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April 2024

I didn't really enjoy _To Paradise_, but have some things to say about it. It's a strong libertarian dystopia, in which the biggest threat is the authoritarian state and disability comes from treatments, not illnesses. It measures up quite badly against the reality of Covid.

Saturday's physiotherapy plan is to get me back on the exercise bike. Pretty terrifying as I'm still learning to walk, but also exciting!

I'm reading Yanagihara's _To Paradise_ and it's clear, if there's one thing she got wrong, that she massively overestimates the desire of the state to make public health interventions.

The physio regime is exhausting but hope inspiring. I can see the goals and have the exercises. It's really rebuilding very basic muscles from nothing, though. So, tough times ahead but eyes on the prize.

This morning I begin phase 2 of physiotherapy. A challenging balance between enhancing mobility and not enraging the vicious tendonitis.

Today's surgery recovery is a mixed bag. I can walk once more, and I feel stronger, but I can also feel the tendonitis just lurking, waiting for me to overdo it again. Physiotherapy ramps up tomorrow.

In June, I hope to take a break to the West Country to see my in-laws. This involves organising remote dialysis, which involves a rectal swab, a swab from your central line's exit site, MRSA swabs, plus Hepatitis and HIV blood test. All for one remote session.

The "crisis" in UK university finances has been a decade-long ambition of student fee policies. The sub-inflationary rates are designed to trigger "market exit" among institutions without endowments or substantial assets. It's a feature, not a bug.

Urgh. I had the most dreadful night. Terrible pain in my thigh muscles and an ache down the whole leg starting deep in the hip. Slept for 1.5 hrs total. Pain was/is awful. Think it's an iliopsoas tendonitis, which happens in up to 30% of all hip replacements.

More steps without crutches today. By most benchmarks, I'm not going any distance and it's not very impressive. But from where I was, it's a world away, relatively quickly.

Today I took my first steps without crutches (!) I continue to recover and to get stronger every day. I also setup the dialysis machine with minimal assistance.

Night time and sleep is the worst time for chronic pain. Painkiller doses seem hours away. The lack of visual stimuli gives little to focus on, except the pain. Dull aches are amplified to excruciating level.

Yesterday felt like real progress - I did some good walking and strong physio movement. It was hard work, but there was real improvement. Today, I feel very sore, in pain, and beaten up. Should've know it wouldn't be linear.

Day 1 of home physiotherapy. Boy it's tough work. Pain levels very bad and just, say, lifting my leg to get back into bed is a massive challenge, with which I need help.

OK - after much palaver, I am dressed and ready to leave the hospital. (You try dressing when you can't reach your toes!) But pharmacy, as usual, are SO slow and SO frustrating.

I made it up the stairs, with crutches! It was extremely painful and exhausting, but I did it. Now I must cut back the ketamine and hope for prompt discharge tomorrow.

Today I am going to attempt to climb stairs for the first time since the operation. So far, the physiotherapy has been hard and very painful. Still, onwards; eyes on the prize etc.

Urgh, still struggling with severe pain after my operation on Saturday. This is apparently because I am very much accustomed to opiod anaesthetics and they don't work well on me. Sigh!

I think my pain levels are higher than usual because of long-term steroid use creating massive haemotoama. I'm on ketamine, tramadol, oxycodone (morphine), codeine, and paracetamol (does nothing). I also need a blood transfusion.

One of the things I *hate* about being in hospital is how they try to take control of my daily drugs away from me. They nearly always get it wrong and it's hard for me to check when they just give me some pills. I don't trust them to get right something I've done for 20 years.

A substantial portion of immunocompromised people remain under near-shielding conditions; myself included. NICE has announced that the appraisal committee for protective "Evusheld 2" (Sipavibart) will not meet until December '24. These delays are inappropriate given the urgency.

Feeling nervous about my hip replacement now. It's under spinal block and, I hope, sedation. But last time I had sedation was during a colonoscopy. It didn't work terribly well and I had a long chat about the novels of Thomas Pynchon with my consultant during the process.