Continued from home page, column 3.
The people here at Emerson Hospital managed to get my insurance company to agree to a few days of PT before going home. I learned about it when someone came in and announced I was being transferred to the TCU. Ever suspicious, I wondered what that could be. My first guess was Terminal Care Unit. Whew, it turned out to be Transitional Care Unit.
Emerson is a great place, by the way. Full of competence, and they laugh at all my jokes.
Of course in a hospital, they always want to know what you do with your time when not lying around in a hospital. MIT gets mentioned. My roommate, David Manalan, says Oh, I'm a course X graduate, class of '65. I give him the deer-in-the-headlights look. As it happens, I'm also class of '65. Small world.
I had planned to get a lot of work done, but this, S+3 D, is the first time I put fingers to keyboard. Before this, sitting up put more blood in my knees, which made them ache a little, which led me to think about an interesting feedback loop. Pain increases stress which increases blood pressure which forces more blood to flow in the wound, which causes more pain.
Actually, there hasn't been what I would call pain, just that early aching. Opioids had been prescribed, but I complain and insist on cutting back in quantity and strength, going through Percocet and Vicodin and on to Tramadol by S+3 D. By S+5 D, I insist on dumping the Tramadol in favor of Tylenol, which I didn't think I needed either. I quit that on S+8 D.
The rugby story is getting more traction. One of my students, Harry Bleyan, brought me an inspirational souvenir, presumably intended to get me thinking about actually taking up the game.
PT taught me the gymnastics of stair climbing and car entry/exit. OT gave me an exercise device that can double as a tourniquet or a commando weapon. She also showed me how to use kitchen equipment. It's not as stupid as it sounds. When you are running around on two immobilizers and a walker, a kitchen offers subtle opportunities for disastrous falls. You need to learn the safety rules, just like when learning how to use a table saw.
One week post surgery. Alas, they won't let me go around with any kind of speed on the walker. It's more like a wedding march: left foot forward, bring right foot next to left foot, move the walker, right foot forward, bring left foot next to right foot, move the walker, repeat.
Every once in a while, while up for PT, I run into the friendly local robot, Emmy, who delivers drugs. Strangely, they don't trust her with opioids.
A new nurse shows up. How to you take your Mirilax? Orange juice?
I don't always use Mirilax, but when I do, I mix it into a glass of Dos Equis.
She looks at me funny. I guess she never saw the most-interesting-man-in-the-world ads.
The nice thing about the torn-tendon problem is that you do get all better and back to normal. I'm planning my next 5k (slow) run for on or about 1 October 2016. Meanwhile, around about August, my effective but boring elliptical machine will start to get some persistent exercise.
By convention, my surgeon initialed each leg with a Sharpie before I got wheeled into surgery. In my case it didn't matter, but if you are having just one leg done, they want to be sure they don't open up the good one by mistake.
I've been taking pictures of the incisions when they change the dressings but Karen won't let me post them. Of interest are lines drawn across the incision areas before the work begins. The lines are there to help them line up the sides when they staple you back together. Yep, staples.
Time to go home. I am now a thoroughly trained patient.
Because I can't bend my legs, getting into a car the usual way is out of the question. Instead, I'm loaded into the back seat, crosswise, like a log. An attendant holds my legs up while I skooch in. The garbage bag helps me slide. Alas, no seatbelt protection is possible in this configuration, so I won't be making any optional trips for a while.
The red gadget is a must-have handle that fits into the door latch. It's called a car cane. Get one now, before you need it.
And by the way, for your well-equipped walker, you need these. Simple, effective. Borrow them from the kitchen. You need them to pick up stuff you drop on the floor.
Now that I'm back home, not much is happening, so now I'm scribbling down just the key milestones.
Staples removed. Ouch!
Out with the old, in with the new. I'm graduated from immobilizers to fancy braces. My surgeon styled these as sexier. Right now, they are locked at 0o of bend.
For a month after knee surgery, you take an anticoagulant. I had two choices: Coumadin or Xarelto. I learned that Coumadin is a brand name for Warfarin, which is used to poison rats, which turned me off, so I chose Xarelto. Of course I looked it up on the web:
Thereís no antidote available to reverse the effects of Xarelto, so even a relatively minor bleeding accident can prove to be fatal... [by intensifying the drug's effect] alcohol consumption can seriously harm a patientís health or even cause his death.
Today, the Xarelto month has past, and I am switched to a daily full-strength aspirin.
Now that the proscription against alcohol is lifted, I celebrate at dinner with a fine glass of Elkhorn Peak's Pinot Noir.
For the past 10 days, I've been walking around the driveway, building up to 2 km. I should say wobbling; with bulky braces between my legs, it is not normal walking. Anyway, knee bending PT has started. Goal is passive, lying-on-my-side, 90o of knee bend at S + 10 weeks starting at S + 4 weeks; I easily did 45o today. I'm cautioned not to be a herotendons still have a lot of mending to do.
Karen, to cheer me up, mused about a day when I could substitute two canes for the walker. That got me thinking. Would I ever cross a boulder field with two canes instead of my lovely carbon-fiber trekking poles? Unthinkable. So about a week ago I thought I would try a lap around the driveway with them and ended up doing 2 km. I wouldn't dream of using the walker outside again. I would need canes if I had to get weight off my legs, but I don't; what I need is stability and trekking poles give me a wider stance and a better grip.
Actually, the arm workout you get with the trekking poles is about the same as with cross-country skiing. I'll be ready when snow falls, a comforting thought.
Although I'll be locked when walking for a few more weeks, I am unlocked when sitting, with flexion steadily approaching 90o. Quad sets, heel slides, leg raises, hip abductions, and toe stands, have all become part of my twice-daily exercise routine.
So, eight weeks in, I can get both legs to 90o. This means I can manipulate myself into a comfortable position in the passenger seat of a car.
Karen decides I am recovered enough to go on a long-planned working vacation. We head for Rome, via Lisbon. There is no gate in Lisbon; we park at a remote stand and everyone starts going down stairs to a waiting bus.
What do I do? I wonder. Well, I go out through the catering door to a strange telescoping vehicle that moves around a little and then drops from airplane height to the ground where I board another strange vehicle with a lift in the back. That one eventually gets us to a transfer area with a waiting wheel chair.
I curse and I swear about the wheel chair, but it turns out that it gets me through passport control and security in seconds, without the stress of standing in a hour-long line and without the danger of getting knocked over by a high-speed, out-of-countrol child or a clueless zombie attached to a cell phone.
There's more; see more of the rest of the story.