Return to Tango: Week 5 after Anterior Hip Replacement

The Sidewalk Tango class this week was on Open and Closed Embrace.. I would really have liked to do that class to help me refine what I know already. At least this week, I felt strong enough to stand in the lounge and do some of the steps which don’t involve twisting. 

I enjoyed the regular Wednesday night after-class Practica. My legs and feet felt quite strong and springy as they walked and I relished the changes of pace and direction that Nick led me into. I can now go into the cross and step out backwards and even follow the lead to step over my partner’s leg. This is very encouraging as it’s been a long time since I’ve been able to cross my right leg over towards the left side of my body. I even tried an ocho on my new right hip joint. I did take care to set myself up on my axis and engage every muscle I could think of before moving into the step. It worked and felt alright but at the same time, I was aware that it wouldn’t be a good idea to do many more of them. It was encouraging to be able to complete a whole Tanda.

Background.

Thigh muscles are still tight and complaining but less so.However, I can loosen them more quickly now with stretches.  My upper thigh is still a little bit swollen.

Exercises: I’m increasing the the intensity of these now. It’s odd, but  during the last few weeks most of my energy has been spent managing daily life and I didn’t seem to have the energy for doing a lot of exercises.  Now I have and it’s good to do them and start feeling specifically stronger. My poor old left leg needs as much attention as the right.

Backache: still there and I’m a bit sick of it. But it is ‘just’ muscular for which I am grateful.

Walking: much better around the block now. I can walk quite steadily and at a sensible speed but still find it hard to maintain the enrgy for sustained walking.

Pain relief: down to Targin10 twice a day for a week. Time to step down further.

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 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!

Goodbye, Hip.

 

Tomorrow my right hip will be excised, pruned, dismantled, de-commissioned, removed, taken away, discarded, supplanted, to be replaced, implanted.

Something made of living bone which has been with me for all of my life will be replaced with an inert substitute. I know that the hip joint I have now, at 69, is not composed of the same bone cells as the one I had when I was born but it is the same structure being replaced constantly with new cells all my life. It has known what shape it was meant to be and the cells just got on with it.

I’ve never seen it. Like so much of my body it is buried deep, protected and wrapped by muscles and tendons.

My mother tells me that one of my knees had to be dislocated to let me be born. But that knee has always felt fine. Tomorrow my right hip will have to be dislocated after the muscles have been laid bare and drawn aside to allow access to the joint: the anterior approach. The ball at the end of the femur, now arthritic and covered in cysts, will be dislodged from its socket now lacking intact cartilage, and both surfaces exposed to the air and the lights.

I feel tender towards these poor worn out parts of my skeleton. At least the socket will still be in situ after being scraped out and resurfaced. But the femoral head will go. No saving it.

Thank you hip! You served to crawl, walk, run, ride a tricycle and a bike, and drive a car. You played hopscotch, marbles, dodgie, rounders, softball, tennis, netball. You loved being in water, and swam and kicked up and down the Bendigo pool for miles and miles and miles; although you didn’t really like kicking that much. It was the shoulders living above you that pulled you through the water. You were made to ski, reluctantly. You enjoyed dancing at parties and later you went to work at jazz ballet. You never much liked walking and the feet below you hurt until they were equipped with orthotics. Just walking was boring, and you got sore and creaky – until you discovered that you loved walking up mountains on little uneven paths. Somehow this sort of walking suited you. It stopped you being bored and doing the same old steps all the time. Going down was fine, except that the knees had a grumble about that.

When you were fifty you started working a potter’s wheel, which meant sitting with knees either side of a sort of drum enclosing the electric motor that turned the wheel. You had to make the right foot push down to work the power pedal near the floor. After about 14 years of this the muscles supporting you got very tight and made it hard for you to move easily.

By the time you were sixty six you had given up the wheel, but then you climbed up some concrete stairs and started learning tango. This was hard for you. You had to carry a whole body’s weight on your own – hold, balance and swivel around on one foot. The muscles you needed weren’t strong enough to protect your cartilage. Soon you were scraping femoral head against boney socket and irritating muscles and tissues around you. You found it harder and harder to slide smoothly in the socket. You developed cysts. It was no good. X rays showed you had lost all your protection and lubrication. You were scraping bone on bone. You hurt!

It is time to say ‘thank you’ for all the happiness and experiences you have given me, my dear hip joint. I’m sorry you have broken down.

I’m glad I live in a time when I can be anaesthetized, my body cut open, have old damaged parts removed and new parts inserted, sewn up, woken up, pain controlled, infection minimized, and then helped to recover by people whose work it is to do so.

Good bye old hip.

Hello new hip.

 

 

Tango,Arthritis, A Total Hip Replacement and a Return to Tango

 

Who would have thought that just walking backwards around a dance floor would be so fraught with complexity!

The first two years of learning tango had been so full of new ideas, names, people, music and movements such as ochos, the Lady’s Basic and walking, that it was often difficult to recognise that my brain and the body actually had a connection with each other.

By the third year, 2014, I decided to consciously turn my brain off and let my body do what it had been practising and repeating. It seemed to work. I stopped leading, though in class it had felt like ‘anticipating’, and enjoyed just waiting to see what happened. I felt that I was starting to get the feel of the dance and was enjoying the never-ending refinement of the most simple elements-such as the walk!

The lady spends a lot of time balancing and turning on the one leg, and I became aware that my legs and hips were not as strong as they might have been. My right hip was getting sorer and sorer, feeling weak and it was painful to step that leg across my body. I stopped doing the classes, hoping rest would help.

I sit in one of the big armchairs in the darker bar section of Sidewalk Tango watching the brightly lit Intermediate class, with my husband in it, work on the figure for the night. David calls, ‘Change partners,’ and the women move to the next man in the line of dance. My friends are practising their ochos and adornments while I sit and tell myself that it’s quite good to learn by watching. Hah! Who am I kidding? I long to be out there with them.

Rest, Pilates and the Physio seemed to be getting me nowhere so towards the end of October, I took myself off to the GP. My hip movement was restricted enough for her to write two referrals, one for an Xray and the other for an orthopaedic surgeon. She was certain that I had osteo-arthritis and would probably need a hip replacement.

I was shocked but she was absolutely right. By November, I’m sitting in the rooms of the surgeon and holding a surprisingly heavy ceramic and titanium replacement hip joint as he explains how it works. Up on the screen, my right hip joint showed as an amorphous, grey shadowy mass.

‘It’s bone on bone,’ he said. ‘I’m surprised I haven’t seen you sooner.’

I had been surprised too. Up to that point I had had no direct pain in the hip but a lot of what I now realize was referred pain in my hip flexor and glutes.

I was almost too afraid to ask if I’d be able to return to the balancing, turning and twisting of tango, but did. Yes, I will. The physiotherapy will get me there. I can’t wait!

The surgeon has a really good website,which has an animation of the Anterior Total Hip Replacement operation. After the incision in the front of the hip, the muscles are drawn aside in turn, getting ever deeper and deeper to reveal at last, the star of the show, the arthritic hip joint, whitely gleaming. I’m reminded of the series of curtains being drawn at the cinema before the screen appears with the promise of real action. Here, the action continues with the hip being dislocated, the top of the femur sawn off and the replacement inserted into a hole drilled into the femur. A new socket is cemented into the old one, and the replacement ball placed into it. The muscles are released to return to their tight overlapping pattern, enfolding and protecting my new hip.

All this looks deceptively simple on the computer screen, with no blood or real body parts. This is where the huge, exciting leap happens as the surgeon’s skill, experience and expertise translate this cool, schematic plan into reality in the flesh and blood of my body. On my part, this is where real trust is needed.

By the end of November, I had a date for my surgery – January 13, 2015.

There’s now the prospect of returning to normal life. I’ve been living in limbo for months. I can’t tango. I can’t walk. I can’t sleep. I can’t think clearly. I’ve been holding pain at bay with pain killers and anti-inflammatories. My strength and agility have gone. I feel off-colour a lot of the time. I’m increasingly irritable and hard to live with.

But now I wait. By January I was in real pain within the hip and finding walking any distance at all extremely painful. There are two days to go.

I’ll keep you informed.

 

 

 

 

Tango, Arthritis, A Hip Replacement and a Return to Tango .

Who would have thought that just walking backwards around a dance floor would be so fraught with complexity!

The first two years of learning tango had been so full of new ideas, names, people, music and movements such as ochos, the Lady’s Basic and walking, that it was often difficult to recognise that my brain and the body actually had a connection with each other.

By the third year, 2014, I decided to consciously turn my brain off and let my body do what it had been practising and repeating. It seemed to work. I stopped leading, though in class it had felt like ‘anticipating’, and enjoyed just waiting to see what happened. I felt that I was starting to get the feel of the dance and was enjoying the never-ending refinement of the most simple elements-such as the walk!

The lady spends a lot of time balancing and turning on the one leg, and I became aware that my legs and hips were not as strong as they might have been. My right hip was getting sorer and sorer, feeling weak and it was painful to step that leg across my body. I stopped doing the classes, hoping rest would help.

I sit in one of the big armchairs in the darker bar section of Sidewalk Tango watching the brightly lit Intermediate class, with my husband in it, work on the figure for the night. David calls, ‘Change partners,’ and the women move to the next man in the line of dance. My friends are practising their ochos and adornments while I sit and tell myself that it’s quite good to learn by watching. Hah! Who am I kidding? I long to be out there with them.

Rest, Pilates and the Physio seemed to be getting me nowhere so towards the end of October, I took myself off to the GP. My hip movement was restricted enough for her to write two referrals, one for an Xray and the other for an orthopaedic surgeon. She was certain that I had osteo-arthritis and would probably need a hip replacement.

I was shocked but she was absolutely right. By November, I’m sitting in the rooms of the surgeon and holding a surprisingly heavy ceramic and titanium replacement hip joint as he explains how it works. Up on the screen, my right hip joint showed as an amorphous, grey shadowy mass.

‘It’s bone on bone,’ he said. ‘I’m surprised I haven’t seen you sooner.’

I had been surprised too. Up to that point I had had no direct pain in the hip but a lot of what I now realize was referred pain in my hip flexor and glutes.

I was almost too afraid to ask if I’d be able to return to the balancing, turning and twisting of tango, but did. Yes, I will. The physiotherapy will get me there. I can’t wait!

The surgeon has a really good website,which has an animation of the Anterior Total Hip Replacement operation. After the incision in the front of the hip, the muscles are drawn aside in turn, getting ever deeper and deeper to reveal at last, the star of the show, the arthritic hip joint, whitely gleaming. I’m reminded of the series of curtains being drawn at the cinema before the screen appears with the promise of real action. Here, the action continues with the hip being dislocated, the top of the femur sawn off and the replacement inserted into a hole drilled into the femur. A new socket is cemented into the old one, and the replacement ball placed into it. The muscles are released to return to their tight overlapping pattern, enfolding and protecting my new hip.

All this looks deceptively simple on the computer screen, with no blood or real body parts. This is where the huge, exciting leap happens as the surgeon’s skill, experience and expertise translate this cool, schematic plan into reality in the flesh and blood of my body. On my part, this is where real trust is needed.

By the end of November, I had a date for my surgery – January 13, 2015.

There’s now the prospect of returning to normal life. I’ve been living in limbo for months. I can’t tango. I can’t walk. I can’t sleep. I can’t think clearly. I’ve been holding pain at bay with pain killers and anti-inflammatories. My strength and agility have gone. I feel off-colour a lot of the time. I’m increasingly irritable and hard to live with.

But now I wait. By January I was in real pain within the hip and finding walking any distance at all extremely painful. There are two days to go.

I’ll keep you informed.

 

 

 

 

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.