Friday, November 28, 2008

Guest Post: After Knee Replacement Surgery--What to Expect

By Sarah Scrafford

Our knees are subject to intense strain each time we walk or even stand. So it’s no surprise that these joints tend to give out sooner or later, especially when you become old or if you’re regularly involved in activities that place undue stress on them. Knee replacement surgery involves coating the worn ends of your thigh and shin bones and/or your kneecap with metal and plastic surfaces. The success of this surgery depends as much on the skill of the surgeon wielding the scalpel as on your ability to follow instructions after the procedure. Here’s what you need to do to get back to normal life once your surgery is complete:

Adhere strictly to your physiotherapy and rehabilitation program: Knee replacement surgeries are followed by rehab programs that last between six weeks and three months. Your therapist will guide you through a whole range of exercises designed to improve mobility and strengthen your thigh muscles (quadriceps and hamstrings). It’s important that you follow these exercises regularly; if you feel lazy or if you think it’s not worth the effort, then the whole point of going under the knife is a wasted exercise.

Don’t put on additional weight: Your knees support your entire weight, so don’t give them additional strain by packing on the pounds. Eat sensibly and exercise according to your doctor’s instructions so that you don’t gain weight after the surgery.

Monitor your medical conditions: While not a life-threatening procedure, knee replacement surgery does come with a few risks like the formation of blood clots, infection of the incision, or a nerve injury. Call your doctor at the slightest feeling of discomfort to ensure that there’s nothing to worry about.

Refrain from intense activities: While it’s true that your knees are sort of brand new, there are limitations to what you can do with these “replaced” joints. Any activity that puts a large amount of stress on your knees is not advisable – like running and sports like tennis or squash. You’ll probably be able to walk, exercise on a stationery bike, swim, golf, and ski though.

Stay positive: The worst part of any surgery is the pain you feel immediately after you wake up in the recovery room. Knowing what to expect and being ready to deal with it is an important part of the recovery process. Accept that there will be pain and that it will go away with time. Staying positive and not griping about your condition go a long way in speeding up the recovery process.

This article is contributed by Sarah Scrafford, who regularly writes on the topic of Radiology Technician Classes. She invites your questions, comments and freelancing job inquiries at her email address:

Thursday, November 27, 2008

Thanksgivings Past and Present

As this year's Healthy Choice turkey dinner awaits in my freezer and the organizers of Chicago's Thanksgiving Day parade prepare for their 8:00 a.m. step-off, I have decided to rerun last year's post about Thanksgiving memories. This has been a trying year, but I take comfort in reviewing Thanksgivings past and present, joyous and not, in the hope that next year will be better. Happy Thanksgiving to all!

Here is what I wrote last year:

"I remember the hot kitchen, the wonderful smells, my grandma in her white "cooking dress" making sure that everything was just right. I remember the spotless white linen tablecloth and napkins, the polished silver, the gleaming china and crystal, the place settings arranged just right, no fork out of place.I remember the small family gathered about, just five of us, my father silent as usual, my mother trying to be helpful despite her barely-disguised dislike of her mother-in-law. I remember my brother impatiently waiting for the food, eager to escape to a more active atmosphere somewhere, perhaps a ball game with his friends if the weather was good. I remember sneaking just one more chocolate from the Whitman’s Sampler box that was a holiday tradition. I had no fear of "spoiling" my gigantic appetite when I was surrounded by such great smells!

"I remember my own little apartment kitchen, my husband struggling to cook everything on the tiny stove and in the tiny oven while I tried to find places for all the mismatched plates on the long, makeshift table with the slightly stained gold permanent press tablecloth. The napkins were paper.I remember the crowd of ten or twelve crammed into the little apartment, mostly the single patrons of my husband’s bar who had nowhere else to go for the holiday. Family Thanksgivings had been a tradition in my husband’s family, so this was an important day for him. I was as inept at cooking then as I am now, but he did it enthusiastically. Most of the guests were men, and they ate every crumb of food. We seldom had leftovers in those years. A few guests fell asleep immediately after dinner, usually on the floor if any space was available there.

"We continued this Thanksgiving dinner tradition for several years after we moved to our house nearby. It was not a large house, but we filled it with good food and holiday joy for many of the same guests, and a few more.

"I remember the year when we finally ran out of friends to invite for Thanksgiving dinner; everyone had a family and lived in the suburbs by then, while we were still a city family of two. We made reservations for dinner at the Signature Room at the top of the John Hancock Center. It seemed very expensive to my frugal husband, but he ultimately enjoyed the experience. We ate so much at the sumptuous buffet that we couldn’t eat much of the small turkey provided for us, so we took it home (as advertised and recommended). Jules made turkey soup and turkey sandwiches enough to last at least a week. I think we got our money’s worth that year.

"I remember our last Thanksgiving together in 1999. It was also my last Thanksgiving with my mother, who was eighty-eight years old by then and living in a retirement condo in Northfield, Minnesota. My nephew and his wife cooked dinner at their house, and two grand-nieces were there as well. The food was fine, but I remember little about it. My mother lived on until this year, and I always sent her flowers for Thanksgiving. However, I didn’t join her in Northfield for the holiday again.

"I remember mostly that my husband was not feeling well on Thanksgiving, 1999, that he left immediately after dinner to return to the motel to rest. That was very uncharacteristic of him; he was usually the life of the party. I was very worried. He seemed to feel better later, but it wasn’t long after our return home that his pancreatic cancer was diagnosed. He would die in March of the following year.

"I remember later Thanksgivings with a friend’s family, including her husband and her two daughters. That tradition, begun when Jules was still alive, ended when one of my friends’ daughters moved away and her parents began to visit her for Thanksgiving. I understood.

"This year [2007], I’ll enjoy my Lean Cuisine turkey dinner, watch parades on television, read, write, and feel content. I may even open a bottle of Chardonnay. I’ve come to terms with the changes brought by aging and the passing of time and loved ones, and it’s all right. However, I am happy to remember those Thanksgivings from the past and many more, the good and the bad. Life goes on."

Co9pyright 2008 by Marlys Marshall Styne

Monday, November 24, 2008

The Agony of Uncertainty

Have you ever felt like your world is crashing down around you? Unfortunately, that's the way I've been feeling, which explains the decreased frequency of my posts here. My recovery from knee replacement surgery doesn't seem to be going especially well (too much pain, too little movement), but other matters are affecting me more.

I have a moving date: January 9. That's the day I'm supposed to move from my condo to The Clare at Water Tower lifetime care community. I have an estimate from a mover. I have tentative plans to get more help from an organizer and downsizer. So what's wrong? My condo has not sold, despite price reductions. If it doesn't sell by the end of the year, I will probably not have enough money to pay the entrance fee at the Clare. I have big decisions to make.

Do I give up my plan and dream of moving to The Clare? I hate that idea. Can I borrow money? Acccording to my financial planner, I can't get a home equity loan on a condo which is on the market, even though it's mortgage-free. Will the Clare help me with a payment plan, or arrange a loan? I haven't been able to get an answer to that question.

I have less than a month to solve these problems; then I'll be off to visit relatives for Christmas, so things must be settled by then. Help!

Copyright 2008 by Marlys Marshall Styne

Wednesday, November 19, 2008

Rehab Life in Diapers: What a Nursing Home is Really Like

So you think a nursing home could be a good place to read, write and relax? Perhaps it might be if you could afford a private room, but if a roommate prefers to watch TV most of the time, it's easy to just go with the flow. I've never watched so many soap operas and newscasts in my life! At least I was able to watch Chicago Bears games on Sundays and lots of election hoopla, not to mention depressing economic commentary.

Don't get me wrong; the nursing home where I languished for nearly five weeks wasn't bad, as nursing homes go. It's just that I'd always thought of nursing homes as necessary places for some very old people in the final stages of life. I didn't belong there, or so I thought.

Since I live alone, without a family caregiver, I had no choice but to move from hospital to rehab care after double knee replacement surgery. That's how I got my first-hand look at a nursing home.

Despite a lot of hard effort by the overworked staff, things did not exactly move like clockwork there. There seemed to be a lack of communication among staff members and between staff and patients. Patience became my motto.

I was not able to walk to the bathroom for a while, so I had to wear diapers. I now know why babies cry then they're wet. There were some agonizingly long waits for changes, and later the annoyance of an aide waking me up regularly during the night to ask if I was wet, even after I had recovered enough to shed the diapers. I guess the night shift had too little to do.

I don't think many people get much sleep in a nursing home unless they take sleeping pills. I did not. I was treated to loud post-midnight TV down the hall, arguing and laughing employees, and the occasional loud patient complaint.

Laundry seems to be a problem. Two pair of my sweat pants went to the laundry, where they immediately disappeared. One pair eventually reappeared, but the other is gone forever. My roommate sent her laundry home with her daughter. I solved the problem by begging a few more pair of sweat pants and shirts and just alternating them, dirty or clean. Better soiled clothes than none at all! A hospital gown is not appropriate for all occasions and activities.

We were offered showers every two days. Taking a shower while swathed in bandages was more trouble than it was worth, especially when I couldn't stand up or walk. Showers not only took forever, but they required waiting long after being summoned for physical therapy; the line for showers was always long. I soon insisted on fewer showers and more therapy time.

As an early riser, I spent many hours sitting up in bed watching the passing activity in the hall. It was too dark to read or write, and I didn't want to awaken my roommate. Breakfast never came until almost 8 a.m. However, I couldn't have slept late anyway. A young man from the lab often rushed in about 4:45 a.m., turned on the light, and cheerfully drew my blood. So much for my roommate's sleep, although she seemed able to go back to sleep quickly. I still wonder what all that blood was for.

The food wasn't gourmet quality, but it wasn't bad. My requests for skim milk (rather than 2% or whole) and for cold cereal rather than the awful hot varieties were usually ignored, there wasn't much fresh fruit, and the coffee was undrinkable. Still, the occasional piece of cake, chocolate chip cookie, or small serving of ice cream made the menu bearable. In a way, it was a relief to avoid having to think about what to eat. I was always hungry by the time the food came.

The best feature of my stay was the chance to see and hear from some old friends--visitors. I learned that even a loner like me can depend on friends for help and comfort. I am especially grateful to the friend who stopped by my condo twice a week to pick up my mail and deliver it to me, the employee of the Clare, my future home, who brought me some clothes and some stamps for paying bills, and my former teaching colleagues (I retired nine years ago) who sent flowers. My visitors were few, but very important.

I hope I can avoid nursing homes in the future, but at least I know what to expect. I hated the feeling of helplessness. The secret is patience. A nursing home stay is no picnic, but it's bearable.

Copyright 2008 by Marlys Marshall Styne

Saturday, November 15, 2008

Make No Small Plans!

The holidays are creeping up on us. The Macy's tree is up and lighted, the Michigan Avenue Lights Festival is only a week away, and it's not even Thanksgiving yet.

Holidays can be a problem for those of us who live alone, far from relatives, but I made a big decision yesterday: I made plane reservations to accept my niece's invitation to visit her and her family in Tulsa, Oklahoma, for Christmas.

I've enjoyed visiting Cindy and her family in Houston, Texas, and now that they've moved to Tulsa, I'm anxious to see their "new" (remodeled) house, and of course to see them again this year.

Planning the trip requires a leap of faith: faith that I'll be able to walk well enough to travel by late December. It also brings thoughts of my unsold condo and my scheduled move to The Clare on January 9. At the very least, this will be a challenging holiday season.

Someone said, "Make no small plans." Time will tell if mine are overly ambitious, but just having those reservations makes me feel hopeful.

Rictameter from Rehab

This is the second rictameter I wrote while I was recovering in a nursing home. "Kindness" was the first; see it in my other blog, Write Your Life!

Rictamer from Rehab

Yes, it's painful
Bending legs so stiff, sore,
Knees expected to support me.
Heavy body, weak muscles rebelling.
Still, I need to walk, rejoin the
Outside world, go home to
Live where life's not

Copyright 2008 by Marlys Marshall Styne

Thursday, November 13, 2008

The Experience of Knee Replacement

This isn't my knee, but I have two that look remarkably like this picture. Unfortunately, my legs are fatter.

So what is double knee replacement surgery like? That's a rather long story, but stay tuned for more details.

First, why? Why would anyone have both knees replaced at once? This isn't a decision to be made carelessly. For me, it was a sort of "go for broke" or "let's get this over with" decision. Both knees were equally painful and disfunctional to the point where I could hardly walk at all (my limp was embarrassing), and at age 76, I just didn't want to go through this experience twice.

For those more timid or fearful of pain, one at a time may be the way to go. Or, ideally, you may have only one "bad knee." There was a time years ago when I did. The other knee caught up rather rapidly.

Are there alternatives to this type of surgery? Of course you should try all the conservative approaches: losing weight, exercising to strengthen muscles around the knee, etc. If that lessens the pain and allows you to walk, good for you. Depend on your doctor's recommendations. But when osteoarthritis brings extreme deterioration of the knee joints and conservative measures stop working (as in my case), see a joint replacement surgeon. My knee x-rays were frightening.

So now I have new knees. They don't work perfectly yet, and I need to use a walker. But I have confidence that all will be well eventually. The estimate is three months for total recovery.

So if you have "bad knees" or a bad hip, talk to your doctor. Don't suffer needlessly. Despite all the agony (which I'll describe in later posts), I'm glad I went through this ordeal. Things can only get better!

Copyright 2008 by Marlys Marshall Styne

I'm Back!

Just a note to thank all of you for your kind comments and best wishes. I'm back home after my nearly six-week ordeal, and if you'll give me a few days, I'll be writing about my experiences. I still have a lot of rehab to do, and I'm not walking very well yet. Happy blogging!