Friday, July 29, 2011

And Now for the Rest of the Story


lateral radiograph post op

Lateral radiograph with overlay

AP radiograph post op
For those who read my previous blog post describing my surgery (March 19 (more information revealed)), I apologize, I have misled you. I pulled up a picture that seemed to fit with my MRI with the medial damage. However, my procedure was a Total Knee Replacement. I think these pictures will make more sense. I found a schematic and a couple of x-rays that better describe my reality. 


continuous passive motion machine

I haven’t read  everything posted about this surgery, but felt I had a handle on it. I had only heard 2 negative anecdotes and one of them  included infection. (Pat’s story is a horror story.)  Everyone agreed that if you do the physical therapy, you will be so happy you had the surgery.  My surgeon, Dr. Robert Bane, has a fantastic reputation among former patients and healthcare workers. I, of course have extra confidence in him because his father is still practicing veterinary medicine in a near-by small community. I feel I know that he comes with more than good education and surgical skills.. At this point, my only disappointment has been the pain level. You probably know that they constantly ask you where your pain is on a scale of one to ten. . That is tough because it is perfectly clear to me that you cannot understand another person’s perception of pain. Therefore they try to establish a scale for you, using this system. I think I started with a slightly high number and relatively narrow window. I do know that I spent the first few days  at “Barely tolerable. I went into this with the belief  that I have a fairly high pain tolerance. I need to take you back a few years to sy sense of “toughness” developed. Growing up on the farm in a relatively unemotional family,  I thought Ii was pretty tough although I didn’t  remember my broken collar bone at 3-4 from falling out of the hay mow. I had had my share of smashed fingers from hammers, slipped wrenches and gate and cardoor pinches. I had had more than my share of “nad smashes” from icy wooden fences, sports and nasty cousins and friends who thought a nad punch was funny. On the negative side, I remember being knocked out by Elbert (Bud) Lewis in junior high when we boxed on the stage during noon gym playtime. That wasn’t necessary a toughness issue, but it did shake my physical confidence.  I  got to remind Bud about this last summer. He remembered more that we both ran the distances for the Silver Lake track team. Somewhere in my  writing s, I have described the “tough Mitchells in our class. During “middle school” years there was Mitchell Manns (And his gorgeous sister Della) . Also from somewhere around that time through graduation  was Mitchell Bradford. I may be misspeaking but it seems these guys would get into contests to see who could hold their arm over a burning lighter the longest. If they didn’t really do this, they were the type of guys who would.. I know they did fight a lot , and although I never got into fights , I was always glad to know they were my friends  at the “Tippy” Hop and other similar youth rumble prone occasions.. This is specifically  important here because Mitchell Bradford had total knee replacement this spring and is walking 18 holes several times a week, pain free. He admits that his pain tolerance is much higher than for most people.. Did I say that Mitch has always had one of the most tender and caring hearts I have known?  So with Mitchell’s success as my goal, I do understand that my pain tolerance isn’t what I thought it was. I am so concerned that adhesions will form that I am being diligent  with the exercises.. In the hospital, as I bore more weight on my operated leg, there was a little sideways motion. They felt it was because the nerve block hadn’t completely worn off yet.  As we moved toward going home time , everyone seemed very happy. Oh, my diabetes  control got a little messed up but seemed to  be coming around.   So, home we go.
                                                                   
This is a good place to mention that I didn’t really think we would need help at home. After the boys visited me in the hospital, they had a meeting and mobilized an army. WE ARE SOOOO THANKFUL. Thankful first that at this time within our family there is time available for people to be at our house helping out. Thankful also that it is within their hearts to do so.. At this point Bruno hasn’t been here, but the only people who have bumped into my leg inadvertently have been adults.  The first problem was the evening we came home., I have mentioned that my diabetes control had gotten a little shaky. Well it seems that I was “not myself” Sunday evening. My blood glucose had dropped to 33… hmmmm.. We have been keeping track and have kept in in line sense. Monday  went as expected except that my entire right leg got swollen and the knee was swelling more.. Through that we worked out the tasks of keeping my foot elevated when sitting up and keeping the knee above my heart when in bed.  Oh, when I got out of bed, my left foot slipped off the covers and my right foot came to the floor “more quickly” than I had planned.. It gave me a bit of quick pain, but nothing of concern.  The next morning,  (Tuesday) it was Sophia, Ava, Georgia and I. The girls  had really stepped up and had done so well. However, they had stayed up a little late, so when I needed to get up Tuesday Morning, we had to wake Sophia. She and Ava came in and we started the procedure. Sophia seemed a bit “out of it” but responded that she was “just tired” when asked how she was.    We found out later that she had a headache and was dizzy, but thought she could “get through this, then could go rest. Again, I asked her if she was  OK. She gave this little grimace, shook her head slightly “no” and fainted, falling on me, with both of us crashing to the floor. OMG!!!   Foul language came pouring from me, Ava ran to get Georgia who thought we were having an earthquake. I couldn’t see Sophia because the end table we fell on was between us. Georgia came and untangled us from the table and Sophia was sitting on the floor against the chest of drawers, but “asleep”. She soon regained consciousness  and Georgia and Ava got her something to drink and out of the scene. Georgia started calling for Greg and Jeff.  I had gotten to a relatively comfortable position, lying on my sides. If fact, it felt quite good since I hadn’t laid on my side since Thursday morning.. The boys got here and lifted me back up and we were in business. When told about the incident, then next door neighbor made sure we had their cell numbers so we could call them should a similar incident occur again. ( We could have run over and pounded on the door, but that’s not where our mindset was. (It’s nice to know that you have neighbors available for such stuff..)  Fortunately, we had a home care nurse scheduled for 8am (one of the reasons we were trying to get things moving. We also had a physical therapist schedule for early afternoon. They both agreed that it appeared that no damage had occurred in my knee. The nurse also examined Sophia and said she was “OK”  Apparently she may be manifesting a syndrome that her mom and sisters went through. I think they are having her seen by a doctor, just to make sure. 

From then on, everything has been good. Good night’s sleep with pain level nearly constant at 3 (that’s good for me.) Got back on the computer. The Continuous Passive Motion machine that I came to love in the hospital because it gave me the confidence that adhesions were not forming, was discontinued until Dr. Bane could see me on Friday and get an x-ray. They want to be sure there is no damage before allowing the machine to “force” my knee into motion. We are also to put off the stretching exercises, only using isometrics to strengthen muscles..  This morning, Mahala helped me with the early morning stuff and Sophia just woke up to come help me get out of bed. She came in and looked very much like she did on the fateful morning. I said, “Mahala, keep her away from me.”  We all had a good laugh.

Here we are now early Friday afternoon., waiting for the Physical Therapist to come. It should be a very eventful meeting. Rod and Charlie took me to see Dr, Bane. Georgia stayed home and tried to rest. Her dental situation has gone from bad to worse. . She is in constant pain.. We did get hold of her dentist who is in Chicago and he started her on antibiotics for yet another root canal ablation.. (If you don’t know that word, get off your butt and look it up.)    Dr. Bane was happy with the x-rays.  He thinks the slightly extra laxity in my joint is due to the same problem we have been fighting with the exercises. The Therapist talks about a “guarding syndrome, where the muscles “refuse” to work as an effort to guard the limb. I do know that if I get my leg up in the air, I can hold it there, but I can’t initiate the move…. Really weird. Now that we know that there isn’t anything wrong with the joint, I expect Dr. Bane to turn the Physical Therapist loose to become a “Physical Terrorist”. I’m not afraid, however because he has been so gentle to this point. I need to read some on the guarding syndrome, but at least I don’t feel like such a wimp. All we have to do is to convince my muscles that it is OK to contract when asked to do so. Thanks to all for your prayers. As I said, we couldn’t be more blessed for the home care we are getting, both from the professionals and the family. It’s nice to know that where there is a need, the need will be met. I said yesterday that I felt about the way I expected to feel when I came home from the Hospital (4 days earlier). My intent for this post was to clear the air. I wanted people to know that it wasn’t a painless procedure. Either those who “witnessed” to me about this surgery just forgot those first few days, they are much tougher than I, or they just lied. When I think about it, nearly everyone started their description a few weeks after surgery. Now I know why. I can say that here a week after surgery I feel pretty  good in all respects. I just can’t get this leg to do what I want. I’m sure Raymond will get things going. I’ll have to post again once I reach that place where people start bragging  (in a good way) about the things they can do. So, Mitchell, make those trips around the course for me til I’m able to do something similar. I don’t golf (Right Terry???) but I am so ready to tend the garden, etc.. I’m sure the therapy folks will have something a little more vigorous for me.

Friday, July 8, 2011

How are we supposed to stay slim.... with all this good food?

Warning, don't read this post and follow links if you haven't eaten in the past 2 hours. But if you are looking for some really tasty food, read on. Aside from the occasional breakfast at Sammy's or LePeep and a once in a while lunch at Lil Porgys, (http://lilporgysbbq.com/) when we are home, I think we eat in a fairly healthy manner. Of course those breakfasts and lunches only occur when the timing and route of my business takes me there. (It's amazing how those things just seem to work out). When we are on the Oregon or Florida coast we make it a point to eat as much fresh local fish as possible. Over the years I have migrated from the deep fried version to grilled and blackened cooking methods. That all sounds like it shouldn't be so difficult to shed this "apple" shape that I inherited. We just returned from our (every 2 year) week on the Florida coast. Did pretty well the first night by eating grilled fish at the River Grill. (http://rivergrille.net/), but on the way home we stopped at Rita's (http://ritasice.com/). That blew all the good decisions I had made earlier. The next night, I again made good decisions by eating ahia tuna at the North Turn (http://www.racingsnorthturn.com/index.php) at Ponce Inlet. Alas, the group had a hankerin for ice cream again. This time we stopped in at Hershey's ice cream (http://www.hersheyicecream.com/) another place I had never heard of. I really recommend the peanut butter cup if you like that sort of thing. Before we launched out for Disney, we ate one more meal out (I think).... I had seen the Bonefish Grill (http://www.bonefishgrill.com/) before and knew it was a chain of sorts. Some how, we passed up a couple of my favorites from the past, Since we never made it to the lighthouse at Ponce Inlet, we didn't eat at Down the Hatch (http://www.facebook.com/pages/DOWN-THE-HATCH/176321229346). It is a real boat dock restaurant with fishing boats coming in and out of the inlet and brown pelicans roosting on the dock posts. We had some really funny conversations about another great eating place, Barnacles (http://barnaclesonline.com/) . As it turned out, the Bonefish Grill was fantastic although maybe a little "spendy". I again made a good choice with fish tacos.... mmmmm good!. I think everyone in the group was again fully satisfied, until we walked out the door. That big ice cream cone flashed in someone's head and away we went again. this time south to "Cowlicks". For years we had driven past this place on the way to the North Turn or Ponce Inlet. Let me tell you that Cowlicks and Hershey's makes Baskin Robbins seem like the McDonalds of ice cream. Sorry, I couldn't find a site for this Cowlick's, but here something to help if you're in the area. (Oh, the black raspberry was absolutely wonderful.) (http://www.urbanspoon.com/r/124/892119/restaurant/Cow-Licks-Homemade-Ice-Cream-Daytona-Beach) . Well, we ran out of eating times with the whole group, so after a couple of days at Disney and a last breakfast together before the kids left, we could now eat a bit more on the healthy side, right????  Well, we finally got clear on a couple of "new" place Georgia's sister recommended from her trip last spring. Friday night, we went another direction and took her advice to eat at a place in Port Orange. Genovese's, an Italian place, which also had a site in Ormond Beach, but supposedly the bread is better in Port Orange. (http://genovesesitaliancafe.com/) We asked what they were famous for. She said, "the pizza". We had seen the menu, so we ordered a "small" pizza as an appetizer and each ordered a pasta dish. It was all really tasty. The pizza dough seemed more "authentic" and Georgia who had had pizza in Italy said it tasted much the same. We had stuffed ourselves, so made it past the ice cream pangs although there was still a Coldstone located in Daytona. Now we had one more chance to eat in the area, so took Nan's other recommendation, back to Port Orange to Aunt Catfish's (http://auntcatfishontheriver.com/) . I don't know which of our fish places will be replaced, but for the next trip down, this place is surely on the schedule. Again, had a pretty healthy fresh fish meal and got out of town without the ice cream.


I have told you about the places we ate in the Daytona area, but would be remiss to leave out the trip down and back. We met up with the kids in Macon at the Hilton Garden Inn. I think they have one of the best breakfasts of the travel lodging chains. We ate our first meal out together near Jacksonville at Buffalo's Southwest Cafe  (http://www.buffaloscafe.com/).... Not BWW. I really got off on the wrong foot. I don't even remember what I ate, but it was deep fried and tasty. Not a good way to kick off the trip, but then maybe that was why I made the good choices (for main event eating). Going home it was even worse. Our last meal out was in Nashville. If you read this post a couple of years ago, you will surely remember me saying that if you are in the Nashville area, don't miss the chance to eat at the Loveless Cafe. (http://lovelesscafe.com/)  Well, we did and I still say the same thing. Their Blue Plate Special for the day was "Watermelon Ribs".. Never heard of it. I considered if for a while, wrestling with the pork chops (which Georgia got) and the ribs. Although I love good ripe watermelon, I don't like watermelon flavored stuff. In the process our waiter agreed that it was a gamble, but "well worth it"!. Finally, I went for it. IF YOU EVER GET A CHANCE TO EAT WATERMELON RIBS AT THE LOVELESS CAFE: DO IT!
 I walked out of there stuffed because I ate all the ribs and greens and the really tasty baked beans. Georgia being a bit wiser, saved quite a bit of her pork chop and caramel sweet potato to carry home. We have this cool little electric cooler we got as a reward from our bank. So we got to take the food home.

That's the end of this eating saga. Now it's oatmeal for breakfast and grilled or stir fried, or steamed meals with lots of fresh summer veggies, right???? Actually it sounds good. I didn't yet tell you that we stopped in Georgia and got some "fresh from the tree" peaches and several different versions of pecans (http://www.werenuts.com/) Well, those peaches were so good and so ripe that we have to eat them up as soon as possible. So goes the battle!!!