Author: Bob Harrison

Today it’s not about me. Isn’t that a change. Well, okay, it is sort of about me.

As it turns out I have at least two followers for all these hip replacement posts. The first is a both a friend and the mom of a friend. She’s been a huge influence on me as she’s the person who suggested that I ride across Iowa, something I’ve done twice and documented here on Statrix.

She’s been following because she was scheduled for the same surgery a couple of weeks after mine and was interested in my experience. She’s now had her surgery and I had a chance to talk with her today and she’s says she’s doing great. Perhaps even better than I am when it comes to healing! That’s great news.

She reports that, like me, the pain relief was pretty much instantaneous. It’s not that you don’t hurt after surgery, it’s just that the pain is so much less than what you’ve been living with that you really do get instant relief. This is something I’ve heard over and over and almost didn’t believe until it proved true for me, and now for a good friend.

And now that bit about me. During our chat today she thanked me for all this writing saying it gave her some confidence heading in. You are quite welcome. It’s been a great outlet for me to articulate what’s been going on and, if it has helped even on other person, I’m gratified.

But that’s not all. I have another friend who is, at the very least, contemplating have the same surgery. She’s another good friend and has been following along to see what my experience of all this has been. The infection and auto accident aside, it’s been all good and I hope I’ve been able to convey that.

If you are considering a hip replacement all I can really say it don’t wait. My recovery has taken some effort so far, but frankly the PT is really stuff I should have been doing for years anyway: stretching is good for you. The pain relief, right after the surgery, and increased mobility, with days if not sooner, is really something not to be missed.

And now a bit about me. As I’ve mentioned I’m using a wet-to-dry dressing to help the spot that hasn’t healed close up. The biggest problem I’ve had with this since I learned how yesterday and have had to change the dressing both last night and this morning is the tape used to put the dressing on. The paper tape I was given for the job was just too darn sticky and, given that I have to tape my upper thigh, I’ve had issues with my skin being pulled painfully and worse (a bit of tearing – blood and all).

I’ve just purchased some expensive blue tape by NEXCARE that purports to be much better for this sort of thing. I’ll let you all know on my next post as I don’t have to change the dressing right now. By the way, I didn’t actually use the same tape they gave me yesterday for my dressing this morning, I used some other paper tape I had around that isn’t quite as bad and I used a lot less of it. I may use the stuff the gave me under things that clip to my bike for a bit of added friction.

I’m not recommending the 3M NEXCAREproduct, at least not yet, but here’s what it is:

Aloha!

Okay, I’ve finally gotten more information about my incision and what’s happening down there. It’s not good, but it’s not incredibly bad, or at least it doesn’t seem so.

As I’ve mentioned I saw my regular physician last Tuesday as a follow up to my auto incident; getting hit by a car. I’d asked him to take a look at my wound and he was concerned and did a culture. Following that I saw my surgeon’s assistant who prescribed an antibiotic and suggested that if it my wound hadn’t cleared up by this coming Tuesday we’d change dressings.

That brings us up to yesterday.

My regular physician gave me a ring yesterday and said the lab test had come back and he felt it best to switch my antibiotic from Sulfamethoxazole-TMP DS (what was on the label) to Levofloxacin. The bacteria in question is named Pseudomonas (which seems to be Pseudomonas aeruginosa).

It’s kind of a nasty bug which, while it’s pretty common, seems to like wounds and can be very resistant to antibiotics. The lab hopefully decided that Levofloxacin should be effective against this particular strain. The stuff must be powerful because I have a five day prescription of just five pills.

My regular doc also suggested using a wet-to-dry dressing on the wound. No clue…but no matter.

Today I got a call from my surgeon’s assistant and he said he’d been in contact with my regular doc and was happy with the prescription and did i know how to apply a wet-to-dry dressing?

Nope.

Such service. He asked where I was and, once I’d communicated that, he said he’d call the office at my regular location (they are at a remote locale today) and have a tech (nice guy too) show me how to apply a wet-to-dry dressing. That all happened with 45 minutes of the call. Wow.

Here’s the thing. This bug is worrying, but I’ve been assured it should really be no problem. I’m going to run with that while keeping up my prescription, my new dressing technique, and being nosey during appointments for a bit.

As my medical knowledge only extends to that required to kill vampires (I played a vampire hunter on stage twice during my theatrical career), I’m not completely up to speed, but I get the idea of driving little antibiotic stakes through my pet bacteria.

I have a regular PT session later today which means I’m headed back to the hospital later…way too much time around the place, no wonder I’m infected. I also have a follow up appointment with the surgeon’s assistant on Tuesday to keep on top of the latest developments.

And finally, this is pretty much my last hurrah for time off. I head back to work on Tuesday and frankly, I’m of two minds. Yeah, I like my job and have been pretty much bored out of my mind, but I honestly think if I put my mind to it I could find plenty to do. Ah well…only a decade or so till retirement and I’d really rather not rush on this getting older stuff.

Aloha!

 

It’s three week anniversary of my hip replacement at the one week anniversary of getting hit by a car. Most people do things the other way, get hit by a car then have surgery, leave it to me to do it the other way. Actually I’m quite grateful I did it the other way and that the accident really has had few consequences so far.

The accident was a shock and my back was definitely wrenched. There doesn’t seem to be much damage as far my spine goes, that is, it seems to muscle pain more than anything else. I was told by my PT trainer last Wednesday that it would probably take a couple of days for the pain to really set in and he was absolutely right. Friday was grim. I ached all over and definitely had limited movement. It’s been improving since then as far as I can tell.

I saw my regular doctor today as a follow up to the emergency room visit and he’s looked at the x-rays and read the reports and seems pretty confident that things will clear up.

My hip is coming along as well. Most of the swelling is gone and I have very little pain. Actually if I’m not actually stretching something there I have no pain to speak of at all. But of course, if I over use it I get some swelling and can definitely tell I’ve gone overboard. Again this is not pain ‘inside’ my leg as it were. It’s just muscle pain and pain around the incision.

I am very happy with the replacement. Very happy.

I’m less happy with the incision at this point however. I’m still getting some drainage when I have to move around running errands or doing PT. If I’m simply resting at home with the wound exposed it dries up and there’s no problem. But, of course, it’s not possible to simply lay around all day everyday (nor would, if push comes to shove, even want to do that).

Thus is was that I asked my regular doctor to take a look at it while I was visiting him following up on the accident. He was happy to do so and showed some concern about the drainage and a bit of redness around the draining area. As post-surgery infection is a huge concern he took a swab and sent it the lab and immediately called my surgeon’s assistant and asked that I be worked in. Given how busy they are and how long one generally has to wait for an appointment I was shocked to be ushered in about twenty minutes later.

The surgeon’s assistant looked at the incision and said he didn’t really think anything was wrong but, and there was a ‘but,’ he was wanted to put me on antibiotics as a precaution and asked if I could come back in a week (unless it looks worse in which case I should come right back).

So, while no one is definite about an infection, they are now preemptively treating me for it.

Now let me be clear, there’s nothing I would identify as a definite infection. The discharge isn’t what one would normally see with an infection and I don’t have any redness around the draining area if I’ve been resting. Still I’m quite sure that better safe than sorry is appropriate in this case. An infection that gets to the bone could be terrible.

Scared? Don’t be. I’m in good hands and, as I said, it’s most likely fine.

In fact this might all be just the effects of overuse over the weekend. On Saturday my moped died and I had to push it over a mile to the shop and then walk over a mile home. I probably walked three miles in total, half of it pushing a scooter. I didn’t have any pain till about a block from home and that was swelling, not internal pain. I iced myself up for a couple of hours after that and was back to normal, but I’m sure it put some stress on the healing incision it could have done without.

Still, think about it, the fact that I could even do that less than three weeks after surgery is simply amazing. Wow. My moped is repaired now and I won’t be doing any major walking like that for a while – though I am supposed to walk.

All in all, things are great three weeks out from surgery and good one week after the accident. I’ve talked with the insurance people and my bills from the accident will be paid, at least up to a certain limit which I doubt I’ve reached.

It’s time for bed, I’m still shorter on energy than I was before surgery, though that’s getting better too. Have a good one!

 

 

Today I went back to the hospital for my two week post-op exam. At this exam I saw one of the doctor’s assistants who made sure my wound is healing, it is, and that I’m generally following orders. I also received paperwork allowing me to stay out of work through next week. That will make it a total of four weeks that I’ve been off work. As my would still drains a little and I really need to keep it exposed to fresh air it’s definitely a good idea to stay out.

Two weeks after arriving home I’m far more mobile than I was just after surgery. That is, of course, to be expected, but I’m surprised by how well it’s going. The medical folks are all telling me that I’m doing really well and that it’s mostly my doing:

1. I came into surgery in good health and had been exercising (bicycle) right up to the day of surgery.
2. My attitude is very positive.
3. I am following instructions.
4. And, not to be discounted, I have a real goal for recovery: to be able to ride my bike as soon as possible.

All it all I’m quite happy with the way things are going: hip-wise anyway.

I ran into several folks from my cohort, those at the same pre-op class, and they are happy though, sadly, a bit less mobile than I am. That’s understandable though, the folks I saw are both older than I am and both had knee replacements, a tougher surgery I’m given to understand. It was nice to see them though.

I’ve had only one problem and I’m not going to write about it much for the moment. I had a run-in with a car last night and was hit in a crosswalk as I was crossing the street with the light legally. Witnesses saw me fly a few feet and I landed hard. The car did stop and I think they called the authorities, somebody did. I was taken to the hospital by ambulance, after being loaded on one of those boards used to protect one’s spine. X-rays showed no breaks and no damage to my hip replacement, at least none apparent at the time, but I do have pain and pulled muscles, bruising and the like. I will be talking with a friend who is a lawyer tomorrow and seeing what is what. I don’t feel I should have to pay my medical expenses on this one. That’s all I’ll say for now. I’d say I’m fine, but that’s not a medical diagnosis.

 

 

It’s been two weeks since my surgery and so far I have to say that it’s been very successful. Of course I’m not a physician so my increased mobility, lessened pain, and improved mental state might just be an illusion.

The wound appears to be healing and isn’t as tender as it has been in the past. I’m also finding less and less to clean up when I change my dressing. Keep in mind that, per doctor’s orders, I’m keeping it open to the air whenever possible: basically at home. I do dress the incision lightly when I go out, mostly to keep clothing from rubbing the site. In addition I haven’t seen any signs of infection. That’s sort of a worse case scenario so I check frequently and strive to keep the area clean.

I’m still swollen in the area, though it is certainly less so that even a few days ago. I’m doing my best to keep the leg up when home, it’s not actually that convenient, but one does what one can. I do find that it’s a bit more swollen at the end of the day than at the beginning but as that seems to make sense it’s not worrying.

As for pain, I still have muscle pain from the strain put on by all the stretching. Here’s an animation of the process and you can see why the muscles might be a bit stressed. Please note that while this is animation of an anterior hip replacement I can’t say that it actually resembles the process used on me. It’s similar for sure, but as technique and tools probably vary to some degree and I’m not an expert take it for what it is:

Suffice to say that things are definitely improving. I’m still using the pain medication, though not much. It’s helpful, but I can see the end of the tunnel. I’m going to stay on it till I see my doctor in a couple of days and ask if I can switch to Tylenol (plain – no extras). Until then I’ll continue to follow directions. I don’t want to take something that might have a bad interaction with the other things I’m on.

I’m still using a cane. I rely on it less for support now than simply for for safety. Prior to surgery I really needed it to take up a good deal of my weight, now it’s mostly to make sure I have a secure base from which to move. I can walk normally without it for short distances but as I don’t want to take chances I only do it as a demonstration for friends and only for a few feet. I suspect I’ll be keeping a cane near me for a while yet.

I have more and more energy every day which is great but as I’m only two weeks out I don’t want to overdo any activities. I can tell at the end of the day when I’ve done too much. Yes, I can certainly tell.

My PT activities continue and generally feel great. Stretching out tight muscles can be a bit painful but it’s an odd “good” sort of pain. Indeed it’s almost time for me to stop writing and go home and exercise a bit.

All in all my guess is that I’m recovering at a pretty good pace. I don’t really have anyone to compare myself to and really that wouldn’t be a great idea anyway. We all have our own pace for healing.

That’s it for now. There’s really less and less to report about my surgery, barring a sudden change anyway. When I see the doctor (actually his assistant I think) I’ll report again.

Aloha!

You can tell I’m getting better if I can think about something other than my hip!

Or maybe not if what I’m thinking about is a banjo. Do I need one? I already own three guitars, two mandolins, at least three ukuleles, but no banjo. None. Not even one. I don’t even own one of those little pins you can buy and stick on hats or whatever to show what instrument you play. Okay, I don’t own any of those for the instruments I do play either.

But why a banjo? Admittedly I haven’t mastered any of the instruments I already own. I can play them enjoyably, but certainly well by any means. Although, from an amateur philosophic point of view, if I enjoy playing them, I’m doing well.

I don’t really have an answer for the question other than to say I just sort of want one. Sigh. I guess it’s good I want something like that instead of a new car. I mean I could certainly buy a banjo as expensive as a car, but they one I’m thinking of is a beginner sort running around $400.

 

I can get one of these locally, which is preferable, especially for musical instruments as I can try it first (or try it again really).

Can I resist? Should I? Will shopping help my hip? Argh!!!

Aloha!

After going on and on about what a great day Tuesday was, and it was, I have to admit that yesterday, Wednesday, wasn’t quite as great. No, I didn’t have a lot of pain, but I also didn’t have a lot of energy.

Ultimately that seems to be what I’m about these days: energy. Every day is a bit better than the day before, but I haven’t yet felt like I’ve a had a full day’s worth of get up and go. I was pretty darn busy before my surgery, perhaps even doing so much to keep my mind off the pain of a pre-op hip. But just the thought of being that busy exhausts me. I’ll get back to it I’m sure, but for now, rest is an integral part of the day.

Today will be an interesting challenge. I’ve been sleeping in since the surgery and today I had to be at PT at 7 AM. Ouch. Okay so during normal times I’m at work at 6 AM, but hey, I’m off work and am supposed to be taking it easy, except during PT of course.

That meant I was up around 6 AM to clean up and take my meds. Yes, I’m still taking pain medication as recommended, that is to say, before PT. I haven’t felt the need to increase my dosage from the twice daily 50 mg pills I’ve been on which is great. Conversely I haven’t felt I’m able to go down to just one dose yet either. There’s no hurry, but I don’t want to find myself dependent on them either,

I also hadn’t really had time to stretch out, sort of a pre-PT PT, so this morning’s PT session was a little more painful than the previous two. Still, once the kinks were worked out, I felt pretty good. I learned a couple of new exercises including balancing on one leg which it seems I’m pretty good at and doing a different sort of leg lift at which I’m not good at all. That’s the one to work on I suppose.

I was also back on the stationary bike and had it up to 90 RPM for my 5 minutes today. It felt great, no pain at all. I’m still not allowed on a real bike though. Sigh.

And now we’ll find out how much energy I have today. I have evening plans so I’ve got to keep myself good to go for that. This pretty means, if things run their normal course, that I’m already mostly done for the day. Or will this be the day I get an extra few hours of pep? It’s darn hard to know.

So what’s the score so far? I’ve been out of the hospital for a week and out of those seven days I’ve really only had one bad day: more of a bad night really. My meds are down about as far they can go and still do their job and it seems I still need that job done. My energy level is improving but by no means back to normal. I’m told by my therapists that I’m doing really well and while I’m sure some of that is said to keep me motivated I also think it’s mostly true. All in all things are good. Part of me thinks I should be farther along, but it’s a small part and it is wrong. My wound hasn’t completely healed yet so I’m still rebuilding actual flesh, I’m supposed to be a bit tired. What I’m coming to believe is that tomorrow should be even better. Yes!

Aloha!

Tuesday was a great day. I don’t mean that anything unusual happened or that I suddenly could run at top speed, or at all for that matter. Indeed, after eight days I’m still hurt when I move, though again, it’s not nearly as much as I might expect, especially when I’m fresh.

The wound has not completely healed and I’m getting a little drainage, non-infectious thank goodness, requiring me to use bandaging when I dress. Earlier on this was not happening but for the last couple days I’m getting a few drops. This happens pretty much only when I’m sitting. My suspicion is that as part of swelling would naturally be excess fluid, as the swelling subsides the liquid has to go somewhere. A few drops are finding their way out through what amounts to a hole in my leg. In truth the cut itself is dry. The leakage is coming from a small patch near the cut that appears to be caused by something other than a knife.

But I digress. There’s no problem here or so my PT person tells me. Though I remain on the watch for any signs of infection. So far so good.

No, the great part of the day has nothing to do with that. Basically it has to do with my second PT session where I was complimented again on my apparent willingness to follow directions and the speed at which I seem to be improving.

I was reminded by the therapist that I can thank myself for my recovery in that I kept riding my bicycle until the week before surgery. He said that thanks to the fact that I kept up this exercise my legs were in excellent shape before the operation. That alone accounts for much of the outcome so far. In other words, if one expects to have this surgery one should do everything they can to get in shape before hand, don’t slack off. I was very lucky in that cycling never hurt thus I was not compromised. If walking or running were more to my taste I might have had to find something else.

In any case, the therapist, a replacement as my own was out sick, pushed me hard today, starting with my five minutes on the stationary bike. Like last week there was no pain and I had to be told to get off. Oh well.

Then I demonstrated the other exercises I’d learned, at full energy. I worked up quite a sweat and felt pretty good about things. I might note that I did take a Tramadol about an hour before the exercise session.

Then I was helped at shopping by a friend with a pickup truck. She’d given me a ride to therapy, which was great because it was raining, and ran errands in town while I exercised. I’d asked for help because I wanted to stock up on paper products and some other things that are just hard to carry in any amount on a scooter.

No rest for the wicked I’m afraid because as soon as shopping was done it was time for laundry, something I didn’t get to do last week as I was still in the hospital. I may have mentioned it before on the blog, but we have assigned laundry times and, while we can switch or use open times, it’s just easier to use your own time.

My concern over laundry was caused by the fact that the machines are on the roof, a full flight of stairs after the last floor serviced by our elevator. I’ve had trouble getting my rolling basked up the stairs before because of the bad hip and I wasn’t so sure I was ready given my current, albeit healthier situation.

I needn’t have worried. I won’t say it was hugely easier getting to the laundry area but it was easier. It was still work, but in the end I have clean clothes.

And here’s why it was a great day. For the first time in months and months I was able to walk up and down stairs using both legs as they are meant to be used. I’ve had to use my right leg to do all the hard work and pull the left even with it going up or down till today. Yes, I needed my cane and the rail of the stairs. But it was normal.

I know it seems pretty tiny, but mentally it was huge. Sometimes we forget just how important little things can be till, after a period of loss, we get them back.

After that I went out for a burger with a friend and came home completely done in. I did have that second pain pill today after laundry, and am grateful I did because all the exercise I’d done really started an ache (not worse than any I’ve had, but an ache nonetheless). I remembered something I’d been told by my doctors, that in cases like this it’s important to take pain medication in advance of exercise and movement.

This seems foreign to me as it leaves open that excuse of, “I’ll take this just in case I have pain later.” But they are right. It takes an hour for the effects to be felt and you don’t want to show up at PT in pain before exercising, just as you don’t want to go out, where you’ll have to walk around, in pain. Plan ahead.

For the record I’m still a low twice a day dosage of 50mm of Tramadol. Well under what I’m allowed and, while I’ve been at this level for a couple of days, the trend would still be down after eight days.

You might note by the time of this post that I’m up fairly late, but it isn’t because I’m having a bad night. I went to bed ridiculously early this evening, and have already had several hours of sleep. I’m headed back now and don’t think I’ll have much trouble nodding off.

Tomorrow? No real plans actually. No laundry, that’s for sure.

The course of a hip replacement never did run smooth.

Last night was less than the best night I’ve had. I’m not quite sure what was going on but I had more pain than I’ve had since those early nights in the hospital. I think that perhaps I’ve been doing a bit more than would normally be suggested and things just caught up to me.

How bad was it? In truth, it really wasn’t as bad as my opening statements might make one imagine. It was just unpleasant. I’ve had worse nights prior to surgery. Still it did make me want to get out of bed and take extra painkillers. I hadn’t had any since late afternoon so I was ‘allowed’ by the prescription to take more, but I didn’t.

I’m really trying to wean myself off them completely. Perhaps it’s foolish to think I can be done with them so quickly, but I’ve spent a lot of time in pain with nothing stronger than an NSAID or two so I’m not unused to pain. If the truth be told, I’m really rather afraid of addicting myself to the other part of the pill, that feeling of euphoria that comes along with opoids.

I’m on Ultram (Tramadol) and am currently allowed a full 100 mg every six hours. That would be a bit much. In fact other than the first day in the hospital i haven’t had that much. I never asked for morphine in the hospital which I was allowed and really haven’t needed all that much of the Ultram either.

On Tuesday last week, in the hospital, I think they actually only gave me three doses of 100mg each. I didn’t get any before bedtime and spent that night just fine. The next day, Wednesday, when i was to be released, I was given 100mg in the morning, but only 50mg in the afternoon before I was released. That evening I took one more 50mg for a total of 200mg.

The next day I started using only 50mg doses and, as I recall, only had three doses for a total of 150mg. On Friday and Saturday I did the same, but yesterday I only gave myself two doses of 50mg each for a total of 100mg.

That could explain the pain in the evening but frankly I haven’t been taking a bedtime dose for the entire week since surgery. They weren’t giving me one in the hospital so I followed their lead and figured that as long as I wasn’t moving I wasn’t in pain (true) so no medication was necessary. Last night I wasn’t moving and I was in pain. Go figure.

Ultimately I changed my position in bed, did a few stretches, tried to meditate and slept after an hour of unpleasantness.

What makes me think I’ve been overdoing it is that this morning I slept late and deeply. Normally I wake up around the time I’d normally start getting ready for work, 4:30 AM. Today I woke up around 8:30 AM.

I’m not in much pain today so it was transitory. I did a dose an hour or so before I went out today. I was told to do that, especially before PT so that I can do the exercises comfortably. Once I felt the effects (very mild) I did my daily PT and haven’t had any problems since. I haven’t been doing a lot of moving around though. Basically I’ve sat in a couple of places for an hour so each time. I’m soon headed back home and to bed before perhaps having dinner with a friend.

Pain is a warning that something is wrong, but it’s not all that helpful when the ‘wrong’ was inflicted on purpose to make something right. I’m going to get better, I know that. Sometimes it’s just frustrating that it doesn’t happen immediately. Still I know from what I’ve seen that my experience so far has been quick and better than expected. I’m grateful for that.

Aloha!

It’s been almost a week since my hip replacement and, gosh, I’m not running marathons yet. Actually I wouldn’t be running them anyway so it’s no big loss. Actually I’ve never liked running. Period.
All kidding aside I’m doing pretty well. On Friday I had my first PT session and it went very well. My PT person, who is someone I’ve worked with before, is impressed and happy with my progress so far. In fact, he even let me ride on a stationary bike, something he said he normally wouldn’t do this early without the progress I’ve made. I rode for five minutes at about 80 RPM with no pain. None. He had to make me get off the bike. Then he bribed me by saying if I did my exercises between Friday and Tuesday when I go back he’d let me ride it again, maybe for longer.
I was pretty beat after that so after a quick trip to the drug store, more cane tips, and coffee it was time for a nap. I did go out for a walk in the evening and did about four blocks with a break in the middle, rather a long one, but hey, I’m in recovery.
Saturday I had planned on getting out early but that didn’t happen. I’d forgotten that everything takes longer than you expect, especially in recovery. I did get in a shower which was much needed and even washed my compression hose. By the time I got out it was time for lunch so that ended up being more or less the entire plan for the day. I did a few emails, had some coffee, and ate a nice light lunch at a sushi place on Keeaumoku. Then home.
[While writing this at Starbucks on Ala Moana near Kakaako Park the fire alarm went off and we were all asked to evacuate the building. That’s a first for me at Starbucks. I don’t know the outcome because, having already finished my coffee I simply went home for yet another nap. Strange though.]
On Saturday night I was taken out for a celebration by some of my best friends. We had Chinese food in Niu Valley then had a bit of a get-together. It was good fun, not too stressful, and really helped show me how many friends I have. I’m grateful.
Sunday, today, seemed a bit hot and muggy and by the time I’d exercised and gotten myself together I was sticky and, while not really tired, just wanted to sit somewhere cool. I went to Dole Cannery Theatres and took in the latest Captain America flick. Not bad for a Sunday matinee. It was just mindless enough and cool enough to pass the afternoon. I did have to move though as it seems some folks don’t care to keep their kids from talking through a movie. I’m not a parent, what do I know?
Then it was off to try to write this post and, as noted, I survived a fire alarm evacuation!
That’s been it. I’m headed to the shower now and then will figure out if I’m headed out this evening for a bit. I think so, I’m not really in any pain so I’m not concerned that I’ve overdone it today.
So far so good.
Aloha!