This seems to be a common theme running through this whole experience. The medical services people of my generation and earlier are used to receiving and the type of care that's available today are just two different things. The bottom line is that if you don't have someone paying attention you're screwed. You will get a different story from eveyone you talk to, and then the outcome will be something different yet. We were under the impression (from the hospital oreientation) that in-home skilled nursing would be taking care of removing the staples. This was reiterated at the surgeon's orientation that case management from the hospital or rehab would take care of scheduling the staple removal at 12-14 days after surgery.
Well, imagine my surprise yesterday when the outpatient rehab told us that they were not responsible in any way for the staple removal. Brent came home and went through all the appointments that were scheduled by the case manager at rehab: 1st appt. at outpatient rehab, post-op appt. with surgeon; 1st post op appt. with primary care physician. Nope, no appointment for staple removal.
I know that Brent called the surgeon's office yesterday and had not heard back until sometime today. I think he and Jayne are keeping me out of the loop as they work through this, trying to keep me calm. A good call on their part too, as I'm starting to panic. Today is day 12, so this needs to be taken care of somewhere between today and Thursday.
Truly the only thing keeping me calm is that I know I have the best pit bulls on my team.
Tuesday, June 15, 2010
Monday, June 14, 2010
Diligence Pays Off
It was a pretty good weekend. A time to settle in and get things rearranged to accommodate the walker and all the other gadgets I'll need for a short period of time. A time to get my system back to normal. A time to get some real rest and sleep without being awakened every several hours.
Thanks to Loren for loaning and sturdy chair with arms from his waiting room. It's been multi-functional; great for dining, doing seated exercises, and sponge baths. Renee and Jeff brought a nice upholstered chair with great arms and it's been so comfortable to sit in for an hour or so.
Good for visiting, icing knees, or even watching the Tour de Suisse.
I was very conscientious about my exercises this weekend. I tackled the standing exercises on Saturday afternoon. Using the butcher block on one side and having someone sit in a chair so I could hold onto the back of the chair, I was able to replicate some parallel bars. Worked great having someone built into the equipment to do the rep count and read directions for the next exercise.
Sunday I tackled the seated and the supine items. I hate the seated exercises. The one where I have to just slide my foot in as far as I can just kills my left knee. I've gotten smart enough to break out the headphones for the seated exercises. I had my music on, my eyes closed, and tears streaming down my face. The next thing I knew, someone was rubbing my back. Jane rubbed my back as I finished up the last of the "hurty" moves. It was awesome and really helped me get through it. I am being very tenacious and it paid off today.
Today was my first day of outpatient rehab. I chose the Pinnacle Health Rehab at the old Osteopathic Hospital. The facility, in the Bloom Center, is new and very nice. The "gym" is bright and airy, very clean, and brand new equipment. My therapist, Nate, is a young guy and seems pretty nice. This first session was just spent taking the history and taking measurements. Well, last Friday my left knee was 45 active (54 passive). Today is meausred at 54 (60). I'll take that increase! Nate said that the swelling is going down and my diligence has paid off. I'll be going 3 times a weeek. He showed me a few addiional exercises to add to my book. He said I seem to have a good attitude and he expects things to go well. I think we're on the right road.
Thanks to Loren for loaning and sturdy chair with arms from his waiting room. It's been multi-functional; great for dining, doing seated exercises, and sponge baths. Renee and Jeff brought a nice upholstered chair with great arms and it's been so comfortable to sit in for an hour or so.
Good for visiting, icing knees, or even watching the Tour de Suisse.
I was very conscientious about my exercises this weekend. I tackled the standing exercises on Saturday afternoon. Using the butcher block on one side and having someone sit in a chair so I could hold onto the back of the chair, I was able to replicate some parallel bars. Worked great having someone built into the equipment to do the rep count and read directions for the next exercise.
Sunday I tackled the seated and the supine items. I hate the seated exercises. The one where I have to just slide my foot in as far as I can just kills my left knee. I've gotten smart enough to break out the headphones for the seated exercises. I had my music on, my eyes closed, and tears streaming down my face. The next thing I knew, someone was rubbing my back. Jane rubbed my back as I finished up the last of the "hurty" moves. It was awesome and really helped me get through it. I am being very tenacious and it paid off today.
Today was my first day of outpatient rehab. I chose the Pinnacle Health Rehab at the old Osteopathic Hospital. The facility, in the Bloom Center, is new and very nice. The "gym" is bright and airy, very clean, and brand new equipment. My therapist, Nate, is a young guy and seems pretty nice. This first session was just spent taking the history and taking measurements. Well, last Friday my left knee was 45 active (54 passive). Today is meausred at 54 (60). I'll take that increase! Nate said that the swelling is going down and my diligence has paid off. I'll be going 3 times a weeek. He showed me a few addiional exercises to add to my book. He said I seem to have a good attitude and he expects things to go well. I think we're on the right road.
Sunday, June 13, 2010
Home At Last
I am amazed that I made it into the passenger seat of the Buick! We made one pit stop along the way to get more comfortable (and to say a quick prayer for Brent's improved driving skills and that of all the truckers on I78). All in all, it wasn't too bad.
I think I mentioned previously that my friend Jayne Zamzes was brave enough to volunteer to take care of me this first week home. I can't believe she was willing to drive up from North Carolina for the week. I know that Jayne will have everything and everybody (myself included) whipped into shape in no time.
Kylie's 4th birthday is coming up on June 14. Months ago it seemed perfectly reasonable to expect to be home by the 10th and to have the family birthday celebration at my house.
Really. It did. Perfectly reasonable for someone mentally challenged! Thank goodness my family was willing to take care of everything because they knew that I didn't want to miss seeing Ky for her big dayl A feast of Ricky Burgers, Kera's bake-ed beans, Mom's children's veggie platter, another of Kera's cake masterpieces and the usual picnic odds and ends made me so thankful my family indulged me. They certainly picked up the slack.
Kylie seemed really excited about all of her gifts. The party finished up with the girls giving us a little dancing recital done to Gwen's request for classical music. They are just so cute where they are, I wish they didn't have to grow up.
I think I mentioned previously that my friend Jayne Zamzes was brave enough to volunteer to take care of me this first week home. I can't believe she was willing to drive up from North Carolina for the week. I know that Jayne will have everything and everybody (myself included) whipped into shape in no time.
Kylie's 4th birthday is coming up on June 14. Months ago it seemed perfectly reasonable to expect to be home by the 10th and to have the family birthday celebration at my house.
Really. It did. Perfectly reasonable for someone mentally challenged! Thank goodness my family was willing to take care of everything because they knew that I didn't want to miss seeing Ky for her big dayl A feast of Ricky Burgers, Kera's bake-ed beans, Mom's children's veggie platter, another of Kera's cake masterpieces and the usual picnic odds and ends made me so thankful my family indulged me. They certainly picked up the slack.
Kylie seemed really excited about all of her gifts. The party finished up with the girls giving us a little dancing recital done to Gwen's request for classical music. They are just so cute where they are, I wish they didn't have to grow up.
Friday, June 11, 2010
Putting it All into Perspective
The reality is that my day started out kind of bad. This nutso OT (you know the type, they're always late, their hands are going along with their mouths to explain away their incompetence, there's a whole lot of commotion and very little accmplished) should have been in my room to wake me up at 7....yes, that's AM. When OT works with you in the morning before breakfast they actually get you into the shower (otherwise you do your sponge bath in the sink by yourself) and you're all ready for breakfast at 8. Today I also had PT scheduled at 8:30.
So she showed up at 7:30, already 30 minutes late with a multitidue of excuses rolling off her tongue. "Would you like a shower this morning?" Yes. "Ok, I'll be back in a minute." Unfortunately I promptly fell back asleep and when I awoke it was 7:52. Crap. I had 8 minutes to get myself out of bed, cleaned up and over to breakfast.
Motor Mouth was full of excuses, but she did roll me into breakfast where I met my nurse with my next fix. I inhaled about 1/2 of a bagel and swished the pills down with half of my grape juice, and propelled myself down the hall for PT. You know how that went from a previous post.
MM (new acronym for Motor Mouth) told me to come down to see her in OT and she would show me how to put my shoes and socks on. Ok, cool. But, I clearly forgot who I was dealing with. MM. MM yammered about how cool my socks were, handed me one and just stood there. Duh. I don't care for the sock gadget, but wouldn't you think she would have some ideas about how to get them on. I mean if she's just going to stand there then I really don't need her for anything. She watched me fumble around for awhile then without a word put them on me.
Next came the shoes. "I'm not sure your swelling has gone down enough to get your shoes on." HUH? Then seriously wth am I going through this exercise in futility? I am seriously trying to Again, she handed me a shoe and just stood there waching me. I pulled a few of the last laces out opened it wide and got it on. I struggled but finally got it loosely tied. I looked up from my accomplishment, and I kid you not, she had disappeared. No lie, this loon was nowhere to be found!
My roommate and I exchanged a few rolled eye glances and I headed back to my room. Guess what I found on my way? Yes, here came MM carrying a glass of ice water. "Are you practicing walking in your shoes?" Yup, I'm practicing walking right back to my room. "Oh no, we should kill 15 minutes more (aha! Billable Hours!Finally, the first thing I could understand about this entire crazy situation!) how about you lift the bar a few times?" That was technical occupational therapist lingo for do 3 sets of 10 arm curls. I did them and cross my heart hope to die stick a needle in my eye, she had disappeared again. Honestly, you can't make up stuff like this.
There was no stopping me this time. I made a beeline for the door and my room where I could vent in reasonable peace either under the towel (which I forgot) or behind Curtain #2, the bathroom curtain.
So she showed up at 7:30, already 30 minutes late with a multitidue of excuses rolling off her tongue. "Would you like a shower this morning?" Yes. "Ok, I'll be back in a minute." Unfortunately I promptly fell back asleep and when I awoke it was 7:52. Crap. I had 8 minutes to get myself out of bed, cleaned up and over to breakfast.
Motor Mouth was full of excuses, but she did roll me into breakfast where I met my nurse with my next fix. I inhaled about 1/2 of a bagel and swished the pills down with half of my grape juice, and propelled myself down the hall for PT. You know how that went from a previous post.
MM (new acronym for Motor Mouth) told me to come down to see her in OT and she would show me how to put my shoes and socks on. Ok, cool. But, I clearly forgot who I was dealing with. MM. MM yammered about how cool my socks were, handed me one and just stood there. Duh. I don't care for the sock gadget, but wouldn't you think she would have some ideas about how to get them on. I mean if she's just going to stand there then I really don't need her for anything. She watched me fumble around for awhile then without a word put them on me.
Next came the shoes. "I'm not sure your swelling has gone down enough to get your shoes on." HUH? Then seriously wth am I going through this exercise in futility? I am seriously trying to Again, she handed me a shoe and just stood there waching me. I pulled a few of the last laces out opened it wide and got it on. I struggled but finally got it loosely tied. I looked up from my accomplishment, and I kid you not, she had disappeared. No lie, this loon was nowhere to be found!
My roommate and I exchanged a few rolled eye glances and I headed back to my room. Guess what I found on my way? Yes, here came MM carrying a glass of ice water. "Are you practicing walking in your shoes?" Yup, I'm practicing walking right back to my room. "Oh no, we should kill 15 minutes more (aha! Billable Hours!Finally, the first thing I could understand about this entire crazy situation!) how about you lift the bar a few times?" That was technical occupational therapist lingo for do 3 sets of 10 arm curls. I did them and cross my heart hope to die stick a needle in my eye, she had disappeared again. Honestly, you can't make up stuff like this.
There was no stopping me this time. I made a beeline for the door and my room where I could vent in reasonable peace either under the towel (which I forgot) or behind Curtain #2, the bathroom curtain.
Lowering My Expectations
Since I'm checking out of here tomorrow, we needed to go through everything to make sure I can walk far enough, do the steps, and take measurements. Flew through the first two "tests" with no problem. Then we warmed up the knees with a series of exercises and then measured the range of movement. It's taken me all day to write this post because I'm not sure what I think about the outcome. They measured both knees for active and passive straightening and bending. Active is me doing the action, and passive is the therapist pushing my poor fatigued body parts into the crazy pretzel shapes (ok, this might be a slight drug-induced exaggeration):
Active Straightening: Right -7, Left -6
Passive Straightening: Right -5, Left -4
Active Bending: Right 64, Left 45
Passive Bending: Right 72, Left 54
All I know is that when the therapist bent my left knee in as far as she could I let out either a loud moan or a soft scream (LOL! Not sure which). Holy moly that hurt. I guess I thought the right knee measurements were about right but I was surprised that the left measurements were so bad. Big numbers, I'm looking for massive flexion here! I've worked my butt off so is it too much to expect better results?
Apparently so because what actually happened was that I was upset, I vented to a friend, and I forgot to put the towel over my head. The truth is out there now. They really were tears.
Active Straightening: Right -7, Left -6
Passive Straightening: Right -5, Left -4
Active Bending: Right 64, Left 45
Passive Bending: Right 72, Left 54
All I know is that when the therapist bent my left knee in as far as she could I let out either a loud moan or a soft scream (LOL! Not sure which). Holy moly that hurt. I guess I thought the right knee measurements were about right but I was surprised that the left measurements were so bad. Big numbers, I'm looking for massive flexion here! I've worked my butt off so is it too much to expect better results?
Apparently so because what actually happened was that I was upset, I vented to a friend, and I forgot to put the towel over my head. The truth is out there now. They really were tears.
OT: A Picture is Worth a Thousand Staples
Gadgets - Trust me there are more gadgets than you can imagine. This gadget is designed to pick things up. As my neighbor Loren discovered today though, it won't hold a full styrofoam glass of water. Leave it to Loren to decide to clean the floor in my room!
Sock on...yeah, I don't think if does sock off.
Here's the very cool 3-in-1 commode which you can actually place over your commode at home. This will give you some height and the handles help you get up and down. Is this TMI or what??!!
The gel ice bags are worth their weight in gold. This is truly something to look forward to following a painful pt session. Here's the crazy thing about them. This is a rehab facility. The only place these suckers are used is in the pt room. We're supposed to ice the knees at least 6 times a day, so if you have pt twice a day, you still need to get ice on them 4 more times. In the rooms, they have these cheap little "accu-therm" bags that hold next to nothing and don't get cold enough to do anything. Apparently the good gel packs have a habit of disappearing, so here you are in rehab where you can't really do a good job of icing your knees for some strange reason that no one understands.
Each morning the aide changes the dressings (the white strips) and wraps my legs in ace bandages and puts on the slipper socks. The bandages help to keep the swelling down and they stay on until around 8 at night. That's the end of visiting hours and time to take the second sponge bath of the day at the sink in the room. You can kind of see the lines drawn across my knees. The surgeon matches up the lines when he staples the incision shut. I have no idea how many staples were used, but each knee is just a full line of staples all along the white bandages.
Getting out of bed requires you to heft the dead weight of your legs over the side, let gravity help to painfully bend the legs to the floor, push up from the bed, and shift weight onto the walker.
Getting in and out of bed presents all kinds of challenges. A hospital bed allows you to lean on the railings to get some leverage. Occupational Therapy helps you practice all sorts of everyday tasks. In fact, this facility has a mocked up apartment with a bathroom, bedroom, living room, dining room and kitchen. It has a washer, dryer, fridge, sofa, bed...all the stuff you have to deal with at home. Diane took pictures of my OT session on Tuesday.
Thursday, June 10, 2010
Turning the Corner
As you can see from the word of the day, it was a rough night. I h0pe that soon my drugged up body will decide to resume those natural bodily functions and save my any more humiliation in the middle of the night.
I was in a stupor this morning, but knew I needed to get a move on to make the day's schedule: 7:00-8:00 Morning Ablutions, 8:00-8:30 Breakfast, 8:30-9:30 PT, 11:30-Noon OT, Noon-1 Lunch, 1:00-2:00 PT, and 5:30 Dinner. I needed to also consider the meds and how to best fit a nap in. Ah the busy schedule of the rehab resident.
It was cutting it close this morning for the AM drug regimine to kick in for PT. But, I didn't feel too bad. In fact, it was going so good that the therpist suggested that if I finished the supine exercises in the morning, we could cut the afternoon time back to 30 min. Hmm. I searched for any hidden meaning in this because those therapists are tricky little buggers. (For example, the slim, attractive therapist says ,"If you do 3 more we can stop. Yeah. What she means is do 3 more of these and we can stop...AND move onto the next thing.) It's all semantics the cute little triksters. I couldn't see any chicanery, and things were feeling pretty good, so I opted to continue on. I did a total of 1.75 hours this morning and when I rated my pain between 2/3 my therapist and I were both thrilled. The bad leg usually hovers around a 5, and sometimes after therapy I've rated it a 7/8 (and if I was not crying under the towel, it was probably an 8/9). Great news, but I was cautious, trying not to be too excited.
I came back to my room and who found me there but Deb and Loren. Loren found that my little "gripper" tool will not hold a full styrofoam glass of water. Boys and their toys.
They went along with me to OT and today we tried the shower bench in the full tub bath. This worked great and I think this will be the way we go. This place actually has a full demo apartment with washer/dryer, fridge, counters, bedroom, bathroom, etc. You can go to the apartment and try out the different types of equipment to decide what will work the best for you and your situation.
Deb and Loren had lunch with me and we went for my reduced PT schedule. It's actually good to have someone else go along to PT. Just because I think I'm getting a lot of range of motion doesn't mean that's really what's happening. There aren't really good mirrors so it's sometimes hard to determine if you're doing it correctly. The good news was that following Round 2 I rated my pain level at about a 1. Have I turned the corner? Tomorrow will tell.
It has been confirmed now that I will be coming home on Saturday. I believe the hospital bed, walker, and commode are being delivered tomorrow. I'm really happy about the news, but I'm a little nervous too. This is a controlled, relatively safe environment and being home will be, well it'll be real life I supposed.
I was in a stupor this morning, but knew I needed to get a move on to make the day's schedule: 7:00-8:00 Morning Ablutions, 8:00-8:30 Breakfast, 8:30-9:30 PT, 11:30-Noon OT, Noon-1 Lunch, 1:00-2:00 PT, and 5:30 Dinner. I needed to also consider the meds and how to best fit a nap in. Ah the busy schedule of the rehab resident.
It was cutting it close this morning for the AM drug regimine to kick in for PT. But, I didn't feel too bad. In fact, it was going so good that the therpist suggested that if I finished the supine exercises in the morning, we could cut the afternoon time back to 30 min. Hmm. I searched for any hidden meaning in this because those therapists are tricky little buggers. (For example, the slim, attractive therapist says ,"If you do 3 more we can stop. Yeah. What she means is do 3 more of these and we can stop...AND move onto the next thing.) It's all semantics the cute little triksters. I couldn't see any chicanery, and things were feeling pretty good, so I opted to continue on. I did a total of 1.75 hours this morning and when I rated my pain between 2/3 my therapist and I were both thrilled. The bad leg usually hovers around a 5, and sometimes after therapy I've rated it a 7/8 (and if I was not crying under the towel, it was probably an 8/9). Great news, but I was cautious, trying not to be too excited.
I came back to my room and who found me there but Deb and Loren. Loren found that my little "gripper" tool will not hold a full styrofoam glass of water. Boys and their toys.
They went along with me to OT and today we tried the shower bench in the full tub bath. This worked great and I think this will be the way we go. This place actually has a full demo apartment with washer/dryer, fridge, counters, bedroom, bathroom, etc. You can go to the apartment and try out the different types of equipment to decide what will work the best for you and your situation.
Deb and Loren had lunch with me and we went for my reduced PT schedule. It's actually good to have someone else go along to PT. Just because I think I'm getting a lot of range of motion doesn't mean that's really what's happening. There aren't really good mirrors so it's sometimes hard to determine if you're doing it correctly. The good news was that following Round 2 I rated my pain level at about a 1. Have I turned the corner? Tomorrow will tell.
It has been confirmed now that I will be coming home on Saturday. I believe the hospital bed, walker, and commode are being delivered tomorrow. I'm really happy about the news, but I'm a little nervous too. This is a controlled, relatively safe environment and being home will be, well it'll be real life I supposed.
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