  • Check the house for mats, cords, and ensure you have a clear pathway for your crutches - reduce the risk of tripping and falls!
Goals before admission
  • Assess what might be difficult to do at home, so you can get help from the OT
  • Organise your home environment
  • Buy the small aids you need
  • Finish any necessary tasks (pay bills, pre-cook meals, etc)
Walking Aids

After surgery you start out on a forearm support frame, then move to a pick-up frame or a wheelie frame. Finally, crutches and walking sticks, which you'll need for quite some time at home. I've got walking sticks and elbow crutches of my own.

NB : It's normal to get an increase in pain when you go home from hospital, as you're being much more active.

Hip Dislocation

You'll know if it dislocates! Go straight to Casualty (by ambulance if you can't sit up), and get them to call your surgeon - they can fix the joint, pulling it into place, but it will require anaesthetic. Possibly surgery. Urk.


Your Miss Petal photo reward. She's wearing a little jumper I designed for her.

19 June 2009

She's a TINY thing

Just so you can see how tiny Petal is - this is her in the kitchen with Dotter, having a little chat ...

18 June 2009

Baking Soda Poultice

My sports physician Dr Rob Reid (who knows everything there is to know about joints, tendons, bones, and such) recommends using a baking soda poultice on swollen and inflamed joints. I find this quite soothing on my sore knee.

He says : "A poultice using bicarbonate of soda is used to decrease the swelling in and around a joint or draw out fluid or oedema from under the skin. The joint swelling may be because there is fluid within the joint, or that the covering of the joint (the synovium which holds the fluid in the joint) is "waterlogged" and this produces a boggy swelling of the joint."

Here's how to make one!

1. Gather your equipment : a bag of baking soda, some water (warm or cold, up to you), a mixing spoon, a glass bowl, and a piece of scrap fabric (old shirt / t-shirt etc).


2. Mix roughly 2 cups of the baking soda with enough water to make a firm paste, roughly the thickness of bread dough. It should be soft and moist, but not runny.

3. Place the lump of baking soda onto your square of fabric.

4. Tie up opposite corners, to make a neat little bundle like so. There should be just one layer of fabric under the poultice.

5. Sit or lie down for an hour, with the poultice sitting or lightly strapped onto your swollen knee, ankle, wherever ... I usually keep a face washer or towel handy, as it can drip a bit.

After the hour is up, put the baking soda mix into a lidded container, rinse and dry the fabric, and reuse the next day (just add a bit more water to get the paste consistency again).

Dr Reid says you should refrigerate the poultice, and replace the baking soda after about 3 or 4 uses, but really, I don't see how that would be necessary, as it's never going to go off ... I've used the same batch of un-refrigerated baking soda for more than a week without problems, it still fizzes slightly when I add water.

He goes on to say : "The bicarbonate of soda poultice will draw the fluids out of the joint over a period of time, and this commonly takes 7 to 10 days, especially for a joint that has a boggy swelling for more than 1 or 2 days. The poultice can be used in association with any other treatment that is being used, and does not cause any skin problem."

15 June 2009

More delays

I called the Surgical Bookings at hospital this morning ... and they're saying August/September for my THR surgery. Sigh. I will still have my Pre-Admission Clinic soon, but that's 'valid' for 6 months. I reckon I'll be lucky to have this thing done by the end of the year.

This is the disadvantage of being a public Medicare patient - private patients and more urgent cases take precedence, and push you further down the waiting list. Canberra has the worst / longest waiting lists in the country, too.

The advantage of being a public patient is the operation and hospital stay don't cost me a cent. So the wait is worth it! I'll keep posting about my preps and stuff now and then, but don't have to think about it quite so seriously just yet. The waiting is the hard part!

14 June 2009

What the Physiotherapist Said

Part 2 of the Patient Information Session

Physiotherapist - Christie

This is the physio program after THR, at the Canberra Hospital. If you're having this operation, your own hospital and physio may have different guidelines.

Day of surgery (Day 0)
Deep breathing / coughing exercises, to help expand the lungs after surgery
Ankle/foot exercises

Day 1

  • 1 physio session : start on exercises
  • Get out of bed with 2 people assisting
  • Walk 10 metres
  • Use large walking frame
  • Sit out of bed 1-2 hours
  • Discuss hip precautions (next post)

Day 2
  • IV pain relief comes down, onto oral analgesia - take it regularly!
  • 2 physio sessions, morning and afternoon
  • Progressively more difficult exercises
  • Out of bed with 1 assistant
  • Walk further than 10 metres
  • Sit out of bed morning and afternoon, 2 hours
  • Use smaller walking frame

Day 3
  • 2 physio sessions
  • Be independent with your exercises
  • Get out of bed independently
  • Get into bed (harder than getting out) with help from only 1 person
  • Progress to small walking frame or crutches
  • Walk at least 30 metres
  • Looking at discharge options, and discussing home environment
  • Moving around frequently
  • Walk to toilet, no bed pan
  • Sitting out of bed morning and afternoon
  • Need to change position hourly.
Goals for Days 3-5
  • Practice stairs with crutches / walking stick
  • Standing exercises
  • Independent with exercise program and transfers (in/out of chairs, beds, car etc)
  • Able to walk over 50 metres
  • Able to negotiate 5 steps
  • Sit out of bed most of the day
  • Perform physio outcome measures
  • Good understanding of hip precautions

Generally go home around Day 5

After leaving hospital
The hospital offers 2 free physio sessions a week, for a month, to progress your mobility, functioning and self-care for hip and knee replacement patients.

Ongoing physio is vital!

What the Occupational Therapist said is next .... :)

Your Petal Photo reward for today :