Derek McMinn Tips from his Patients
Donald Moseman Jr. LBHR 03APR12
On Jun 23, 2012, at 2:30 PM, Donald Moseman Jr wrote:
I'm a 48 year old male who competed in collegiate wrestling and still, for the last several years maintained myself in pretty decent condition even though I couldn't run for 5 - 6 years before my hip surgery. I am hopeful that more of you will feel comfortable sharing your own recovery experiences with the group so we can continue to learn from each other's experiences.
While I've read thousands of posts on hipresurfacingsite, hipsrus and surfacehippy over the past three years, my own experience is limited to my left hip and the time I've shared with my friends on the ward at Edgbaston, my neighbor who had his surgery (McMinn Centre and Edgaston as well) four weeks before us and helped us get ready for ours, and the communications we have had with each other offline. My takeaway from all this is as follows: 1) Each of our recoveries will be unique and, from what I've heard, can even vary from right hip to left hip in the same person. For example, I still get a good laugh out of how badly the female network genius (you know who you are!!) kicked my butt in rounds around the exterior of the Edgbaston hospital. No ego's allowed in this recovery. We have to each go at our own pace and be grateful for the minor milestones we see each week or two!!
2) Expect your recovery to take longer if you waited longer and allowed your hip to be in worse condition. If someone has just the opposite experience (i.e., amazing recovery after letting hip get bone-to-bone)....congratulations!!! I'm sincerely happy for you. :)
3) As an athlete, I didn't expect a heroic recover, but I did expect it to go a bit faster. However, I've kept myself from doing anything that might jeopardize the good work of the McMinn Team and am being quite patient with my recovery.
4) Rehabilitation routine and timing of activities allowed appears to be dependent upon which surgeon took our case. For example, the McMinn Centre seems to be quite conservative (i.e., we can't run until one year after op, no hip weight bearing weight lifting (i.e., deep knee squats) for the same period of time though they'll let me lift weights that don't bear heavily on the hips after 6 mo.) whereas I've seen loads of other patients say their surgeon allows them to run as soon as 6 mo.
Some recoveries appears to be downright heroic and, I must admit, I wish mine was going that well. However, I'm very OK with how mine is going and will stick to the guidelines my surgical team has set for me as they know best and have followed thousands of recoveries like mine.
Below is a brief summary of where I just near the completion of twelve weeks after surgery for a left BHR courtesy of the good folks at the McMinn Centre and BMI Edgbaston (Old Nuffield) Hospital!!
No formal PT with the exception of what exercises the PT's at Edgbaston taught us prior to leaving hospital and the additional exercises on the McMinn Centre site. Also, as of week six, the McMinn Centre is good with us starting stationary bike (20 min) and swimming (20 min. to work abductor/ adductor muscles).
Socks - For the 1st time, I've been able to cheat on my left sock using both hands (kneeling down on one knee) though still a bit stiff in the hip. I expect it'll take several more weeks for my hip to loosen so that this will be as easy as before my hip starting giving me problems.
Swimming: As of the start of week 7, I've been swimming (400 - 500 yards breast stroke) and riding stationary bike (20 min. level 4 - 5 of 25). Not much of a workout, but does help to loosen up the hip. As of today, after seeing my weight yesterday, I swam 1,000 yards and 20 min. stationary bike.
Weight: As of a few days after coming back to the states, I was down to 194.8 lbs and I suspect a bit lighter while in the UK. This is roughly 4 lbs less than usual. As of two days ago, I was 206.8 lbs, a gain of 12 lbs in two months. Not really bummed. I know why and what to do to get my weight back under control. Four factors contributed to this weight gain:
1) 3 - 4 ensure drinks a day (loaded with protein and calcium...good for rebuilding muscle & bone)
2) Can't/ won't push myself hard enough to work up a good sweat (when I did push a few weeks ago, I needed to back off and take a week or so rest then come back lighter so hip felt OK);
3) Eating habits not as good as pre-op though not making a pig out of myself;
4) Stopped, intentionally, weighing myself and measuring my waist (usually do this 5 - 6 times a week and it really keeps me on track). As of this morning, 204.8 before going to work out. Pushed a bit harder today....1,000 yards swim (500 yards breast stroke and 500 yards mixed) and 20 min. stationary bike on level 5 of 25. Hip feels very good ...just still stiff from the operation.
Weight Recovery Plan: Simple....1. Cut back to 1 Ensure a day; 2) Increase swimming distance; 3) Be more careful with what/ how much I eat; and...most importantly....restart weighing/ measuring waist 5 - 6 times per week. Should be back on track in 6 - 8 weeks.
Limp: McMinn Centre prescribed 4 weeks on two crutches, 4 weeks on one crutch, then no crutches...or, as I like to say....4 weeks to learn not to limp. Looks like I'm almost on schedule for that with quite a limp during week 11 and limp almost not noticeable this week..week 12.
Work/ Sitting: Feel great and have an energy level I never did pre-op. At this point, able to work as many hours as I need. :)
I hope the above is of some help to those of you considering surgery or those of you kicking yourself as to why your recoveries aren't going as well as you expected. Please be patient and follow the guidelines put in place by your surgeon. For me, I may not always agree with the guidelines (i.e., could be lifting weights..have done so for 38 years and feel comfortable knowing what I can/ can't to ensure no loading on operated hip), but I will respect my surgical team's guidance as I do not want any regrets should my hip take a turn for the worse. Take care and the best to each of you in your surgical decisions and recoveries. :)
Mister McMinn & Team and BMI Edgbaston Hospital
Update written on August 5, 2012 A play be play detailed account of his experience.
Thank you Don for sharing all the details, I know other patients planning on going to Derek McMinn will love all the details.
I've been meaning to detail my experiences with the McMinn Centre team and BMI Edgbaston ("Old" Nuffield hospital) Hospital for quite some time now. In short, the operation and aftercare went very, very well. The McMinn Centre team and hospital staff provided fantastic support. I'd return in a heart-beat if I ever needed another resurfacing or revision. I've provided a brief summary for those who just want the big picture. For those of you who like the detail, I've included almost all of my notes for the first four weeks along with key milestones (plus, at the very bottom of the list, a list of key personnel for those of you thinking of having your hip done by the McMinn Centre):
Brief Summary (For those who don't have the time for the long list of details below)
- Bathroom: Sadly, some of my key milestones revolve around when I could go on my own...sort of like when we were babies...For the guys this is tough. For the ladies, even worse as you need to use a bed pan. Be thankful if you worked out well pre-surgery so that you're strong enough to use your bed "triangle" to pull yourself up and hold yourself over the bed pan. Best techniques I found were 1) press hard on belly in area of bladder outlet valve and hold; 2) Squeeze diaphragm muscle; Took me 'til 24 hours after surgery until I was able to pee on my own. Took until 72 hours after op until I had my first BM.
- Capabilities of Medical Team: Primary Surgeon (Mister McMinn) - Surgeon extraordinaire - "The British Bulldog"; Staff Surgeons (Drs. Pranhad and Daniel) - Very strong, very detail oriented. Terribly competent at their jobs; Surgical Coordination/ Logistics: Pam "the Great" Charles; Awesome at her job. Incredible help; Nursing Staff - Highly competent and caring. Very experienced. Lovely ladies and gentlemen (porters, food servers)
- Driving: Drove automatic 3 weeks after operation.
- DVT Prevention: Calf pumps during and after surgery; 300 mg Aspirin first few weeks after surgery; Ultrasound of main veins in upper thigh and comprehensive UT of both calves before discharge. Teds for 6 weeks 24x7 except when showering. Knee high on non-op leg. Full waist high on op-leg.
- Food: The food was pretty darn good as was the service!! Felt spoiled. :)
- Infection Prevention: Space suit worn by primary surgeon. Three doses of antibiotics (Vancomycin, Cefuroxin) post op.
- Nausea: Tramadol did a few of us in, lowering our blood pressure and making us feel woozy. I couldn't get up the morning after when Physio wanted me on the "old man" walker. Had to wait next day to use it.
- Pain Management: Phenomenal!! Ist day epidural. Next several days combination of Tramadol and Co-Dydramol (Codeine based) which kept pain to a very manageable 1 - 1.5 out of a scale of 0 - 3 with 3 being worst. After being back in states a day or two, I simply stopped taking all pain meds.
- Patient Care: Excellent. Felt spoiled/ very well taken care of most of the time.
- Physio: Got on walker 48 hours after surgery. Walked up/ down two flights of stairs w/ elbow crutches roughly 72 hours after surgery. Elbow crutch (4-point) walk around hospital grounds with Anne "Hell on wheels" Johnson. Two elbow crutches for four weeks. One elbow crutch for weeks 5 to 8. Then no crutches. No limping after 16 - 17 weeks post-op. Best I've walked in 7 years. Was up to walking 1.25 miles (in addition to stationary bike and swimming) around week 8 and decided to cut out walking altogether as I get enough at work anyway and doing the walk immediately after stationary bike and swim was starting to irritate my hip (the "famous" quote I always see about "listening to our bodies")
- Rooms: Beautiful private, spacious room w/ TV. No sleep-overs for spouses, children, etc., though I didn't push this issue to hard. No more than three people visiting at a time, though they did let wife and kids visit (4 total)
- Sleep: Will suck the first few days to week+. Plastic sheets in hospital bed make you sweat, are noisy and too much noise in the corridor (buzzer in hallway, a loud nurse or two). Also uncomfortable to sleep on back. Fortunately for me, I brought some fun reading and made some good progress on it.
- Swelling: Only a little for me on left cheek.
Epidural: While awesome for pain management, not good to stay lying on ones back as it can travel above T10 (thoracic vertebrae number 10) and start numbing things we don't want numb!!! Thank you Bridgett for catching this. :)
Friends: I cannot tell you how much of a difference it made to have the help of those who went before me, those who shared of their experiences to prepare me and the others who went on the same day (Jim Richardson), and those with whom I was able to share this experience (My wife & children, Russ/ Kanae, Anne/ Husband, Cynthia). Their support and companionship made all the difference in the world. Yes you can do it on your own (except the TEDs...don't try it alone) but it's so much easier when you supportive family and friends. I've listed as many folks (McMinn Centre, Hospital Staff, Premier Inn, Beefeater's Restaurant, Friends) as I can remember at the very bottom of this e-mail.
Johnson Shoot-Thru X-ray: U.S. x-ray techs didn't seem to recognize this. Be sure to get a very good description before going for your 6 - 8 week follow-up x-rays. I got lucky and the x-ray tech and I figured it out (I had done a little internet searching before my appointment).
Meds - Always ask what your getting. Name (spell it please), dose rate, and what it's supposed to do. I will never be embarrassed to insist upon this again. While the nursing staff was very competent, I cannot expect them to know all about the meds and I need to be the one to ask and get clarification.
Note Taking: Take diligent, complete and neat notes. You will be foggy after the surgery, maybe for several days. I was or least that's where I was pointing the blame. The note taking saved my butt a number of times by enabling me to remember what I needed to ask when the docs popped by on numerous occasions. Physion & Exercising: As my friend & neighbor (literally less than two miles from my house) Jim R. put it so well, "after 4,000 surgeries, you come to the realization that they know what they're talking about" (referring to rehabilitation/ physio recommendations). Amen to that!!! Can't tell you how many times I didn't think I was pushing too hard only to find out I was and have to rest a few days to a week. i've found it best to improve slowly, incrementally.
Rehab & the Sisters: Listen to the Sisters...they know best in this regard. Meds had me feeling pretty good so I went up and down half the corridor (first day on elbow crutches), tried again and Sister Linda sent me back to my room, but before going in stopped chatted/ standing for half an hour. Paid the price big time early evening!! Listen. :)
TEDS: Don't be foolish. Be darn sure you have someone to help you on/ off with your TEDs when you leave the hospital. The week after hospital, I was blessed to have the help of Gosha and Estell of the Premier Inn. After arriving home, my wife and daughter helped me until the day I removed them, 6 weeks after op.
Tramadol: Tramadol is not my friend though it might be yours. Just goes to show we can all have different reactions to the meds. Had me woozy w/ low BP (92/58) causing a one day delay in getting on the "old man" walker.
McMinn Centre failure modes versus time graph: It's on their web site for those interested. (Link: http://www.mcminncentre.co.uk/research-lectures-history.html, go to video entitled, "Birmingham Hip Resurfacings", slide #9 with title slide being #1.
Play-by Play (For those who like the Details)
Initial Hip X-Rays & Consultation
28MAR12 - Initial hip x-rays after which I had my initial consultation w/ Dr. Pranhad (Chandra) who performs initial physical evaluation of hip and patient interview. Just the facts, very detail oriented, very focused man. Then, a brief meeting with Mister McMinn who consults with Dr. Pranhad. The two of them discussing my case. Mister McMinn also noticed small, white, pimple appearing on my left (to be operated) hip. Fortunately, it doesn't appear infectious. I had question on metal ion levels to which Mr. McMinn responded, "12 - 13 ug/L is a problem if you believe the result. 60 - 70 ug/L is a big problem. Apparently, around this time he made me aware of the four center laboratory study the McMinn Centre was conducting to determine lab-to-lab variability in metal ion level readings for similar samples. For fun, Mister McMinn enjoys watching football (no...not american football), rugby and cricket.
28MAR12: Cervical spine x-ray. Dr. Pranhad referred me for c-spine x-rays after I told him about a foramenal stenosis I had between C4/C5 (tight hole where nerve goes through bone...pinches nerve if I bend my next for extended period of time...like reading in bed with back and neck bent up against pillows). Nothing much came out of this.
02APR12: Checked in mid-afternoon.
03APR12 @ 9 AM: They let me wear my wedding ring, but nothing else. Wheeled me down to the pre-op/ prep room where Dr. Ahmed informed me, jokingly, that he'd hoped I left my dignity at the door to the hospital upon entry. All in all a good group of folks prepping me for surgery. Don't know exactly what they gave me initially, but shortly after I was fast asleep.
03APR12 @ 12:50 PM: Immediately post-op, I remember the following:
- 12:50 PM: Awoke very groggy, but had my senses. I believe they were still monitoring my BP, pulse, O2, temp and I think I still had my IV in place.
- 1:50 PM: I can't believe an hour passed. Much more alert now.
- 2:00 PM: They took post-op hip x-ray. I'm thinking they did this to have a baseline for position of the acetabular cup.
- 2:15 PM: Back in my room. Epidural (Thoracic no. 10 block) still in. No pain.
Up in my room after surgery
03APR12 @ 2:00 P.M.:
- Donut balloons on both calfs w/ air pump. Reduce the risk of DVT and keep heels off bed. These stayed on at least until late in the night (my notes indicating still on at 8:45 PM).
- Arnica: They gave us this to reduce bruising. I really didn't have too much bruising even before taking the Arnica.
- Rhus Tox: They gave us this to reduce pain from joints/ ligaments.
- Blood Drains: Quantity two. Still bleeding from them at 10:45 PM. They decided to remove anyway. For next 1 - 2 days, could feel/ hear blood sloshing in my left rear cheek when I pushed on it.
- Dr. Daniel (Joseph) post op interview: Joseph said my operation went very well, that I should drink lots of fluid and that today is a day for rest. I asked what damage the surgical team was able to see inside as I had originally (2000) been diagnosed with a torn psoas with no surgical intervention nor imaging to support this diagnosis. Joseph noted that that I did have a labral tear. Also, worn out cartilage on anterior/ superior region of the acetabulum and femoral head. He did not see any femoral acetabular impingement wear marks (this was the radiologist's diagnosis from the MRI I had in 2008). So far, strike one for the psoas (though in fairness, they likely did not have a visual on the area in which the PT's "felt" the step-off (tear)) and strike two for FAI. I asked for my inclination/ anteversion angles angles, but Joseph didn't have this information handy. He said Mister McMinn almost always shoots for 40 degrees inclination for the acetabular cup.
03APR12 @ 4:00 PM: Physio (Fiona) came by. They said I needed to keep pumping my calfs 10 times per hour. I did 10 times every 15 minutes. They also wanted me to breathe deeply 3 x per hour...this one I didn't do consistently but should have once I learned this is to be done in case one has bad respiratory reaction to the
anesthesia. They also emphasized that I needed to keep myself hydrated which I did by drinking several liter size containers of water. The anesthesiologist (Dr. Ahmed) also came by. Very nice and funny guy. Said my response to the anesthesia was "spot on." Said they used lots of fluids as my blood pressure needed increasing. Said not be alarmed when i saw my anesthesia report (I had requested a copy) as they brought my BP a bit low (35 mm Hg) and that I was also a little tachycardic (my notes indicate 95 beats per minute though this doesn't seem to high to me). I later learned that the low BP is intended to make sure that the milled acetabular surface is dry when Mister McMinn hammers in the cup.
03APR12 @ 6:15 PM: 300 mg aspirin, Co-codamol for pain relief though I wasn't in any pain (epidural still in). Also took amantadine....to protect stomach lining...I'm guessing from one of the meds they were giving us. Also had first of three doses of general spectrum antibiotic..probably Vancomycin. Have to pee every 15 minutes or so, but only very little comes out.
Now for the play-by-play
03APR12 @ 18:33: So far 1.25L (must be referring to my urine container). Also BP was 110/ 80 earlier and 102/71 now.
03APR12 @ 18:45: BP 104/70. Pulse rate 70 flat on my back...changes to 80 beats per minute when I raise bed 20 degrees.
03APR12 @ 19:15: BP 101/68. Pulse rate (PR) 80 - 85 flat on my back...changes to 77 beats per minute when I raise bed 20 degrees. In hindsight, this makes no sense to me considering my PR at 18:45.
03APR12 @ 19:45: BP 106/68 plus bit of pee.
03APR12 @ 19:50: Can't sleep due to time difference and calf pumps. Changed calf flexes to one set of 10 per hour in the hopes that bleeding from hip drains (lower of the two) will slow down.
03APR12 @ 20:00: Nursing hand-off. Sister (this means experienced nurse in UK) Bridgett taking over graveyard shift. The sisters wear the blue work clothes. She did not seem that friendly at first, but turns out to be a wonderful lady with a beautiful heart and a terribly competent nurse. Glad I had her looking out for me.
03APR12 @ 20:15: BP 102/67
03APR12 @ 20:25: BP pulse machine removed as I think it was not working well.
03APR12 @ 20:30: Not sure if this was the Anesthesiologist who first interviewed me (Dr. Pranasada) or the surgical anesthesiologist (Dr. Ahmed). At this point, lower cannula has filled bag with 170 mL of blood. Upper at 70 mL.
03APR12 @ 20:40: 4th liter container (although one was 1/2 and another only 2/3 full) of pee....finally found something I'm really good at!!!
03APR12 @ 21:00: Bridgett took my BP at 102/67. I think she also recorded accumulated blood and asked about another machine...may have been another nurse who removed the machine.
03APR12 @ 21:30: One of cannula (blood drains) stopped bleeding. I think it was the lower one. Dr. Prasana told me that bladder control comes back more slowly (A day or so later he was ecstatic that I had filled up nearly 6 liter containers. To this day, not sure of what he was concerned, but glad whatever it was didn't come to pass).
03APR12 @ 21:33: Other cannula seems to be bleeding much slower.
03APR12 @ 21:40: Switched back to 3x per hour for calf flexing as feet are a tiny bit stiff.
03APR12 @ 21:45: Bridgette noticed I was on my back flat when I should have been a bit inclined to keep the epidural anesthesia from traveling up my spine. Not a good thing!!! She raised my bed and had only noticed when monitoring the feeling in my operated hip. This was the first time I realized how very lucky I was to have her taking care of me.
03APR12 @ 21:50: Bladder still weak. Have to push very hard with diaphragm to go pee.
03APR12 @ 22:00: 2 x 500 mg Co-Comadol
03APR12 @ 22:05: Epidural transition zone at 1" below 12th (floating) rib via pinch test.
03APR12 @ 22:30: Called wife and kids at the Premier Inn on Hagley to have peace of mind that they made it to hotel safely.
03APR12 @ 22:30: Filled 5th urine bottle plus two more 500 mg Co-Comadol or was it Tramadol...not sure.
03APR12 @ 22:35: Bridgett shut down Epi drip (6 mL/hr). BP at 102/67. She let me know we should be able to manage the pain with the two meds she gave me, but to call her if I need more. I didn't need any more. Pain was quite manageable.
03APR12 @ 23:00: Epidural needle removed. Cannulae (wound blood drains) still bleeding.
03APR12 @ 23:05: Removed both Cannulae. Wow! They were about four inches higher up than the entry point. Didn't hurt too much when removed.
03APR12 @ 23:30: Bladder starting to work on its own....first of a series of minor little victories!!!
03APR12 @ 23:40: Started feeling a little pain in left cheek...about 15 minutes ago...not a big surprise when considering the epi was shut down at 22:35.
03APR12 @ 23:52: Epidural transition zone at 2" below 12th (floating) rib via pinch test.
Wednesday, April 4, 2012
04APR12 @ 00:00: Bridgette took BP at 103/69
04APR12 @ 00:05: Epidural transition zone 1" lower to waist via pinch test.
04APR12 @ 00:20: Pee 3 - 4 oz. Very, very difficult. Had to strain stomach/ diaphragm very hard to go. Dr. Ahmed's advice...take pain meds before pain hurts bad.
04APR12 @ 00:40: Epi transition zone around same location. 3 deep breathes exercise, 10x calf flex. Pain in left cheek around a 0.40 on a scale of 0 to 3 with 3 being the worst.
04APR12 @ 01:20: Epi transition zone around same location, but can now feel pinch at front of hip near iliac crest (hip bone protrusion just under stomach near side). 3 deep breathes. 10x calf flex. Pain 0.50 in left cheek. With epi. was zero. Notes: exercise (and note taking as you can see) was my routine to make the time go by and feel some sense of control. Also noted that Bridgette was measuring my temperature to see if I caught any "critters" while in surgery.
04APR12 @ 01:45: Arnica (2) + rhus Tox (2), both 30cc (84)
04APR12 @ 01:50: Pee - Filled both containers to near top. First half unforced. 2nd half - forced with diaphragm pressure.
04APR12 @ 01:52: Epi transition zone moved a bit to the left, but not much. Now able to feel pinch on left thigh. Pain 0.60.
04APR12 @ 02:00: 3 deep breathes. 10 calf flexes. Able to feel pinch at top of left thigh. Still numb. Pain 0.60.
04APR12 @ 02:15: 2nd dose of antibiotic (Vancomycin). Last antibiotic dose will be at noon tomorrow. BP 105/64. PR 77. PO2 99%.
04APR12 @ 02:27: Epi - feel hard pinch (a "little") near surgical site
04APR12 @ 02:30: Feel throat very dry. Bit of coughing and scratchy throat. Feel it deep in my trachea/ bronchi like bronchitis but not a real bad one.
04APR12 @ 02:35: Still can't pee easily though I feel bladder has urine.
04APR12 @ 03:45: Pee - belly press and hold. This seemed to work quite well as bladder still won't go so well on its own.
04APR12 @ 04:30: Pee - belly press and hold. This seemed to work quite well as bladder still won't go so well on its own.
04APR12 @ 06:00: 3 deep breathes. 10 calf flex. Epi transition zone - can now feel pinch well on most/ all parts of top/ anterior portion of thigh. Interesting....a little numb
04APR12 @ 06:10: Pee - still not on own. Had to press and hold around 45 seconds.
04APR12 @ 06:30: Bridgette took BP at 102/61/ PO2 @ 99% and PR @ 80 BPM. temp good, urine bottle 2/3 full. Pain meds - two white ones (I think Co-Comadol), 1 orange, plus 1 green(half)/ orange(half)..likely this was the Tramadol w/ 6 oz. water. Removed arterial needle from neck. Bridgette says we could have removed sooner. Removed O2 tube from nose. Arnica and Rhus Tox mine to take home. Teds need to use for six weeks. Snowing outside...wind blowing snow sideways!! (This was really surprising considering all the beautiful, hot, sunny days that preceded this one morning of snow)
04APR12 @ 07:35: Left cheek swelling down, though wasn't tremendous swelling after surgery anyway. Dr. Pranhad told me resurfacing failure modes are AVN, femoral neck fracture, cup slipping, etc.. Need to remember to ask Dr. Daniel for McMinn Centre failure modes versus time graph...its' on their web site for those interested. (Link: http://www.mcminncentre.co.uk/research-lectures-history.html, go to "Birmingham Hip Resurfacings", slide #9 with title slide being #1.
04APR12 @ 07:40: Graceyard/ Day shift turnover from Bridgette to Mandy
04APR12 @ 07:45: Breakfast plus water.
04APR12 @ 08:05: 3 deep breathes, 10 calf flexes. Epi transition zone....not much numbness now.
04APR12 @ 08:45: Jenny stopped by for lunch/ dinner order.
04APR12 @ 08:55: Mia (doctor) came by to do a blood draw (i.e., liver panel (explanation - "Dr. McMinn is thorough", kidney/ renal - "dehydration check", hemogloblin - "does patient need transfusion"...me...didn't need anything...I looked good clinically
04APR12 @ 09:30: Bath...i think this was the one in bed....and change of stockings. Not too embarassing.
04APR12 @ 10:00: Sister Mandy gave me third dose of antibiotic...I believe it was cefuroxin this time, not the vancomycin I remembered from the first two doses
04APR12 @ 10:30: Physio came to teach me what not to do: Never bend knee more than 90 degrees towards head; no pigeon toes; no cross over. Exercises - 1 set per hour or 2 hours...depends how I feel...5 - 10 reps. 1. Bend ankles, push knees into bed; 2. Bend and straighten knee; 3. Mid position - out - mid position on plastic garbage bag (adduction/ abduction); 4. Leg extension w/ leg resting on rolled towel; 5. Squeeze "bum" (glutes).
04APR12 @ 11:25: Tried, couldn't sit up & get on walker. Too dizzy. Face turned white. Nurses thought was due to Tramadol. I later found out it (possible bad reaction to Tramadol) happened to a few other patients on the ward. When I asked a few days later, one of nurses told me Tramadol is hot or miss.. some patients handle it fine, others don't.
04APR12 @ 11:30: 3 deep breathes, calf flex 20 each. Physio - 5 sets of 10. Abduction/ adduction very, very hard to do..very slow. Took 20 minutes to do exercises. Chandra (Dr. Pranhad) wants me to do butt raise exercises (grab triangle bar above bed and raise butt off bed - 10 reps @ 10 seconds.
04APR12 @ 12:30: First pee on my own since stopping epidural!!! First little milestone. :)
04APR12 @ 12:35: Physio - 5 sets of ten. Long time, lots of interruptions. Abduction very, very hard.
04APR12 @ 13:30: 2nd pee after epidural removed without strain/ push
04APR12 @ 14:00: 3rd set physio. Two new exercises - can't quite make out my notes. something like #6 leg press...#7 leg no abduct..stretch then back...sorry guys...will try to be neater next time
04APR12 @ 14:30: Got on walker - Load left, load right, left foot front I am able to feel load left leg. Got a little dizzy. Jason (Physio) sat me back down in bed to equalize BP (This is actually when they measured BP at 92/58). He and Emma will return at 4 to try again. Jason has me sitting up in bed, no calf pumpers. Doing foot rotators, raising my knee (while sliding heel on bed), and leg extensions
04APR12 @ 15:00: BP 105/63, PO2 - 99%, PR - 82, Temp 37.1 Deg. C. Sister Linda took all of these.
04APR12 @ 15:03: Arnica plus Rhus Tox
04APR12 @ 16:30: Physio - 7 x 10 much improved
Not sure of time: 300 mg aspirin, rimantidin (gas relief), Arnica, Rhus Tox
Thursday, April 5, 2012
05APR12 @ 08:00: Physio - 3 deep breathes, 40 calf flex, 10 butt lift + 7 physio exercises...took 17 minutes
05APR12 @ 09:25: Walker went fine. No dizziness, but sweating a bit and feel exerted. Went about 35 feet. Jason suggested doing one more before the afternoon, after which he'll show me chair exercises and get me on elbow crutches. Keep doing bed exercises. For frame walking..remember FOG.....Frame...then operated leg forward to midway of frame...then good leg to go. Pain 0.7 of 3. Swelling mot much at all, went way down from where it was after surgery which wasn't a terrible amount but enough that I noticed my left cheek swollen. Jason also wants me laying flat at least 2 times for 20 min. per day. Also when I sit, no more than 30 minutes. When sitting on toilet, operating leg out.
05APR12 @ 10:00: hip x-rays. Flat on back x 2. Ultrasonic - Veins of the upper thigh. All over front and back of both calves. No sign of clot. :) Dr. Wingate said, 90% of the time, no sign of any clots at all. Normally would have done ultrasonic on Friday, but Friday (tomorrow) to be a Banker's holiday. Dr. Wingate - Very nice man. Said, when I asked, that Dr. McMinn would replace BHR if we had a pseudotumor.
05APR12 @ 12:20: 2 x 500 mg Co-Comadol, No aspirin. No Rimantidin.
05APR12 @ 12:35: Took Lactulose - To relieve constipation caused by pain meds.
05APR12 @ 18:10: Pain @ 1.25 of 3. Pain caused from the following: 1. Frame walker 60% of hallway and back; 2. Standing 20 min. + 10 min chatting; 3. Sister Linda told me to only do another 35'. She knew better. I didn't as pain wasn't there due to meds I was taking, but I paid the price in the early evening.
05APR12 @ 18:15: Dr. Ahmed (Anesthetist) told me at 40 mm HG blood pressure no blood flow on acetabulum when cup is placed. Mister McMinn believes there may be less adhesion if cup is placed when there's blood on the acetabulum; Jason also noticed my neck twitches when I exert myself. Not sure whether this is due to anesthesia, something new or the C4/C5 foramenal stenosis I already have with nerve.
05APR12 @ 18:20: 2 x 500 mg Co-Comadol, 300 mg aspirin, Rimantidin. Will get another Lactulose (anti-constipation med) w/ 10 AM meds tomorrow..
Typical - Hip clicks when I walk. Also earlier, IT band was snapping @ right medial knee cap.
05APR12 @ 19:40: Leg swelling and very sore from walking today. Decided to stay in bed and let it rest.
05APR12 @ 21:30: 2 x 500 mg Co-Comadol, 2 x small green pills (probably the Rimantidin). Temp. 37.5C w/ sweats in morning. 36.9C during day. 37.6C in evening, then 38.0C @ 20:45
Friday, April 6, 2012
Only four hours sleep last night, but really needed it. BMI needs to change buzzer in hallway (patient call to nurse on duty) to visual paging system.
06APR12 @ 04:30: Lite fever broke, swelling improved in leg, but still sore. Throat still slightly sore. Take it easy today.
06APR12 @ 06:00: Rhus Tox, Arnica, 3 deep breathes, 40 calf flex, 10 butt raises w. knees bent
06APR12 @ 06:35: Bed Physio 7 x 10; 2 x 500 mg Co-Comadol, 300 mg aspirin, 1 green "IL" pill (??), Lactulose (3rd dose)
Mid-morning: Sister Mandy taught me how to care for Ted stockings. Always attach velcro so it doesn't grab onto and wear the Ted material.
06APR12 @ 08:00: Took 1.5 hours to do physio, remove all clothing except Teds (needed help with these), shower, brush teeth, dress and get help with clean Teds (two pair...one dries out over night). Walked half the hall on elbow crutches. Focusing on head up, left heel strike,roll through w/ weight bearing on left hip.
06APR12 @ 10:55: Up and down two flights of stairs with elbow crutches. Easy up and down hallway twice. Didn't notice any clicking of the hip this time. Focus - head up, heel/ toe, load on left hip, smaller steps = more control, Sarita (Physio) also showed me how to properly get up from and sit down in a chair. Set both crutches in front of me together in middle. Raise up on good leg. Throat only a bit sore this morning. Still feels like left hip is pushing out of the socket. I'm thinking this was just swelling of tissue in the hip joint.
06APR12 @ 11:30: First BM since prior to op. Another little milestone!! Funny what can make you happy in the hospital!! Hard to get off toilet. Operated leg (left) a bit twisted out and it hurts.
06APR12 @ 12:15: 2nd BM. Still hurt to get off seat.
06APR12 @ 12:45: 3rd BM
06APR12 @ 12:45: 3 deep breathes, 40 calf flexes, 10 butt lifts, 7 x physio. Adductors still ery, very difficult. All other exercises pretty easy.
06APR12 @ 13:02: 2 x 500 mg Co-Comadol
06APR12 @ 14:35: Chair - Standing exercises + 4 point walk. Abduction still very difficult.
06APR12 @ 14:45: Temp 37.8C after physio.
06APR12 @ 18:30: Very sore. Decided to rest instead of doing bed, chair and standing exercises. Will try these tomorrow morning.
06APR12 @ 18:30: 2 x 500 mg Co-Comadol, 300 mg aspirin, IL pill??
06APR12 @ 20:30: 2 x 500 mg Co-Comadol
Saturday, April 7, 2012
4 hours sleep. leg does feel better but I wish even better. Tried briefly laying on both sides w/ pillow between legs, but didn't work out too well.
07APR12 @ 05:30: 3 deep breathes, 40 calf flexes, 10 butt lifts
07APR12 @ 06:09: Rhus Tox, Arnica
07APR12 @ 06:35: 2 x 500 mg Co-Comadol, 300 mg aspirin, IL pill??
07APR12 @ 06:47: Finished bed physio 7x sets. Abductors getting a bit easier. Adductors still difficult but getting a little bit easier. Two times half distance of hall, 4-point elbow crutch walk. Finished sitting and standing physio. 2x hallway 4-point elbow crutches.
07APR12 @ 11:00: Signed physio discharge papers. Told them I wanted to stay one more day and be discharged on Sunday.
07APR12 @ 13:45: 2 x 500 mg Co-Comadol after long walk (elbow crutches) around hospital w/ Anne and her husband.
07APR12 @ 17:41: 2 x 500 mg Co-Comadol, IL (Rinitadin), 300 mg. aspirin
07APR12 @ 18:07: Rhus Tox, Arnica (Homeopathics)
This was the first day I was actually able to enjoy reading my book and responding to my e-mails
Sunday, April 8, 2012 (Discharged from Hospital Today!!!)
3 hours sleep. leg hurt a bit, slept 1 hour and 3 hours day before during day. I do not nap so this was very unusual for me.
08APR12 @ 02:30: Arnica, Rhus Tox
08APR12 @ 02:45: 3 deep breathes, 40 calf squeezes, 10 butt lifts
08APR12 @ 06:40: Bed physio x 7, adductors a bit easier
08APR12 @ 07:02: 2 x 500 mg Co-Comadol, 300 mg aspirin, rimantidin
08APR12 @ 12:00: 2 x 500 mg Co-Comadol, last dose, Sister Mandy told me the Rimantidin is for acid reflux prevention from lying down a lot or from the codeine based pain med.
DISCHARGED MYSELF FROM HOSPITAL. CHECKED INTO PREMIER INN ON HAGLEY ROAD W/ WIFE AND KIDS
08APR12 @ 17:30: 300 mg aspirin
08APR12 @ 20:00: One pain pill Co "something"?? Pain tolerable (4 on a scale of 10 w/ 10 being worst). Hip stiff.
Physio Final Recommendations Going Forward
Swimming - Wait three weeks, then start swimming (breast stroke) at least 20 min. per day for at least 3 months. Improves strength of abductor/ adductor muscles
Car entry - Plastic garbage bag on seat. Swivel in and out on bag
Bed/ Standing Exercises - Do for 6 weeks???? I've been doing them a lot longer, just not as consistent as I should
Knee Bending - Not more than 90 degrees
Crossing - No crossing
Pigeon Toes/ Rotating Legs - Don't do it
Sleeping positions - Do not roll or lie on operated side for 3 mo.
Elbow crutches - Two crutches for 4 weeks, one crutch next four weeks, then no crutches
Walking w/ crutches - 3/4 mile per day at 4 weeks w/ 2 elbow crutches; 1 mile per day at 2 mo. w/ one crutch
Sitting - No more than 30 minutes
Doctor's (Dr. Daniel) Hospital Discharge Interview
I took advantage of this opportunity to ask some interesting questions for all of us:
Pregnant Women or those contemplating getting pregnant: Wait to have baby before getting surgery or have surgery but wait 2 years before getting pregnant.
Cup Loosening Prevention: Decreasing BP during surgery means no blood on milled/ finished acetabular surface resulting in a better hold when the cup is hammered into place.
6 - 8 week post op x-ray: Got scrip, took x-ray. X-ray technicians do not know what is a "Johnson shoot-thru" x-ray. You will need to have this described in another way if you want it done right. My 2 mo. follow-up turned out fine.
Right Hip Strengthening: Physio to strengthen right hip to delay or prevent future surgery for it.
Hi Vicky!! Joseph says hi. Sorry I didn't remember to tell you until now.
Sunday, April 9, 2012
Bed physio. Abductors a bit easier. 300 mg aspirin. one co-hydro??? pain pill
09APR12 @ 12:00: Chair and standing physio. Abductor a bit easier.
Later: Chair and standing physio. Abductors still hard
09APR12 @ 21:00: Bed exercises. Abductors still hard.
09APR12 @ 21:40: 300 mg aspirin, Arnica, Rhus Tox
09APR12 @ 23:50: One Co-H??? for sleep
Monday, April 10, 2012
HAD TO DROP FAMILY OFF AT BUS STATION FOR THEIR TRIP TO LONDON, HEATHROW TO HEAD BACK TO USA :(
10APR12 @ 08:00: 300 mg aspirin, Arnica, Rhus Tox
10APR12 @ 09:45: Bed physio - More flexibility w/ frogs; abductors still hard but a tiny bit easier; Knee raises with heel sliding on bed, hip clicks on up only
3/4 mile walk w/ elbow crutches to Mortison's (Deli). Arnica, Rhus Tox, 3 x chair/ standing physio. Adductors w/o plastic...still hard. One Co-Dydramol for sleep.
Tuesday, April 11, 2012
0.5 + 3.5 hours sleep. Still very difficult to sleep.
300 mg aspirin, Arnica, rhus Tox, Bed exercises
1 mile walk or more at Palisades shopping center/ Bull Ring. Very sore. Decided not to do any exercises......are you seeing a theme here???? I am...even to this day (04AUG12).
No exercises, 300 mg aspirin, rhus Tox, Arnica
Wednesday, April 12, 2012
12APR12 @ 01:00: Two Co-Dydramol to help me sleep. 7 hours sleep. Best sleep in a long time!!!
12APR12 @ 08:00: 300 mg aspirin, Rhus Tox, Arnica
12APR12 @ 09:30: Two Co-Dydramal; Bed physio, 2 x chair/ standing physio. Easier w/ meds and rest
12APR12 @ 12:00: One Co-Dydramal
Thursday, April 13, 2012
0.75 + 3.25 + 3 hrs sleep. Difficult. Hip "achy" upon waking
Arnica, Rhus Tox, 300 mg aspirin
13APR12 @ 09:30: Bed exercises. Adductors a bit easier
13APR12 @ 14:00: 2 x 500 mg Co-Dydramol, Chair and standing physio, 3 x calf raises, leg extensions, no others..rested legs
Went out to various computer stores looking for converters
Arnica, Rhus Tox
13APR12 @ 19:00: 300 mg aspirin
Midnight - Arnica, Rhus Tox
Friday, April 14, 2012
Night before, laid down at 18:30...awoke at 23:45...then slept again to 05:45...all in all...10+ hours of good sleep, feel well rested
Late breakfast at Beefeaters. Thanks goodness it's basically in the hotel
300 mg aspirin Arnica, Rhus Tox, 2 x 500 mg Co-Dydramol, 3 x chair + standing exercises
3 x chair + standing physio
Rest, no bed exercises
3/4 mile elbow crutch walk w/ Cynthia @ Saltwells Inn. Had an excellent lunch with her as well. Very good food at reasonable price. Nice company as well! :)
Arnica, Rhus Tox, 2 x 500 mg Co-Dydramol, 300 mg aspirin
As I read the above, am a little confused as to how I slept so much yet made my way out to Saltwalls Inn....guess, for now, I'll blame it on the anesthesia...good one to have in my pocket here and there...
Saturday, April 15, 2012
Slept night before from 21:00 to 22:00, from 22:30 to 02:15, then from 02:45 to 06:00, all-in-all around 9+ hours of good sleep. Finally starting to catch up with my rest. :)
15APR12 @ 06:45: Rhus Tox, Arnica, 300 mg aspirin
15APR12 @ 13:00 to 14:00: 3 x chair and standing physio + 120 yard elbow crutch walk by Beefeaters restaurant, Rhus Tox, Arnica, 300 mg aspirin
15APR12 @ 14:00: 2 x 500 ng Co-Dydramol
15APR12 @ 19:30: Finally able to use toilet decently. This is a major milestone!!! Funny (not ha-ha funny, strange funny), how a number of the key events revolve around my ability to use the pot...sort of like when we were little ones!!!
Sunday, April 16, 2012
Slept from, night before, 21:30 to 04:14, from 04:30 to 06:45...around 8 - 9 hours of good sleep
16APR12 @ 07:30: Rhus Tox, Arnica, 300 mg aspirin
16APR12 @ 08:00: Bed exercises, physio, abductors/ adductors still difficult
16APR12 @ 11:15: Trip to Edgbaston Hospital to have staples removed. 28 in all. Not that tough.
Thank goodness for Estelle and another really nice lady at the Premier Inn for helping me 3 - 4 days during my stay to get TEDs on after shower.
Took off for Hilton from BMI Edgbaston to be closer to airport for trip home tomorrow.
16APR12 @ 17:06: 2x chair and standing physio, Rhus Tox, Arnica, 300 mg aspirin
Monday, April 17, 2012
17APR12 @ 03:30: Early shuttle to airport. 300 mg aspirin, rhus Tox, Arnica. Repeated this later plus 2 x 500 mg Co-Dydramal. Had to walk a long distance with 25 lb pack on my back at Birmingham airport even though my wife had setup pickup. While on plan, calf flexes and seated exercises every two pages of reading. Up every half hour or so to walk around the plan and do standing exercise. Did this entire way back to U.S. First flight from Birmingham to Amsterdam. From Amsterdam, stewardesses and steward were absolutely awesome. One Stewardess found me two chairs where I could rest and stretch my leg. What a life saver!!
BACK HOME IN SFO. :) NICE TO SEE MY WIFE AND KIDS
Tuesday, April 18, 2012
Slept all day and night. Two Co-dydramal.
Wednesday, April 19, 2012
1 bed + 3 chair/ standing physio, meds + 2 Co-Dydramal + 3.4 mile elbow crutch walk + sat for 1.75 hours at computer. Hip swollen.
Thursday, April 20, 2012
Had to rest today. Regular meds but no Co-Dydramal. Probably ran out. GP gave me scrip for Vicodin. Not a big fan of Vicodin. GP did not recognize Co-Dydramol when I gave the name to him.
Friday, April 21, 2012
02:00 - Bed physio
Saturday, April 22, 2012
3/8 mile on crutches then went to Costco & Safeway for more walking around.
Sunday, April 23, 2012
3/8 mile on crutches. 2 x 300 mg aspirin, 2 x 500 mg Co-Dydramol (guess it reappeared)
Monday, April 24, 2012
3x sitting, 3x standing physio, 300 mg aspirin, 5/8 mile on crutches, Drove for first time. Felt great!!!
Tuesday, April 25, 2012
300 mg aspirin, 6 x sitting, 3 x standing, 2 x bed physio, 300 mg aspirin, No walking. Left lymph node swollen a bit. Weak and tired.
Wednesday, April 26, 2012
2 x bed, 3 x sit/ stand physio, 5/8 mile walk on crutches, 2 x 300 mg aspirin, Walgreens, Hair cut, , Apple. Abductors/ adductors much easier but still a bit difficult. Lymph node still sensitive. 15:00 to 01:45 next morning sleep. Still catching up with sleep.
Thursday, April 27, 2012
2xbed, 3x chair/ standing physio, 5/8 mile walk on crutches..easy...now starting to transition to one crutch, 2 x 300 mg aspirin
Friday, April 28, 2012
Day of rest. Working to transition to one crutch.
Saturday, April 29, 2012
2xbed, 3x sit/ standing physio; 5/8 mile mostly one crutch. 2 x 300 mg aspirin (when you see this, most likely I took one in morning and one at night)
Sunday, April 30, 2012
2xbed, 3x sit/ standing physio; 5/8 mile mostly one crutch. 2 x 300 mg aspirin, Costco, Safeway, Trader Joe's, Walgreens, Orchard Hardware, El Mercadito, etc.
Monday, May 1, 2012
2xbed, 3x sit/ standing physio; 5/8 mile mostly one crutch. 300 mg aspirin, Nina doctors, YMCA enrollment for swimming, Targer, 300 mg aspirin.
Tuesday, May 2, 2012
2xbed, 3x sit/ standing physio; 5/8 mile one crutch 24 min.. , 2 x 300 mg aspirin, Went to work, lots of additional walking 1+ mile.
BMI Edgbaston Personnel, Premier Inn, Beefeater Restaurant and other friends (My apologies if I've forgotten someone. Please know we sincerely appreciated all of you support throughout this time)
Amazing how many people contributed to this adventure. Unbelievably supportive, nice, capable and competent. I was lucky to have all of your support. :)
Angelina - Young nurse. Was doing well in banking. Left to pursue nursing. Fitted me for my Teds. Very helpful, sweet young lady.
Anne & Husband: Lovely and brilliant lady there for her other hip resurfacing. Hell on wheels - kicked all of our A#$#S up and down the hallway and outside around the hospital. Very nice husband.
Bintou - Young Ghanan lady. Helps with food service. Might just be Ms. Ghana? Human Resources Degree. Very nice and sweet.
Bridgette (Sister, Nurse) - She did not seem that friendly at first, but turns out she's a wonderful lady with a beautiful heart and a terribly competent nurse. Damn glad I had her looking out for me.
Cynthia - Lovely and beautiful lady I met in hospital. Dancer by trade. Lives quite north of us. Met her for an excellent lunch and a nice walk at the Saltwells Inn. Met up with her in Santa Cruz, CA after we both returned.
Dr. Ahmed - Very funny, nice and helpful surgical anesthetist. Confirmed, just prior to entry into the surgical suite, my loss of dignity at the hospital entrance on my way to check-in.
Dr. Daniels (Joseph) - Head of Research for McMinn Centre. Very nice and competent guy. He was the reason (able to show me) that I finally made my mind up to take care of my hip. Really enjoyed our conversations and his support.
Dr. Pranhad (Chandra) - Mister McMinn surgical assistant. Very detail oriented. Nicknamed "smiley". I like him. Very focused, no nonsense man. Good man!!
Dr. Prasana - Anesthetist - Nice man. Very proud of protocol they've established that they teach to other hospitals for pain management. After experiencing it (or not as pain was quite modest) I can see why he is so proud!
Dr. Wingate - Very nice and extremely experienced and competent radiologist. What a nice man.
Elisa - Day Porter. Very helpful.
Ely (Eleanor) - Nurse
Emma - Physio. Quite a nice young lady.
Estelle - Lovely lady who was so kind to help me with my Teds a few times at the Premier Inn
Fiona - I believe she is the manager of the physical therapists. I only saw her once briefly just after returning to my room from surgery.
Geraldine - Nurse, I believe...
Ghosa - Lovely lady who was so kind to help me with my Teds a few times at the Premier Inn
Helen, Sister - Nurse. Very nice, helpful and competent. Took my initial blood and MRSA swab. Worked day shift.
Hena - Whiz-bang biomedical scientist from the McMinn Centre. Sharp young lady. She makes rounds along with the staff surgeons, Joseph and Chandra. Presented to us along with Dr. Daniel and Mister McMinn at the Fremont Hippy gathering (Thanks Vicky!). At first entry into my hospital room, in my anesthesia induced fog, I thought she was Sarita (physio). She got quite a kick out of it. Glad to see she at least had a good humor about it.
Jason - Physio. Really nice guy. Super sharp physio. Blessed to have had his support.
Jenny - Nice lady who stopped by to take food orders.
Jerry - Nurse
Jim Richardson - Sought me, Russ, and Anne out to share of his experiences 4 weeks before us. Setup Skype telecon to share of his experience. Selfless, caring nice gentlemen. Provided invaluable support before and after surgery. Met him for coffee the first day I could drive!
Karen Feeley - Admin Support from McMinn Centre. Very helpful.
Lee - X-ray technician. Nice guy. Very efficient at his job. Saw him for hip and neck x-rays. He was going to make me a CD. I should have taken him up on it.
Lin or Liz: Radiological receptionist. Very nice lady.
Linda, Sister - Nice, caring, very competent day nurse. Really lucky to have had her support.
Liz - Nice room cleaning lady
Lorraine - Nice nurse that answered questions about the anesthesiologists.
Mandy, Sister - Very nice, helpful, competent nurse. Has dogs that she presents at dog shows. Very experienced.
Marcus - Chef at Beefeaters. Very nice guy.
Marie - Nurse
Meryl Wellings - Nice lady. Very helpful admin support from the McMinn Centre
Mia - Doctor who checked in on me. Not sure of her role in the surgery/ hospital. Answered my questions very thoroughly.
Mister McMinn - Surgeon extraordinaire. Very funny guy. The british bulldog (in a good way...won't let go of a problem once he sinks his teeth into it). Blessed that he considered taking me on as a patient.
Pam Charles - "Pam the Great" of the McMinn Centre. Incredible help throughout the entire process. Awesome at her job. McMinn Centre is very, very lucky to have her.
Patty - Nice young male waiter at Beefeaters. Going to college and enrolling soon in the Royal Air Force. Super friendly, helpful guy. As good as he is, hard to believe he's only 18. Apparently, you enter college at 16 in the UK as he already had two years in.
Phil - Awesome day porter. Very proud of his local soccer team. Very nice guy. Made sure to give my son a poster/ calendar of the soccer team and to be sure my son knew who he should be rooting for if he knew what was best for him (just kidding)!
Rona - Night nurse
Russ & Kenae: The Saipan connection!! Russ, the adventure racer, and his lovely wife. Beautiful couple. Good company, good people.
Sarita - Physio - Very nice young lady.
Sheena - Nurse. Nice, nice lady. Very helpful.
Shirley - Nurse during nights.
Smoot - Birmingham U. Mech. Engr. Helps w/ Food. Very nice young man. Needs an auto industry mentor. Very bright young mechanical engineer I believe in the UK from Nigeria.
Stacy - Wonderful, wonderful help. Works at the Premier Inn. Helped us tremendously with our bookings. :)
Sylvia (Admin) - Helpful lady who I met on first day... Saw her again while leaving. Very nice, sweet lady.
Teresa - Nurse. 2nd grandchild coming in August. "Saint" Teresa.
Thomas Unger - Patient and master mathematician at University College, Dublin.
Vicky: Without a doubt, the reason I made my way to the McMinn Centre.
Yahoo Group hippys (Hipresurfacingsite, Hipsrus, and surfacehippy): So many intelligent, caring and sharing friends in this journey. Cannot thank you all enough for your input, advice, etc...."