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Saturday, April 30, 2011

The Reluctant Roomie and other news

My roommate is Joan, an elderly woman who was sent here from French
Hospital because the doctors there felt she was not stable enough to go
home. She has heart trouble and has had strokes. I don't remember what
she was there for, some kind of operation. She did not want to come here
and it seemed initially like she was very resentful. Now she seems to be
adjusting, realizing it's a lot better than the hospital in any case.

In other news, Maryann was not able to start my car this afternoon. The
alarm key would not unlock the doors, either. So I asked her to go to
Batteries Plus to get another battery for the alarm key and see if that
worked. It didn't, so I called Better World Auto Club and a tow truck
showed up eventually to jump start the car battery. Now Maryann is at an
auto parts store where they will test batteries and charge them for
free. I hope that is all that is needed. That battery is not all that
old. Maybe two years. If a new battery is needed I will need to take the
other one back to get a partial refund from where I got it.

In any case, it's good this happened today and not tomorrow morning.
Would have been really frustrating waiting here past my scheduled
leaving time. Chances are they will have another patient ready to move
in as soon as I hit the road.

My last night on this not-so-comfy hospital bed. Tomorrow could seem
quite luxurious.

The Sounds of Caring

One of the first things I noticed when I came to the transitional care center is that there is no music! No background theme to go with our pursuit of wellness. There is probably some scientific or medical reason for this, or maybe too many residents have complained, but whatever the reason I consider this one of the high points of my stay here. Everywhere I go these days I am assaulted by Top-40 tunes or renditions of older songs in Elevator Style. I can't ignore the sound and it seriously bugs me. I want it gone. For a while a few years ago I went around asking people in the stores that had music (which ones don't??) if it bothered them or if it is ever turned off or if anyone else complained. The clerks usually told me it helped them "pass the time". Others said it blocked out more objectionable (to them, anyway) noises. They did point out that they would be happy to reduce the volume if I asked, but this is not what I want. I want it gone altogether.

There was one time when I was in a drugstore looking for something and some popular song came on. Another customer nearby started humming along and moving to the music. Clearly some customers enjoy it and I would not want to deprive them...or would I? Yeah, actually I would, even though it cheered me to watch this woman. Whenever I witness a person just being themselves spontaneously I am usually cheered by it.

Instead of music here we hear calls for assistance, which are simple beep-like sounds, accompanied by flashing lights on top of our doors, and sirens, which go on when one of the more fragile patients moves outside restricted boundaries. The siren can mean a serious emergency. The calls usually just mean help me to the bathroom or please I want more drugs.

This is a social place in some respects. There are two main sections, twelve beds (six rooms) in each, and each section has a living-dining area, where people gather at any time of day. Certain people are out there all the time, chatting up their neighbors. Sometimes the television out there goes on and I hear (or partially watch) the news or a cooking show or, for some reason, 2-1/2 Men, which seems to be a favorite around here (maybe just because there are limited choices). I have gone out there to join the small group from time to time, and had small pleasant conversations of no particular consequence. Most of the active hours there is a lot of chattering going on in the rooms, the hallways, the social areas. Only after about nine at night does it become quiet.


This last day is going rather slowly. And I have a new roommate. I
almost made it. But at least it looks like she'll be quiet. She has a
lot of family, though. I just finished a sixth book. I can hardly wait
to get back to so I can enter reviews and get something
entered about the book box I received.

I went out to the terrace this aft and sat there a while, reading. The
weather is nice, probably the only day it has been suitable to do that
for any length of time. I asked myself why I didn't just ask to leave
today. The answer is that I wanted to get that last PT session in.

I am curious whether I can drive. I want to find out. Tomorrow afternoon
I think I'll test it out. Just get in my car and see if I can drive
around the block.

Obviously a slow day.

Getting Close

Yesterday I had Scott for PT both morning and afternoon. I was scheduled
to have Tim in the afternoon but Scott had some problem in his schedule
and Tim offered to take on some of his clients while Scott took me. I
had been looking forward to one last time with Tim and felt sad when I
learned this. Fortunately, I felt both sessions with Scott were
productive and even challenging in parts, which is what I always like
about Tim's. Still, I miss having that chance to say goodby
(full-timers don't work on weekends). Today I understand I will have
someone I have never met before, and that will be the last session,
because they only have one on Saturdays and none on Sundays.

When I mentioned to Scott that they have not seen the last of me, that I
will be back with the second knee, he said that the patients he has seen
who have done this have generally done better the second time around.
The pain and weakness is the same but the patient knows what to expect
and is able to focus on that and get through it more easily. I expect
that to be the same for me.

Maryann came and after our visit she took away many books! Books I have
read along with many I have not (from the bookbox that arrived while I
was incarcerated here). She'll take more stuff today so that tomorrow,
when I leave, the load will not be so daunting. I practically feel like
one of those travelers of old, the rich ones, who take large trunks with
them. It's true that I have many clothes but most of what I'd have in
that trunk would be books.

After all that she has done for me, I hope that I have some chance to do
something of the same for Maryann some time!

Last night I had Percocet at 8:30, sleeping pill at about 10:15, another
Percocet at about 4:15. Same, generally, as the night before. It got me
through. When I get home I think I'll use tylenol pm at night, two
tablets. That stuff usually knocks me out and maybe it can help me avoid
taking more Percocet.

The real joy is that I had another day and night without a roommate! If
I can just not get one today I am home free!

Thursday, April 28, 2011

Moving Along

My time here is coming to a close. But wait, more on that later.

I did PT with Tim again yesterday afternoon and we got back up to normal
speed. I really enjoy challenging myself here, continually upping the
ante. Tim believes in keeping it interesting and he really does that. I
will miss him particularly. At one point he mentioned that I have very
good body awareness. I was surprised to hear that but when I thought
about it I realized it's true. I know what my body parts are doing. I am
aware of changes in how my body reacts to certain moves. When I do an
exercise,whether it is here or at the gym I never do it mindlessly. I
think about every part of the move.

Last night I took a percocet at about eight, hung around and finally
slept a bit, then took a sleeping pill at midnight. I woke at four and
was too uncomfortable to get back to sleep for about two hours. At this
time it seems like the leg pain is more a discomfort of the "restless
legs" type than a sharp or persistent pain in the usual sense. Although
I do get knee twinges frequently, usually a type that slides away as I
get warmed up in PT. I get out there and take walks to keep the knee
from stiffening too much and I hope the accumulation of this work
eventually rewards me in a deep, long sleep. Still waiting. But I did
get enough sleep, overall,last night.

My roomie Patricia (did I mention she moved in yesterday?) moved out
today, at about 1:30. Nice woman with a son who is a pilot who flew
here to drive her home. Not long after she left, the person who is in
charge of the checking in and out came in and suggested that she might
move me to another room or add me another roomie. I had quite a look of
despair on my face. She said she would have to work something out - and
I have not heard more about it. I am hoping.

I also talked to her about leaving and found that the therapists have
cleared me for takeoff. So what day, she asked, and I said how about
Sunday? So at about 11:30 Sunday I am going home!

PT with Scott again this morning. He's a nice guy,and funny, but I don't
get much of a workout with him. Mostly lots of walks and a few other
things. This afternoon I was with Tim again. We got a little warmed up
and then took a different type of walk: up the street to the probation
department building. I managed it much better than I expected. It got me
excited - hiking is not so far away now! We did a number of other
activities after getting back, and then went to my room, where Tim took
my brace away to lubricate the "joint" in it and bring back some ice. He
also got a tube of a t-shirt-like knit that he pulled onto my leg to
give it a break from the foam inside the brace. What a relief! Loving
it. It was feeling really scratchy.

A good day overall. I am hoping for a good night as well.

Wednesday, April 27, 2011

A Day in the Life

A typical day for me here at the transitional care center:

I wake up. If I had a bad night, chances are this is at three a.m. If
things go well it could even be after seven. The vitals person comes
with the blood pressure cuff, the thermometer. Used to get blood gases
too but they haven't been lately. When that's done usually I get washed
up and dressed before breakfast, which arrives at 7:45. For me,
breakfast is always the same: oatmeal with walnuts, raisins, and brown
sugar, a cup of decaf (Sanka!), water, small half-cup of apple juice,
and maybe fruit or bread.

Depending on my state, I may go to sleep again after breakfast. This has
happened more than I care to admit. Some time in the morning I learn
when I will go for physical therapy, so I try to be ready for that. What
this means is I get some pain meds about an hour before PT time. Even
though I now have a fentanyl patch, I am finding that I need to
supplement that low dose with the occasional percocet. A lot fewer
percocets than I was taking before the patch.Sometime in the morning
somebody comes by with our meds. In my case, zantac to avoid stomach
troubles from taking the meds.

If I have a chance I'll check email, answer it, do any number of
computer things, or read. I have read four books so far (since I went to
the hospital on April 11) and I am near the end of the fifth. To be
fair, I had already started two of them, was well into one and a little
bit into the other.

I go for physical therapy. I have found that if I go to an early session
there are fewer people. There is an advantage if so in that everything
is available. However, there is a disadvantage in that I don't get to
watch what others are doing and sometimes join them for a laugh. Most of
the time my therapy begins with a walk around the building, outside,
including several steps up and down. Then inside to the real work. Then
a walk back to my room, where I get my knee iced for 15-20 minutes.

A person comes by with tea, coffee, whatever. Sometimes I have green or
herbal tea.

Lunch arrives at about 12:45. Always an 8-oz can of ginger ale and a
small bowl of fruit, whatever else is on the tray. I happened to mention
in my early interview that I liked ginger ale now and then. Now it's a
ritual. I tend to take the afternoon to drink it, oddly enough.

Usually I rest, read, work on something on the computer, until I am
called out for the afternoon PT. Different therapist, different
approach. I usually end with icing the knee.

I rest some, visit if someone has come to visit (generally Maryann),
take walks to keep myself from getting stiff. Write these entries.
Answer emails.

Dinner comes at about 5:45. Lighter than lunch, as rule. Later, though,
at about seven or so, somebody comes by with snacks - ice cream,
sherbet, cookies, bananas and soda crackers. Lately I have been saying
yes to bananas and soda crackers.

At eightish the meds nurse comes around with the cart. I get a blood
thinner (operations can lead to blot clots - the dosage is gradually
being reduced), and I usually ask for hydroxazine for a rash that has
been bothering me forever. And tonight I also had one Percocet to take
the edge off, give me a chance to relax, maybe sleep.

Sounds like the life of Riley, huh? It might be if it weren't for the
pain management part (esp. at night), but I am beginning to get onto
that. The nurse just told me they are relieved that I am not taking so
many percocets because the tylenol in them can be bad for the kidneys.
The patch plus a few percocets a day is a better combination. If I can
get this pain thing down better I will feel more ready to go home. One
of the physical therapists said, though,that my job here is to eat,
sleep, and do therapy. Ignore all else. get well. It's a good prescription.

The Therapy Dance

When I go into the rehab room I am usually treated with views of others
doing their therapy. There are so many different conditions and so many
ways of improving our strength and flexibility, and some of the ways are
surprising and even fun.

As I have mentioned here before, sometimes the work looks like a dance.
But in fact it almost always does. I would love to take a video camera
in to photograph all the different activities and put it together with
music, as a dance. I think the film would be fun to watch and
interesting as well, as it would show the innovative techniques, the
simple ones, and the wonderful feeling that sometimes comes over us when
we get better at any particular activity.

My guess is that somebody has already done this. But maybe not?

Tuesday into today

Yesterday what happened? Several things, and it seems like so long ago

My roommate Denice went home. And my pal Helen went home. I got to say
goodbyes to Helen and Jamie and Jamie's husband and I got Helen's
address and email address so we can continue to be in contact.

The day started in the same bad way as the last few; waking up early
with great pain in my inner and top thighs, especially my right leg. On
my way back from a trip to the public bathroom (which is near the
entrance to the center), because somebody was occupying our joint
bathroom, I met Dr. Sturgeon, the on-staff doc (there are two of them, I
understand, but neither is in-house all the time), and he said, "and how
are you doing, Judith? It looks like you're moving well."

"Yes,I am moving well," I replied, "but I am having a very hard time
with pain."

"Do you want something stronger?"

"Stronger or different. Something that works better, " I said.

"I'll take care of that," he said, as he sped away.

I didn't hold out a whole lot of hope but still. Managing the pain is my
number one concern right now.

In the afternoon a nurse came by to put a fentanyl patch on my upper
shoulder! Woo! I worried a little that I might get nauseous but they
have drugs for that and I'd take them. I knew and they knew that I could
tolerate narcotics because Percocet is one. By the time Tim came around
for my afternoon therapy I felt the pain was manageable. Tim was extra
cautious yesterday, though, didn't want to push anything, afraid it
would set off more pain issues later. Perhaps today he will be willing
to go again with the clock or something like that.

Last night came and I was afraid. Would the patch do all right? My brace
felt scratchy against my leg and it was hard to get comfortable. I tried
every which way, as usual, and finally asked for one sleeping pill and
one Percocet at about nine. I learned, in other words, that I don't have
to depend on the patch alone.

I slept better than I had in the last few days but it continued to be
difficult to get comfortable after I got up to go to the bathroom. When
I woke this morning I just wanted to keep sleeping. Which I did. Finally
breakfast came along and I got up to eat that and decided I needed to
get moving. Scott came in to ask about when I'd like to go for therapy
and we agreed on an hour from then, which gave me time to hit the
bathroom with my toiletries and take a shower.

I had just gotten out of the shower and was dressed and sitting on the
bed, waiting for therapy, when the administrator came in.

"You were in the washroom," she started.

I worried that my shower activity had leaked (we aren't supposed to do
this without assistance and only twice a week and in another shower!),
and that my wet hair was giving me away.

But no. "You are getting another roommate," she said.

I groaned. She said it will only be for one night and she's quiet, like
you, reads, like you, doesn't watch television all day or talk all the
time,so it should be a good fit. and anyway it's just one night.

So I sat and watched another bed being rolled into the room. They are
forever moving beds around here. And shortly after came my roommate,
whom I had met in therapy. She's nice, she's quiet, it will be okay.

Therapy this morning consisted of three walks around the building,
inside and out, leg kick-outs, leg raises (sort of like marching),
stepping sideways while holding onto Scott's hands (like a dance), and
doing some beanbag throwing using first my right hand with my right leg
stepping out, then the left. Needless to say, my left side work needs
work,but I think I did better than I expected. Anyway, I liked doing it,
using those different muscles, getting that additional balance work.
Afterwards I requested ice and got it. Damn cold, that stuff.

Which brings me up to date. Which means I may be writing more posts that
are generally about this experience rather than day-to-day.

Tuesday, April 26, 2011

Monday Monday

Yesterday, Monday the 25th, I woke again early in the morning, with pain
that would not go away. More tylenol, later more percocet, more hot
cloths. I managed to get in a little rest by the time the therapist came
to take me for morning therapy. This was somebody different, whose name
I forget. The therapy session was pretty unmemorable, too. But again, I
got through it. In the afternoon I got Nancy again and we did some good
work together, after which she measured my range of motion again. 97
degrees! I was amazed it had moved so much! The straight angle is about
the same,though. Not likely to change much for quite a while, I understand.

Maryann came by with fresh-baked bread just for me! She later told the
kitchen about it and put it on the patients' shelf in the break room
fridge. So today I have been treated to having it twice.

I went to bed hoping to make it through.

Easter Weekend

I wish I could respond to the comments many of you are making on my
other posts during this time that I am in the Transitional Care Center.
But I rarely can. The posts don't always show up on my facebook app on
my phone and of course I can't get to facebook on my laptop. Still, I
get copies of the comments by email and I appreciate that somebody is
out there!

Saturday I had one therapy session. I had it with Laurie, the part-time
therapist who loves to get deeply into my parts. She wondered why I was
still here, given that I am so "high-functioning". I explained the
nobody-at-home thing and she accepted that. I also said I am happy to
get this extra time with these excellent therapists.

This time she took off my brace and carefully monitored and supported me
while I bent my knee, using the skateboard. I have come to hate that
skateboard but it is a great way to improve motion. I am even wondering
if I might be able to find one used so I can use it at home. Small,
maybe two feet long. She showed me how to put pressure on the scar
tissue on either side of the scar, much as Nancy did. I have been doing
that frequently since, when I have access to my knee. Laurie checked the
way my leg moved and promised me that there is nothing in the way of
deeper movement, that it is only a matter of slowly stretching out the
muscles to get there. She could see that the joint moves freely in
there. I don't know how.

The rest of the day went without much to notice, except that I got a
beautiful lily plant, complete with a cute brown bunny pin, from my dear
daughter Elaine, her husband Ed, and the toddler. I wandered around the
place a few times, as usual, and I had pain, as usual. That night I got
to sleep well enough but woke up a few times to ask for more pain meds,
and then woke at about three with a pain in both thighs, top and inner,
that would not quit. Not cramps, not throbbing, simply
impossible-to-ignore pain. I took tylenol because it wasn't time yet for
more percocet, and I asked for hot pads. The pads helped ease the pain a
bit until it was time for more percocet. Then it calmed down and I was
able to get on with Sunday, Easter Sunday.

I am learning that I am not the only one who feels a bit at odds on
these "free" Sundays. No therapy, just food and sleep. Monday mornings,
I hear from therapists, the therapy room is filled early with those who
want to get on with it.

I did notice that there were a lot of visitors Easter Sunday. I had one,
too, in the afternoon. the couches and chairs in the sitting rooms were
filled and the chatter non-stop. Time to visit the grandma!

Monday, April 25, 2011

Friday the 22nd

I did very well in physical therapy Friday, both morning and afternoon.
Not that this is anything different, except that I even opted to stay a
little longer in the afternoon to play the "clock" game again. This time
Tim added the rest of the clock, so I stood in the middle of it and
stood on different numbers in front, to the side, and to the rear. I
think Helen and I were the only victims in there at the time, but there
were three or four staff members working at the desks, in addition to
Tim. These other PTs were intrigued by the game and before long they
were making music to go with it and clapping in rhythm. Helen, of
course, joined in. By the time I was done I felt like a celebrity.

Friday was also the day I gained a new roommate. Denice (yes, that's the
spelling) came in with her daughter "for two days". She had had a hip
replacement Tuesday and when Friday came along her doctor thought she
would benefit from a few days at the rehab center. I was a little
concerned that she showed up Friday because there is only one therapy
session Saturdays and none at all Sundays, so it seemed bad timing if
you are just there two days. As you might guess, she did not stay just
two days. She is still here today and plans to leave tomorrow - Tuesday.
So she is getting two days out of the deal, more or less, of real work.

Denice is a nice, normal person, looking good for being in her 70s. Who
knows any more, though? She had great difficulty getting in and out of
bed initially but it wasn't long before she mastered it, if slowly. I
learned that there are three things hip replacement patients are told
NOT to do, repeatedly. I might remember all three by the time she
leaves. I don't think there is anything particular that knee surgery
patients are told not to do.

Friday afternoon was the egg hunt. Who comes up with these things? (The
poor activities leader is who.) When I mentioned this to one of my
daughters she said that if they stuffed the plastic eggs with pain
killers we'd get 100% attendance. She might be right about that. I have
no idea how many people did show up because I was in therapy at the time
and not really interested anyway. There was also a religious service
that morning, which I declined.

I had pain in my legs that night. Like "restless legs" that just won't
quit. This has happened on and off during this period. What I continue
not to have is hip pain. I cannot express the joy I feel about that
unexpected result.

Sunday, April 24, 2011

Catching Up: Thursday: Pain and Progress

Thursday the 21st I woke from another bad night but fell asleep after breakfast, which helped me. The morning therapy session felt rough because the pain killers, for whatever reason, did not seem to be working. Just pain upon pain. By the afternoon,though, I was feeling less pain and went through that session without much trouble.

Just for the heck of it I tried to remember everything I did in the two physical therapy sessions on this one day:

*walks with stairs: went on walks around the outside of the building, going up and down stairs with cane, several times
*skateboard: sitting in chair, let left foot rest on short board while right foot moves it toward me, thus increasing bend in knee, hold a few seconds, reverse direction to straighten leg for a few seconds.
*foot raise with weights: Sitting in chair with weights on ankles (more weight on right than on left), lift legs, one at a time, several times.
*"marching": Sitting in chair, raise and lower legs as if I'm marching (this is very difficult for my left leg).
*abduction band: Tie resistance band around thighs, twist and hold with right hand while pushing thighs apart.
*adduction ball: Place ball (maybe soccer-size?) between knees. Press knees together.
*resistance footraises (feet dangling): Sit on deep seat so that knees dangle off edge and are touching front of seat; therapist holds hand against foot while I try to raise it, then holds it the other way while I try to lower it, providing resistance both directions.
*bicycle: Sitting in chair, place feet into stirrups of bicycle-like device. Initially turn wheel half way to raise knee both directions; eventually turn all the way around many times.
*clock steps: therapist lays out clock numbers 9, 11, 12, 1, and 3 in appropriate positions on floor. Places a piece of tape at the bottom, sort of forming a semicircle. I stand on top of the tape and place foot on the 9 (lunge),return to start, then the 11, then the 12, then take the right foot to step on the 12, 1, and 3. After doing that three times I started at the beginning and the therapist told me which clock number to land on. a game!
On parallel bars:
*foot raised to side, to back, to front: Stand in middle of parallel bars, holding onto bar in front of me. Raise foot to the left, to the right, to the back.Both legs, many times.
*obstacle course: Lift legs, one at a time, over or on top of obstacles (or sideways over them) that are laid out in center of parallel bars, going from one end to the other. At the far end, pick up object that sits there and return the same way, going over obstacles. Second time through I picked up small plastic cup and carried it in my right hand while I held onto the left rail.
*lunges: In center of parallel bars step up left foot onto stool. Lunge forward as far as I can handle, hold a few seconds, return to start. Repeat, of course, several times.
*walks forward and back: Starting at one end walk carefully to other end, heel-toe, using rails as needed. Then walk backwards, toe-heel, back to beginning. Repeat of course.

I felt good about my progress. I was enjoying the therapy sessions in spite of the inevitable pain. Making progress is a great motivator.

That evening I asked for a sleeping pill, and when it wore off in the wee hours, another one. Thus I got through it.

Saturday, April 23, 2011

Catching up: Tuesday the 19th and moving to Wednesday the 20th

I wrote a bit about last Monday here already, so I'm moving to Tuesday,
the 19th. Monday I experimented with fewer drugs and wondered if the
pain was going down. Tuesday I was back to the usual dose but I don't
remember anything else particularly about that day.

Wednesday I do remember. I got to the point where I actually liked
physical therapy. It is usually painful yet I see progress just about
every day, which seems a kind of miracle. The therapists had also
discovered how well it works to have Helen and me in the same session.
We laugh at each other, brag about our numbers, grouse about the
torture, and of course applaud each other. And it isn't fake.

Wednesday I walked down the middle of the parallel bars without touching
anything. Felt just a little unbalanced. Later I started going out on my
own without my cane. Taking smallish steps and paying attention. When I
used the cane I rarely used it for more than just a touch on the ground.

I had a bad night Tuesday night and it carried over into Wednesday. IN
the afternoon, the therapist even went out to get a nurse to give me
pain meds NOW. I felt I needed some sort of consultation, a discussion
of the pain and where it is coming from (it is a bit hard to pinpoint
other than the whole leg hurts along with various parts of it) but still
hoped that I would start feeling less pain and no longer feel the need
for a change.

Maryann came by with fresh, folded laundry, plus my mail. None too soon,
'cause I was running out of stuff.

And I graduated from Occupational Therapy. heh. No need to have any more
consultations about the everyday challenges I will face when I go home.
I had already been facing them before I had the surgery.

Oh, and I made 92 degrees in the bend of my knee. The brace makes it
doubtful that I will make any meaningful gains on that number.

One day in therapy the therapist said something about the therapy room
being open at night. He didn't actually say that but that's what I
heard. I immediately thought, "Great! When I can't sleep I can come in
here and do some weight lifting or cycling or maybe there will be a
therapist in here to help me?" It seemed like such a great idea for
insomniacs. Especially if there were a therapist in there. Wednesday
night maybe I would have gone there.

Catchup Catchup: more about weekend of 16-17

I looked back at my notes and realized I had left out two significant

No. 1. On Friday night roomie Elinor got up in the middle of the night
without calling for help. She was confused, she said later, did not know
where she was. Elinore is very law-abiding, unlike me. Unfortunately,
she fell down. The first I knew of this was when I woke up hearing the
voices of the nursing staff asking her questions - grilling her,
practically - about her fall. I think they worry a LOT about liability
here. The final decision was to get her to and from the bathroom, her
original destination, and then to bed for the rest of the night, because
it appeared that she was not hurt.

Saturday morning, though, they took steps. They moved her to a different
room, at the other end of the building. She now has a yellow wrist band
and blanket, designating her to be in danger of falling, and they put an
alarm on her. I know from being in physical therapy at the same time
that she was that the alarm goes with her when she is in her wheelchair.
It went off one time when Tim was helping her to her walker.

Thus I was freed! The whole world looked a little bit more colorful and
my time here appeared manageable.

No. 2. Every Sunday a young woman named Andrea comes to the care center
to do hair. She sets up in the employees' bathroom. Not a big space but
with various bits of equipment she is able to do it all. She does
shampoos, shampoo & set, cuts, and even color (with notice). I made an
appointment to have my hair cut. I figured why not, as long as I am
here, get it done because it is going to be harder when I get out and am
not yet able to drive.

She did a nice job and we had a nice chat. This is her only gig at this
time. She has a four-year-old daughter so she is taking time to be with

So I guess Sunday was not just one big wash of time after all.

Friday, April 22, 2011

OT: The Poor Relation

The day before yesterday the occupational therapist here, Amanda,
visited me. Her job is to help patients get back into the real world, by
introducing them to devices and techniques for functioning in spite of
the various disabilities they have, when they are home again. In my
case, I will return home with a left leg that is not yet up to snuff. I
won't be able to drive, and I will still be working on perfecting
walking without hurting myself. What I realized several days ago,
though, is that I will be no more disabled when I go home than I was
when I left. I have been modifying my house to suit my physical
condition for years. She has given me some tips that are helpful but for
the most part I had already figured things out. Thus the day before
yesterday she terminated her visits with me. Our work together is done.

I have been watching how the various therapists work. There are several
physical therapists and only one Amanda. When Amanda wants to schedule
time with a patient she first discovers the patient's PT appointments.
She then clears her visit with the physical therapist so she won't
interfere with what they are doing. I couldn't help but notice that her
position is like that of a poor relation. She is happy for what grubs
can be thrown her way by the more important PT folks. I don't think this
is an intentional relationship, but there it is.

Then there is the activities director. I look at the cheery little
flyers she sends around, with the day's meals on it, with various
puzzles to do...and I think, she's really on the bottom.

Thursday, April 21, 2011

Catching Up: Saturday the 16th and Sunday the17th

Saturday was another nice day, as I recall. I met with Laurie in the morning for physical therapy, but had no afternoon therapy. I had not realized there would not be two so I was waiting around for a while. I thought about working on daughter Mary's taxes but hey, I had a couple more days and most of it was done anyway.

Laurie is a very determined therapist. After subjecting me to more torture, she had me sit down and she held my leg on top of her legs. She opened the brace enough to get to the knee cap. With her fingers, she deliberately moved the kneecap around. I remembered that when I had seen a physical therapist some months prior to surgery he had tried to move my kneecap around, too. But he was unable to. The knock-kneed leg kept the kneecap imprisoned, would not let it go. He said, in essence,that with that permanent bend in the joint the knee cap can never "rest".  Now it can. It can get around, do other things. (I realize I am not explaining this well technically.)

When the session was over she said she'd see me tomorrow.

But that did not happen. I did see her in passing, not even to say hello, but it turns out I was not scheduled for any PT Sunday. This is the usual, and I did not know it. I gather she was there to deal with special circumstances, like incoming patients or those who are leaving.

I felt a bit dozy Sunday. I read a lot, lay around, took some walks, ate the meals. My actual appetite came back. Initially I was able to eat a meal but I couldn't "connect" with it. I could taste it but the taste didn't mean anything. I guess that is how it is with some people who often have trouble eating. By Sunday I was tasting again. And gaining an understanding of institutional food, even institutional food that has been veganized.
The above meal is a good example of what I mean. That stuff in front is spaghetti. At least I think so. The pasta was cut into short pieces and cooked to within an inch of its life. It was then combined with a whole lot of tomato sauce with peppers and onions and a few other things. The veg is well-cooked green beans and carrots, plus a half tomato, which appears to have been grilled a bit.  In back is a small can of ginger ale and a half glass of cranberry juice, plus a bowl of fruit - grapes and cantaloupe. It would be possible to eat this meal without teeth, I am convinced. I also suspect this is the aim of much institutional cooking, especially when cooking for the elderly.  I ate it all,by the way. I am not picky that way. I just notice some things.

Wednesday, April 20, 2011

Catching Up: First Full Day at the Center

Friday, April 15, was my first full day at the rehab center. I had two PT sessions and one OT:

Both physical therapy sessions seemed productive. The morning was with Laurie, and it was a joint session with my French Hospital roomie Helen. Did a lot of straightening and stretching, quite challenging. One maneuver requires a small skateboard. I sit on a chair and place both feet on the skateboard, which is ahead of me. I move my right leg back towards me until I feel a stretch that I can hold 15 - 30 seconds. I felt a burning sensation and she said that was just fine! The other was where I stretched my knee by focusing on just my kneecap. That hurt like hell, too. Then I got to walk around with the cane. Very nice outside. And of course there was the bunny.

A little black bunny lives around here. He is friendly, not afraid of people, very very cute.

IN the afternoon I was with Tim. Really liked him. He said our job here is to rest,eat, and do therapy, and not be distracted by anything else. With him I walked through the parallel bars, forwards and backwards, a few times, then walked sideways a few times. He tested the strength in my arms (good) and my movement with them. I sat on a wheelchair, stationary, and pushed my foot into a big ball that was in a corner, stretching the leg. Like leg presses. I did a few other indoor things, then we went outside and I went up and down stairs. I'll be fine with the stairs at home. Finally, we moved to my room, where my pulley bed had been placed, and I ran through some pulley exercises, after which he opened the brace and iced the knee. It was very relaxing, or would have been if I could have read over Elinore's constant chattering.

Oh, and I had a shower, which was quite a production. I had to wait almost an hour to get an opening, then had to get to the shower, have the occupational therapist remove the brace and cover parts of the knee that shouldn't get wet. Then I got to sit there and wash to my heart's content. Afterwards, I dried, brace got replaced, I stood up and changed. I felt so much better.

Catching up: Moving Day

Thursday, April 14 was the day I was to move to the San Luis Transitional Care Center. The plan was to do physical therapy in the morning, then pack and get moving.

I woke at about two in the morning with the rash that I have had for months. During the first three days of my stay at the hospital the rash disappeared and I dared to hope that something in the meds I was taking was working on the rash. But its reappearance Thursday morning disabused me of that notion. I asked about getting the prescription antihistamine at the care center and was told that I could simply bring my own bottle with me. I therefore let Maryann know where to find the bottle before she came to pick me up.

We had breakfast and therapy. Shortly after eating, at about 8:40, I started to feel nauseous. This was the first time I'd had this reaction, so I suspected it was not from the pain meds. The nurse suggested it may have been the prune juice they gave me, because of its acid content. Whatever the reason I did not feel well. The nausea came and went during the day, so I was able to get packed, with help, and ready to go.

The hospital offered two options for getting to the care center: by private car with a friend or by dial-a-ride for about $40 for a ride just up the street. My choice was private car. I would have paid the $40 but I did not have any money with me (hospital instructions said "leave it at home") and they needed the cash up front.

Maryann came to get me at a bit after 11 a.m.  The above pic shows me ready to leave, wearing my pajamas. They let me walk out of the hospital. No walker, not even a cane, and I was carrying some of my luggage.  We arrived at the care center shortly after. As I walked in, again carrying luggage, several people gave me strange looks. "A new patient?" They did not comprehend how I could be walking so soon.  They led me to my room and immediately put Maryann to work sorting through my clothes and putting them away. They were ready to enlist her in any number of activities, in fact. She stayed around a while to keep me company during the welcome period.

I did get lunch first. A baked potato, fresh fruit, some kind of vegetable, juice, and coffee as I recall. The baked potato was nicely cooked and I was hungry. It was a better meal than had been coming to me in the hospital, so I was grateful.

The introductory period involved several people. One by one, people from the different departments came to talk to me. Usually at length. They explained their roles and asked if I had questions, generally. The dietitian came with the cook and they asked me many questions about my vegan diet. I gave them a list of easily-prepared foods that they should be familiar with that are vegan, and I told them other things I'd be happy to eat. It was clear that neither of them was particularly familiar with this plant-based eating. We might hope that everyone watches Dr. Oz and Oprah and the many others who have in fact brought real vegans into American homes, but no, that is not the case.  Maryann thought that I gave them plenty of ideas and I was as open as I could be, not fussy except for the no-animal-products part.

The occupational therapist came in to talk about what she does. She helps patients find ways to adjust to the somewhat disabled (or clearly disabled, depending on the patient) condition they will be in when they return home. She has tools and techniques for any occasion. The nurse came in, Gary, had forms to fill out and he was supposed to do a "skin check" as well, but each time he got called away, when he came back somebody else was in the room. He managed to do the skin check that night, after dinner. And no, no problems.

The head of physical therapy came along with a booklet in hand, containing suitable bed exercises and sitting exercises for knee patients. He talked about what they do in physical therapy in a general way and sometimes specifically, and he went on and on and on. Partway through I was feeling nauseous again and I told him I was not feeling well, but he kept talking.  He was interrupted by the cook, who told Maryann that all of the bread they use has honey in it. Maryann gratefully took off to buy me some "special" no-honey bread, and brought it to the center later. She escaped the rest of the PT talk. The physical therapist finally left when interrupted by somebody else. It was an exhausting afternoon and I hadn't actually done anything.

I was so ready to sleep. I lay down on the bed, alone at last. Except for my roommate Elinor, who was on the other side of the curtain.

To be alone with Elinor is not to be alone ever again. She asked me, out of the blue, if I knew what this "Boost" stuff was. I had no idea and said so. She talked about that for a while and segued to other topics, and from time to time I made what seemed an appropriate reply.

Dinner came. I ate, Elinore did not. She had no appetite (hence the Boost) and talked about that for a while. She had certain themes that she repeated and repeated. I'd say it was pretty clear at the outset that she had memory problems. I had listening problems. I was so exhausted that night and the one thing I kept thinking was, "how can I get away from this roommate?"

How Easy to Harbor Resentments

A small combination of factors has led to my feeling irritated and out
of sorts this morning. It's funny how these little factors can add up
and nobody is really at fault.

1. I am in pain. In spite of getting pain meds at six - about an hour
and forty minutes ago - my leg hurts like hell. A note about that: this
is not necessarily the usual experience one has with knee surgery.
Yesterday I was talking to my friend Dorothy, and she mentioned that she
felt pain only when she was pushed in therapy to increase the range of
motion. The rest of the time she was simply pain-free. I don't wish to
represent my experience as typical.

2. Two rooms share a bathroom here. So that's four people. There is only
one person in my room (me) and two in the other.

3. Somebody in the other room has long morning rituals in the bathroom.
It appears that both of the women in that room are frail and it probably
takes a long time to do much of anything, and for some reason she always
takes showers, long ones, and follows that with additional activity in

4. I have been waiting about 45 minutes to get to that bathroom.
Initially I just wanted to get some water in my plastic bin so I can
wash up and brush my teeth, but now I have to use the toilet as well.

5. Because it's morning and I have not gotten dressed I am wearing a
night dress. This night dress is not long and I don't feel comfortable
going to the public bathroom outside this room. Further, because of my
leg brace, it is no easy feat for me to jump into some pants and run on
over there.

If I did not have the brace, if the woman took shorter showers, if if
if... Here I am, feeling a bit distressed for good reason but I can't
blame anyone except for the institution. I can blame them for not giving
me my own bathroom! Somehow I don't see that working out.

Pressing the Red Button

Years ago, in hospitals, people were given the unique opportunity to
control their own pain. When they felt pain they pressed a button and
more pain relief would flow through their veins, from an intravenous
line (IV). This technique is not in fashion any more, from what I have
seen, and of course it would not be used at a rehab center, where you
don't want patients hooked up to IVs if you can help it. Patches are
another way to manage pain relief, with small doses of the pain killer
being released into the bloodstream throughout the life of the patch.
This technique has some drawbacks as well: by the time the pain killer
starts to have a negative side effect on the system, it will still
continue to course through your blood for a while. With pills you can
control the pain more specifically. If there are reactions, stop the
pills. So this is how it is here, at the rehab center. Every other pill
is brought to me in a little cup at regular intervals, but pain relief
is at my discretion. I have to call for it. To do that I press a red
button on a cable near my bed.

I suppose this method reduces the chance of abuse. Every time I want
pain relief I have to call someone and ask for it. I find I am reluctant
to do so. I think the staff is going to pin me as someone who simply
enjoys those pills. They say not, and repeatedly tell me the old refrain
that if there isn't enough pain relief in my system I won't be able to
do the therapy I need to do and therefore will not recover as quickly.
They say it's fine to call for it; if I need it, I need it. Yet still
it's hard.

When I finally decide I need to call I am sometimes in a lot of pain,
even when I call at the earliest possible time. Last night I could not
get relief much of the time. I woke up sobbing, whimpering to myself,
trying to keep down the pain. The dose can be repeated only every four
to six hours, so I could not call between midnight and four, because I'd
had my last dose at midnight. So even if I am johnny-on-the-spot and
call right away when the four hours are up it may not be soon enough,

It's an imperfect system. I expect a good system would include visits
from some sort of pain management person, a doctor of course,who
evaluates a patient's experiences and changes the drug if necessary.
There is a general-purpose doctor on staff here (he is not usually
actually on the grounds, though) to address the odd issues, like my
rash. The pain relief, though, is prescribed by the surgeon, and he is
the one who can change the dose or the medication. I am reluctant to ask
for help from him because he does not visit the care center and any
information would get to him third-hand.

Right now I am in pain and therefore this issue feels more important.
Chances are good that I will find some relief later, with another dose
or two, and I'll get through the day all right.

Tuesday, April 19, 2011

More of the thirteenth

That Wednesday was a day for gifts. First the frog -

Then Maryann's response to my request for a notebook and pen:

Finally, at just before noon a delivery of Thai food arrived at the hospital. Daughter Mary had arranged for it, as well as for the pizza that was delivered the night before (which I forgot to mention in that post!). I had Thai food for lunch and dinner that day. It was a darn sight better than what the hospital had on offer.

Right now I can't get to the published posts to update or correct them (blogger is also blocked, in part, by this rehab center), so I have to make separate posts (by email) with the corrections or additions.

For the curious, here is a pic of my knee at that time:

The mark on the bandage is where there was a little leakage of blood. The nurse wanted to make sure it didn't get larger. The pink pad on the left side of my knee is the drainage hole. It was originally connected to a tube that ran down my leg and went to a container hooked on the end of the bed. When I got up out of bed I had to unclip the bottle and attach it to my walker.

In case it isn't obvious, the blue thing is the open brace. It's made of thick foam, velcro, webbing, and controls on either side of the knee that allow little or a lot of movement. In this pic one cannot see, of course, the outside webbing that belts it together.

Day 3

April 13: two days after surgery. Things looked up. My doc raised the
dosage of percocet from one to two tablets and that solved the
pain-during-therapy issue. I have been on that dosage ever since, hoping
to cut back but knowing that one just does not cut it.

I felt much better after going for a walk with the walker, down the hall
far enough to meet my goal (150 feet before leaving the hospital). Lots
of applause from therapist and roomie Helen, who at least was getting up
and shuffling around some by then. Helen has several daughters, and most
of them showed up at one time or another, sometimes all at once. They
tend to be a bit motherly toward their mom, repeating what she needed to
do and what she should not do. Ordering her around, in other words.One
of them brought many herbal remedies (she called them homeopathic but
they sounded to me like just plain herbal) and insisted that her mom
take them. I don't know if the staff there as told about these
supplements. I hope so.

In the afternoon, as I as returning from my triumphant walk down the
hall, I almost ran into a woman with reddish longish hair, who cried
out, "already walking!". Clearly she knew me. I wasn't sure I knew her
but when she said she had forgotten to bring the books with her I knew
she was Laurie (not sure of spelling, have never seen it spelled) from
Aqua class. She arrived with a large plush frog that has bunny ears, to
celebrate Easter (the ears come off, she said, in case I need him for
some other occasion).

We had a nice conversation once I got back to bed. Why might I not have
recognized her? Because in Aqua she is covered with a
long-sleeved-high-necked jacket, sunglasses, and a large hat. I had no
idea of her eye color even. Now I do!

That night I downed a sleeping pill along with the percocet. It wasn't
easy getting to and staying asleep. It still isn't exactly a walk in the
park,but when I have enough drugs I do well enough.

Good day all around, so much better than the second.

Monday, April 18, 2011

An Unhappy Tuesday

Continuing my catch-up. Tuesday, the 12th of April, dawned early for me. I had slept a lot the night before, still feeling the effects of anesthesia, probably.

People had been telling me that the second day is the worst. I was about to find that out. Contrary to what I wrote in my post about the day of surgery, I didn't actually go to the bathroom Monday at all. I still had a catheter in me at that time. What else? The IV tube was still attached to my wrist (but not to any nutritional source; it was there to allow quick access to my blood in case it was needed. I also had a drain tube from my wound to a bag at the end of the bed. Collecting blood from the wound, thereby reducing some of the swelling and bruising. About this last: interestingly, on Monday, when there was enough blood in the collection bag it was connected to a filter and fed back into my bloodstream - a transfusion of my own blood. This is the way it is designed to work, and is another newer process that I think is excellent. As usual, many measurements were taken during the day. My temperature was one of them, and it happened to be a little up. The nurse told me to use the incentive spirometer (IS) to help bring it back down. This handy little gadget helps clear the lungs of any stray unwanted material, thereby preventing pneumonia and other respiratory infections. The staff told me that when we are not bed-ridden we walk around and provide enough clearing of our lungs, just by breathing, to avoid respiratory illnesses. In the hospital I was supposed to use he device ten times per hour while awake. I used it a lot, but not quite that often. I still have it and am advised to continue using it here, but I don't do so more than ten times a day, usually. Therapy in the morning went well. I got up on the walker and outside the door, to a little way down the hall. Not wondrously comfortable but I was really walking. I was the envy of my roomie Helen, who had difficulty moving her leg at all. In the afternoon, though, everything hurt so much that I was constantly feeling tears spring to my eyes. I was unable to make the IS reach my goal volume of air. I could barely make my leg rise above the bed. It seemed like everything hurt too much. I was afraid I was slipping. I did, however, get the catheter out and went to the bathroom three times that day. I was actually making some progress. It just didn't feel that way.

And today...

I meant to get all caught up before I went into current events but
instead I'll just interweave them. So today.

Today was one week after surgery. I was in the hospital three days, and
moved to the transitional care center last Thursday. I had two physical
therapy sessions Friday, here, one on Saturday, and none Sunday. Today I
am back on the weekly schedule, with two sessions. Plus one with the
occupational therapist. More on her at another time.

I have been taking two percocets about every four hours. But I have
worried about taking so much. The nurses assure me I won't become
dependent but I am not sure if I won't increase my need during the time
I'm here. Also, I noticed that in the doctor's orders that I took with
me from the hospital suggested a reduction in pain medication as time
goes on.

I'd had my morning dose of pain meds at about 7 am today. I found that I
was not feeling much pain when four hours had passed, which was when the
physical therapist came along. I decided to go for the therapy, see how
I did. And I did fine. We did several bed and sitting exercises, did
some standing and at the sink in the bathroom,then we went for walks
that included going up and down short flights of stairs. At the end of
the session I was still okay, so I waited until lunch to get new meds -
six hours after the morning dose. I wanted 1-1/2 percocets instead of
two, but the nurse said the way the order is written I can only have one
or two. I took two. I was thus drugged when I had the second bout of PT
about an hour later. This session, with a different therapist (Tim) went
well, too, was more strenuous and more painful. I don't know if pain
killers will really get to the heart of that kind of pain, the type that
means the muscle is stretching over the knee cap, for example. So I was
pleased to be treated to various burning pains. Tim never pushes too
hard and always insists on rests but one does get one's money's worth.

In the end I felt I was managing the pain better than I had yesterday.
It was just the tiniest notion but it may be true. I have noticed, too,
that I've had no hip pain since the surgery. I do think that's
meaningful. It seems like I am a little bit more stable now than I was
pre-surgery. And the stairs seem easier to maneuver than they did
pre-surgery, too.

Nevertheless, when I go on my little walks around the building I do feel
pressure and pain with every step. I am looking forward to the day that
does not happen. Maybe 12 weeks? Maybe sooner!

One Week Today

Clearly, this blog has shifted focus. I have had surgery. But in other
ways I am still seeking and using solutions to arthritis challenges that
I can do myself.

I am currently at a transitional care center. The Information Tech
people at the center have decided that presents some sort of
security threat to their operation so it is blocked here. I cannot get
to it to post updates. Facebook is also blocked. Therefore I am now
updating by email. I will begin with the day of surgery.

April 11: day of surgery. I arrived at 5:30 am with my friend Maryann,
who is stoking the home fires for me while I am away. We met Helen, also
there for knee surgery, with her daughter Jamie. We got to chatting and
hoped to keep in touch after surgery.

I was brought to a pre-op area, where blood was taken and an IV tube
inserted. It wasn't too long before I was saying goodby to Maryann and
heading off to the operating room. Interestingly, I had a spinal block
for the area from my waist down, numbing it completely, and a sedative
("twilight sleep", they said) above. So I was capable of being awake, to
some extent, during surgery. I had hardly slept at all the night before
so I conked out. I woke up as the finishing touches were being made to
my leg. I could feel and hear the brace being attached to my leg with
velcro, although at the time I did not know what it was.

I woke as if from a good sleep. I felt rested. I was wheeled to some
sort of recovery area for about an hour, then taken to my room, where I
found Helen, to my delight.

That afternoon the physical therapy person brought me a walker and
helped me stand up. I felt pain but I was able to manage it. I did some
side steps, using the walker, that day, no more. The physical therapist
also helped me with several exercises to do in bed, involving a pulley
and sometimes a plastic bag. I was feeling good and capable. By that
night I was managing to get to the bathroom (a few short steps from my
bed) on my own, with a walker. It was not a pleasant experience,
however. The bathroom was not equipped or sized for people with
disabilities. The toilet was low and the space very tiny. I had quite a
challenge getting up from the seat. However, I felt like I was doing
well and so did the staff. Helen was having a much harder time because
the medications they gave her were not effective. It was not until the
evening that they finally gave her percocet, which is what I was on, and
that worked. I went to bed feeling like wonderwoman. I could do this.

Getting there- test of update by email


sent from mytouch


Sunday, April 10, 2011

I'm Excited

The day is almost here. Tomorrow I get knee surgery. And after several days of uncertainty and then nervousness I am now excited. I am thinking about how it will be to have one straight leg, for example. Miracle!

This afternoon I visited the transitional care center. I went there mainly to check on the food - as I am vegan I wanted to be assured that they could feed me. The answer was a reserved "yes". They try to accommodate all kinds of diets. I am now working on a list of simple vegan dishes to give them. No recipes, just ideas - veggie chili, spaghetti with marinara sauce, peanut butter and jelly, mushroom and barley soup, and so on.

While I was there I saw the therapy room (small and not a lot of equipment) and the break room and living room and a typical bedroom (two beds with a screen between).  It's a small, homey kind of place. I expect I'll be able to do some reading there easily enough, along with the therapy. The patients I saw there were older than I am, which suggests to me that I may be able to get through the therapy more easily. We'll see.

As always, getting ready to go somewhere takes a lot of work. I bought two more bags of kitty litter (I blend two types), I washed lots of clothes, I cleaned this and that and now I think I am reasonably ready. and I am getting excited.

Wednesday, April 6, 2011

The Stress Test

Today was my stress test. I went to sewing class in the morning and left at about one to get to the cardiologist's office. I spent more time filling out papers than doing the test - or at least it seemed that way. It actually did take over an hour for everything.

First they did an ultrasound of my heart. This meant they plugged pads with cables on various parts of my chest, then I lay on my left side while the technician moved the instrument around a little, first on about the center of my chest, then on the lower left side. She got pictures of my heart beating away nicely. Then another person came in and put an IV in my right hand. It hurt! Another person plugged more cables in different places on me for an EKG and finally they hooked me to the drip bag and the test actually began.

They started with a low dosage of this stimulant and gradually increased it. By the time they hit my target heart rate I could hear my heart and feel it thumping away, and I felt a bit dizzy. After topping out the cardiologist said my heart is fine and left the room. It was a few minutes before my heart beat came back to normal. The results were faxed to the surgeon's office so I should be hearing about the surgery date for sure soon.

Monday, April 4, 2011

The Story So Far

I checked with my insurance company and they verified that I do not have a pre-existing condition clause in my supplement. Thus my supplement is effective now. So that takes away one worry. I was scheduled for April 4 and I was ready for it:

* I got the EKG and the chest x-ray on March 12.
* I got the blood and urine tests the following week.
* My daughter made a reservation for a plane ticket to be with me for the first three days.
* I arranged to put a hold on my gym membership starting April 4 (that's today).

But then came the glitch.

I was scheduled for a pre-op appointment on March 30 with the doctor, and with a rep from the hospital on March 31. When I went to the doctor appointment the nurse told me she had been trying to reach me. There was an abnormality on my EKG and they were trying to get clearance from my regular doctor. The surgery may have to be postponed. But because I was already there the doctor came to see me. I told him I really wanted to stick to that original date if we could. He said he would go ahead with the pre-op appointment and I should go ahead with the hospital pre-op appointment and he would do what he could to keep it on schedule.

At the pre-op at the doctor's office they took my temp and blood pressure, then the doc came in to explain what I would need to do from that point:

* Get prescriptions for one oxycontin tablet, to be taken the day of the surgery, plus a special kind of antibiotic to take on days I had dental work done (after surgery for the rest of my life), plus another type antibiotic ointment which I would dab into each nostril twice a day until the day of the surgery.
* Pick up a cleanser called Hibiclens. I would clean my leg, from armpit to toes, twice a day, using this formula.

The ointment and Hibiclens have been shown to reduce chances of infection significantly. The use of the antibiotic before dental work reduces the chance of infection in the knee.

The following day I went to the hospital, got shuffled from place to place, finally met with a couple of reps there. Lots of papers. They did the filling out, asked me questions. Essentially I was pre-admitted so I would not have to fill anything out when I came in for surgery.

The following day I learned that no, the surgery can't go forward on April 4. The cardiologist who looked at the EKG could not, in all conscience, clear me for surgery. I took a lot of deep breaths, could hardly blame them for this decision. The doctors both talked to me at length, both worked hard to get this issue cleared up as quickly as possible. I ended up with an appointment for a stress test for this Wednesday, April 6.

And so my daughter changed her plane reservations, I changed the hold on my gym membership, and I have been explaining and explaining to those I meet that no, no surgery yet.