h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Get the local Cricket Team or Rugby boys to give you a hand. OK chaps spread out, line abreast, ears to the ground and RING.

Talking of medical bits, I've finally got an appointnment with an Orthopaedic Consultant to start the new hips thingy again. I started it over two years ago with one consultant who advised me I needed two new hips and the later the better so "Phone my secretary when it begins to get uncomfortable". Phoned in Feb only to be told he'd retired so I had to start the process off all over again. Here we are nearly six months later and having to go private just to get an appointment.

I bet most Albatrosses don't have dodgy hips.

Most people feel loads better once they're actually on dialysis. Usually once you get down to about 20% kidney function you feel knackered, and dialysis starts when you get down to about 10-15%.

I will fully admit to not being a huge fan of PD - the quality of the dialysis isn't great and there can be some nasty complications if infection gets into the abdomen. You can either do the dialysis during the day or be connected to a machine that does it all overnight. Most people these days go for the second option. Very few people start with the PD changing over 4 x a day.

Most people who do that have been using it for years and don't fancy changing over. Also some people find that being connected to a machine interfers with other things they enjoy doing in the bedroom.

I've worked in a renal unit fairly recently and would be happy to talk things over with your parents should they want to. If I've not got the answer I've got at least 4 renal registrars on Facebook who would be able to find out other things.

You don't do hips do you?

Getting ready for my first day at the new job. I am supposed to be there in a little over an hour and it's not that far away. I'm anxious to get there soon and see what it's like.

'Friad I know all about hips - other than that it sounds that you need a new one, and I'm sorry you're having to wait to get an appointment.

Also wishes Marv good luck with the new job.

I'm a big boy and lots of my buddies from Aberdeen are or were consultants of one form or another, ENT, Gynaecology, Anaesthetist, Thorasic, GP's but I think my Ortho mate moved to London.

Best of luck with that, WA. Unfortunately, it looks like I'll have to go down that road one of these days. Only one of mine bothers me, though. The right hip and the left knee. Isn't getting old a hoot! (That was sarcasm, folks.)

I'm glad to hear that people start feeling better after the dialysis starts. Which makes me wonder why they wait until patients are sick and exhausted before they start it. If their quality of life is compromised at 20%, then why wait until they are down to 10%, since they know they're going to have to do it eventually?

That is similar to orthopedic procedures. Sorry, you can still walk. Come back when you're in so much pain you can't even take a step without being in agony.

Not quite as bad as that but going downhill rapidly over the last six months. As the Vet said to me when I took the dogs in for their annual checkup, "Get the weight off, it works for my patients."

See ya'll in a week, I'm taking some leave and I haven't got the new laptop at home up and running yet. Maybe a job for next week.

Hyp - we wait because people don't want to start dialysis - they want to get as much as they can do before they are restricted by the therapy.

Very rarely someone is lucky enough to have a sibling or relative who can offer them a kidney before they need dialysis and then they are usually trasplanted before it gets too bad.

They would usually beg us to put it off for as long as possible - then once they started they'd wish they'd started earlier!

With orthopaedic proceedures the problem is that the implants themselves have a limited life and need to be replaced after 20-39 years or so. But if you need them in your 60s you might not be fit for surgery to replace them in your 90s, then you're a bit stuck. YOu can't have the joint replaced, and you can't walk.

Each operation has a increased risk of complications so it makes sense to minimise the number of operations.

So the best thing to do is to wait for as long as possible, then you'll get the maximun lifetime of the joint replacement.

I knew one consultant who would explain all the risks in graphic details and say

'I'll do the operation when the pain is so bad you'll say 'sod the risks I want the operation!'

Getting the weight off of failing knees and hips makes a lot of sense. I'm trying folks. Must try harder.

Z, my problems now are that I don't sleep well because of the hip. It keeps waking me up. And when I sit for any length of time, I hobble around for a while before it loosens up again. Once I'm up and walking around, I do just fine. If I sit for longer than a hour or so at a time, it becomes painful.

Putting it off for as long as possible makes sense. None of us want surgery except as a last option. But I'm not looking forward to years of thingsthe way they are now, either.

Disturbed sleep is a problem. - I do know a lot of surgeons that would operate at this point. Especially if you nag enough!



Though if it's at night you can use the sort of painkillers that cause drowsiness without too many problems, Tramadol and Codine.

Yeah, I guess I should ask for something. I take ibuprophen when it gets too bad. I hate taking medicine. But the discs in my neck are acting up again, too, so I'm going to have to get something a bit stronger. It should work for both problems. I have been toughing it out with ibuprophen for years, ever since the Vioxx fiasco. I was on that for quite a while. When the proverbial hit the fan over that, I decided that something safe was better, even if it doesn't work quite as well.

I know it's silly but have you tried regular paracetamol,(acetemorphine I think it's called in the US) it's lot safter than NSAIDS including Ibuprofen. 1g four times a day can make things a lot easier - and reduce the amout of times you need to take something else. I think it's really quite harmless at the regular dose, the dangers come if you take too much of it.

I'm a bit fan of regular analgesia for arthritis rather than just taking it when you need it. If you have regular painkillers you can move your joints more which stops them becoming stiff and more painful.

I have to admit I hardly ever prescribe NSAIDS to the over 70s I think the risks are too high.

Codine and Tramadol are also really useful, but sometimes they can cause drowsiness, so I'd probably start of taking one before bed at first. You can get codine mixed with paracetamol which is a useful combination that reduces the number of tablets.

Z, I've never found acetaminophen helpful. I'm one of those folks who don't respond to it for some reason. Plain old aspirin works better for me, but if I take it regularly I get tinnutis and stomach problems. But you're right about taking something regularly. That's why my neck is causing problems now, because I have let those discs get inflamed again. If I don't head it off at the pass, I'll wind up not being able to move my right arm again. The inflammation causes that shoulder to freeze up and be absolutely miserable. That's why I was on Vioxx, for the neck.

All of this is due to a drunk driver, folks. Almost constant pain since I was 23 years old. I have no sympathy for drunk drivers. You get so used to a low level of pain that you forget what it is like not to have it. You just keep going in spite of it. It's the first thing you're aware of when you wake up in the morning and the last thing at night.

I found a B&B with a cancellation near Lindisfarne Abbey for our anniversary.

Everywhere in Northumberland's booked that night, so I was really pleased to get somewhere on Holy Island. And I like the idea of the place you can only get to when the tide is low.

We're going to visit a stone circle on The Day. Luckily the UK is full of the things!

>> All of this is due to a drunk driver, folks. Almost constant pain since I was 23 years old.

*makes sour face*

That sounds wonderful, Ben. And quite exotic to a hillbilly. Happy Anniversary, in case I miss it on the day.

Well, I managed to get the doctor to renew my prescription. Huzzah! She's halved the dose, though, so we will see how that goes. I understand her concern that the drug in question will exarcerbate my (mild) asthma, but I've been taking it for six weeks already and it hasn't been a problem.
Still, the lowest effective dose is always a good thing to aim for.