Re: (unknown)

November 1, 2002

,

Boy, you sound hypO to me. When was the last time you had labs done? Even

if they're in normal range, they could be too low for your body. Do you

have the exact numbers with you? You could post them and maybe someone

would have some insights. I know for me, normal ranges are too low. I

always feel " normal " when the labs show me a tad hyper. All the symptoms

you listed are hypo symptoms, so you should definitely look into it. What

meds are you on besides pred. ?

Kristi

(unknown)

> Hello to everyone. Hope all is well. I'm writing this in

> desperation, seeking answers or at least suggestions my doc wont give

> me. I was on a high dose of prednisone for my eyes for several

> months for my eyes and was gradually tapered off a couple months

> ago. Since then, I have been having fatigue, joint pain, hair loss,

> and (ack!) decreased libido. I thought maybe my thyroid was going

> out of whack again, but my tests came back normal. STILL, I wonder

> if there is some other sort of hormonal imbalance going on, perhaps

> brought on by being on the prednisone? My doc isn't really LISTENING

> to me. He's saying the joint pain is just previous pain I had that

> I " forgot " about while being on the prednisone and now that I'm off,

> my " memory " is coming back and my body isn't used to dealing with the

> pain now but it will get better. He says my hair falling out is

> simply hereditary, and afterall, I'm " getting older. " I'm only 35!

> I haven't even started menopause yet! Besides that, I have a license

> in cosmetology and know that hair does thin out for some people as we

> get older, but gradually, not over the course of a couple months.

> This is soooo frustrating because I KNOW when something different is

> going on with my body, I wouldn't go in to see the doc if I didn't

> really think I needed to, and the doc is practically laughing in my

> face, no he DID laugh in my face and suggested a wig (all in good

> humor, of course) and then he suggested if the joint pain gets worse,

> come back in, otherwise, he'll see me for another thyroid check in 6

> months. He never bothered to suggest a hormone imbalance not

> particularly related to the thyroid. Anyway, my question is, has

> anyone else here gone through anything like this after taking

> prednisone? Perhaps it is something coincidental, NOT caused by

> being on and then off the prednisone, but I do believe it is some

> sort of hormone imbalance nonetheless. Is there ANYONE here who can

> relate? Any responses will be very much appreciated. Thanks.

>

> -------------------------------------

> The Graves' list is intended for informational purposes only and is not

intended to replace expert medical care.

> Please consult your doctor before changing or trying new treatments.

> ----------------------------------------

> DISCLAIMER

>

> Advertisments placed on this yahoo groups list do not have the endorsement

of

> the listowner. I have no input as to what ads are attached to emails.

> --------------------------------------------------------------------------

------------

>

November 5, 2002

Hi Machelle,

It's well known that TSH can take many months, even years, to rise after

you've been hyperthyroid, particularly if you have high titers of TSH

receptor antibodies. Your levels of free thyroid hormone, FT4 and FT3 measure

how much thyroid hormone is available to your cells. These levels indicate

what your true thyroid status is. TSH is a pituitary hormone that reflects

thyroid function in normal people. Studies show that the pituitary has TSH

receptors and recognizes these antibodies as if they were TSH and thinks you

have enough. Take care, Elaine

November 6, 2002

In a message dated 11/5/2002 5:24:03 PM Pacific Standard Time,

tazbaby@... writes:

> Sure we have a disability and it is treatable might take sometime

> but you will get there guess it all depends one how you decide to

> treat it, I have graves just like my mom did when I was little. I

> had decided to go with RAI and I do think it was the right thing to

> do I have nodules 4 times larger than normal. Now the nodules are

> gone and I was put on ptu after that 2x 50mg 3 times a day now I am

> on 2x 50mg 2 times a day. My T3 was at last visit 135.45, TSH3GEN

> was <0.018 L, TSH, Sensitive <0.03 L. T4 Free 1.170. Now I started

> out pretty high they say I will probably have to have another dose

> of RAI since my number are so low and have not changed on the

> TSH3GEN that it might be needed I still dont know why but will be

> asking on Thursday when I go to the Dr again. The only thing that I

> dont like about what I have decided to treat this with is that I

> have gained all this weight and cant hardly walk for very long I

> also take Inderal 2x a day 40 mg for my heart rate. Well I can

> understand what is happening to me now I am becoming hypo right well

> when does it change and get to where I can loose this weight I just

> can't take it anymore it is driving me crazy 50+ lbs since July is

> alot. I hear all these things some of you are doing and complaining

> about, well this is a treatable disease and I know it I would not

> quit my job because of it I am a cashier nothing important just on

> my feet all day for 91/2 hrs but dont complain about it much. I

> dont feel this is life threatening and some of you do so is there

> something I am missing or what. You guys talk about getting money

> because of the disabilities act well this does not stop you from

> having a job or doing it, I just dont get some of you why would you

> need to quit your job to get things better. Well I could go on and

> on but would probably piss some of you off but I will stop here

> maybe next time

>

> Thanks

> Machelle

Hi Machelle,

I think your view is the general perception and I'm not angry that you ask

why some of us think we have to quit our jobs to feel better.

My job was unusually stressful. I'm a financial programmer and have been

consulting for several years. I live in Washington state and was working in

Texas for the past year. I worked crazy hours--sometimes in excess of 90

hours per week! I went for as long as 2 months without seeing my husband.

It got to the point where I just could not sort out my thoughts well enough

to do my job. I would have to track down clients, turn their fragmented

ideas of what they wanted into a workplan that I would then follow to write a

program. The last few months I worked, I would forget what I was doing in

the middle of a task, my thoughts were jumbled, my designs didn't make sense,

I'd have to redo the simplist things 10 times because I kept screwing up. If

I had stayed there, I probably would have been fired after a few more months

of mistakes. My doctor told me that I couldn't keep doing this to myself and

I needed to take some time to get better. I needed to be home where I could

be monitored and receive proper treatment. Unfortunately for me, the work I

do is concentrated in Houston and New York. To get a job here, I'm having to

learn to do something else.

I don't think that I'm permanently disabled. I hope to be back to work in a

few months. However, I think that my situation satisfies all the

requirements of my disability policy. This is why I took the policy out--in

case something happened to me and I was out of work for a while.

I hope I've answered your questions. I haven't given up because of a

diagnosis, but I do need time to get better.

Peace,

Tori

April 20, 2003

It looks really cute for anyone with school-age girls.

> Eloise is a six year old ornery rich girl who lives at the Plaza

> Hotel. They are very fun books. The movies looks to be fairly

> accurate to the book.

> http://disney.go.com/wonderfulworld/eloise/index.html

> We intend to watch it. Leggs

Thanks, Leggs! We have ALL the Eloise books. I'll tell Sophie.

Salli

April 20, 2003

> Thanks, Leggs! We have ALL the Eloise books.

Salli, Somehow I thought you might! :-) Leggs

September 24, 2003

it is an old wives tale taking castor oil with sure give you diarrhea

though and you'll spend the day in the bathroom or at least not far from it,

lol...

HUGS, ROBIN, NY

Age- 41

TTC#4 -

OPEN RNY

10-18-02

378/246/170???

DR.EDWARD HIXSON

SARANAC LAKE, NY

Mom to:

&

7 1/2 year twin boys and

Madison age 4 1/2 yrs.

Miscarraige August 2001

Miscarraige August 2003

Married to Pup:

15 years this

Halloween : )

September 24, 2003

it is an old wives tale taking castor oil with sure give you diarrhea

though and you'll spend the day in the bathroom or at least not far from it,

lol...

HUGS, ROBIN, NY

Age- 41

TTC#4 -

OPEN RNY

10-18-02

378/246/170???

DR.EDWARD HIXSON

SARANAC LAKE, NY

Mom to:

&

7 1/2 year twin boys and

Madison age 4 1/2 yrs.

Miscarraige August 2001

Miscarraige August 2003

Married to Pup:

15 years this

Halloween : )

September 24, 2003

it is an old wives tale taking castor oil with sure give you diarrhea

though and you'll spend the day in the bathroom or at least not far from it,

lol...

HUGS, ROBIN, NY

Age- 41

TTC#4 -

OPEN RNY

10-18-02

378/246/170???

DR.EDWARD HIXSON

SARANAC LAKE, NY

Mom to:

&

7 1/2 year twin boys and

Madison age 4 1/2 yrs.

Miscarraige August 2001

Miscarraige August 2003

Married to Pup:

15 years this

Halloween : )

October 13, 2003

Hi,

Sorry about that........... Aussie for 'big note yourself'.......be proud

etc etc........... People here tend to talk about someone having a 'big

head' when they think a bit of themselves........or say 'hope they don't get

a big head' - after some big achievement............... and so it sort of

tickled my fancy that you will have every reason to talk about your big

head - as you will truely have one............. and if like the rest of us -

will not stop talking about your new hip and what it is etc for a couple of

years anyway.........

Big smile..............

Edith................

> At 08:49 PM 10/13/2003 +1000, you wrote:

> >.Just think you will be able to skite a big head now and

> >no one can argue that point.....

>

> Edith,

>

> Help!! Skite???? Translate or explain please for us up-overs (wouldn't

> that be the opposite of down-unders?)

>

> Cindy

>

November 17, 2003

In a message dated 11/16/03 6:26:15 PM Eastern Standard Time,

cgronbach@... writes:

> dept. She said she couldn't recommend any particular anesthesiologist. I

> told her I wasn't looking for a recommendation, just wanted to be scheduled

> with someone good. She said she would schedule me with one of her

> favorites, and it was a great experience. You may be able to do the same,

> or at least say you don't want that particular one...

>

> Cindy

> C+ 5/25/01 and 6/28/01

Thanks, Cindy.

I have a close friends who is an anesthesiologist and he will call the chief

in Sarasota and talk with him.

Diane

March 6, 2004

Hi ine

The drive was less than 200 miles and we took a scenic route taking nearly 3

hours. It was no problem at all. I sat in the front passenger seat and had

plenty of leg room. I did lower somewhat the back rest. It also helped, I

think, that the seats were leather as it was easier to slide into a comfortable

position, and that it was a high-seated vehicle (BMW X5) making it very easy to

mount a seat. Getting out was also dead easy.

I hope you find the drive comfortable too. Good luck with your 2nd resurfacing.

Dan

* +44 (0)7974 981-407

* +44 (0)20 8501-2573

@ dan.milosevic@...

_____

From: wimpybear2003

Sent: 06 March 2004 22:08

To: surfacehippy

Subject: (unknown)

Hi Dan

Thank you for your very detailed posting.

I get my second hip resurfaced next Thursday, and your diary helped

to prompt what I might hope for.

One question: how did you find the drive to your sisters? I will be

being driven from Birmingham to Hampshire?

I hope your recovery continues to go so well.

ine

>

> Dear Surfacehippies

>

> This may turn out to be a long message/post, so I'll divide it into

various headings. IÃ¢â‚¬â„¢ll be posting snapshots as well Ã¢â‚¬ " check the

Photos link on the left side of the surfacehippy home page.

>

> Facts

>

> I had my left hip resurfaced on Monday, 16th February 2004, at St.

Cross Hospital in Rugby, Warwickshire, United Kingdom. The operation

was performed by Mr. Krikler. The procedure was done on the

NHS (National Health Service), or free of charge.

>

> Chronology

>

> Sunday, 15/02/04 Checked in St. Cross's Cedar Ward; met

Harry who is also a 53-year old with a left hip due for resurfacing

by Mr Krikler; Harry is very fit) I carry some 8 pounds of excess

weight round my waist)

>

> Monday, 16/02/04 Agreed with anaesthetist to have spinal

anaesthetic (like epidural for women in birth); Mr Krikler was happy

to provide a " running commentary "

>

> At approx. 12:00 taken to pre-op theatre room where spinal was

applied

>

> Apparently was taken to op theatre where Mr Krikler started the

incision and I mentioned that I could feel it - he asked the

anaesthetist to apply general anaesthetic. I do not recall this

exchange. I understand that the op lasted 1 hour and 45 min. Mr

Krikler said that the hip was very stiff and that I had very hard

bones. It appears a bit more work than usual. He fitted a Cormet

device with a 48mm cup on femoral head.

>

> At about 16:30 I was awake and back at the Cedar ward.

>

> A couple of hours later Mr Krikler saw Harry and me (Harry was

operated after I was and his op lasted 1.15, I understand). By then

the small of my back was quite uncomfortable and I asked Mr Krikler

if it would be OK to turn on my 'good' side (non-operated right). He

said that'd be OK (many nurses were later surprised by this - I guess

they are still more familiar with the THR post-operative procedure

which prohibits sleeping on your side, or crossing legs, for months,

I understand)

>

> Spent the night mostly awake; did not use PCA (Patient Controlled

Analgesia) - morphine pump to you and I - as the discomfort was

bearable (I have to stress here that I was not playing macho, but

that I have extremely high pain threshold and went through years of

OA with bone-on-bone and a cyst without ever taking a single pain

killer); passed water 4 times (nearly a pint each time?!?) and sat-up

on the bed to wee (I could never do it using the 'goose' bottle lying

down in bed); constant sitting-up and fidgeting led to some leakage

and oozing from the incision which got redressed 3 times that night;

all-in-all not too bad a night.

>

> Tuesday, 17/02/04 Day 1 - is how the hospital staff refer

to the day after the op; given a 'Zimmer walking frame at about 08:00

(after breakfast) and told to apply full weight bearing on the

operated leg/hip

>

> Walked round the Ward and to the main corridor all the way to the

lifts where use of mobile phones is permitted; phoned friends and

loved ones to inform them that all's OK; couldn't find a place to

connect my laptop (rather found a connector but the hospital

switchboard could not enable it for external calls to an ISP -

however, this week a new cable system went live there and each bed

will have cable TV, telephony [outgoing only, I understand] and full

internet access); alternated the day between walking, laying in bed

reading an obscure book and talking to Harry and the other 4 patients

in our room; had bowel movement and used toilet.

>

> Wednesday, 18/02/04 Day 2 - had a shower in the bathroom; no

problem washing both legs; could see bits of bruising on my bottom;

very little swelling.

>

> Told that I have a 9-10 " incision/scar (22.5 - 25 cm); not bothered

by that; it is healing beautifully.

>

> Harry and I are given 2 walking sticks/canes each cut to our size;

we start walking with these; usual destination: outside the lifts in

the main corridor; spending a fortune on mobile calls; after an hour

I drop one stick/cane and use one only (I'd like to stress here -

mainly for our Yankee friends - that one is free to walk round and

explore as we do not have the culture of suing the hospital should we

stumble, fall and injure ourselves; it is pretty much left to the

patient to be sensible; I always informed the duty nurse when I went

for a walk, especially at night when I couldn't sleep; but I

appreciated the unrestricted, yet caring, environment I was in).

>

> The continuous walking, interspersed with periods of

rest/sleep/reading appear to have speeded-up the healing

tremendously - both the bruising and the swelling are fast

disappearing.

>

> Made a mistake of not asking for a sleeping pill and spent most of

the night awake but without any pain.

>

> Thursday, 19/02/04 Day 3 - Physiotherapist gives us (Harry

and I) the steps (up and down) and the platform test (up and down)

with one cane/stick - we pass and are ready to go home.

>

> Blood test shows our INR (International Normalcy Ratio) for blood

coagulation is too low at 1.2 and 1.4 respectively for myself and

Harry; the hospital decides not to release us until we reach the

accepted INR window of 1.5 - 2.5 (apparently, if our blood coagulates

faster that 1.5 times the blood of a normal person, i.e. the range

between 1.0 and 1.49, we are at risk of DVT of sorts where a

thrombocite can get lodged in our lungs causing sometimes deadly

pulmonary thrombosis; if, however, our blood coagulates slower than

2.5 times that of a non-operated person who moved round normally, we

are at risk of suffering bleed which could be very difficult to stop

and even fatal if internal and unobserved); at St. Cross's hospital,

or maybe even at that Health Trust, the DVT is dealt with using

Warfarin tablets (also known as rat poison as that what it is

commonly used for).

>

> Mr Krikler visits us and I take snapshots - I hope I'll be able to

post these.

>

> Nicola, the occupational therapist, is moving heaven and earth to

arrange all the necessary equipment for me when I'm released - there

are peculiar problems as I am way out of my area (I live in North

East London, some 120 miles south-east of Rugby), and I shall be

staying at my sister's place in Essex, another 50 miles east from my

home. Nicola is trying to arrange through the local social services

for raised toilet seat, bed mats, raised chairs, bath boards (to

enter a bath tub safely), grabbers, long shoehorns etc. to be

provided by one Health Trust, via another one where I live in the

third one where I'll be staying - ah the vagaries of bureaucracy.

>

> Friday, 20/02/04 Day 4 - failed the test again;

Warfarin dosage upped to max.

>

> Saturday, 21/02/04 Day 5 - failed again; only managed to

get the ratio to 1.49; Harry is allowed to go home for the night as

he lives only 7 miles away.

>

> I continue my 15 min walks round hospital complex/park at least

twice daily without a cane or stick which I carry in my arms but do

not use. I regret not bringing my car to the hospital - I could have

driven it already on Day 3 as it is an automatic and given that in

the UK the steering column is on the right and I had my left hip

operated, I could have driven my car without any problems for, say, 3

hours.

>

> Sunday, 22/02/04 Day 6 - finally passed my INR test

(barely, with 1.51); in the afternoon my daughter and her boyfriend

gave me a lift back to my sister's place.

>

> 22/03/04 - 29/02/04 Daily - walks approx. 1 mile without any

aides.

>

> Bruising has nearly all disappeared; there's no swelling; once a

day, usually before going to bed, I take 2 Paracetamol tablets and 1

Ibuprofen tablet - these are meant to be pain killers and anti-

inflammatory in their actions; the latter I welcome, the former I do

not need, but I do want to be a 'good patient'

>

> I can do most things without a major inconvenience - dressing and

undressing; using the toilet; walking; using the stairs; putting

on/off left sock & shoe; washing/drying left foot etc.

>

> 01/03/04 Ã¢â‚¬ " 06/03/06 Moved back home; IÃ¢â‚¬â„¢m using my bath

shower now; I no longer wear a dressing/plaster over the scar (Mr

Krikler used subcutaneous self-dissolving stitches Ã¢â‚¬ " the 9-10Ã¢â‚¬Â

incision has fully healed).

>

> IÃ¢â‚¬â„¢ve been driving my car for the last 6 days Ã¢â‚¬ " no problems in

driving it, getting in/out, etc.

>

> Went to Central London Ã¢â‚¬ " the usual Friday lunchtime drinks with

pals Ã¢â‚¬ " I went there unaided (no walking stick/cane) using public

transport (bus and London Underground, or Tube as we call it).

Again, no problems using any of these means of transport.

>

> Comments

> Leg length

>

> Mr Krikler explained the mechanics of the procedure in detail; my

leg was 1.5 cm shorter; once the bio-physics of the pelvis-to-foot is

clear and the resurfacing procedure is factored in, it is clear to me

why the resurfacing procedure can do very little regarding leg length

(mine looks OK now, but I'll have to wait until my gait and posture

are corrected and straight before I can establish if there'll be a

discrepancy) while THR can be much more effective in mitigating leg

length. That's about the only advantage that I could see that THR

may have over resurfacing.

>

> Mobility

>

> Extremely high extremely early - I'm absolutely impressed.

>

> Recovery / rehabilitation

>

> Unbelievably fast and painless (for me at least). However, I

realise now that the operation is less than 50% of the solution - the

larger part is recovery/rehabilitation.

>

> ROM

>

> Could not have imagined that the range of movement would be

restored to such a high level so quickly. I said, probably too

optimistically, to Mr Krikler that I plan to come for a 6-week check-

up on my Honda Hornet to Rugby (ha thought I was mad and he is a

biker too).

>

> My final challenge Ã¢â‚¬ " to tie the shoelace on my left foot/shoe. I

hope IÃ¢â‚¬â„¢ll be able to do that in a few weeks time. Standing on my

operated leg, with my good leg in the air (crane-like position), I

not a problem but I lack the balance I have when I stand on my

Ã¢â‚¬ËœgoodÃ¢â‚¬â„¢ leg.

>

> Blood coagulation risks & management

>

> Probably the least impressive of the otherwise superb NHS (or, at

least that particular Health Trust). Two of us were kept in valuable

beds for 3 days - the only thing that happened throughout these 3

days was the dispensing of the correct dosage of Warfarin in the

evening and a subsequent INR test in the morning. I'm certain that

could have been done in the local surgery / health centre where the

patient is based.

> Thanks & appreciation

> Where do I start? Mr Krikler for his wonderful manner and style

with patients. He answered every question without ambiguity, without

use of a patronising tone, with the patience that professionals have

to have when they're dealing with a layman. The fact that he was

nearly invisible and that he made himself appear accidental in this

process, helped reassure me, and I suppose other patients of his,

that this is a routine op. By the way, Mr Krikler has performed 330+

resurfacings using Cormet in the last 8+ years. If you ask him,

he'll tell you openly about the 3-4 cases that needed revisions and

why. He does also perform this procedure privately - I understand

that the package costs Ã‚Â£9,000.00 (US$16,200.00 at 1.8 exchange rate)

all inclusive (of course, there's the added travel costs for our USA

friends). Considering that the Cormet device costs some Ã‚Â£2,000.00,

I believe this is very good value for money. Admittedly, it is

slightly more expensive than DeSmet in Ghent, Belgium, but we might

be splitting hairs here.

>

> I must mention Safi, a Ward Nurse who appears to be quietly running

the show. She is a perfect example of a person who gains respect

through her actions and deeds. Her dedication, application,

thoroughness, devotion and professionalism were a sight to watch.

Luckily, she was given a student nurse to teach as well - the student

was in perfect hands and would learn the profession well by being

tutored by Safi.

>

> Nicola, who joined this site and offered to help with advice, is

one of these people for whom no problem is unsolvable. One felt safe

if she said she would look into something. I can't thank her enough.

>

> There were numerous staff that were ever so eager to help - I'll

mention Ivan (from Zimbabwe, if I remember correctly) and Riki (from

Zambia, I believe). These guys were there throughout the long night

shift and would respond immediately if you pressed the buzzer - you

could have tea at any time of day or night. Whatever you needed, they

provided it.

>

> Lastly, it would be unfair if I did not mention and thank all the

other staff at St Cross hospital. This is a nice hospital with

diligent and conscientious staff that look well after their

patients. Even the food was nice.

>

> I must finish by mentioning the NHS - this is for the Brits - and

stress that anybody who wants to abolish it or plans to privatise it

is either insane or deliberately criminal. We have institutions for

both types. And for the unfortunate Yanks who have to fork out

personal cash for the op - consider strongly Mr Krikler and St Cross

in Rugby (although Mr Krikler may suggest another hospital where he

operates also).

>

> I'll shut up now. I hope to have more good news in 4 weeks time

when I'm due to see Mr Krikler for a check-up.

> 3 +44 (0)7974 981-407

> * +44 (0)20 8501-2573

> @ dan.milosevic@i...

> * 1A Cypress Grove

> Hainault

> ILFORD

> Essex

> IG6 3AT

> United Kingdom

>

March 7, 2004

dear dan

i am on an nhs waiting list for resurfacing (doing both six weeks

apart) - your letter was brilliant - such an inspiration... i think

i should be done this year and you have helped allay some fears....

it is important to know what happens to others

good luck and lots of love in your recovery

jane (north east wales/shropshire border)

xxx

> >

> > Dear Surfacehippies

> >

> > This may turn out to be a long message/post, so I'll divide it

into

> various headings. IÃ¢â‚¬â„¢ll be posting snapshots as well Ã¢â‚¬ "

check the

> Photos link on the left side of the surfacehippy home page.

> >

> > Facts

> >

> > I had my left hip resurfaced on Monday, 16th February 2004, at

St.

> Cross Hospital in Rugby, Warwickshire, United Kingdom. The

operation

> was performed by Mr. Krikler. The procedure was done on

the

> NHS (National Health Service), or free of charge.

> >

> > Chronology

> >

> > Sunday, 15/02/04 Checked in St. Cross's Cedar Ward;

met

> Harry who is also a 53-year old with a left hip due for

resurfacing

> by Mr Krikler; Harry is very fit) I carry some 8 pounds of excess

> weight round my waist)

> >

> > Monday, 16/02/04 Agreed with anaesthetist to have

spinal

> anaesthetic (like epidural for women in birth); Mr Krikler was

happy

> to provide a " running commentary "

> >

> > At approx. 12:00 taken to pre-op theatre room where spinal was

> applied

> >

> > Apparently was taken to op theatre where Mr Krikler started the

> incision and I mentioned that I could feel it - he asked the

> anaesthetist to apply general anaesthetic. I do not recall this

> exchange. I understand that the op lasted 1 hour and 45 min. Mr

> Krikler said that the hip was very stiff and that I had very hard

> bones. It appears a bit more work than usual. He fitted a Cormet

> device with a 48mm cup on femoral head.

> >

> > At about 16:30 I was awake and back at the Cedar ward.

> >

> > A couple of hours later Mr Krikler saw Harry and me (Harry was

> operated after I was and his op lasted 1.15, I understand). By

then

> the small of my back was quite uncomfortable and I asked Mr

Krikler

> if it would be OK to turn on my 'good' side (non-operated right).

He

> said that'd be OK (many nurses were later surprised by this - I

guess

> they are still more familiar with the THR post-operative procedure

> which prohibits sleeping on your side, or crossing legs, for

months,

> I understand)

> >

> > Spent the night mostly awake; did not use PCA (Patient

Controlled

> Analgesia) - morphine pump to you and I - as the discomfort was

> bearable (I have to stress here that I was not playing macho, but

> that I have extremely high pain threshold and went through years

of

> OA with bone-on-bone and a cyst without ever taking a single pain

> killer); passed water 4 times (nearly a pint each time?!?) and sat-

up

> on the bed to wee (I could never do it using the 'goose' bottle

lying

> down in bed); constant sitting-up and fidgeting led to some

leakage

> and oozing from the incision which got redressed 3 times that

night;

> all-in-all not too bad a night.

> >

> > Tuesday, 17/02/04 Day 1 - is how the hospital staff

refer

> to the day after the op; given a 'Zimmer walking frame at about

08:00

> (after breakfast) and told to apply full weight bearing on the

> operated leg/hip

> >

> > Walked round the Ward and to the main corridor all the way to

the

> lifts where use of mobile phones is permitted; phoned friends and

> loved ones to inform them that all's OK; couldn't find a place to

> connect my laptop (rather found a connector but the hospital

> switchboard could not enable it for external calls to an ISP -

> however, this week a new cable system went live there and each bed

> will have cable TV, telephony [outgoing only, I understand] and

full

> internet access); alternated the day between walking, laying in

bed

> reading an obscure book and talking to Harry and the other 4

patients

> in our room; had bowel movement and used toilet.

> >

> > Wednesday, 18/02/04 Day 2 - had a shower in the bathroom; no

> problem washing both legs; could see bits of bruising on my

bottom;

> very little swelling.

> >

> > Told that I have a 9-10 " incision/scar (22.5 - 25 cm); not

bothered

> by that; it is healing beautifully.

> >

> > Harry and I are given 2 walking sticks/canes each cut to our

size;

> we start walking with these; usual destination: outside the lifts

in

> the main corridor; spending a fortune on mobile calls; after an

hour

> I drop one stick/cane and use one only (I'd like to stress here -

> mainly for our Yankee friends - that one is free to walk round and

> explore as we do not have the culture of suing the hospital should

we

> stumble, fall and injure ourselves; it is pretty much left to the

> patient to be sensible; I always informed the duty nurse when I

went

> for a walk, especially at night when I couldn't sleep; but I

> appreciated the unrestricted, yet caring, environment I was in).

> >

> > The continuous walking, interspersed with periods of

> rest/sleep/reading appear to have speeded-up the healing

> tremendously - both the bruising and the swelling are fast

> disappearing.

> >

> > Made a mistake of not asking for a sleeping pill and spent most

of

> the night awake but without any pain.

> >

> > Thursday, 19/02/04 Day 3 - Physiotherapist gives us

(Harry

> and I) the steps (up and down) and the platform test (up and down)

> with one cane/stick - we pass and are ready to go home.

> >

> > Blood test shows our INR (International Normalcy Ratio) for

blood

> coagulation is too low at 1.2 and 1.4 respectively for myself and

> Harry; the hospital decides not to release us until we reach the

> accepted INR window of 1.5 - 2.5 (apparently, if our blood

coagulates

> faster that 1.5 times the blood of a normal person, i.e. the range

> between 1.0 and 1.49, we are at risk of DVT of sorts where a

> thrombocite can get lodged in our lungs causing sometimes deadly

> pulmonary thrombosis; if, however, our blood coagulates slower

than

> 2.5 times that of a non-operated person who moved round normally,

we

> are at risk of suffering bleed which could be very difficult to

stop

> and even fatal if internal and unobserved); at St. Cross's

hospital,

> or maybe even at that Health Trust, the DVT is dealt with using

> Warfarin tablets (also known as rat poison as that what it is

> commonly used for).

> >

> > Mr Krikler visits us and I take snapshots - I hope I'll be able

to

> post these.

> >

> > Nicola, the occupational therapist, is moving heaven and earth

to

> arrange all the necessary equipment for me when I'm released -

there

> are peculiar problems as I am way out of my area (I live in North

> East London, some 120 miles south-east of Rugby), and I shall be

> staying at my sister's place in Essex, another 50 miles east from

my

> home. Nicola is trying to arrange through the local social

services

> for raised toilet seat, bed mats, raised chairs, bath boards (to

> enter a bath tub safely), grabbers, long shoehorns etc. to be

> provided by one Health Trust, via another one where I live in the

> third one where I'll be staying - ah the vagaries of bureaucracy.

> >

> > Friday, 20/02/04 Day 4 - failed the test again;

> Warfarin dosage upped to max.

> >

> > Saturday, 21/02/04 Day 5 - failed again; only managed to

> get the ratio to 1.49; Harry is allowed to go home for the night

as

> he lives only 7 miles away.

> >

> > I continue my 15 min walks round hospital complex/park at least

> twice daily without a cane or stick which I carry in my arms but

do

> not use. I regret not bringing my car to the hospital - I could

have

> driven it already on Day 3 as it is an automatic and given that in

> the UK the steering column is on the right and I had my left hip

> operated, I could have driven my car without any problems for,

say, 3

> hours.

> >

> > Sunday, 22/02/04 Day 6 - finally passed my INR test

> (barely, with 1.51); in the afternoon my daughter and her

boyfriend

> gave me a lift back to my sister's place.

> >

> > 22/03/04 - 29/02/04 Daily - walks approx. 1 mile without

any

> aides.

> >

> > Bruising has nearly all disappeared; there's no swelling; once a

> day, usually before going to bed, I take 2 Paracetamol tablets and

1

> Ibuprofen tablet - these are meant to be pain killers and anti-

> inflammatory in their actions; the latter I welcome, the former I

do

> not need, but I do want to be a 'good patient'

> >

> > I can do most things without a major inconvenience - dressing

and

> undressing; using the toilet; walking; using the stairs; putting

> on/off left sock & shoe; washing/drying left foot etc.

> >

> > 01/03/04 Ã¢â‚¬ " 06/03/06 Moved back home; IÃ¢â‚¬â„¢m using

my bath

> shower now; I no longer wear a dressing/plaster over the scar (Mr

> Krikler used subcutaneous self-dissolving stitches Ã¢â‚¬ " the 9-

10Ã¢â‚¬Â

> incision has fully healed).

> >

> > IÃ¢â‚¬â„¢ve been driving my car for the last 6 days Ã¢â‚¬ " no

problems in

> driving it, getting in/out, etc.

> >

> > Went to Central London Ã¢â‚¬ " the usual Friday lunchtime drinks

with

> pals Ã¢â‚¬ " I went there unaided (no walking stick/cane) using

public

> transport (bus and London Underground, or Tube as we call it).

> Again, no problems using any of these means of transport.

> >

> > Comments

> > Leg length

> >

> > Mr Krikler explained the mechanics of the procedure in detail;

my

> leg was 1.5 cm shorter; once the bio-physics of the pelvis-to-foot

is

> clear and the resurfacing procedure is factored in, it is clear to

me

> why the resurfacing procedure can do very little regarding leg

length

> (mine looks OK now, but I'll have to wait until my gait and

posture

> are corrected and straight before I can establish if there'll be a

> discrepancy) while THR can be much more effective in mitigating

leg

> length. That's about the only advantage that I could see that THR

> may have over resurfacing.

> >

> > Mobility

> >

> > Extremely high extremely early - I'm absolutely impressed.

> >

> > Recovery / rehabilitation

> >

> > Unbelievably fast and painless (for me at least). However, I

> realise now that the operation is less than 50% of the solution -

the

> larger part is recovery/rehabilitation.

> >

> > ROM

> >

> > Could not have imagined that the range of movement would be

> restored to such a high level so quickly. I said, probably too

> optimistically, to Mr Krikler that I plan to come for a 6-week

check-

> up on my Honda Hornet to Rugby (ha thought I was mad and he is a

> biker too).

> >

> > My final challenge Ã¢â‚¬ " to tie the shoelace on my left

foot/shoe. I

> hope IÃ¢â‚¬â„¢ll be able to do that in a few weeks time. Standing

on my

> operated leg, with my good leg in the air (crane-like position), I

> not a problem but I lack the balance I have when I stand on my

> Ã¢â‚¬ËœgoodÃ¢â‚¬â„¢ leg.

> >

> > Blood coagulation risks & management

> >

> > Probably the least impressive of the otherwise superb NHS (or,

at

> least that particular Health Trust). Two of us were kept in

valuable

> beds for 3 days - the only thing that happened throughout these 3

> days was the dispensing of the correct dosage of Warfarin in the

> evening and a subsequent INR test in the morning. I'm certain

that

> could have been done in the local surgery / health centre where

the

> patient is based.

> > Thanks & appreciation

> > Where do I start? Mr Krikler for his wonderful manner and style

> with patients. He answered every question without ambiguity,

without

> use of a patronising tone, with the patience that professionals

have

> to have when they're dealing with a layman. The fact that he was

> nearly invisible and that he made himself appear accidental in

this

> process, helped reassure me, and I suppose other patients of his,

> that this is a routine op. By the way, Mr Krikler has performed

330+

> resurfacings using Cormet in the last 8+ years. If you ask him,

> he'll tell you openly about the 3-4 cases that needed revisions

and

> why. He does also perform this procedure privately - I understand

> that the package costs Ã‚Â£9,000.00 (US$16,200.00 at 1.8 exchange

rate)

> all inclusive (of course, there's the added travel costs for our

USA

> friends). Considering that the Cormet device costs some

Ã‚Â£2,000.00,

> I believe this is very good value for money. Admittedly, it is

> slightly more expensive than DeSmet in Ghent, Belgium, but we

might

> be splitting hairs here.

> >

> > I must mention Safi, a Ward Nurse who appears to be quietly

running

> the show. She is a perfect example of a person who gains respect

> through her actions and deeds. Her dedication, application,

> thoroughness, devotion and professionalism were a sight to watch.

> Luckily, she was given a student nurse to teach as well - the

student

> was in perfect hands and would learn the profession well by being

> tutored by Safi.

> >

> > Nicola, who joined this site and offered to help with advice, is

> one of these people for whom no problem is unsolvable. One felt

safe

> if she said she would look into something. I can't thank her

enough.

> >

> > There were numerous staff that were ever so eager to help - I'll

> mention Ivan (from Zimbabwe, if I remember correctly) and Riki

(from

> Zambia, I believe). These guys were there throughout the long

night

> shift and would respond immediately if you pressed the buzzer -

you

> could have tea at any time of day or night. Whatever you needed,

they

> provided it.

> >

> > Lastly, it would be unfair if I did not mention and thank all

the

> other staff at St Cross hospital. This is a nice hospital with

> diligent and conscientious staff that look well after their

> patients. Even the food was nice.

> >

> > I must finish by mentioning the NHS - this is for the Brits -

and

> stress that anybody who wants to abolish it or plans to privatise

it

> is either insane or deliberately criminal. We have institutions

for

> both types. And for the unfortunate Yanks who have to fork out

> personal cash for the op - consider strongly Mr Krikler and St

Cross

> in Rugby (although Mr Krikler may suggest another hospital where

he

> operates also).

> >

> > I'll shut up now. I hope to have more good news in 4 weeks time

> when I'm due to see Mr Krikler for a check-up.

> > 3 +44 (0)7974 981-407

> > * +44 (0)20 8501-2573

> > @ dan.milosevic@i...

> > * 1A Cypress Grove

> > Hainault

> > ILFORD

> > Essex

> > IG6 3AT

> > United Kingdom

> >

March 8, 2004

Zoe

I did no exercises/physic prior to the operation â€“ my left hipâ€™s condition

prevented me from any sports and exercises.

Dan

* +44 (0)7974 981-407

* +44 (0)20 8501-2573

@ dan.milosevic@...

_____

From: zoeezee

Sent: 08 March 2004 21:22

To: surfacehippy

Subject: (unknown)

Dan

Your diary was very interesting. It sounds like you had a possitive

experience in Rugby. Thank-you for sharing this as it makes the

future less worrying seeing the excellent progress you made so

quickly.

Did you do physio/exersize before alot to prepare?

zoe

>

> Dear Surfacehippies

>

> This may turn out to be a long message/post, so I'll divide it

into various headings. IÃ¢â‚¬â„¢ll be posting snapshots as well Ã¢â‚¬ "

check the Photos link on the left side of the surfacehippy home

page.

>

> Facts

>

> I had my left hip resurfaced on Monday, 16th February 2004, at St.

Cross Hospital in Rugby, Warwickshire, United Kingdom. The

operation was performed by Mr. Krikler. The procedure was

done on the NHS (National Health Service), or free of charge.

>

> Chronology

>

> Sunday, 15/02/04 Checked in St. Cross's Cedar Ward; met

Harry who is also a 53-year old with a left hip due for resurfacing

by Mr Krikler; Harry is very fit) I carry some 8 pounds of excess

weight round my waist)

>

> Monday, 16/02/04 Agreed with anaesthetist to have spinal

anaesthetic (like epidural for women in birth); Mr Krikler was happy

to provide a " running commentary "

>

> At approx. 12:00 taken to pre-op theatre room where spinal was

applied

>

> Apparently was taken to op theatre where Mr Krikler started the

incision and I mentioned that I could feel it - he asked the

anaesthetist to apply general anaesthetic. I do not recall this

exchange. I understand that the op lasted 1 hour and 45 min. Mr

Krikler said that the hip was very stiff and that I had very hard

bones. It appears a bit more work than usual. He fitted a Cormet

device with a 48mm cup on femoral head.

>

> At about 16:30 I was awake and back at the Cedar ward.

>

> A couple of hours later Mr Krikler saw Harry and me (Harry was

operated after I was and his op lasted 1.15, I understand). By then

the small of my back was quite uncomfortable and I asked Mr Krikler

if it would be OK to turn on my 'good' side (non-operated right).

He said that'd be OK (many nurses were later surprised by this - I

guess they are still more familiar with the THR post-operative

procedure which prohibits sleeping on your side, or crossing legs,

for months, I understand)

>

> Spent the night mostly awake; did not use PCA (Patient Controlled

Analgesia) - morphine pump to you and I - as the discomfort was

bearable (I have to stress here that I was not playing macho, but

that I have extremely high pain threshold and went through years of

OA with bone-on-bone and a cyst without ever taking a single pain

killer); passed water 4 times (nearly a pint each time?!?) and sat-

up on the bed to wee (I could never do it using the 'goose' bottle

lying down in bed); constant sitting-up and fidgeting led to some

leakage and oozing from the incision which got redressed 3 times

that night; all-in-all not too bad a night.

>

> Tuesday, 17/02/04 Day 1 - is how the hospital staff refer

to the day after the op; given a 'Zimmer walking frame at about

08:00 (after breakfast) and told to apply full weight bearing on the