Return to Tango after Total Hip Replacement. Weeks 11-13

These have been a good few weeks. First, I’m off the Targin. Probably I did it a bit too quickly, but who knows. I had a week or so of feeling a bit uneasy and unwell, a bit cold but with no pain so I was happy enough to put up with that. Now I’m fine- still on Panadol Osteo but starting to ease back on the anti-inflammatories. No hip pain, just muscular tightness which comes and goes with what exercise I’ve done.

I’m getting stronger and looser but it will take quite a bit more time to be any where near normal – whatever that is/was!

As for Tango – I joined the Beginners’ Class last week for the introductory walking section and enjoyed it hugely and it felt fine. However, it was interesting how much harder it was to walk in strict time and at a slower pace than just practising at home.

I actually danced last weekend at a wedding- a mixture of bopping around and some simple tango to very untango rock music. To my surprise, I found myself doing some good neat ochos. My new hip feels so much stronger than the poor old one which I now realize had no strength or support.

 

Return to Tango after Total Hip Replacement. Weeks 6-10

These last weeks have been all about my KNEE! This was not part of the plan.

During week 6, I developed a bit of pain below the knee on the same side as the hip replacement. Within a few days, it had become so intense that I could put no weight on it and was back on my crutches and scrabbling around for strong pain killers again.

Off to the doctor and off for an Xray and Ultrasound and back on the big pain killers. Results were that I had Bursitis of the Pes Anserine- a bursa just below the knee where 3 large muscles cross. Also some inflammation and degenerative tearing of the Medial Collateral Ligament and inflammation of the meniscus, which I used to know as the cartilage. Well, that explained the pain, at least.

Treatment: 5 day course of cortisone, Targin again and rest and physiotherapy. About a 6 week recovery period.

Apparently, this knee problem after hip surgery is not uncommon and  is related to tightness from the surgery, existing weakness and increasing activity.

What I’ve learnt is that, in this case, ‘rest’ meant sitting or lying with no activity beyond the absolutely essential. That actually made a big difference once I’d brought my version of ‘rest’ down to that.

The physiotherapy is based on releasing the tight muscles around my thigh and strengthening the almost non-existent muscle on the inside of my knee.

This has all been gradually working to relieve the pain but I find it hard to get the balance right between strengthening and straining the muscles. Also, once I started improving, I found it very easy to overdo any walking or exercise and end up sore rather than gratifyingly just tight from execising.

I’ve started going to a remedial masseur also because my body needs loosening up generally, compared to the focussed treatment of the physiotherapist. This has been very helpful in starting to balance up my back, hip and leg muscles from all the compensation during the hip pain before the replacement.

It’s been strange to remember that I had such a big hip operation so recently with this knee totally up-staging it. ‘What hip?’ I say. I’ve been sorry and frustrated not having been able to just move steadily along with specific hip physio and strengthening and get back to tango and normal walking and activities. However, it’ll sort itself out in time if I’m careful.

Meanwhile, I think I must be going for some sort of record for watching tango lessons from the side. There’ve been no more little walking forays on the floor, just watching. Frustrating but I’d rather be there watching than stay at home while Nick goes to classes. Plus, I’ve had the pleasure of watching him really improve over the last few months and am looking forward to being up and dancing with him again when I’m ready.

The watching has actually been very interesting. I’ve liked listening to the lesson, mentally doing it and just enjoying  and thinking about the many and varied responses of the people in the class. It’s given me time to appreciate even more the patience of the teachers. Best of all, watching and going to Sidewalk Tango through all this has helped keep me engaged and motivated to get back on the dance floor.

 

 

 

 

Tango Suspension

TANGO SUSPENSION.

Last Wednesday’s Intermediate Class at Sidewalk Tango introduced the concept of Suspension in the Embrace to us. David and Di talked about the embrace and the pause and the opportunities these generated. They moved from tango music, selected Claude Debussy’s Clair de Lune from the play list and turned the lights down to a pinky glow. David mentioned that Debussy once described music as, ‘The silence between the notes.’

I was still sidelined with my hip and watched the couples quietly exploring this moment in the dance. I longed to be out there on the floor with them.

However, it got me thinking, and next morning when ‘negative space’ popped into my head, I realized that if I can’t dance it, I can think it and write it.

So….

 I learnt that the leader draws his partner into suspension, a pause. It’s a moment to hold and transform the pause into a gathering point or a threshold. It is time, hanging in space, isolated in the now but with resonances of the past and the opportunities of the future.

This pause is wide reaching. Isaac Stern, the conductor, talks of ‘silences which give the form’ of a piece of music, echoing Debussy.

Suspended time is not unlike the visual artist’s concept of the negative space which exists around and between two objects. In this case, the space has a strong role in the whole composition and is about the rightness and balance of the positioning. Negative space can often create a presence or image of itself such as the obvious case when two vases placed side by side will create an image of a face between them. In tango there is not only a temporal pause but a pause in space where the embrace and the position of the dancers’ bodies speak their own language.

I discovered that the Japanese take this concept further with their principle of ‘ma.’ Very simply, this refers to the space or interval between two structural parts and a consciousness of these two elements. It is also about what takes place in the imagination of the person who experiences these transient elements and it’s in that that I found the connection to tango deepened. I really liked the idea of the imagination and mind engaged in this suspended moment between two people. There’s an interesting sense of being both within and without the body.

Then in The Age on Saturday (28 February, 2015), I was reading a discussion by Kathy Heyman on writing dialogue. She says that the author and the reader listen to the silences and pauses between words. It is the silent subtext flowing beneath the words which draws the dialogue and narrative along.

To complete the circle and return to last Wednesday’s tango class, I found it very interesting to discover how far that word, ‘suspension’, took me into the wider artistic world. It deepened my understanding of a very specific layer of meaning. I’m thinking about a feeling of height, lift and poise coupled with the suspense of being open and quiet. I flow into this moment.

 

Return to Tango: 4 weeks after total hip replacement

This week, I actually did ‘return to tango’, on day 22 to be precise. Sidewalk Tango resumed classes on Wednesday, Feb 4th, after the summer break and Nick did the Intermediate class and I watched.

It was a quiet, reflective class with the last of the daylight filtering rosily through the drawn back curtains. The couples gradually became silhouetted against the last of the light as they worked on musicality and fluidity. Towards the end of their lesson, I put on my tango shoes for the first time in months. These are flat shoes as I have trouble with my metatarsal arches and don’t go near heels. It was achievement to bend enough to tie my laces.

During the twelve days since my first tentative steps at the Australia Day Milonga, my normal walking had freed up, my balance strengthened and I was more physically confident.

I stood in the embrace, waited for the lead and felt quite strong. And I was. I could step back, straighten my leg (no more creeping, Di) and feel spring in my feet and calves. I felt better than I did in my last ‘dance’ before stopping completely last year.

At one stage, Nick inadvertently led me into a little ocho – I flipped around automatically! What have I done!! I shoudn’t be doing this yet! Yet it felt fine, no pain, no strain, just a neat,quick ocho – straight and strong. Well, I’d better put that away for a couple more weeks.

I managed three pleasurable dances, a full song each, but just one at a time with a rest between. Two were with Nick and the third with a friend who led me around carefully and safely. That was another milestone.

———-

As a background to the actual tango, this is what was happening.

Stretches increasing and improving. Aiming for standing knee lifts, pulling knee into chest on floor, loosening tight hamstrings, thigh muscles, lower back. All still pretty tight but improving.

Strengthening: balancing, squats and increasing walks up stairs. Can do 5 flights of 11 steps up and down in one go now.

Walks. Can now do the 5 minute walk around the block quite comfortably and have today tried a different bigger block – 10 mins – good until the last couple of minutes. Tired and noticeable in the right glute.

Tightness easing in thigh muscles and I can now squat on my heels- just.

Back ache still there first thing as I wake. It goes during the day. It will gradually ease as all this tightness eases.

Started to reduce the Targin by a third during the day, ie down from 15 to 10, with the 15 still at night.That seems ok so far. In a couple of days, I’ll drop the night dose to 10 and see what happens.

———–

I wonder if anyone is reading this! I would have liked to learn about the rehabilitation process before my hip replacement, which is part of the reason for writing these rather navel/hip gazing posts.

 

 

 

 

 

 

 

Return to Tango: Sidewalk Tango Australia Day BBQ and Milonga.

Nick and I are on the dance floor at Sidewalk Tango. Around us, couples are waiting for the music. We move into the embrace and, on the beat, Nick takes a small step . I step back, feeling the weight on my new hip. It’s alright. I transfer to the other leg and we are dancing. It is very modest. I’m not to straighten my leg on the step back, nor step back very far because of the pressure it puts on my still healing incision. So I’m ‘creeping’ – Don’t look, Di! – but a creep is better than sitting on the side. The embrace feels comfortable and Nick leads me into a little fake. That’s a bit harder but I can do it safely. And so we progress! This is Tiny Steps Tango and I last about half a song. I’m so happy.

Back in December, when this Australia Day BBQ and Milonga was announced after class, yet another one I had watched, I did a quick sum. Thirteen days after my hip replacement. I should be able to get up the stairs and just be there.Yes. I’d aim to do that.

This afternoon, I got out of tracksuit pants and into tango clothes, left one crutch behind and we drove through the quiet, public holiday streets to Swan St , Richmond. The music spilled down the stairs and out of the windows of the Tiki Bar onto the empty footpath. Through the tall wooden doors were the stairs, quite a long straight flight but now, not as insurmountable as I thought they might have been. Up I went, one step at a time with Nick following in case I decided to plunge backwards

No such drama. There I was, up in the Tango world. Couples quietly danced, people chatted, the BBQ on the roof outside the high back windows sent down good smells and our tango friends were there. Food descended from the BBQ, more food appeared from the Tardis like kitchen and we ate and talked and caught up with Christmas and New Year stories. Nick had a few dances with people who could do more than tiny steps and he and I had another short dance.

It was a perfect occasion to emerge from two rather claustrophobic and self absorbed post operative weeks  I spent the entire afternoon with a huge grin on my face.

 

 

 

Return to Tango after a Total Hip Replacement. Day 10

Day 10. My walking has improved a lot, so much so, that I suggested to Nick that we try a few small tango walking steps.

We stood facing each other with my crutches parked against the kitchen bench. We opened our arms to take the embrace. It felt odd and uncomfortable. I think I must have been standing stiffly, Nick’s posture felt nervous and the whole thing was awkward. Nick took a tentative few tiny steps, I tried to follow but my right leg and hip had very little strength. Walking backwards felt unsafe and definitely unpleasurable.

OK. I wasn’t ready for that but decided to practise by myself. I could hold onto the kitchen bench and walk backwards at my own pace. That was better. I continued to walk to the music and when we tried again the next day the ‘experience’ did feel safer and marginally more fluent.

About the next day, about day 12 by now, the muscles in my feet sort of released so that I could walk heel ,sole and toe- not just plonking down a flat foot. That made a big difference to the smoothness of my walking and the practice to the music became very enjoyable. I could do this with just one crutch now.

Return to Tango After a Total Hip Replacement. Day 7.

IMG_20150122_142445 IMG_20150122_142524

My Right Total Hip Replacement-Anterior Muscle Sparing Approach operation was performed a week ago (I’ve only posted this now)

What a triumph of medical technology and surgical skill that has been. This is Mr Phong Tran’s demonstration ceramic and titanium hip joint – the stem and the socket. I like the grooves on the unpolished shaft (see the cutaway image) which encourage the new bone growth to attach to..

It’s a strange thought to think of that new inert shaft being inserted and cemented into my living femur. My femur is now truncated, neatly sawn off, and the slim, shiny titanium stem extends and holds the polished ceramic ball. I meant to ask if it really is pink. I try to imagine how my body’s muscles, blood vessels, tendons and  nerves, adjust to the different proportions, edges and angles.They must have to fold in and around the new structure. I’d like to see a real colour 3D image of that.

I can’t tell by feel. I don’t feel anything in my hip – it’s not numb- but there is no glute pain, no inner ache. Nothing. Is that what normal is like? I’ve forgotten. Of course, I don’t really know what I might be feeling in there because I’m on 12 hourly Targin tablets which I’m presuming are suppressing any pain. Do you have pain if you don’t feel it?

This new hip is working very well. The Anterior approach, a 10 cm incision on the thigh, starting from the crease between the body and the thigh, has eliminated most of the restrictons which follow Lateral or Posterior approaches. The only real restriction is to not lunge or step back too strongly with the new hip. This puts pressure on the incision and the weakened, settling muscles.

This move is actually alarmingly like the lady’s walking step backwards in tango. I’m going to have to be very careful with that for about 6 weeks.

In fact, my new hip is thinking Tango! Today I put some tango music on while I was doing my exercises. I was practising walking tall and evenly with my crutches and found myself walking in tango rhythm. What a happy unanticipated moment it was to feel the spontaneous movement after all the post-op careful, controlled  and on the edge of pain walking up.

Let’s see what happens next!

Right Anterior Hip Replacement, Day 14

It’s been fourteen days since my right anterior total hip replacement operation on Tuesday January 13th, 2015. The operation, performed by Mr Phong Tran, went well. Both hips are level, and here at home I can now walk around without crutches.

Now, the biggest improvement for me is that at night I am sleeping again. I had about nine months before the operation of tossing and turning and never being comfortable in bed. I would have to get up in the night and walk around, do my stretching exercises, refill the hot water bottle, have a cup of tea, anything to distract me from the nagging and niggling ache. I would lie on a tennis ball, judiciously placed under my hip’s right buttock to relieve the inner pain.

The four nights in hospital weren’t good even though I had a spacious private room. A hospital is often noisy at night, and in this orthopaedic ward where there is a constant need for ice to relieve sore joints, the corridors sometimes rang with the sound of ice crushing. I was always waiting  for the pain relief, sometimes up to three hours when the pain had reached the 8/10 mark. The hospital system understandably allows no flexibility in the prescribed timing or dosage of analgesic drugs. The 24 hour time lag in adjustments was difficult. However, the visiting peri-operative physician improved the pain relief regime each day  until it was nearly right by the time I got home.

I went straight home from the hospital, and as soon as I was at home I sat down and looked at what drugs I was able to take and adjusted the timing so that there were no distinct peaks and troughs in pain relief delivery. Being at home meant that I had discretion of up to two hours with the panadeine I took, and that made a big difference.

My first night at home was magnificent. I slept. I did have to get up with a rather restless bladder (I’m drinking a lot of water) but went to sleep again immediately. I’m surprised I’m not bothered by having to sleep on my back. I have now had seven nights of sleep and feel there is quite a bit of pleasant catching up to do.

The pain issue has been interesting and quite difficult for me to work out. During the operation, a tube was inserted  into the joint for 48 hours of constant delivery of local anaesthetic from a little pouch which lay next to my thigh. I felt no pain at all from the joint. But there was a lot of generalised pain around my back, abdomen and thigh muscles. I hadn’t expected this and it was quite difficult to manage. I’ve learned that the back pain is related to the rather vigorous manipulation during the operation in which the hip had to be dislocated, and also to imbalance from the preceding months of limping. My thigh muscles are sometimes excruciatingly painful – not surprising considering that , although they weren’t cut during the operation, they were pulled aside and held there while work on the bone and prosthesis took place. The poor things are still grumbling, as are the tendons, one of which had to be cut and repaired. They like ice packs. My back likes a hot water bottle.

It took a bit of time and a visit to my local GP who helped further with the pain relief management to sort out this rather confusing melange of sensations ranging from quite mild to wincingly strong. But knowing what is going on in my post-op body is good and all this will improve with exercise and physiotherapy,

One of the things I was hoping to be an outcome of the surgery was not having to take pills any more. Usually I take nothing, touch wood, and I was fed up with having to rely on pills and vigilant timing to be able to function at all. Strangely enough, now I am taking many more but I’m not bothered. I think it’s because I know that the prime cause of the pain has been removed and that the need for pills will diminish as I become stronger and my body heals. I’m a bit fuzzy in the head at times but don’t mind. I just have a rest and feel relieved that it’s all over.

I am astonished at how well I’m getting about. As I said, I can walk around home from about 12 days after the operation without crutches, if I’m not tired. It was bliss the morning after the operation when the physio helped me move my leg and lightly bend the right knee which with my leg had been safely immobilised overnight. The leg was really aching by that time. It hurt to move but the movement was better than the ache. I swung around to sit on the side of the bed and lowered it to the floor. It was painful but OK. Then he helped me up into a standing walking frame and there I was, standing on two legs 16 hours after the operation. I walked a bit around the room and from then on walked everywhere. That afternoon he brought my crutches and I walked out to the corridor to do my first set of standing exercises. I’d been doing the bed ones since regaining feeling in my legs and feet.

From then it became easier. Exercises 3 times a day, walks in the coirridor, learning how to go up and down steps. I concentrated on walking tall and as evenly as I could without limping or swaying from side to side. By now I was very appreciative of the pilates and physiotherapy I had been doing in preparation for the surgery.

I managed getting into and out of the car perfectly well, and it wasn’t much different from my efforts before the operation. Home was comfortable and manageable. I had hired a shower seat which feels safe and luxurious. I’m increasing my walks outside on the one crutch now and feel well on the way!

This afternoon I’m celebrating a recovery goal. Nick and I are going to Sidewalk Tango’s Australia Day barbecue and milonga. I will climb the concrete stairs to my tango world. I will see my tango friends again, hear the tango music, enjoy the familiar Tiki Bar, and I will definitely at least stand on the dance floor in the tango embrace of dear Nick who has been looking after me so well.

My Place, Sidewalk Tango

MY  PLACE. AN UPSTAIRS TANGO CLUB IN RICHMOND.

Published  in The Sunday Age, 2.3.2014

I step through the door between the chefs’ clothing supplies and the bolt warehouse in Swan Street, and climb the steep concrete stairs. Music becomes louder as we rise. We pay at the retro bar and sit down to change into our dance shoes.

People appear at the top of the stairs, pay and join us on the vinyl couches and chairs to chat and get ready for class. The piles of shoe bags accumulate. David and Di, the teachers, are moving around, checking the music, greeting us, putting out trays of water jugs and glasses. Evening light filters through the bamboo blinds and unlined red curtains across the dance floor to where we sit and wait at the back. The roar of trams competes with the background music.

A bit after seven, David gathers us onto the floor and the tango lesson begins. We stand in a line facing the mirrors on the opposite wall. We’re a varied lot, ranging from very tall to very short, from quite large to tiny. We could be aged twenty or seventy and could have been learning for years or be joining our first lesson.

The class accommodates each of us, rigorously and courteously. We move from partner to partner, gradually developing the steps for the night as the Golden Age tango music swirls around us. Our brains and bodies work really hard. After an hour, those water jugs and glasses are very important.

I love Sidewalk Tango.

www.sidewalktango.com.au

Tango,the Mountain and the Entrega.

image.

Picking my way along narrow, steep mountain paths in the French Alps, I found that I was being accompanied by tango music from our Melbourne Sidewalk Tango classes running through my head. The beat gave a rhythm to my steps which were often up and down and around awkwardly placed rocks. My peripheral vision was of an ongoing rock garden filled with Alpine flowers or snowy peaks or the valley below.

However, my attention was always on my feet and the path they were about to walk on – too much scope for accidents otherwise. So I’d stop and stand still if I wanted to look up from the path.image.

It came to me gradually that I was dancing a sort of tango with the mountain as my partner. I embraced the mountain leaning slightly forward, feet placed firmly and cleanly. Grasping the walking poles , I took care to plant them one at a time in a steady balancing position. There is a direct contact with the mountain. The gaze varies according to the difficulty of the path.

In the Open Embrace, when the walking is fairly straightforward with the poles used quite lightly, the gaze is centred in a widish circle slightly ahead of the feet and monitoring where to step.image.

The Close Embrace is used when the path is steep and rocky. Here the gaze becomes intent on the actual area of the feet and path and the pole grip is firmer and closer to the body. It’s intense and focused.image.

I realized that when I was lifting my foot and leg cleanly and neatly over and around rocks so as not to trip, I was actually doing Decorations.

There’s a closeness between me and the mountain path where I have to be attentive to its every configuration and follow its lead. Sometimes it leads me in a steady, smooth walk, sometimes it will ask me to step over a rock, or, with more complexity, ask me to choose a series of short, safe foot places in a short rock climb.

My body and mind are totally engaged in this tango with the mountain.

You’ll note the dress code is very different for mountain tango.