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Pradnyadeshmukh8's Blog

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Month

July 2011

Few wow factor restaurant in london

Big and beautiful flash and showy or unexpectedly impressive wow factor makes an event unforgettable.

1) 40|30 at the Gherkin.

Location:-The city—-Nearest tube:- Aldgate—-Cuisine:- French

40|30 is the restaurant and bar at the very top of the gherkin- one of the most iconic building in london. So if you are looking to impress you know what they say :big building, big party.

2) Altitude 360

Location:-Westminster—-Nearest tube:- Pimlico—-Cuisine:- British

Altitude 360 London is situated in the heart of Westminster in London’s famous SW1, right next to the London Eye, The Houses of Parliament and The River Thames. The venue commands stunning views over all of London and her prominent landmarks.

3) Attic London

Location:-Canary Wharf—-Nearest tube:- South Quays DLR —-Cuisine:- Canapes

The attention to detail of the interior is staggering with ‘50s style furniture offering commodious comfort whilst a panoramic view of London brings an unadulterated wow factor. The bar is surrounded by black granite and the precious stone Tiger’s Eye flown in from India.

4) Hurlingham club

Location:-Fulham—-Nearest tube:- Putney Bridge —-Cuisine:- British

Bordering the Thames in Fulham and set in 42 acres of magnificent grounds, The Hurlingham Club is a green oasis of tradition and international renown. Recognised throughout the world as one of Britain’s greatest private members’ clubs, it retains its quintessentially English traditions and heritage, while providing modern facilities and services for its members.

5) The landmark

Location:-Marylebone—-Nearest tube:- Marylebone —-Cuisine:- British/Afternoon Tea

Whether for business or please, this hotel caters to your every need making it a landmark by name and nature.A lavish banquet in the The Grand Ballroom after a dramatic entrance through the atrium of the hotel mesmerises your mind.

6) Vista

Location:-Trafalgar square—-Nearest tube:-charing cross —-Cuisine:- Modern Europe

A stylish oasis above the chaos of trafalgar square, vista is a design as sophisticated as the view. In true London style, the sleek, monochrome design tells a story of the city in all its fashionable, trend-setting glory. With black polished tables, smooth white stools, charcoal decking and signature patterned cushions, the design achieves a neutral yet striking space.

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Canape Cuisines

Lately i was suffering  to some recipes where in i encountered this word canapé recipes.My increased curiosity led us to a hotel themed with canape cuisine.

canapé is a small, prepared and usually decorative food, held in the fingers and often eaten in one bite.

Because they are often served during cocktail hours, it is often desired that a canapé be either salty or spicy, in order to encourage guests to drink more. A canapé may also be referred to as finger food, although not all finger foods are canapés. Crackers or small slices of bread or toast or puff pastry, cut into various shapes, serve as the base for savory butters or pastes, often topped with a “canopy”

The French started offering canapés to their guests in the 18th century, and the English adopted the practice at the end of the following century. One modern version of the canapé is the amuse-bouche. Amuse-bouche literally means “mouth amuser” but is translated more delicately as “palate pleaser”

Being a vegetarian few canape recipes go well with cocktails are:- Tomato tarte tatins and Mini lemon Tarlets.

21st Feb 2011-Hydrodilatation

Reached hospital 2 mins late for the appoitment.I was asked to remove all the metals that i wore on my body. I changed into the hospital cloths and was asked to wait for 5 mins till the operation theater was getting ready.

I sat looking around the hospital and trying to gulp my fear.My friends revathy and srenuka were waiting  outside, in the lobby, looking towards me. The expression in their eyes was hilarious…. it was u have to be brave for the operation but at the same time they hoped it doesn’t cause me much  pain. My husband-vishal was looking into some papers to be signed.

In mids of my thought i heard  nurse calling my name, once i went to her she asked me to step in the operation theater and I looked in the direction of vishal, revathy and srenuka. They waved me a thumbs up–convening best of luck.I nodded my head and went inside.

I was asked to lay down on the operation table. My effected left shoulder was rubbed with a antiseptic spray and a local anesthesia was given. I was so scared, the doc saw the expression and started a conversation with me.He asked me about the condition and what i did for living etc etc etc etc.

He injected a needle syringe on my shoulder through which the hydrodilation water (or what ever you call) could pass in my body. I didn’t feel perk of the needle but suddenly i felt such a great pressure on or inside my shoulder that i started to shever.The pressure was so intense i felt like some one has kept the 50kg dumbels on it. Than with in next 2 sec it got all relieved…..he repeated the same procedure for one more time and then it was over.

Doc said the process was successful and i can go ahead and enjoy my day.I thought the doc was jerk. Anyways came out got dressed and started towards home. 3 of them (revtahy, srenuka and vishal) were so anxious to know. I told them everything and tried to relax a bit as my shoulder was giving me a tough time.It was paing as the anesthesia was becoming inactive. Reached home and had lunch prepared by my friends.To distract my self we all sat to watch a movie as always.By the time the movie was over my pain had gone and suddenly i realized my hand was no longer stiff.

Out of curiosity i moved my hand and wola…..i had my movements up to 70% . Couple of hours before I could not lift my hand and here i am with all the stiffness gone….hurray celebration time.I couldn’t believe what magic had Hydrodilatation done to me….I am very thankful to the god for such a miracle.I was supposed to go in for physiotherapy session for next 8 weeks which could improve the hand movement.

From that day onwards i was able to pull out shelfs, comb my hair without pain, eat food with fork and knife (of course with both the hands), take shopping bags i.e weight, finally run fit.I was extremely happy with the result…..Felt wried for all the people who didn’t get success in the blogs that i had read to gain confidence. So readers i would say please try hydro-dilatation if you have an option.

Way to treat the frozen shoulder in my case

After evaluation of frozen shoulder my doc advised to go in for physiotherapy sessions for 12 weeks. Depending on the improvement we could take it fruther.It sounded fair to me.

Started my physiotherapy sessions in mid Nov 2010 till jan 2011 end.There was a 10% improvement in my hand. With regular visit to hospital twice a week the pain was not much but the hand movement was restricted.

The orthopedic evaluated my condition in feb 2011 1st week. He realized the movement was not as per accepted, my hand was still stiff but pain had reduced drastically was rather to put it this way- i was use to pain.Way forward was to either surgery or hydrodilation or leave it on its own to heal.

1) Hydrodilation:-

Some cases of frozen shoulder or adhesive capsulitis are very resistant to the normal treatment methods used and the pain and limited movement persists for many months.

Hydrodilation or hydrodilatation (the two words mean the same thing) is a unique way to improve frozen shoulder. It works well for almost every case of a frozen stuck shoulder.

The principle is simple really.

The sticky adhesions of a frozen shoulder cause the joint capsule to stick to the bones and to other parts of the capsule – leading to pain and limited movement. By using an x-ray machine to guide a needle into the shoulder joint and then using that needle to inject fluid under gentle pressure, these sticky adhesions can be teased apart and stretched – causing a release from the pain and stiffness.

2. Surgey

Frozen shoulder is a self-limiting Condition.The key is to find a way to obtain pain relief while nature gets on with the job of regaining normal movement and function. Nature achieves this in almost every case. That doesn’t leave much of a role for surgical treatment!

Operations for frozen shoulder tend to be reserved for those who have failed to gain pain relief from other means or who have ongoing stiffness and loss of function after long months of treatment. Modern surgery for frozen shoulder involves going into the joint with an arthroscope (a camera) through a very small incision. The surgeon can see any tight areas in the joint capsule and can free up the joint by separating any stuck sections. Some surgeons previously manipulated the shoulder very aggressively when the patient was under anaesthetic but this technique is now rarely used. It was often effective but carried quite a high risk of damaging the joint or the bones of the shoulder region.

3. Leave it in its own:- Nature works out a way to heal the frozen shoulder, so you can leave and it will heal eventually.

My choice was to go ahead with hydrodilatation.mI dint wanted to go in for another surgery as i have seen the effect of 1 before. As there was no alternate choice than to go in for hydrodilatation. Doc refered me and i got an appointment on 21st feb 2011.

Mean time i thought to google out about this process. I read many blogs who didn’t hd quite a good experience and resulted in more mess. I was really worried but had no option.

Hydrodilatation simply put is a process in which a salt water is injected in your shoulder. Due to the excess pressure the capsules expands and breaks realising all the joints.Scary right….even i was.The follwoing fig shows when the injection is important.Tried to be clam and go ahead with the process.

Landed in frozen shoulder (from clavicle fracture)

After meeting an accident which broke my clavicle bone, I meet an orthopaedic in Nov to re-exam my situation.Thats is after  5 months. The doc who operated me had assured that i would be running fit and fine with in 2 months. I want to tell him(if he is reading the blog) i am still not able to run fit.Hence the situation give opportunity for a  second opinion.

Movement of hand was 20 to 30% as compared to the earlier static situation– in my opinion it was much better than before.I was hoping after physiotherapy session i would be running fine. The day arrived –had a evaluation and the result was told in fraction of second. I have developed frozen shoulder.

Little brief about frozen shoulder:- Frozen shoulder (sometimes called adhesive capsulitis) is a condition where a shoulder becomes painful and stiff. Shoulder movements become reduced, sometimes completely ‘frozen’. It is thought to be due to scar-like tissue forming in the shoulder capsule. Without treatment, symptoms usually go but this may take up to 2-3 years. Various treatments may ease pain and improve the movement of the shoulder.

Reasons for frozen shoulder:-

The cause is not clear. It is thought that some scar tissue forms in the shoulder capsule. The capsule is a thin tissue that covers and protects the shoulder joint. The scar tissue may cause the capsule to thicken, contract and limit the movement of the shoulder. The reason why the scar tissue forms is not known.

A frozen shoulder occasionally follows a shoulder injury. However, this is not usual and most cases occur for no apparent reason.

What are the symptoms of frozen shoulder?

The typical symptoms are pain, stiffness, and limitation in the range of movement of a shoulder. The symptoms typically have three phases:

  • Phase one – the ‘freezing’, painful phase. This typically lasts 2-9 months. The first symptom is usually pain. Stiffness and limitation in movement then also gradually build up. The pain is typically worse at night and when you lie on the affected side.
  • Phase two – the ‘frozen’, stiff (or adhesive) phase. This typically lasts 4-12 months. Pain gradually eases but stiffness and limitation in movement remain and can get worse. All movements of the shoulder are affected. However, the movement most severely affected is usually rotation of the arm outwards. The muscles around the shoulder may waste a bit as they are not used.
  • Phase three – the ‘thawing’, recovery phase. This typically lasts anywhere between five months and four years. The pain and stiffness gradually go and movement gradually returns to normal, or near normal.

Symptoms often interfere with everyday tasks such as driving, dressing, or sleeping. Even scratching your back, or putting your hand in a rear pocket, may become impossible. Work may be affected in some cases.

There is great variation in the severity and length of symptoms. Untreated, on average the symptoms last 2-3 years in total before going. In some cases it is much less than this. In a minority of cases, symptoms last for several years.

As per the docotr’s evaluation i was in second stage, the 1st stage had passed. I really felt like hell….

The most obvious question that i asked the doc was as how to get rid of frozen shoulder. His answer was

What are the treatment options for frozen shoulder?

The aim of treatment is to ease pain and stiffness. Also, to keep the range of shoulder movement as good as possible whilst waiting for the condition to clear. One or more of the following may be advised to help ease and prevent symptoms:

Ordinary painkillers

Paracetamol may be advised first to try to control the pain. Codeine is a stronger painkiller which may be used as an alternative to, or in addition to, paracetamol. Constipation is a common side-effect from codeine. You can take ordinary painkillers in addition to other treatments.

Anti-inflammatory painkillers

Examples of these include ibuprofen.. These drugs work by helping to ease pain and also by reducing any swelling (inflammation) in your shoulder. There are many different brands. Therefore, if one does not suit, another may be fine. Side-effects sometimes occur with anti-inflammatory painkillers. Always read the leaflet that comes with the drug packet for a full list of cautions and possible side-effects.

Shoulder exercises

These are commonly advised. The aim is to keep the shoulder from ‘stiffening up’ and to keep movement as full as possible. For most benefit, it is important to do the exercises regularly, as instructed by a doctor or physiotherapist.

Physiotherapy

Many people are referred to a physiotherapist who can give expert advice on the best exercises to use. Also, they may try other pain-relieving techniques such as warm or cold temperature packs and TENS machines.

A steroid injection

An injection into, or near to, the shoulder joint brings good relief of symptoms for several weeks in some cases. Steroids reduce inflammation. It is not a cure, as symptoms tend to gradually return. However, many people welcome the relief that a steroid injection can bring.

Surgery

An operation is sometimes considered if other treatments do not help. Techniques that are used include:

  • Manipulation. This is a procedure where the shoulder is moved around by the surgeon while you are under anaesthetic.
  • Arthroscopic capsular release. This is a relatively small operation done as ‘keyhole’ surgery. It is often done as a day-case procedure. In this procedure the tight capsule of the joint is released with a special probe.

Although surgery has a good rate of success it does not help in all cases.

Hola, again a surgey.1 week i was depressed and thought to myself…..is this real.Than i tried to movie my hand and got the feeling of being real with the pain.So readers i managed to land in frozrn shoulder from a clavicle fracture…..

2 months after surgery (from 15th June 2010 till 15th August 2010)

The improvement of hand was not as accpeted.  The  Healing time varies based on age, health, complexity and intensity  of the fracture as well as the bone displacement. For adults, a minimum of 3–4 weeks of sling immobilization is normally employed to allow initial bone and soft tissue healing, teenagers require slightly less, children can often achieve the same level in two weeks.Usual my scars or any body injuries do not heal fast,so i was excepting the progress to be slow.Pain was still there with restricted hand movement. Though the movement and flexibility increased with time but it was not perfect.

By July 28th i flew to UK due to my husband nature of work. He had to fly in little early due to work pressure.Hence i was travelling all alone on 28th july. Had a direct flight, did my security clearance  with people eyeing me as a drug dealer with the security door beeping so loud.Got settled after lot of struggle.With the help of pain killer i was hoping the journey to be better…..

The food was served (Obviously with fork and knife), i was waiting to gulp the food so that the painkiller would land in my stomach and kill the pain. As soon as food was served, i had only 1 right hand to cut the food and eat the food which otherwise people do it with both the hands.My fracture is on left hand and it was immbolized.

A gentleman sitting beside,, some where aorund 32, profeesionaly dressed with nice slim body, observed what i was doing and after some times he spoke to me – his words were,”’I can teach you how to eat with fork and knife”’ and i told him, ”’I can give you my fracture and than you can teach me how to eat with knife and fork”’.He kept mum for the whole journey….good for him….That was the 1st hilarious incident after fracture.

Never mind, landed in uk. Struggled with the left hand for next 2 months and consulted GP to recommend a physiotherapy sessions thought that would be a break through the pain. By hand moved 20% with all the jerks that felt while seating in car.

Post surgery (15th june 2010)

As per doc the surgery went well no complications whatsoever.Felt relaxed.But had a server pain in left collarbone, couldn’t  even move the hand forget about lifting it.

Next 15 days had severe pain due to infection, the doc said there are high chances of injection in any metal implant.Doc suggested to in for a 2 a day antibiotic injection for 8 days to kill the injection.

Finally got relived of the pain.But couldn’t lift the hand nor move it, felt really handicapped.Requested the doc to advice for physiotherapy ,but he said collar bone fracture do not normally need a physiotherapy.As per him i should have been running by 1 month.But reality is i couldn’t walk fast forget about running.

Deciding the treatment for the Clavicle fracture/collarbone fracture

Got operated with a implant which is screwed to my collar bone with 4 screws.Wow what a accessories on the body!!!!!!!!!

For rest of my life i have to carry a hospital stamped certificate indication the size and location of the implant in my body to avoid misunderstanding of a drug dealer.Surgery was smooth as per doc.As per normal terms doctor said i should be running within 15 days.

Let me tell you what is a clavicle fracture/collarbone fracture.A clavicle fracture is a bone fracture in the clavicle, or collarbone. It is often caused by a fall onto an outstretched upper extremity, a fall onto a shoulder, or a direct blow to the clavicle. In my case i had fallen on my shoulder.

There are 2 types of treatment to deal with a clavicle fracture depending upon the complexity of fracture

1) Non operative:-

Treatment usually involves resting the affected extremity and supporting the arm with the use of a sling.

In older practice, a figure-8 brace was used, designed to immobilize and retract the shoulder, maintaining symmetric positioning to facilitate healing. More recent clinical studies have shown that the outcomes of this method were not measurably different from simple sling support, and due to the movement difficulties caused to the patient, this method has mostly lapsed.

Current practice is generally to provide a sling, and pain relief, and to allow the bone to heal itself, monitoring progress with X-rays every week or few weeks. Surgery is employed in 5-10% of cases. However, a recent study supports primary plate fixation of completely displaced midshaft clavicular fractures in active adult patients

More than 90% of clavicle fractures are successfully healed by non-operative treatment.

If the fracture is at the lateral end, the risk of nonunion is greater than if the fracture was of the shaft.

2) Surgical:-I fell into the remaining 10%

The surgery is indicated when one or more of the following conditions presents.

  1. Comminution with separation (multiple piece)
  2. Significant Foreshortening of the clavicle (indicated by shoulder forward).
  3. Skin penetration (Open Fracture).
  4. Clearly associated nervous and vascular trauma (Brachial Plexus or Supra Clavicular Nerves).
  5. Non Union after several months (3–6 months, typically)
  6. Distal Third Fractures which interfere with normal function of the ACJ (Acriomio Clavicular Joint).

A discontinuity in the bone shape often results from a clavicular fracture, visible through the skin, if not treated with surgery. Surgical procedure will often call for ORIF (Open Reduction Internal [plate] Fixation) where an anatomically shaped titanium or steel plate is affixed along the superior aspect of the bone via several screws. In some cases the plate may be removed after healing, but this is very rarely required (based on nerve interaction or tissue aggavation), and typically considered an elective procedure. Typical surgical complications are infection, neurological symptoms distal the incision (sometimes to the extremity), and non-union requiring re-plating.

I had 2 fractures, so had to go in for a surgical method in order to heal or seal the bone in correct position.

Meet accident – acquired clavicle fracture( on 14th June 2010)

I got married on 30th May 2010, after hectic preparation, shopping  and after marriage rituals —-Honeymoon was the prefect break. I dont really understand why they call it honeymoon……..for me it was a relax-moon.

Our planned honeymoon was in goa. 6 days in goa was awesome with beaches, night parties, temporary tattoo and various food to please our taste buds.

On our last day, we headed form north goa to south goa for our dinner at about 7 in the evening.It was a prefect weather -slight drizzle at the sunset.On the way our bike sid and v fell off. As normal got up checked for any inquires, no visible ones hence got relived and where about to start I realised near my left neck…..something pricked. My husband’s visual contact told me i had a swollen muscle.

Just to be sure on safe side we decided to see a doc.I told myself it was just a minor accident a normal skid……what would happen that wrong? After inspection, doc relieved  i have 2 (Vertical and horizontal)  fracture on my collar bone. What the hell? Notting wrong could happen more than this…..

We hit mumbai, doc said i need to have implant in order to help my bone join correctly.Hence a surgery.With the surgery my bone structure is as—–

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