A Fortuitous Fall?

July 4, 2011

My knees are almost completely healed from their replacement last November … except, they still don’t bend quite as far as they should.

A friend had her knees replaced in May, but has just had an additional little procedure done by the doctor that broke up scar tissue that was keeping her knees from bending as well as they should.

So, that made me wonder if I had missed the boat by not asking about that procedure soon after my surgery.  I was thinking I might make an appointment (I haven’t seen the knee doctor since December) just to see what the doctor  had to say about my flexibility.

Then the other day (a very hot morning) I was watering flowers on the deck barefoot (which I don’t normally do) and discovered that that composite decking apparently really holds the heat, because it was reallllly hot on the bottoms of my feet, so I hurried to the two steps down to the yard to get off the deck.

But being distracted by hot feet and hurrying I missed the first step, lost my balance and fell, huge plastic watering can and all, face-first into the yard.  (The picture flashed through my mind of  people sitting behind windows in homes on the other side of the lake, sipping their morning coffee and chuckling at the free entertainment.)

I can’t decide if having the watering can in my hand was a blessing or not.  On the one hand, it may have broken my fall because it hit the ground first.  But, on the other hand, if I hadn’t been holding it, I might have done a better job of catching myself with my hands.  My knees hit first (oh-ohh) and then I went down on my face.  Luckily the grass somewhat padded the fall.

I immediately got up not wanting to entertain the neighbors any longer than necessary, if they were watching (ahh, vanity)) and was relieved that my knees still worked!  But I was also surprised that while the fronts of my knees had some small abrasions, it was the backs of my knees that really hurt!  So I went in the house, took a couple aspirin, and waited to see if they would get better or worse as the day went along.

They never felt any worse.  In fact, the next day they didn’t hurt at all!  And the big surprise is … they seem more flexible than they did before the fall!

So, I’m thinking my little unexpected fall may have done for me what my friend’s visit to the doctor accomplished.  And my version was free!   That seems to have turned out to be a very fortuitous fall.

Progress: High Heels, Low Kneels and Sweat

January 18, 2011

Small milestones make progress noticeable.

On Sunday I wore heels to church for the second time.  It’s now confirmed that I actually can wear heels for a few hours without falling off of them, turning an ankle or having my knees become painful — that first time wasn’t just a fluke.

When we take communion at our church, the lines of communicants walk up three steps to the level of the communion rail with a padded kneeler in front of it.  Without thinking, for the first time I walked up the steps without holding on to the hand rail on the side of the steps.  But when I got to the communion rail, I didn’t kneel.  I haven’t knelt on my knees at all since the surgery, and I didn’t think at the communion rail was the place to find out that kneeling created horrible pain that made me scream in agony.  So I stood for communion, but after the service I asked Hubby to go up to the communion rail with me again, and I tried out kneeling.  No problem at all, including no problem getting down and up from the kneeling bench, so I’ll be prepared next time.

And yesterday, I did another first.  I went back to the gym with Hubby for the first time.  I had no idea how my new knees would handle my routine of tread mill, followed by 12 reps on nine different Nautilus apparatus, followed by the Nu-Step (a version of a stationary bike).  It went really well.  I shortened my time on the treadmill and Nu-Step, and lessened the weight on the Nautilus machines that involved my knees, but was able to do all of it without pain.  It actually felt good to work up a little sweat (although I prefer to think of it as a “glow”) again!

The road to recovery is made more tolerable when you see a sign of progress here and there along the way.   And I think I’m beginning to actually see my destination of complete recovery on the horizon.  Hooray!

The song bird in the nest

December 12, 2010

In a recent post I pictured the rehab facility where I stayed for 10 days as my “nest”.  Well, there was a very special “little birdie” who I got to know in that nest, and I would like to tell you about her.

Bertie was a wonderful purveyor of kindness and smiles as an aide at the rehab center.  A caring, loving soul who always moved quickly about her business, doing whatever needed to be done.  One time when she walked past the therapy room while I was there, I said something out loud about what a wonderful, kind person she was.  One of the therapists responded that the atmosphere of the whole facility was noticeably lighter and happier when Bertie was in the building.  What a wonderful thing to be able to say about anyone.

The very first day I was there, Bertie came into my room to introduce herself.  And she told me she loves to sing and offered to sing a song for me.  What a nice offer, so of course I said “yes”, but I didn’t have much of an expectation of what  she would sing.  She asked if I liked country music, which I do, so she said she would sing Hank William’s “Cheatin Heart”.

Whatever I expected, I couldn’t have possibly anticipated the beautiful, clear, even sophisticated  alto voice that came out of sweet Bertie (think Patsy Cline without the twang). I am always impressed by a singer whose every word is clear and understandable, and that was her.  But also, she has that talent to add interesting intonation and extra notes to a song, as professional singers do.  But at the same time, her singing was simple and straight forward.  No theatrics, no gesturing, just a beautiful voice.  She also sang a little ditty for me that she had written about herself.  What a treat!  And then she hustled on her way, spreading her good cheer to other patients, while doing her job.

I hope Bertie didn’t think she was done with me when she just sang for me once!  Because from then on, if I had a visitor in my room and saw Bertie going by in the hall, I would ask her if she had a minute to sing “Cheatin Heart”, and she always complied.

An added bonus was a hug from Bertie.  She always smelled so fresh and clean and just enveloped you in a warm, loving hug.  I never had a grandma who gave me those kind of hugs, but in my dreams they would have been just like Bertie’s.

As any of you know who have read here long, I am an early riser, and it was the same in the rehab center.  So one early morning when I was drinking a 5 o’clock cup of coffee that my great night nurses would snag for me, I decided to write a song about Bertie that I would sing to HER.  (Wouldn’t SHE be surprised! Especially after she heard ME sing.)

So, I wrote the following song about Bertie,which I sang to her the next time I saw her.  As you can tell, I’m not great at this, but it was fun to give something back to Bertie who gave her beautiful voice and loving spirit so lovingly to all.

I wrote this to the tune of one of the songs I remember from my childhood:  “Reuben, Reuben, I been thinkin’ … what a funny world this would be … if all the men had been transported … far across the Northern Sea.”

Ode to Bertie

Bertie, Bertie, I been thinkin’ what a great world this would be,

if singing caregivers just like you,

would always sing for patients like me!

Thank you, thank you, Bertie, Bertie,

for all the joy to others you give.

All the songs you gladly sing.

What a life of love you live.

Thank you, thank you, God for Bertie.

Thank you for her friendly ways,

how she lights up each place she enters.

Please bless her with long, happy days.

Okay, so songwriting isn’t my forte, but Bertie seemed to appreciate my song when I sang it to her (in a slightly less melodious voice than the one she has!)  And it was fun to give her a small repayment for the wonderful voice she uses so willingly to uplift her patients.

Thank you, God, for people like Bertie who light up whatever corner of the world they are in, and thank you for giving me the opportunity to know her.

Choose your driver carefully!

December 11, 2010

I’ve been okayed to drive again.  On my first trip to the grocery, I found out that I DO have the strength in my legs to work the gas, and more importantly, the brake.  So, “so far, so good”.

Have I mentioned that I sleep alot since the surgery?  I suppose that’s my body’s way of having enough downtime to heal.

And that combination of circumstances reminds me of a joke that was going around a few years ago:

“When it’s my time, I want to go peacefully in my sleep like Grandpa did … not screaming in terror like his passengers did.”

So, what time shall I pick you up?

Wind beneath my wings

December 7, 2010

When there was first talk about me having both of my knees replaced, there was mention of me “going to rehab” after the surgery.  I had no idea what “rehab” was.  Of course, by its name, I recognized that it would be used to rehabilitate my knees.  But, what kind of place was “rehab”?  Was it a place where you stayed overnight, or was it a place where you just visited a therapist?  I was totally clueless.

So, I began to ask questions and this is what I found out.  Rehabilitation can be done either at a facility where you stay or as an outpatient.  Apparently, living in a rehab facility for 1 to 3 weeks is most often recommended for someone, like me, who has had both knees done, because it is assumed that those patients are the ones who will require the most help with their daily lives, because they don’t even have “a (good) leg to stand on”!  So, it was pretty much a foregone conclusion that I would spend some time in a rehab facility, and a couple of those facilities were near us and were well-known and were recommended by numerous people.

It was suggested that I actually visit one or two rehab facilities before the surgery to find one I liked.  So I scheduled a visit to one of the ones that had been recommended by a friend.  It was nice and clean, but had been built in the 60’s and had very much a nursing-home feel, even in the rehab wing.  And that was one of the negatives I had been told to watch for when visiting facilities.  Since most rehab facilities are associated with nursing homes, it was recommended that I look for one where the rehab patients were in a distinctly separate part of the facility — not integrated with the nursing home residents.  This first one I visited did have a separate area for rehab, but the rooms looked very much like all the other rooms you could see that were part of the nursing home.

Well, I probably would have gone to that facility anyway, except that I found out it wasn’t an “approved provider” by my insurance company.  So, as I should have from the first, I now asked my insurance company for a list of rehab centers which were on their approved list.

The first one on that list was New Haven Care and Rehab.  It is in a small town very near us and one with which we are very familiar, so it immediately appealed to me.  I called and made an appointment for Hubby and me to visit.

Donna was the person I talked to when I called and she was so warm and helpful, and actually acted like they would like for me to choose them.  And when Hubby and I went to visit, she was even nicer in person and gave us a tour.  Everyone we met — the director of nursing, the manager of the rehabilitation wing, the concierge, the resident social worker — were all friendly and welcoming.

Then we toured the rehab hall.  The floor in the rehab hall looked like wood (although I was told it was actually tile), as opposed to the normal tile in the other halls.  I liked that because I’m not particularly good with directions, so I knew I could always look for the hall with the “wood” floor to find my room!

The rooms in the rehab hall were painted a sage green (my very favorite color) and had very nice coordinating valances on the windows.  I just liked the over-all “feel” of the place — somehow it reminded me of the feel of staying in a favorite aunt’s guest room!  So I told Donna that this was where I wanted to come to “rehab” after my surgery and asked that they plan on me arriving three days after my surgery.

Now, let me get to the analogy that I have come up with for the difference between a hospital and a rehab center.

I compare my stay in the hospital to the baby bird in its egg that is in the nest before it hatches.  It is totally taken care of by its mama bird.  In its own little world, it wants for nothing and has no decisions to make.  All it has to do is be cared for and grow stronger, preparing for the day it can come out of its shell.

And then I compare the rehab center to the nest and mother bird of a newly hatched baby bird.  It is still a place where the baby bird is safe, but it is a place that it must eventually leave, and its mama’s job is to prepare it for leaving and being independent.

As the “baby bird”, it was a little bit of an adjustment to move from the cocoon-like “egg” of the hospital to the “let’s help you get out of here” attitude at the rehab center.  But once I adjusted, I loved the we’ll-help-you-help-yourself environment.

Their system of taking care of  help lights was great. If  I pushed the button to turn on the light indicating I needed assistance, a light lit next to my door in the hall.  Then the next employee who came by, whether a nurse, aid, therapist, concierge, whoever, would come in to ask what I needed.  If that person could help, they did.  If they couldn’t, they promptly went to get someone who could.  And I noticed something interesting about the call light system.  The only way the light could be turned off was for someone to come into the room and push a button on the wall beside the bed.  What an interesting design — there was no way for a light to be turned off without actually coming into the room.  Good idea, but I never saw any inclination by the people who worked there, that a light would be ignored or forgotten after it was turned off, anyway.

So where at the hospital I was told everything to do, here I was constantly asked if I needed help doing something, the implication being that I should work at doing for myself whenever possible.  But if I did say that I needed help, it was always given promptly and cheerfully.  My pain medication was even on an ask-and-you-shall-receive basis, and they would talk to me about the level of my pain, to keep me aware of only taking the medication when I actually needed it, not out of habit.

Finally, ten days after arriving at New Haven Care and Rehab, I was released to go home.  What a great experience that had been.  There are many people there I will never forget (some of whom I will be writing about individually, as I have already done about Dave, the concierge).  They treated me just like that baby bird.  They nurtured and encouraged me and kept me safe and fed, while all the while preparing me to leave “the nest”.  And when the time came for me to leave, they were right there congratulating me on arriving at my goal — independence.

Thank you to all the wonderful care givers at New Haven Care and Rehab.  You were truly the wind beneath my wings that allowed me to successfully leave the nest and “fly away home”.

I got the comfortable “cart” before the hi-tech “horse”!

November 30, 2010

I finally downloaded the photos from my camera yesterday.  As I was looking through them I realized that I probably should have started the posts about my surgery with … well, my surgery!

Warning:  Photos of the incisions on my knees follow. So, if you are squeamish about seeing that sort of thing, you should stop here … have a nice day … and come back tomorrow for a less graphic post.

My bi-lateral knee surgery was done at a new, very state-of-the-art hospital.  All of the rooms are private.  But I don’t know if they are all as private as mine. Mine was on a short hall off of the main hall, so it was very cocoon-like.  I never heard any sounds of activity outside my room.  So for the three days I was there, post surgery, many people entered my room, all with a goal to do something to me, tell me something to do or ask me something.  For those three days I was the center of my own little universe.  I had to make very few decisions.  I just had to lay there.  It was exactly what I needed for those three days, but if I had felt better, it would have been pretty boring.

The computer in the left hand corner was used by everyone who cared for me to log everything they did.  Every time I was given a pill, the nurse asked me my whole name and date of birth, and then the pill, dose and time were logged into the computer.

One of those many machines surrounding me was monitoring my breathing and it told us all loud and clear whenever I would doze off that I wasn’t getting enough air, so the nurse would come in and make me do deep breathing, and cough.  Luckily, that went away pretty quickly, because it really got old when it would happen every time I would just begin to doze off for a little cat nap.

Do you see the tube with blood in it hanging above me?  There were drains in the sides of both of my knees and the blood that was drained was collected in reservoirs hanging on the foot of the bed.  When there were about five (some measurement — pints I guess) of blood in the two reservoirs, they gave me a transfusion and put that blood back into me!  No one said that I was anemic and really needed a transfusion.  So the impression I got is that that return of some of the blood lost, is routine.  I thought that was a very clever idea.  They were draining the blood to keep down the swelling of my knees, and then returning it to me.  But after that transfusion, they continued to do the drain.  So the next day I asked a male nurse, who was looking at the reservoirs, if they were full again, and would they be returning the blood again.  He held one up and showed me that the blood now looked different and he said that was because the cells after this long (about a day, I think) are dead and no longer good, so can no longer be returned.

They definitely don’t let you lay around for long.  The next day after the surgery, the exercising began.

(I warned you!)  This machine was sort of a mechanical trough that my leg laid in.  As you can see, the foot is strapped in, and the device has been adjusted so that the bending part is right at my knee.

Then they turn it on, and it slowly bends the knee.

I know it seems like this should hurt, but the machine does it so gradually that it really didn’t.  (Of course, it also helped that I was on alot of pain medication!)

And then it would return the leg to the starting position.  And begin all over again!

Beginning the day after surgery, they would put each of my legs in this machine for a couple hours, twice a day.  It was a nice way to exercise.  I didn’t have to do anything.  In fact, it was so gentle, that I could fall asleep while it was doing its job!

But, of course, they weren’t satisfied with just passive exercise for my young knees for long, so that is when Barb came into my life.  She was my physical therapist.

Barb would help me from the bed into this very comfortable recliner (the stuff laying all over it are parts of the ice machine that was applied to my knees regularly) .  And then, because it was not only a recliner but also a wheelchair, Barb would push me in it down the hall to a therapy room where there would be about a half dozen other patients all doing exercises (most of which could be done while sitting in the chair).  For these therapy sessions, you had to have a “coach” whose main responsibility was to keep count for you of the repetitions of each exercise, and to offer encouragement.  Hubby had planned on being my coach, but when DD surprised us by showing up the day after my surgery, she gladly took on that task.  And let me just say that Gunny may have been our child who was a Marine, but DD has some real “drill sergeant” mentality.  But she also tempered that with her trademark humor, so she would have the whole room full of therapists, patients and their coaches laughing.

Besides the recliner/wheelchair, another thing I had never seen before was the sofa that was in the room.

Okay, some explanation is required here.  First of all, yes, this picture is very blurry, but remember it was taken by a woman who had just had major surgery and was on lots of medication, so let’s cut her some slack, okay?  Also, even though blurry, it’s obvious that I had a really big suitcase full of lots of clothes, considering I was only going to be there three days.  So I kept reminding people (when I would see them looking at my overflowing suitcase) that I had packed all that stuff because I was going directly to a rehab center for a week or two.  It all did actually start out neatly folded but as I would ask Hubby, or DD or one of the staff to get something for me out of it, it got just a little disorganized along the way.  But, hey, I’m not complaining, since I certainly couldn’t look through it myself.  I was just glad for the help.

Anyway, I assume the sofa is part of the decor so that if a family member wanted to stay all night they would have a place to sleep.  I think that is a really great idea.  Many years ago when my father was really sick and one of us would stay with him all the time, I can remember sitting in his hospital room sometimes in just a straight-back chair, WISHING there was somewhere I could lie down for just a little while.

Finally the day arrived when I would be moving to the rehab center, and I got to take one of my first steps back to “normal”.

This is Kate my very favorite nurse.  Don’t get me wrong … there were lots of nice nurses.  But the reason Kate was my very favorite was because very early on the morning that I was to leave, I asked her when I would be able to take a shower, and her answer was “How about now?”.  Music to my ears.  So, that’s the reason Kate will always hold a special place in my heart.  Nothing says normal more than an honest-to-goodness shower and hair washing.

In my next post I’ll tell you a little about the “culture shock” of moving from this cocoon environment to the totally different environment at the rehab center.  Both served their purpose perfectly, but their purposes were just very different.

“So, who’s the guy with the ketchup in his pocket?”

November 27, 2010

The last post I did was the re-telling of a funny story that Dave, the concierge at the rehab center where I resided for ten days, had told me.  But some of the attention that post brought wasn’t about the story itself as much as about the fact that Dave’s job was as a concierge.  And my friend Katharine at Wise Dogs, left a very funny comment about that:

Katharine says:

A concierge? Your rehab center has a CONCIERGE???

Sandy, if you post something about a pool guy, I’m making a reservation for the day that I have a joint replaced!

Sandra says:

Yes, Katharine, they had a concierge, but it wasn’t because they were fancy smancy — it was because they were realllly all about patient care and comfort. I think of it comparing favorably to a stay in a favorite aunt’s guest room.

p.s. I didn’t see a pool guy (or a pool), but maybe he was just off that week.

My response to Katharine says it all.  This was NOT a hoity toity place.  It was a clean, comfortable older facility that stressed patient service and care above all else … hence the presence of a concierge.

concierge |kô n ˈsyer zh; känsēˈer zh|, noun: an employee whose job it is to assist guests

But while the concierge at a hotel might do cool stuff for you like recommend good restaurants near-by or arrange for theater tickets for you, Dave’s job was much more down to earth.  My favorite part of his job was that he came around in the afternoon with a cart of coffee, tea, cider and cocoa.  And when he would stop in to see if any of those sounded good to you, he would always have a few words of conversation too.  A wonderful combination to look forward to when you are confined to a bed most of the day.

He would also help deliver meal trays, get you water and/or ice for your ever-present water mug, etc.  Anything he was able to do to help the medical staff attend to the patients’ comfort, he did.

One evening my friend, Linda, was visiting (she visited many times, and I will never be able to repay her for those visits that were just to cheer my day … and sometimes she even brought me a malt to make SURE I was cheered!).  Anyway, Linda was there when my dinner tray arrived, and the entree was a hamburger accompanied by potato wedges.  As I started to assemble my sandwich, Dave appeared in the door with a bottle of ketchup in his shirt pocket, and wearing his always welcome smile.  He asked if my meal was all right, and then asked if I would like some ketchup for my hamburger and potato wedges.  I said, yes, I would like some … so he withdrew the ketchup bottle from his pocket, put a healthy squirt on my plate … and asked if that was enough.  When I assured him it was, he “re-holstered” his ketchup bottle and went on his way down the hall dispensing ketchup and good cheer.

Linda loved the picture of Dave dispensing ketchup “as needed” (certainly a more cost effective way than putting those squirts in little cups that might or might not be used and possibly having some of it wasted.  I admire that they were being wise in little ways like that.)  So from then on Linda thought of Dave as “the guy with the ketchup bottle in his pocket”.

So, yes Dave’s title was concierge and he fit that title because his job was to “assist guests” in any way he could.  And, God bless him, that he didn’t have any preconceived notion of what was and wasn’t “his job” — he was willing to do anything that was needed, including being the purveyor of ketchup on burger night!

Don’t forget the dryer sheets!

November 24, 2010

One of the great people I met at the rehab center where I resided for 10 days was Dave, the Concierge.  He was a retired guy who was just there to help in any way he could, like help deliver meals, get a patient some ice for their ever-present water bottle — just anything to help and cheer the patients up.  And, believe me he did a good job.  Especially when in the afternoon he would bring around a cart with coffee, hot tea, hot cider and cocoa for anyone interested.

Obviously, someone in Dave’s job needed to be a people person, as he was.  So he and I would sometimes chat for a few minutes (I’m pretty sure that was part of his job too — a few minutes of just pleasant chatting is such a nice break for any patient).

I forget how the conversation came around to static cling, but it did and it inspired him to tell me a story about an incident his wife, Lynn, had experienced.  Afterwards, one of the nurses told me she had worked with Dave’s wife, and she was as charming and funny as he was — so I’m sure she didn’t mind her story being told.

So, this was the story.

Dave and Lynn were going out to dinner with friends.  They parked the car and began walking toward the restaurant.  The other couple were walking behind them.  All of a sudden, one of the other couple said, “Uh, Lynn.  Is there a problem?”

Dave and Lynn turned around to see what problem there could possibly be, and followed their friends’ eyes to something on the sidewalk.  Laying there was a pair of underpants!  Lynn had on a skirt that she had just washed that afternoon and apparently it had had a little static cling, so a pair of underpants had been stuck to the underside of her skirt.  But as she walked from the car to the restaurant something suddenly made the static cling loosen (maybe sudden exposure to cold air?)  and the pair of underwear fell to the ground.

Of course, Dave said they all laughed about the incident, and he and Lynn still enjoy telling the story.  But it is a good reminder to all of us, “If you don’t want something similar to happen to you, never forget the dryer sheets!”

Prayer + Preparation = Success

November 16, 2010

I hope I’m not speaking prematurely.  After all, I am still in the rehab center, and I guess something still could go wrong.  But unless something unexpected happens soon, this whole experience of having bi-lateral knee replacement has been an unquestionable success.  And I believe the reason for that success is two-fold — prayer and preparation.

Any of you who have read here very long know that I believe in the power of prayer.  So I truly believe that the prayers that many friends and family have prayed for me have been answered in spades.

And the other component that I believe was a key component to my success was preparation.

As soon as the word got around that I was going to have both my knees replaced, I got a call from a friend from our church, Paula.  She had gone through knee replacement herself about a year ago, so she had some valuable advice based on her own experience, “Do the pre-surgery exercises!”

The doctor’s office had given me a large booklet full of information about what bases to cover with my insurance company, what to expect during and after the surgery, and how to prepare for the surgery.

In that how to prepare section, there were about eight exercises recommended for you to do twice a day for six weeks before your surgery.  I like to think that I would have been smart enough to do those exercises even without Paula’s advice, but she was so adamant about what a difference they would make in how things went, that it was her voice that I heard urging me on, every time I did them.

And now I’m reaping the rewards of doing those exercises.  I have not encountered any other patient in therapy sessions, either at the hospital or here at the rehab center, who is better able to do the therapy than me.  And I believe the main component of my ability to do what is asked of you in therapy, is that I had started strengthening key muscles six weeks before the surgery.

So, bottom line is, I am thankful.  Thankful for all the prayers that were said for my success, and thankful for that excellent advice Paula gave me.  I truly believe those were the most important two components of my success.

I’m looking forward to going home Thursday afternoon.  They’ve been great to me here, but there’s nothing better than sleeping in your own bed.  One more step toward “normal”.

Like Warm Plum Pudding?

November 15, 2010

Who knew?  If you warm it first in the microwave, a glass of that dreaded juice I was given as a kid to regulate my digestive tract has a very pleasant flavor of warm plums!

But if you forget to order it in the morning … so just tell them to deliver it with your lunch … planning to ask that it be warmed in the microwave mid-afternoon … but then decide “Why go to all that bother?” and just chug it down at room temperature … it will once again taste exactly like that icky stuff Mama gave me when I was little … prune juice.

Just one of the little insights I’ve developed during this very interesting journey.

May you have a great day, and may all your prune juice be warmed!